Journal of Pharmacy

Biological Monitoring of Iodine Content in Human Breast Milk over Six Months Postpartum: A Case Study

Nor Hidayah Mohd Taufek — 2024-07-31

Iodine deficiency was commonly reported in infants and partly attributable to low breast milk iodine content. The role of iodine is crucial in preventing brain damage and hypothyroidism in infants. It is important to monitor the concentration of iodine in breast milk of postpartum mothers. This study aimed to validate an analytical method to determine iodine concentration in human breast milk for biomonitoring purposes. Expressed breast milk samples were collected several times a day throughout six months postpartum from a healthy lactating mother. Samples were prepared with nitric acid digestion and analysed by inductively coupled plasma mass-spectrometry. Data analysis was conducted using Microsoft Excel 2016 for assessment of validation parameters and longitudinal concentration of iodine. The method validation parameters showed that linearity of calibration graph was 0.9987, limit of detection and limit of quantification were 0.218 µg/L and 0.661 µg/L, respectively. A recovery of 100.3% showed good accuracy, whereas inter-day and intra-day repeatability were 5.91% and 3.60%, respectively. The median iodine concentration was the highest in the first month (160.0 µg/L), then dropped to lower than recommended level (110 µg/L) from the second until six months postpartum (range: 31.9 - 98.7 µg/L). Fluctuation in median iodine concentration occurred over six months postpartum but circadian rhythm was observed to be consistent with “V” shaped curve pattern indicating higher concentration was exhibited in the morning and at night compared to evening. The analytical method was robust, accurate and reliable for measuring iodine concentration in human milk and applicable for biomonitoring. Deficiency in breast milk iodine content was observed in the second until six months postpartum. Iodine concentration in breast milk exhibited consistent circadian variation over six months postpartum.

The Investigation of Phytochemicals and Antioxidant Properties of Champereia Manillana(Blume) Merr Stem Bark

Anis Solehah Azman — 2024-07-31

Champereia manillana (Blume) Merr. is one of the plant species that lacks research despite many beneficial claims from consumers. Studies conducted on this species have merely discussed bioactive phytochemicals in the leaves and roots. Therefore, the objectives of this study are to screen for terpenoids, triterpenoids, diterpenoids, carotenoids, flavonoids, phenolics, and steroids, and to evaluate the antioxidant activities of C. manillana stem bark methanolic extract. The plant material was collected from the Forest of ‘Ilm, IIUM. The stem bark powder was macerated in methanol. Phytochemical screening tests were utilized to determine the presence of the phytochemicals. Thin-layer chromatography (TLC) analysis was carried out on the samples using iodine vapor, ferric chloride solution, vanillin solution, and UV light. Next, the total phenolic and flavonoid content tests were conducted to obtain quantitative results, and the antioxidant activity was assessed using the DPPH assay. C. manillana stem bark extract tested positive for steroid and terpenoid contents and negative for carotenoids and flavonoids. For the TLC, the extract was found positive for iodine vapor, UV light, and vanillin/H2SO4 and negative for the ferric chloride test. The flavonoid content was 0.995 mg CE/g, while the phenolic content was 12.326 mg GAE/g. For the DPPH assay, the IC50 value was high (26 mg/mL) compared to the positive control, ascorbic acid, which had an IC50 value of 6.730 µg/mL. The percentage inhibition at 10 mg/mL was 23.4%. Phytochemical screening indicates the presence of steroids and terpenoids in C. manillana stem bark methanolic extract. Compared to the standard (ascorbic acid), the antioxidant activity of the extract is very weak.

Preparation, Characterisation and Bioactivity Evaluation of Curcumin-Loaded Poly (Lactic-co-Glycolic Acid) Nanoparticles

