Pharma Middle East November 02-04, 2015 Dubai, UAE

Sahar M Kamal has received her MD in Basic and Clinical Pharmacology from Pharmacology Department, Faculty of Medicine, Ain Shams University during the period of May 1997- May 2001. Currently, she is working as Professor of Pharmacology in Ain Shams University. She lectures on Basic & Clinical Pharmacology in both faculties of Medicine and Dentistry in Ain Shams University, Cairo, Egypt. She is serving as an editorial member of several reputed journals like Journal of Neurological Disorders and expert Reviewer for Journal of Experimental Pharmacology. She has authored 24 research articles.

The frequent coexistence of depression in epileptic patients raises the issue of simultaneous use of antidepressants along with antiepileptic drugs in the management of such cases. However, it is necessary to evaluate the safety of these antiepileptic/antidepressant drug combinations. The present study investigates the effect of the antidepressant paroxetine (a selective serotonin reuptake inhibitor) administered alone or in combination with the anti-epileptic drug sodium valproate on chemo-convulsions induced by Picrotoxin (PTX). Seizure score was recorded in vivo, and the levels of thio-barbituric acid-reactive substances and gamma amino-butyric acid (GABA) were measured in the nucleus accumbens of the tested groups of mice. The results show enhancement of seizure severity with significant reduction in GABA levels upon PTX treatment that were reversed by its combination with sodium valproate. On the other hand, paroxetine administered in combination with sodium valproate provided significant protection against PTX-induced convulsions as well as a significant increase in GABA levels in selected brain areas. These results favor their application in management of epilepsy-depression comorbidities.

After finishing his undergraduate study of pharmaceutical Sciences with the grade of honour, Dr Mohamed has been awarded his PhD in Infection, Immunity and Inflammation from Leicester University, UK. He served as a lecturer of Microbiology and Immunology, Al-Azhar University, Cairo, Egypt, and he is currently an assistant professor of Microbiology and Immunology, University of Dammam, KSA. Dr Mohamed has published a group of research papers in immunology and tumour pharmaco- and immunotherapy in high impact journals, and he volunteer as a reviewer/ associate editor in a number of internationally reputed journals of the field. In addition, he is a member in many professional societies, such as; American Association of Cancer Research, Saudi Society of Infectious Diseases and Microbiology, European Association of Cancer Research, British Society of Immunology, Egyptian Pharmacy Syndicate. His research interests include; the malignant diseases management via cellular immunotherapy and cancer vaccines and the antimicrobial resistance patterns of Mtb.

Introduction: Due to side effects and resistance to traditional chemotherapeutic agents, new therapeutic strategies are requested for hematologic tumour management. Adoptive T cell immunotherapy represents an alternative effective, long-acting approach of minimal side effects. This study evaluates the ability of hybrid cells, generated by fusion of leukaemia tumour cells with Antigen Presenting Cells (APC) to stimulate tumour-specific cytotoxic T cells with the ability to recognise and destroy parent tumour cells.\r\n\r\nMethods: Acute myeloid leukaemia tumour cells were fused to APC and the growth of the hybrid cells were chemically selected. The hybrid cell growth was maintained in tissue culture conditions, and subjected to phenotypic evaluation using flow cytometer. Tumour antigen expression was detected by RNA extraction followed by reverse transcription PCR using antigen specific primers. Subsequently, hybrid cells were allowed to induce T cell specific response from PBMC of normal donors. Cytotoxicity and IFN-γ ELISpot assays were performed to evaluate the functional activity of the activated T cells.\r\n\r\nResults: The hybrid cells expressed relevant tumour antigens in context of MHC I/II, in addition to T cell co-stimulatory molecules. The immortalised hybrids induced allogeneic cellular T cell responses of both cytotoxic CD8 and CD4 types. More importantly, the induced cytotoxic CD8+ T cells successfully responded by IFN-γ release following co-culture with the target tumour cells and induce target cell apoptosis in cytotoxicity assays.\r\n\r\nConclusion: Hybrid cells of this type had the potential to induce specific T cell response and could be a successful immuno-therapeutic, T cytotoxic cell inducer to be used for adoptive cellular management of hematologic cancers. \r\n

Malak Abouayana and Aya Naiel are third-year Undergraduate Pharmacy Students, Faculty of Pharmacy-Alexandria University.

