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   2018| January-April  | Volume 5 | Issue 1  
    Online since April 30, 2018

 
 
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REVIEW ARTICLES
Schistosomiasis: A neglected tropical disease of poverty: A call for intersectoral mitigation strategies for better health
Kaliyaperumal Karunamoorthi, Mohammed Jubran Almalki, Khalid Yaser Ghailan
January-April 2018, 5(1):1-12
DOI:10.4103/jhrr.jhrr_92_17  
Schistosomiasis (SCH) is one of the neglected tropical diseases, and it is endemic over 78 resource-constrained countries. It is one the indicator of poverty as it is often ubiquitous among the poorest of the poor. A total of 172 potential articles were identified through premier academic-scientific databases, and 86 were chosen. Human beings (permanent-host) are often exposed to infested water (urine/stools of infected persons) that harbor susceptible snails during their routine domestic and occupational activities. The cercaria (released by snails [intermediate-host]) infects people by penetrating into their skin. Currently, several multi-faceted interventions are underway to combat the SCH, namely, (a) potable water, (b) environmental diagnostics, (c) prophylactic chemotherapy with praziquantel, and (d) scaling up of snail control. Although in the recent decades tremendous strides have been made to minimize the disease burden, they are so feeble to eliminate the infection in several poverty-stricken settings. Female genital-SCH is also one of the key parasitic cofactors of HIV transmission. However, it remains neglected in terms of priority in allocating sufficient resources to develop next-generation tools, i.e., vaccine. Therefore, there are challenges lying ahead in achieving our ambitious goal of global elimination. Nevertheless, it can be attained through the recent medical-technological advancements as well as by strengthening the ongoing multi-pronged interventions such as (1) generating awareness, (2) continual surveillance, (3) early case-detection, (4) mass deworming, (5) increasing the research funds, (6) developing sensitive diagnostic tools, (7) prophylactic vaccines, and (8) therapeutic agents. Besides, the improved disease surveillance and response systems could pave the way to build an SCH-free world in the near future.
  15,463 1,090 12
Recent advances and current trend in the pharmacotherapy of postmenopausal osteoporosis
Olumuyiwa John Fasipe, Oluwatosin Beatrice Ibiyemi, Alex Adedotun Adelosoye, Ayodeji Adebayo Idowu
January-April 2018, 5(1):13-21
DOI:10.4103/jhrr.jhrr_104_17  
Estrogen deficiency (most especially low level of β-estradiol isoform) is the major contributing factor to bone loss after menopause. Supplementation with calcium and Vitamin D is an essential baseline therapy for osteoporosis prevention and treatment. Newer emerging agents that will further expand osteoporosis therapeutic options include strontium compound (a bone selective calcium-sensing receptor [CaSR] agonist or calcimimetic which is currently licensed for use in Europe but not in the US that has both osteoanabolic and antiresorptive activity); Lasofoxifene (a new selective estrogen receptor modulator [SERM] or estrogen agonist-antagonist [EAA] with partial agonist activity at both estrogen receptors ERα and ERβ); odanacatib and balicatib (inhibitors of the resorptive enzyme cathepsin K); abaloparatide (a parathyroid hormone [PTH]-related protein analog); ostabolin-C (a new cyclicised PTH analog); romosozumab and blosozumab (monoclonal antibody inhibitors to sclerostin) which are currently undergoing clinical trial for Food and Drug Administration approval. Other agents in preclinical development include anti-dickkopf antibody (BHQ880) which targets specific protein molecules of the Wnt/β-catenin pathway involved in stimulating new bone formation by osteoblast cells; parathyroid selective short-acting calcium-sensing receptor antagonists or calcilytics (SB-423562, SB-423557, JTT-305/MK-5442, and NPS-2143) that will lead to a transient release of PTH from the parathyroid glands; and saracatinib (a novel orally available competitive inhibitor of the enzyme Src kinase and Abl kinase family shown to inhibit osteoclast-mediated bone resorption). This review article discusses these newer evolving agents that will introduce and incorporate remarkable improvements into the management of postmenopausal osteoporosis in the nearer future.