Muhammad Haziq Ezzani — 2024-07-31

Background: One of the main challenges with curcumin is its hydrophobic nature, which limits its solubility and bioavailability. This issue can be addressed by using poly (lactic-co-glycolic acid) (PLGA) nanoparticles (NPs). The small size and large surface area of these NPs significantly enhance drug delivery systems by improving the solubility and bioavailability of the drug. Objective: This project focuses on the preparation, characterization, and bioactivity evaluation of curcumin loaded in PLGA NPs, intended for the delivery of curcumin extracted from Curcuma xanthorrhiza, commonly known as ‘temulawak’ or ‘Java turmeric’. Methodology: Curcumin was extracted and stored at 4?C for testing. PLGA-curcumin NPs were synthesized using the single emulsion method. Nanoparticle morphology was analyzed using SEM, while particle size and zeta potential were measured with a Zetasizer. Entrapment efficiency and drug loading capacity were calculated. In vitro release studies in phosphate buffer were conducted using UV-visible spectrophotometry. The cytotoxicity of the curcumin-loaded NPs was tested on MCF-7 breast cancer cells using the MTT assay. Statistical analyses were performed using Minitab 14, and Microsoft Excel was used for graphical representations, with significance set at p < 0.05. Results: The mean particle size of the curcumin NPs was 498.9 nm ± 597.4 nm. The entrapment efficiency and drug loading capacity were 50% and 5%, respectively. The average zeta potential was recorded as -28.7 mV ± 6.19 mV. The in vitro release study did not produce significant results as low concentrations of curcumin were detected. However, the bioactivity of the curcumin-loaded PLGA NPs demonstrated lower cell viability compared to the curcumin extract, suggesting that the PLGA formulation is more effective at inducing cancer cell death. This indicates its potential as a more efficient therapeutic option in cancer treatment. Conclusion: The single emulsion method managed to produce nano-sized particles with good zeta potential and bioactivity on MCF-7 cells. However, further study needs to be done to produce better formulation which can increase entrapment efficiency, drug loading capacity and also in vitro release profile.

Infection Prevention and Control Knowledge among Health Sciences Students: A Cross-Sectional Study from Malaysia

Abdul Rahman Fata Nahas — 2024-07-31

Introduction: Infection prevention and control (IPC) is a crucial component of the healthcare system that demands adherence to standards to avoid and reduce the risk of infectious diseases spreading among patients, staff members, and visitors to healthcare institutions. The aim of this study was to assess IPC knowledge among undergraduate health sciences students and to identify the critical IPC components that need to be addressed. Methods: A cross-sectional online survey was conducted among 235 final-year health science students at International Islamic University Malaysia (IIUM), involving five faculties: the Faculty of Medicine, Dentistry, Pharmacy, Nursing, and Allied Health Science. A 45-item questionnaire was used to collect participants’ sociodemographics (5 items) and explore their knowledge about IPC across six aspects (40 items). A score of > 24 (62%) indicates satisfactory knowledge. Results: The majority of the participants were female (74.9%), and 34% were from the Faculty of Pharmacy. Medicine students had the highest level of IPC knowledge with a mean score of 29.3 (n = 52), which was significantly different from Allied Health Science students (M = 25.6, n =55, p < 0.001). Other faculties students had similar IPC knowledge with no significant differences (Pharmacy: M = 27.5, n = 80; Nursing: M = 27.4, n = 29; Dentistry: M = 27.2, n = 19). IPC components that need to be improved are knowledge about sharp disposals and sharp injuries, as well as respiratory hygiene and cough etiquette. Conclusion: IPC knowledge was adequate among health science students at IIUM, although certain IPC components still require improvement. Additional IPC educational materials and workshops should be added to all faculties' syllabi to address this issue.

Cigarette Smoking & Electronic Cigarette Use among Malaysian Adolescents: Urgent Call for Action