Aim: 1. To develop a rat model to study vincristine-induced SAIDH 2. To determine the possible role of erythropoietin in reducing\r\nthe hyponatremia and survival rate associated with vincristine-induced SAIDH.\r\nMethods: Rats were allocated into five groups (n=4-8 each). All groups were i.p. dosed 0.15 ug/Kg vincristine sulphate (VCR) for 15\r\ndays 6 days per week. Groups 2, 3 and 5 were administered either 40 U/Kg or 80 U/Kg erythropoietin i.p. along with the VCR. Groups\r\n4 and 5 were administered 40 mg/Kg posaconazole (PSZ) orally starting the day of VCR administration. Rats’ weights and survival\r\nrates were measured daily and their serum sodium and potassium levels were measured at days 0, 5, 9 and 15.\r\nResults: No rats survived after day 12 of dosing. The VCR-induced SAIDH rat model showed 3.4% and 4.1% reduced sodium levels\r\non days 5 & 9, respectively. Their serum potassium level showed no significant change on day 5 and 8% decrease on day 9. The rats\r\nexhibited weight reduction of 10% and 18% on days 5 and 9, respectively. Erythropoietin 40 U/Kg treated rats showed significantly\r\nless hyponatremia (0.6% decrease) and 24% increase in potassium levels on day 5. However, increasing the erythropoietin therapy\r\nduration beyond 5 days and/or dose (80 U/Kg treated groups) resulted in increased hyponatremia and demolished rats’ survival.\r\nPSZ-VCR dosed rats and PSZ-VCR-erythropoietin dosed rats survived only for 4 days. Posaconazole-VCR treated groups showed\r\nincreased VCR toxicity with ~12% increase in serum potassium levels, however, serum sodium levels showed no significant difference\r\nduring the 4 days.\r\nConclusion: Initial rat model to study vincristine-induced SAIDH was developed. Co-administration of low dose erythropoietin\r\n(40 U/Kg) for short duration, ≤5 days, showed a potential benefit in reversing the VCR-induced hyponatremia however, we need to\r\nconsider controlling the induced hyperkalemia. Human serum sodium, potassium and BUN levels for patients administered VCR\r\nalone or VCR along with erythropoietin in ALL treatment protocols needs to be studied to confirm such trends.

M A Yamane is an Associate Professor of Pharmaceutics and Biopharmaceutics at Department of Pharmaceutics and Pharmacy Practice, Faculty of Pharmacy, University of Tripoli. She has teaching experience of more than 20 years, during which she published many papers in reputed international and national journals.

Asthma is one of the major health problems worldwide, and inhalation therapies are central in its management. Good inhalation technique is essential for optimum pharmacotherapy and minimum health care costs. Community pharmacists have become more involved in the care of asthma patients. However, data regarding the intervention of Libyan pharmacists in the management of asthma are scarce. Thus, the aims of this study were to evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Tripoli city, and to investigate counseling skills of pharmacists on asthma devices and asthma medications in general. Other aims for the current study were to explore the perspectives and management adherence by asthmatic patients. Two hundred community pharmacists were interviewed in 60 private pharmacies and 1 hospital pharmacy located in Tripoli areas. Asthma patients (n=85) also participated in this study. The study was carried out for 16 weeks and four asthma devices were tested (MDI, MDI with a spacer, Turbuhaler, and Diskus). Mystery patients and face-to-face interview studies were conducted. The basic steps of using MDI were illustrated to patients by 50% of pharmacists. Only (39%) of them advised their patients about how to use MDI with a spacer and poorly demonstrated for most steps. Whereas correct steps of using Turbuhalers were demonstrated by 66% of the pharmacists, more than half of the pharmacists were capable to demonstrate steps of Diskus at a moderate level. The study recommends a need for training programs tailored toward fostering community pharmacists\' role as primary providers of asthma education.

