Volume 9 - Issue 1

S.No Title & Authors Name Page
Proportion of Resistant Hypertension and Prescribing Pattern of Antihypertensives in Chronic Kidney Disease: A Pilot Study
Arya Rajan*, Anisha DS, Christy Surendran, Alinta SB Muth, Neethu J
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Background/Introduction: Resistant hypertension although being multi factorial in etiology, has been found as major concern in chronic kidney disease. The extent and effect of resistant hypertension in chronic kidney disease among south Indian population need to be studied. Aim: To assess the proportion of resistant hypertension by analyzing the prescribing pattern of anti-hypertensive in patients with chronic kidney disease. Objectives: To assess the prescribing pattern of anti-hypertensive in chronic kidney disease. To assess the proportion of resistant hypertension in chronic kidney disease. Methods: Patients with chronic kidney disease receiving anti-hypertensive were included in the study. Only the out patients were included in the study. The blood pressure readings were taken at their visit to the outpatient department and the anti-hypertensive prescribed was recorded. Statistical analysis was performed using suitable software programme. Results: The proportion of resistant hypertension was found to be 83.3% (p 0.000). 46.7% received triple therapy distribution for the management of hypertension in chronic kidney disease (p 0.002). The most prescribed drug was of the class diuretic (83.3%, p 0.000). Conclusion: The proportion of resistant hypertension in chronic kidney disease was highly significant and greater proportion of patients is treated with multiple drug therapy to achieve the blood pressure goal.

Health Advocacy: What Pharmacists can do towards the Realization of Universal Healthcare Coverage (UHC)
Odhiambo David*
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Health advocacy refers to the activities directed towards ensuring individuals and communities have access to healthcare that they need at any particular time. It involves creating awareness of the deficiencies, mobilizing resources towards addressing them, addressing inequities, and influencing policies as well as creating systems for sustained quality access.

High Dose Folic Acid during Pregnancy and the Risk of Autism - The Birth Order Bias: A Nested Case-Control Study
Sarah Sharman Moser*, Michael Davidovich, Ran S Rotem, Gabriel Chodick, Varda Shalev and Gideon Koren
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Background: There has been a dramatic increase in the prevalence of autism worldwide, concurring with growing use of folic acid for the prevention of neural tube defects. A recent study suggested increased risk of autism at high gestational dose levels of folic acid, raising public anxiety and fears of using folic acid. Our objective was to examine whether gestational use of folic acid is associated with increased risk of autism, with focus on high doses. Methods: This was a nested case- control study in a large health fund insuring 2 million citizens. Among 504,028 children born into Maccabi from 2000 to 2010 (inclusive) singleton children with autism (n=2009) were matched with up to 10 non autistic controls (n=19,886). The main dependent outcome measure was the diagnosis of autism, and the independent variable was the mean gestational dose of folic acid compared between cases of autism and controls after appropriate matching. Results: Significantly more autistic children were first born, and birth order effect was independently and significantly associated with folic acid use; Mothers purchased significantly more folic acid during the first pregnancy than during later pregnancies (P<0.001). In multivariate analysis, accounting for birth order and other confounders, folic acid use was not associated with increased autistic risk, and no dose -response trends were observed. Compared with mothers of the lowest average daily folate dose, the odds ratio for autism among mothers of highest daily dose (3 mg) was 0.99 (95% confidence interval: 0.59-1.67). The lack of association was further confirmed in sensitivity analysis restricted to first-born children only. Conclusions: Folic acid supplementation is not associated with a risk for autism even at high doses. A new type of bias, the birth order bias, has to be recognized and accounted for. The results are of public health importance given that folic acid is needed to prevent neural tube defects, sometime at high doses.

Prevalence and Associated Host Factors of Candiduria and Bacteriuria among Diabetic Patients Assessment of Antimicrobial Susceptibility Patterns of Isolated Bacterial Isolates
Tafadzwa Dzinamarira*
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Introduction: Antimicrobial resistance among uropathogens causing commonly acquired UTIs is increasing. Identifying risk factors for resistance and knowing the current pattern in prevalence in the local context are important steps in choosing an appropriate therapeutic agent. Coupled with a paucity of local context data on the occurrence of candiduria among diabetic patients in Zimbabwe, the study sought to avail more information on this subject. Methodology: A laboratory based cross-sectional study was used on a sample 245 diabetic patients attending out-patients’ diabetic clinic at a referral hospital in Harare, Zimbabwe. Results: The prevalence of bacteriuria was 22.9% with no statistical difference between males and females (p = 0.051). The prevalence of candiduria was 13.5% with statistical difference between males and females (p = 0.042). Gentamycin and Nicene were effective against most bacterial isolates obtained. There was a marked increase in the incidence of bacteriuria and candiduria in the unemployed (25,8% and 16,1% respectively) than in employed individuals (13,6% and 5,1% respectively). Conclusion: High resistance rates exhibited to some commonly used antimicrobials may mean the continued use of these antibiotics when considering therapy for bacteriuria seems to be under threat. Additional surveillance data that combines results of in-vitro susceptibility tests with epidemiologic and clinical patient characteristics is needed.

Antibacterial Activity of Leaf Extract Solanum ferox L Plants
Hazimah* , Zefri Azharman , Yuharmen , Virsa Rahyuti , Afriliani
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Solanum ferox or Acid aubergine plants is one of the vegetables that are made in the food. Solanum ferox contains terpenoids compounds, steroids, flavonoids, alkaloids, and phenolic. Solanum ferox has antipyretic active compounds, antirheumatic, antiasthma, antiviral, and as a syphilis drug. The purpose of this research is the antibacterial activity of Solanum ferox plant leaf extract. Solanum ferox leaves are extracted using n-hexane and methanol. Both extracts were tested for antibacterial activity using diffusion method to use E. coli, S. aureus and B. subtilis bacteria. Amoxicillin is used as a positive standard whereas negative control is the solvent used to dissolve the sample. The antibacterial activity of n-hexane extract and amoxicillin showed inhibitory zone to E. coli of 7.80-12.93 mm and 19.97 mm, whereas in S. aureus and B. subtilis did not provide inhibition zone. Antibacterial activity of methanol extract against E. coli and amoxicillin were 7,72-11,67 mm and 19,97 inhibitory zone to bacterium B. subtilis only at 5.7 μg/mL concentration of 11, 29 mm and amoxicillin 18,51 mm.