Prof Dr Mohamad Haniki Nik Mohamed — 2024-07-31

Adolescence is an important developmental period1,2 characterized by engagement in risky behaviours, including the use of tobacco products such as cigarettes and electronic nicotine delivery systems such as e-cigarettes (e-cigs)3.
The use of tobacco in the form of cigarettes and e-cigs is indeed of interest to the public health community and the nation at large. E-cigs are defined as devices that deliver aerosolized or vaporised nicotine form heating of liquids (e-juice) with constituents including nicotine, propylene glycol, glycerol, and other flavouring agents. It has been reported that 90% of smokers start smoking before the age of 18 years4. The Tobacco & E-Cigarette Survey among Malaysian Adolescents (TECMA) 2016, a nationwide school-based survey, found 11.7% current cigarette smokers among students between 10 to 19 years old. 78.7% of ever cigarette smokers tried their first cigarette before the age of 14. In addition, 9.1% of the students were current e-cigarettes users, with 40.9% vaping once a day and 33.9% doing it 2 to 5 times per day. Alarmingly, data from the 2022 Adolescent Health Survey found a sharp increase in adolescent vaping prevalence among adolescents aged 13-17 years old, reaching a high of 14.9% in 2022.6
E-cigs are heavily promoted directly to users include advertising and promotion at combustible cigarette point-of-sale (e.g., behind cashier’s counter). E-cigs are also promoted via physical and online shops, internet, social media, events, etc. According to TECMA, 10.6% of school-going adolescents aged 10-19 years were offered a free trial session of e-cigarette/vape while 7.9% were offered a free e-cigarette/ vape liquid (e-liquid)5. With proliferation of e-cig promotions via the social media, internet, and vape shops (some under the guise of selling electronic products, handphones, etc.,), using celebrities and others, the number of dual users and vapers among non-smokers, especially adolescents in Malaysia can be even higher now.
In early adolescence, development of executive function and neurocognitive processes in the brain has not fully matured. Adolescence is a sensitive period for maturation of brain circuits that regulate cognition and emotion, with resulting vulnerability to the effects of nicotine and tobacco. The rapidly changing, immature adolescent brain has differing sensitivity to drugs such as nicotine and tobacco, and drug exposure during this time can lead to long-term changes in neural circuitry and behaviour6. The American Academy of Pediatrics produced a policy statement showing evidence regarding the effects of nicotine on the developing brain. Nicotine has neurotoxic effects on the developing brain, an effect on the brain as a “gateway” drug for cocaine and other illicit drugs. The gateway theory postulates that smoking, especially among adolescence, increases the risk of substance use due to effects of nicotine, shown to be a neuroteratogen that exerts long-term, maturational effects at critical stages of brain development7.

Avocado Fruit and Leaf Bioactive Phytochemicals and Cosmeceutical Applications: A Scoping Review

Ling Li Yeoh — 2024-07-31

The cosmeceutical industry has been blooming over the years, necessitating a demand for safe and effective options. Fruit bioactive compounds are reported as safe for human health and broadly effective alternatives with less adverse effects. Avocado (Persea americana Mill.) is a tropical fruit rich in phytonutrients and lipid-soluble bioactive compounds. These compounds have been reported to have various potential health benefits, including improving skin health. This scoping review investigated the bioactive compounds of avocados that were reported to confer beneficial activities on the skin. Published data between August 1982 till February 2022 were extracted from Ovid Medline, Scopus, Pubmed, SciFinder and Web of Science. A total of 307 published articles were identified using the search terms, of which 31 full articles were reviewed and appraised in this synthesis. This comprehensive scoping review examined the cosmeceutical activities of bioactive phytochemicals found in avocado (Persea americana Mill.) outlining their mechanisms of action. The review highlighted the antioxidant, antimicrobial, anti-inflammatory, wound healing, anti-tyrosinase, and anti-aging properties of avocado extracts. Acetone extracts, especially from seeds, showed the highest antioxidant capacity and were also effective in antimicrobial activities. Methanol extracts demonstrated significant anti-inflammatory effects. Furthermore, bioactive compounds from avocados were found to enhance wound healing and anti-aging effects, such as increasing collagen production and improving skin hydration and elasticity. This scoping review provides a comprehensive collection of evidence and critically appraises recent literature on bioactive compounds of Avocado and extraction solvents and potential cosmeceutical applications.

Fabrication, Applications and Future Prospects of Mesoporous Silica Nanoparticles