  8,438 769 2
ORIGINAL ARTICLES
Effect of food and antacid on simvastatin bioavailability on healthy adult volunteers
Khaled M Alakhali, Easwaran Vigneshwaran, Mohammad Asif Ansari Shaik
January-April 2018, 5(1):26-32
DOI:10.4103/jhrr.jhrr_36_17  
Aims: The current research work was framed to identify and estimate the changes in pharmacokinetic data for oral simvastatin 40 mg in healthy adult volunteers during fasting condition and with simultaneous administration of food and antacids at a frequent interval. Materials and Methods: Nine healthy Malaysian male adult volunteers recruited into the present study. If study participants had a history of any major disease, they were excluded from the study. This study comprised of three groups with a crossover design in three blocks. Prior and after intake of drug, the blood samples (10 ml) were withdrawn and transferred to labeled glass tubes at a frequent interval. The blood sample was processed and the obtained serum was quantified by liquid chromatography–mass spectrometry/mass spectrometry method. Results: The pharmacokinetic data such as AUC0–24, Tmax, and Cmaxvalues were increased when the drug is administered along with drug or antacid. The elimination rate constant and volume of distribution do not found to have difference among the three groups. The t1/2of simvastatin was decreased when the drug is taken along with food but not with antacid or on empty stomach. The clearance of the drug is limited when the drug is administered along with antacid. Both antacid and food had the similar effect on simvastatin on various pharmacokinetic parameters such as AUC0–24, Cmax, Ke, Tmax, Cl, and Vd. Conclusion: The prolonged gastric residence time of simvastatin was produced by food and antacid by delaying gastric emptying which is offset by increased pH of the gastrointestinal tract. Thus, it leads to increased stability of lactone form of simvastatin and its absorption.
  8,485 519 1
Otorhinolaryngology postgraduate training in Nigeria: Trainees perspective
Samuel Agida Adoga, Nuhu Danle Ma'an, Amali Adekwu, Aliyu Mohammed Kodiya, Onyekwere George Benjamin Nwaorgu, Kenneth Nnaetio Ozoilo
January-April 2018, 5(1):48-56
DOI:10.4103/jhrr.jhrr_50_17  
Aim: This study is designed to evaluate the challenges of residency training in otolaryngology in Nigeria from the point of view of the trainees. Materials and Methods: The study setting was the 2014 otolaryngology revision/update course organized by the West African College of Surgeons at University College Hospital, Ibadan. This was a questionnaire-based study administered to 78 resident doctors from different training institutions across the country who participated in the revision course. All participants consented to the study and were given a structured questionnaire to complete and return. Data were collated in Microsoft Excel® spreadsheet and analyzed using Epi Info® 2002 Epidemiology program Office Centre for disease Control, Atlanta USA. Results: Seventy-six out of the 78 residents who attended the course responded, giving a response rate of 97.4%. The geographical distribution showed that the South West had 5 (27.8%) institutions, while North East and South East had 1 (5.6%) and 2 (11.1%), respectively. Fifty-six (73.7%) of the respondents were under 40 years of age. The gender ratio was 4.7:1. Sixty-eight (89.5%) were married. The decision to choose ORL was personal interest in 68 (89.5%). Textbooks were available to 45 (59.2%) respondents. Thirty (39.5%) of them read for at least 2 h/day, and obstacles to reading were clinical work overload in 56 (73.7%) and fatigue in 55 (72.4%). Forty (52.6%) respondents had >5 consultant Ear-Nose-Throat surgeons in their institutions. Departmental activities were also highlighted. Conclusion: This study highlighted the location of majority of the ORL residency training institutions in South West, Nigeria, and married. Most of the respondents have the required textbooks but found it hard to read mainly due to clinical work overload and family burden.
