Journal of Research in Pharmacy Practice 11 3 2022 07 01 Evaluation of the Effectiveness of an Herbal Formulation of Boswellia sacra Flueck. In Improving Cognitive and Behavioral Symptoms in Patients with Cognitive Impairment and Alzheimer's Disease 91 98 30288 EN . Mahsa Panahishokouh Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-9648-2651 . Maryam Noroozian Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran . Fatemeh Mohammadian Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran . Mahnaz Khanavi Department of Pharmacognosy, Tehran University of Medical Sciences, Tehran, Iran . Mahnaz Mirimoghaddam Department of Pharmacognosy, Tehran University of Medical Sciences, Tehran, Iran . Seyed Mehrdad Savar Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran . Maryam Nikoosokhan Bahar Sepinood Company, Tehran University Science and Technology Park, College of Agriculture, Alborz, Iran . Hooshyar Honarmand Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran . Niayesh Mohebbi Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-1420-7286 Journal Article 2023 03 28 Objective: This study aimed to assess the efficacy of an herbal formulation based on Boswellia sacra in improving cognitive and behavioral symptoms in patients with mild cognitive impairment (MCI) and mild-to-moderate stages of Alzheimer’s disease (AD). Methods: A 3-month, parallel-group, placebo-controlled trial was implemented from October 2021 to April 2022. Patients with MCI and mild-to-moderate stages of AD aged above 50 years (n = 60; 40 women, 20 men) enrolled in the study using clinical diagnosis and a score of 10–30 on the mini-mental state examination (MMSE) test. They were assigned into two groups; one receiving a herbal formulation) include B. sacra, Melissa officinalis, Piper longum, Cinnamomum verum, and Physalis alkekengi) three times a day and the other receiving a placebo for 3 months. The main efficacy measures were the changes in cognitive domains based on the MMSE and changes in behavioral and psychiatric symptoms based on neuropsychiatric inventory (NPI) scores compared with baseline. Side effects were also recorded. Findings: Results of this study showed significant differences between the two groups after 3 months in terms of all the assessed variables, including the overall result of the mean score of MMSE and NPI tests (P ≤ 0.001). The herbal formulation had the most considerable effects on the domains of orientation, attention, working memory, delay recall, and language of the MMSE test. Conclusion: Herbal formulation based on B. sacra was significantly effective compared to a placebo in improving cognitive and behavioral symptoms in patients with MCI and mild-to-moderate AD.

https://jrpp.mui.ac.ir/article_30288_bc5e6eabfbafdca716f42c5e69644480.pdf

Journal of Research in Pharmacy Practice 11 3 2022 07 01 Adverse Drug Reactions in Psychiatry Outpatient Department of a Tertiary Care Hospital in Western Uttar Pradesh: An Observational Study 99 102 30289 EN . Jaspreet Kaur Sidhu Department of Pharmacology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India 0000-0002-9940-2311 . Kiran Jakhar Department of Psychiatry, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India . Deepti Chopra Department of Pharmacology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India . Aditi Dhote Department of Pharmacology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India . Vishakha Babber Third Year MBBS Student, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India . Mohammad Shadman Third Year MBBS Student, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India . C. D. Tripathi Department of Pharmacology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India Journal Article 2023 03 28 Objective: Psychiatric disorders are chronic in nature which require medications for a long duration. These medications have been associated with many adverse events. Failure to recognize an adverse drug reaction (ADR) exposes the patient to continuing risk of ADR, leading to a significant impact on patient’s quality of life. Thus, the present study carried out to identify the pattern of ADRs reported due to psychotropic medication. Methods: This was a cross-sectional study conducted to analyze ADRs reported from the psychiatry department of a tertiary care teaching hospital from October 2021 to March 2022. Findings: A total of 137 ADRs were identified from 102 patients. Majority of the ADRs were reported from antidepressants, with paroxetine being the leading offending drug. The central nervous system was most commonly affected, and dizziness (13.13%) was the most common ADR noted. On causality assessment, 97 ADRs (70.8%) were of “possible” type. Almost half of the patients with ADRs (47.5%) recovered spontaneously. No ADR encountered turned out to be fatal. Conclusion: The present study revealed that the majority of ADRs reported from psychiatry OPD were mild in nature. We reinforce the identification of ADR is crucial in the hospital setting process as it gives an insight into the risk‑benefit ratio for rational use of the drug.