Fatema Zohera — 2024-07-31

In past decades, nanomedicine has become a prominent area of focus within the discipline of nanotechnology, eliciting significant anticipation within the field of biomedical research. Scientists are creating unique nanoparticles for diagnosis, utilising techniques for imaging as well as therapy applications using medication delivery techniques. Mesoporous silica nanoparticles (MSNs), a recent addition to this area, serve as a sterling example of innovative nanostructures that offer distinctive and exceptional features. These features make them valuable for developing drug delivery systems with consistent and positive advancements in preclinical. MSNs efficiently encapsulate, control, and sometimes deliver biologic agents intracellularly for clinical use due to their distinct physicochemical characteristics, such as high porosity, large surface area, adjustable pore size and dimensions, good biocompatibility, and significant loading capacity. In this article, we discuss the latest advancements in fabrication, their presumed usefulness in delivering medications, and their application as diagnostic tools. It has been demonstrated that silica can store and release therapeutics, such as antibiotics, in a sustained and controlled manner. The desirable properties of MSNs have been further enhanced by modifying the surface of the siliceous frameworks through incorporating supramolecular assemblies and various metal species and their conjugates. These substantial advancements in innovative colloidal inorganic nanocontainers have driven researchers to explore their use in novel applications, such as stimuli (light/ultrasound/ magnetic)-responsive delivery-associated therapies with exceptional in vivo performance. This article provides a brief overview of the fabrication of siliceous frameworks and discusses significant advances in the engineering of MSNs. The precise control of the shape, dimension, homogeneity, and dispersity of MSNs is crucial, as these characteristics are critical quality attributes necessary for regulatory approval. Currently, explicit FDA guidelines for developing nanomaterial-based formulations intended for diagnostic or therapeutic purposes are lacking. Therefore, establishing standardised protocols and techniques for the synthesis and characterisation of nanoparticles, particularly for their use as theranostics, is essential for future commercial potential.

A Comprehensive Review of the Use of Plant-Derived Antioxidants in the Management of Non-Alcoholic Liver Toxicity

Shubham Verma — 2024-07-31

ABSTRACT

With its rising incidence, non-alcoholic fatty liver disease (NAFLD) has become a global health problem. Hepatic lipid buildup, inflammation, and oxidative stress are the results of complex interactions between metabolic, genetic, and environmental variables in the development of nonalcoholic fatty liver disease. The potential significance of antioxidants generated from phytochemicals in alleviating non-alcoholic liver damage has garnered substantial interest among the many treatment methods. The goal of this thorough review is to summarize and assess the body of research on the application of antioxidants derived from phytochemicals in the treatment of non-alcoholic fatty liver disease. A comprehensive examination of peer-reviewed research from many databases demonstrates a wide variety of phytochemicals with antioxidant characteristics and their possible effects on oxidative stress, inflammation, and hepatic lipid metabolism. Prominent phytochemicals such as curcumin, resveratrol, quercetin, silymarin, and green tea catechins are among those whose antioxidative processes are included in the review. Preclinical and clinical research on these substances have revealed encouraging results, suggesting that they may be able to lessen inflammation and hepatic steatosis while also enhancing liver function. We investigate the molecular mechanisms underlying their protective benefits, including reduction of pro-inflammatory cytokines and modification of nuclear factor-erythroid 2-related factor 2 (Nrf2). The study also discusses the shortcomings and difficulties in the existing research, highlighting the necessity of more clinical trials, standardized dosing schedules, and research into the possible synergistic effects of mixing several phytochemicals. To present a fair picture of the therapeutic application of phytochemical antioxidants, safety issues and possible negative effects are also included. This review emphasizes the potential use of phytochemical-derived antioxidants in the treatment of non-alcoholic hepatic damage. Including these organic substances in all-encompassing lifestyle interventions might be a good way to both prevent and cure NAFLD.

Keywords: Phytochemicals, Non-alcoholic fatty liver disease (NAFLD), Anti-oxidants, Non-alcoholic steatohepatitis (NASH), Toxicity.

Updates on Behavioural Interventions for Smoking Cessation: A Systematic Review of Systematic Reviews

Nur Syuhada Abqari Luthfi Albert — 2024-07-31

In Malaysia, tobacco smoking is considered to be one of the leading causes of early and preventable mortality. The ‘Clinical Practice Guidelines on Treatment of Tobacco Use Disorder 2016’ is utilised to provide safe and effective smoking cessation services for smokers to quit successfully. Since the launch of the 2016 CPG, there have been several new pieces of evidence regarding behavioural interventions for tobacco smoking cessation with various outcomes. Therefore, the guidelines are expected to be updated to assist healthcare providers in helping smokers quit smoking. This study aims to review the evidence from 2016 onwards for behavioural interventions in smoking cessation reported from published systematic reviews, and to update the CPG on tobacco use disorder by conducting a systematic review of systematic reviews methodology. The Cochrane Library, PubMed, and Scopus databases were used to conduct a comprehensive literature search. Two reviewers performed the screening and study selection, with disagreements resolved by consensus or the involvement of another reviewer. Quality assessment and data extraction are performed by one reviewer and checked by another. AMSTAR-2 tool was used to perform the risk of bias assessment. A narrative synthesis of the data extracted was provided. The searches resulted in a total of 276 articles and out of these, 23 systematic reviews were included. The included studies incorporated various smoking cessation interventions. Smokers of all ages and a small proportion of recent quitters are involved. They may be from the general or the special population. 14 reviews were rated as high quality, 2 were moderate, 4 were low and 3 were critically low by the AMSTAR-2 tool. The analysis found that counselling sessions, online interventions, self-help materials and motivational interviewing may increase cessation rates in the long term, if not, short term. Counselling sessions demonstrate the strongest evidence of benefit in smokers trying to quit. Findings that can be added to the updated CPG include app-based, incentives, feedback on spirometry results, exercise and behavioural interventions for people living with HIV and AIDS, COPD patients, and underprivileged older smokers.