  5,463 331 1
Hemoglobin and serum ferritin concentration in anemic and nonanemic human immunodeficiency virus females in India
Simmi Kharb, M Lallar, PS Ghalaut, J Bala, M Kumawat, S Nanda
January-April 2018, 5(1):22-25
DOI:10.4103/jhrr.jhrr_90_16  
Aim: This study was planned to assess hemoglobin (Hb) and serum ferritin in anemic and nonanemic HIV females. Materials and Methods: The present prospective study was conducted during 2012–2013 in the department of biochemistry in collaboration with department of medicine (HIV clinic). In 200 seropositive females (age: 18–50 years) attending antiretroviral therapy clinic after routine gynecological and hematological investigations, CD4 count, serum iron, and ferritin were analyzed by chemiluminescence. Results were calculated by SPSS version 17. Student's t-test and regression analysis were done. Results: Hb showed a positive correlation with serum iron and ferritin and was statistically significant. Anemia occurs most commonly in these patients and indicates increased risk of mortality. Serum ferritin was correlated to CD4 cell counts indicating that level of HIV disease progression and viral load. Finding of high serum ferritin with high CD4 in the present study support to the role of inflammation in increased serum ferritin levels and high iron stores in HIV may have adverse events and effects. Conclusion: High ferritin levels in HIV patients suggest that redistribution of iron and decreased activity of erythropoietic cells is mainly responsible for anemia. Serum ferritin levels need to be evaluated carefully in HIV patients with advanced disease. Iron overload and adverse HIV related outcomes due to high iron exposure can be prevented by screening the iron status and stores in anemic HIV women. Also there is need of other effective strategies of locating other causes of anemia that should be adopted.
  5,412 359 -
Assessment of morbidities and pattern of medication use among medical in-patients in a university teaching hospital South-South Nigeria
Peter Ehizokhale Akhideno, Ambrose Ohumagho Isah, Olumuyiwa John Fasipe
January-April 2018, 5(1):33-41
DOI:10.4103/jhrr.jhrr_96_17  
Aim: The pattern of morbidities in a setting often influences the pattern of medications prescribed. Intensified global efforts to improve the rational use of medications necessitated the development of medication use indicators. Materials and Methods: This was a descriptive, prospective study in which inpatients admitted into the internal medicine wards of a teaching hospital over a 9-month period between December 2015 and August 2016 were evaluated on specific days following admission using the World Health Organization-International Network for the Rational Use of Drugs (WHO-INRUD) prescribing indicators. Results: A total of 507 patients were evaluated; 269 patients (53.1%) were male, 238 patients (46.9%) were females, and their age range was 17–89 years. The most common morbidities among these inpatients were infectious diseases such as Malaria (18.9%) and HIV/AIDS (17.2%). The noninfectious disease conditions, diabetes mellitus (17%), and hypertension (16.8%) were next in prevalence. Most patients (412 patients; 81.3%) had more than one morbidity. The most commonly prescribed medications were 5% glucose in saline (300 patients; 59.2%), Vitamin B complex (257 patients; 50.7%), and furosemide (183 patients; 36.1%). The average number of medications prescribed per patient during admission was 9.1 ± 3.8 drugs, while the median number of medications used during admission was eight drugs. The percentage of medications prescribed by generic names was 85.6%, while 88.1% of medications were prescribed from the essential medicines list. Conclusion: The pattern of medication use was largely in-keeping and consistent with the pattern of morbidities despite confirmatory diagnosis and symptomatic treatment observed in most instances. This translates to rational and safer pharmacotherapy practices as the modified WHO-INRUD prescribing indicator will be a useful monitoring tool for rational medication prescriptions among inpatients.
  5,287 392 -
The relationship between self-knowledge sources and mental disorders in Iranian population
Seyyed Jalal Younesi, Mohamad Rostami, Mojtaba Abbasi Asl, Javad Kazemi
January-April 2018, 5(1):42-47
DOI:10.4103/jhrr.jhrr_69_17  
Aim: The aim of this study was to study the relationship between self-knowledge sources and mental disorders in Iranian population. Materials and Methods: This study from the aspect of research design was an ex post facto study and from the aspect of method of collecting data was a survey study. The statistical population included all people between the ages of 20 and 60 years living in Tehran. A total of 800 people were selected using stratified sampling method. To collect data, Depression Anxiety Stress Scale 42 and Self-Knowledge Sources Scale were used. Results: The results showed that there is a significant and negative correlation between self-knowledge sources and depression, anxiety, and stress (P > 0.01). Also there is a significant and positive correlation between the subscales of Self Knowledge Sources with Depression, Anxiety and Stress (P > 0.01). Conclusion: According to the results of this study, any negligence and indulge in each of the sources of self-knowledge may associate the disorders at the individual level and generally at the social level.
  4,077 282 -