https://jrpp.mui.ac.ir/article_30289_216cbd05fb1918ba700506718cd8d915.pdf

Journal of Research in Pharmacy Practice 11 3 2022 07 01 Effect of Selenium Supplementation on Lipid Profile, Anemia, and Inflammation Indices in Hemodialysis Patients 103 108 30290 EN . Samaneh Assarzadeh Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1069-5622 . Sahar Vahdat Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran . Shiva Seirafian Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran . Morteza Pourfarzam Department of Clinical Biochemistry, Isfahan University of Medical Sciences, Isfahan, Iran . Shirinsadat Badri Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-6851-9090 Journal Article 2023 03 28 Objective: Trace elements deficiency is common among end‑stage renal disease (ESRD) patients due to excessive loss during dialysis and the lower intake secondary to loss of appetite. Selenium (Se) is a trace element that plays an important role in the radical scavenging system and helps the body defend against oxidative stress. This study aims to evaluate the effects of Se supplementation on lipid profile, anemia, and inflammation indices in ESRD patients. Methods: Fifty-nine hemodialysis patients enrolled and were randomly divided into two groups. Two hundred microgram Se capsules once daily for the case group and matching placebo for the control group were administered for three months. Demographic data were collected at the study beginning. Uric acid (UA), anemia and inflammation indices, and lipid profiles were recorded at the beginning and the end of the study. Findings: UA and UA‑to‑HDL (high‑density lipoprotein) ratio decreased significantly in the case group (P < 0.001). The changes in lipid profile were not significant among both groups. Hemoglobin slightly increased in the case group, however, it decreased significantly in the control group (P = 0.031). High-sensitivity C-reactive protein (hsCRP) decreased in the case group and increased in the control group, however, none of these changes were significant. Conclusion: According to the results of this study, selenium supplementation in ESRD patients could reduce some risk factors related to their mortality, such as the ratio of uric acid to HDL. However, the changes related to lipid profile, hemoglobin level and hs-CRP biomarker were not significant.

https://jrpp.mui.ac.ir/article_30290_e0f4d7c0453ad5d27b69eba851357a31.pdf

Journal of Research in Pharmacy Practice 11 3 2022 07 01 Efficacy of Lacosamide Add‑on Therapy on Refractory Focal Epilepsies in Children and Adolescents: An Open-Label Clinical Trial 109 115 30291 EN . Tayebeh Mohammadi Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-7700-6257 . Jafar Nasiri Child Growth and Developmental Research Center, Research Institute for Primordial Prevention of Noncommunicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-3624-6849 . Mohammad Reza Ghazavi Child Growth and Developmental Research Center, Research Institute for Primordial Prevention of Noncommunicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran . Omid Yaghini Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran . Neda Hoseini Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2023 03 28 Objective: Epilepsy is a chronic neurological disorder that affects 0.5%–1% of children. 30%–40% of patients are resistant to current anti-epileptic drugs. Lacosamide (LCM) appeared to be effective, safe, and well tolerated in children and adolescents. This study was aimed to evaluate whether LCM could be an effective add-on therapy in children with refractory focal epilepsies. Methods: This study was conducted from April 2020 to April 2021 in Imam Hossein Children Hospital, Isfahan, Iran. We included 44 children aged 6 months to 16 years with refractory focal epilepsy (based on International League Against Epilepsy criteria). LCM was given in divided doses of 2 mg/kg/day, increasing by 2 mg/kg every week. The first follow‑up visit was 6 weeks later, when all patients had reached the therapeutic dose. Findings: The average age of the patients was 89.9 months. 72.5% of children had focal motor seizures. Evaluation of percent change in seizure frequency and duration before and after treatment showed a 53.22% reduction in seizure frequency and 43.72% reduction in seizure duration after treatment. Our study group tolerated LCM well, with few side effects. Headache, dizziness, and nausea were common side effects. In line with other studies, none of the suspected risk factors could predict response to LCM treatment. Conclusion: LCM appears to be an effective, safe, and well-tolerated medication in children with uncontrolled drug-resistant focal epilepsy.