Halit Bugra Koca completed his Phd from Eskisehir Osmangazi University and Postdoctoral studies from Afyon Kocatepe University School of Medicine. He has published more than 15 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Visfatin is a recently discovered hormone known to be synthesized in adipocyte, hepatocyte and granulocytes and its production or suppression is modulated with diabetes mellitus. It has many cellular functions such as cell proliferation, biosynthesis of nicotinamide mono- and dinucleotide and posesses insulin-like hypoglycemic effect. This study aims to investigate the effects of diabetes on the hepatic visfatin, Asymmetric Dimethylarginine (ADMA), Erythropoietin (EPO) levels and histo-pathological features in streptozotocin-induced diabetes. In addition, the effects of resveratrol known as strong protective molecule were explored. Recruited Wistar male rats randomly divided into four groups; (1) control/vehicle; (2) control/20 mg/kg resveratrol; (3) diabetic/vehicle; (4) diabetic/20 mg/kg resveratrol. Hepatic visfatin, ADMA, EPO and insulin levels were measured with ELISA kits. Histo-pathological examinations were carried out to reveal hepatic tissue damage and inflammation. Body weight, hepatic insulin and ADMA levels reduced significantly but hepatic glucose, visfatin and EPO levels increased in the diabetic group. Furthermore, diabetes amplified damage, nuclear atypia and density of Kuppfer cells observed in the liver. Resveratrol treatment normalized these complications in the diabetic group. Oxidative damage triggered by diabetes enhanced ADMA levels but decreased visfatin and resveratrol improved this situation. This may be due to the protective activity of resveratrol on relationship between inflammation-visfatin pathways.

Roger S Klotz finished graduation from the University of Illinois College of Pharmacy. He started out as a Pharmacist at Children’s Memorial Hospital in Chicago where he advanced to Director of Pharmacy Services and Director of Clinical Dietetics. He joined Home Health Care of America in June of 1983 as Director of Clinical Pharmacy Development. In 1998, he opened a community pharmacy practice that provided services including compounding, DME services, immunization services, provision of “CLIA Waived” testing, and nutritional therapy management. In 2006, he created Care Partners Consulting Pharmacists, LLC, which is focused on consulting patients, pharmacists/providers, and physicians. In that same year, he was appointed Assistant Professor of Pharmacy Practice and Administration at Western University of Health Sciences College of Pharmacy. In 2013, he was promoted to Associate Professor of Pharmacy Practice and Administration.

Pharmacists traditionally have been involved in the provision and assessment of medication therapy in diabetic patients. Pharmacological management of medication therapy in the diabetic patient continues to be a significant challenge to the entire healthcare team involved in the patient’s care. Further challenge is presented to the team because a high percentage of diabetic patients also have hypertension which is another therapeutic challenge. If we really look at the biochemistry and physiology associated with the development of diabetes and hypertension, it becomes increasingly obvious that nutrition therapy can became a very useful tool to be added to the therapy plan of diabetic patients. The pharmacist has a strong knowledge base in the fundamental sciences and therefore is in a good position to understand the importance of carbohydrate and electrolyte management to the treatment of diabetes and hypertension. Understanding the importance of reducing the patient’s Glycemic Load (GL) by reducing the amount of carbohydrate in the patient’s diet and assuring that the carbohydrates in the diet are Low Glycemic Index (LGI) carbohydrates are essential to achieving better blood glucose control. This dietary approach will also increase the important electrolytes (i.e., potassium, magnesium), which are critical to the appropriate utilization of carbohydrate and the maintenance of blood pressure control. I actually practice the pharmacist has successful improved the outcomes in diabetic and hypertensive patients. The pharmacist working collaboratively with the patient’s physician can contribute significantly to improving therapeutic outcomes.