Assessment of Methods to Measure Adherence of Antidepressants: A Systematic Review

Nur Aina Abdul Ghafur — 2024-07-31

Adherence towards antidepressant agents is a vital element in effectively managing depression. Non-adherence of antidepressants can lead to a recurrence of depressive symptoms and decreased treatment effectiveness. Adherence is assessed using various types of measures. This study aims to evaluate the different methods used to assess the adherence towards antidepressants on adults with depression. This systematic review adhered to the guidelines outlined in the PRISMA statement. PubMed, Cochrane Library, and Scopus are searching from 2013 to 2023 for articles that studied or reported on antidepressant adherence measures in adults with depression. Two authors conducted independent screenings of the articles against the eligibility criteria, examining titles, abstracts, and full-texts. The risk of bias for all included studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Information from all the selected articles was extracted using a predefined table. 15 studies met the eligibility criteria. When measuring adherence towards antidepressant at initiation and/or implementation phase, self-report methods such as Medication Adherence Rating Scale (MARS) demonstrated acceptable reliability and validity, while Brief Medication Questionnaire (BMQ by Svarstad et al.), Morisky Medication Adherence Questionnaire (MAQ), and Brief Adherence Rating Scale (BARS) showed good validity, and Morisky Medication Adherence Scale (MMAS), Morisky Green Levine Adherence (MGLA), Beliefs about Medicine Questionnaire (BMQ by Horne et al.) and Drug Attitude Inventory (DAI-10) showed good reliability. This study found a diverse range of methods to measure adherence towards antidepressant in adults. Self-report assessments, particularly in primary care and psychiatric settings, emerged as the most practical tools followed by clinician-rating scale, pharmacy refill data, adherence scale, pill count, and average serum level. No single measure with consistently shown strong reliability and validity across different adherence stages, highlighting the need for a combined approach.

In vitro kinetics characterisation of polymeric nanoparticles for anticancer therapy

Umar Azhan — 2024-07-31

World Health Organization (WHO) predicts that cancer incidence will increase in the future, thus research involving anticancer agents such as nanoparticles has gained significant importance. Nanoparticles can be made from various materials, but the focus on polymeric chitosan and/or carrageenan-based nanoparticles is significant. Research on these materials investigates dynamic parameters of in vitro drug release, stability under working conditions and stability under storage conditions (in vitro kinetics characterisations). Here, a literature review is conducted to provide in-depth insights on research methodology trends, drawbacks, suitability, suggestions for improvements and findings related to polymeric carrageenan and/or chitosan nanoparticles for anticancer therapy. Journal articles involving nanoparticles made from chitosan and/or carrageenan containing anticancer agents published between 2017 and 2022 were acquired through Google Scholar search using relevant keywords. Generally, the methods used to investigate drug release kinetics of nanoparticles can be categorised into dialysis membrane, sample and separate or direct measurement methods. Studies on the response of physiochemical characteristics towards changes in environment do not vary highly and are generalisable. Stability studies primarily measure the physicochemical changes of nanoparticles as a response measurement towards storage conditions. Both drug release selectivity and physicochemical characteristics response in different pH environments were found to be predictable via the ionisation of polymers and drugs used in different pH. The size of the nanoparticles formed during polyelectrolyte complexation process was found to be at its minimum at a balanced pH, possibly due to increased polymer-polymer attraction. The methods used for in vitro kinetics studies were generalised, and suggestions to address potential sources of errors were given in the current review. The selectivity of drug release and changes in physicochemical characteristics of the nanoparticles in different pH environments were found to largely coincide with the principles of ionisation of nanoparticle constituent.