https://jrpp.mui.ac.ir/article_30291_c9bbba509b7304e3aec72ce594a0bec1.pdf

Journal of Research in Pharmacy Practice 11 3 2022 07 01 The Efficacy of an Oral Formulation of Glycyrrhiza glabra, Viola odorata, and Operculina turpethum as an Add-on Therapy for Mild-to-moderate Childhood Asthma: A Randomized Placebo-Controlled Clinical Trial 116 123 30292 EN . Faezeh Rabbani 1 Pharmacy Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1729-1751 . Mohsen Raeisi Department of Pediatric Pulmonology, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran . Majid Keivanfar Department of Pediatric Pulmonology, Imam Hossein Children’s Hospital, Isfahan University of Medical Sciences, Isfahan, Iran . Ali Saffaei Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran . Ali Mohammad Sabzghabaee Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-8115-4615 Journal Article 2023 03 28 Objective: We aimed to evaluate the efficacy of an oral combined tablet of Glycyrrhiza glabra, Viola odorata, and Operculina turpethum (Anti-Asthma®) as an add-on therapy for the relief of the severity of symptoms in mild-to-moderate childhood asthma. Methods: This randomized placebo-controlled clinical trial was performed on 60 children and adolescents with chronic mild-to-moderate childhood asthma. Patients were randomly divided into cases who received Anti-Asthma® oral combined tablets 2 tablets twice dailt for 1 month and controls, received placebo tablets identically the same to Anti-Asthma® (2 tablets, twice daily, for 1 month) as add-ons to their standard therapy according to the guideline. The severity and frequency of cough attacks and shortness of breath, respiratory test indices (based on spirometry), and the extent of disease control and treatment adherence were measured clinically by validated questionnaires at the beginning and after the study. Findings: Respiratory test indices improved and the severity of activity restriction decreased significantly in the cases compared to the controls However, the mean difference before and after the study was significantly different between the cases and controls only for the number and severity of coughs and the severity of activity restriction. In the scores of the Asthma Control Questionnaire, the cases group had a significant improvement compared to the controls. Conclusion: Anti-Asthma® oral formulation may be effective as an adjunct add-on treatment in the maintenance therapy of mild-to-moderate childhood asthma.

https://jrpp.mui.ac.ir/article_30292_a30a278ef4861cddd5d253e9c63c1a27.pdf

Journal of Research in Pharmacy Practice 11 3 2022 07 01 Association Between Atorvastatin Exposure and Low Folate Status: A Case–Control Study 124 126 30293 EN . Roberto Lozano Department of Pharmacy, University Clinical Hospital, “Lozano Blesa,” Zaragoza, Spain 0000-0002-0369-0815 . Irati Apesteguía Department of Health Emergencies o61, Servicio Aragones de Salud, Zaragoza, Spain . Alejandro Martínez Department of Pharmacy, Psychosocial Rehabilitation Center of Ntra, Zaragoza, Spain Journal Article 2023 03 28 Objective: The objective of this study is to assess the association between exposure to atorvastatin (ATV) and low-plasma folate (PF) status. Methods: The sample consisted of patients admitted to the internal medicine service of a basic general hospital, located in Zaragoza (Spain). We adopted a pharmacoepidemiological case–control study design. For this, the number of treatment days (TDs) of all the drugs part of their treatment during the study period was obtained from each patient in the sample. The cases were comprised by the number of patient’s TDs for which PF ≤3 mg/dl and the controls by the number of patient’s TDs for which PF >3 mg/dl. To measure the strength of the association, the odds ratios (ORs) were calculated. The Chi-square test, using the Bonferroni correction, was used to calculate the statistical significance. Findings: The sample consisted of 640 polymedicated patients. The mean PF obtained were 8.0 ± 4.6 mg/dl and 2.1 ± 0.6 mg/dl, for the cases and controls, respectively; the total number of TDs for the cases and controls were 7615 and 57899, respectively. We obtained a U-shaped curve when representing the dose of ATV against the corresponding ORs when comparing cases with control. Conclusion: Exposure to ATV at 10 or 80 mg is associated with an augmented risk of low folate status. We recommend implementing guidelines for mandatory folic acid fortification in patients exposed to ATV doses of 10 or 80 mg.

https://jrpp.mui.ac.ir/article_30293_2c442f7c8951648fc9fa4c84f479ec40.pdf