Sawsan Zaitone has completed his PhD from Suez Canal University, Ismailia, Egypt. She has published more than 20 papers in reputed journals and participated in many international and national conferences. She has supervised more than 15 master and PhD thesis during the last eight years.

Aim: The present study assessed the antifungal activity of silver nanoparticles against experimentally-induced oral candidiasis compared to miconazole oral gel/suspension. \r\n\r\nMain methods: Oral candidiasis was induced in male rats using Candida albicans (ATCC 90028). One hundred and ninety two rats were assigned into six groups; 32 rats each. Group 1: rats without oral candidiasis (immunosuppressed/not infected); Group 2: rats with oral candidiasis (immunosuppressed/infected); Group 3: rats with oral candidiasis treated topically with 2% miconazole oral gel; Group 4: rats with oral candidiasis and treated topically with 2% miconazole aqueous suspension; Group 5: rats with oral candidiasis and treated topically with silver nanoparticle solution (50 µg/ml); Group 6: rats with oral candidiasis and treated topically with silver nanoparticle solution (100 µg/ml). All treatments were applied topically every day for 2 weeks. In vitro determination of Minimal Inhibitory Concentration (MIC) was performed using macro broth dilution method. Baseline assessment was conducted on day 0 (just before drug treatment). Macroscopic evaluation of the lesions, microbial counting and histopathological changes were evaluated on day 0, 7, day 14 and the follow up assessment was performed at day 28. \r\n\r\nKey findings: In vivo experiment indicated that silver nanoparticles provided a quicker and effective onset of antifungal activity with greater efficacy on day 7 only regarding all measured parameters compared to miconazole. However, the effect was generally equivalent to that provided by miconazole after day 14 and day 28. \r\n\r\nSignificance: Silver nanoparticles may be considered as a promising candidate for treatment of oral C. albicans infections if clinical safety data are available.\r\n

Roja Rahimi has completed her PhD in the year 2012 from Tehran University of Medical Sciences and she is now an Assistant Professor at School of Traditional Pharmacy of Tehran University of Medical Sciences. She has published more than 70 papers in reputed journals and has been serving as an Editorial Board Member of 6 international journals. Her H-index is 26. Her research interests are discovery of pharmacological mechanisms and pathways of natural products, evaluation of efficacy and safety of natural products, and formulation and standardization of natural medicines.

Introduction: Hypericum perforatum, more commonly known as St. John’s wort, is a recognized medicinal plant with recognized antidepressant properties. It affects the pharmacokinetics of many drugs by inducing cytochromeP450 (CYP) isozymes and the P-glycoprotein (P-gp) transporter. This review focuses on drugs that their pharmacokinetics affected by this medicinal plant.\r\n\r\nMethod: All electronic databases such as PubMed, Scopus, Google Scholar and Cochrane library were searched to identify in vitro, in vivo or human studies about the effects of Hypericum perforatum on the metabolism of drugs. Data collected were published between 1966 and January 2012.\r\n\r\nResults: There are a number of drugs whose metabolism affected by Hypericum perforatum including amitryptillin, docetaxol, digoxin, bupropion, oral contraceptives, fexofenadin, verapamil, immune-suppressants and warfarin. The metabolic interactions between Hypericum perforatum and drugs are not always unfavorable and sometimes have benefits (e.g., reduction of irinotecan toxicity and increase in clopidogrel responsiveness).The pharmacokinetics of some drugs does not affect by Hypericum perforatum, although they are metabolized by Hypericum perforatum-targetted cytochromes. Carbamazepine, ibuprofen and theophylline are examples of these drugs.\r\n\r\nConclusion: The use of Hypericum perforatum preparations is not recommended in patients who are taking immune-suppressants or cardiovascular drugs. With other medications, it is recommended that practitioners should only use preparations with low hyperforin content and under careful monitoring. Because of the reduction in the bioavailability of oral contraceptives, women who use Hypericum perforatum preparations should use additional preventive methods to avoid unintended pregnancy.\r\n