Volume 9, Issue 15, Autumn 2018, Page 0-137

Erectile Dysfunction in Diabetic Patients in the Holy Kerbala/Iraq in 2018

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 1-10

Erectile dysfunction affects more than 50% of diabetic patients and results in miserable
couple’s life, especially for young adults. Possible predictors are proper therapy and
patient’s compliance with treatment, in addition to the warning signs and symptoms of
sensory neuron and motor deficits. Therefore, this study was conducted to determine the
prevalence of Erectile dysfunction and its predictors among diabetic patients in Kerbala.
Material and methods
The study included a convenient sample of 61 patients with diabetes mellitus type I and II.
They were chosen through a systematic sampling among patients at the diabetes mellitus
clinic at Al Hussein Teaching Hospital in Holy Kerbala /Iraq in 2018. All participants
were interviewed using standard questionnaire. Analysis of data used descriptive and
analytic tools including t-test, chi-square test, logistic regression and structural Equation
modeling through the statistical Package of social sciences and Amos and Excel software
at a significance level of


diabetes mellitus
erectile dysfunction
Autonomic changes
sensory and motor changes
glycemic control.

Response to Helicobacter pylori Eradication Triple Therapy in Peptic Ulcer Disease Patients on Curcumin Supplement According to different ABO Phenotypes

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 11-31

Background: Helicobacter pylori infection is one of the most predominant causes of peptic
ulcer disease. There was a correlation between H. pylori infection and ABO phenotypes in peptic
ulcer disease patients. Curcumin has anti- H. pylori effect due to its anti-oxidant, antiinflammatory,
anti- microbial, and anti-carcinogenic effect.
Patients and Methods: This study is a prospective randomized interventional open-label study
which designed to show the potential benefit of adjuvant curcumin therapy in peptic ulcer
disease Iraqi patients with different ABO phenotypes. The patients were allocated into two
groups, group (1) treated with standard triple H. pylori eradication, and group (2) treated with
curcumin capsules as adjuvant with the standard triple therapy for two weeks. The ABO
phenotypes detected by Anti ABO and Anti-D monoclonal kit and the H. pylori infection was
detected at the baseline and after 6 weeks of completion treatment course.
Results: highly significant improvement in H. pylori eradication after addition adjuvant curcumin
to standard H. pylori eradication triple therapy compared to standard triple therapy alone(P<0.01)
for patients holding blood group AB phenotypes ( P<0.01) and significant improvement for
patients holding blood group O phenotypes( P<0.05) reach up to (100 %) after 6 weeks from the
intervention starting point. Besides, there was improvement in H. pylori eradication for patients
holding blood group A and B phenotypes with adjuvant curcumin therapy, though no significant
(P>0.05). This study showed no significant difference in BMI among ABO phenotypes (A,B,
AB, and O) for both groups 1 and 2 patients after 6 weeks from the intervention starting

Study the Effect of Polymer Types on Preparation and in-vitro Evaluation of β-sitosterol as a Topical Hydrogel

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 32-48

Beta sitosterol is a non-cholesterol sterol, or neutral sterol applied locally for
the treatments of acute and chronic ulcers of skin and mucous membranes as well as
post operative wounds. In this work β –sitosterol was prepared as topical hydrogel by
cold mechanical method using different types of gel-forming polymers such as
chitosan (4%, 3%, and 2%) W/W, carbapol (1.5%, 1%, and 0.5%) , and poloxamer
407( 30% and 25%)W/W. Physicochemical properties of all the prepared formulas
were evaluated as a visual inspection, determination of pH, and spreadability, in
addition to an in-vitro drug release.
The obtained results indicated that all the different concentrations of each
polymer gave a percent of drug release profile inversely proportional with the
polymer concentration. F8 which contain poloxamer 407 at 25% produced higher
drug release than other formulas (100% β-sitosterol release withim 3 hrs).
Based on overall result, β-sitosterol can be successfully prepared as a topical hydrogel
using 25% poloxamer as the best prepared formula.البيتاسايتوسترول هو ستيرول غير الكولسترول ، أو ستيرول محايد تطبيقه محليا لعلاج القرحة الحادة
والمزمنة من الجلد والأغشية المخاطية وكذلك الجروح ما بعد العملية. في هذا العمل ، تم تحضير
البيتاسايتوسترول علىشكل هلام مائي موضعي باستخدام طريقة ميكانيكية باردة باستخدام أنواع مختلفة من
1٪ ، و 0.5 ٪) ، و البوليكزامر ، ٪ 2٪) ، الكاربول ( 1.5 ، ٪3 ، ٪ البوليمرات المكونة للهلام مثل الكيتوسان ( 4
%25 ) و مع تركيز مختلف لكل منهما. تم تقييم الخواص الفيزيائية الكيميائية لجميع الصيغ ,%30 ) 407
المعدة على أنها فحص بصري ، وتحديد درجة الحموضة ، وقابلية انتشار ، بالإضافة إلى إطلاق عقار في
أشارت النتائج المتحصل عليها إلى أن جميع التراكيز المختلفة لكل بوليمر أعطت نسبة مئوية من
التي تحتوي على البوليكزامر 407 بنسبة F صورة إطلاق الدواء تتناسب عكسي اً مع تركيز البوليمر. أنتجت 8
25 ٪ الافراج عن المخدرات أعلى من الصيغ الأخرى ( 100 ٪ الافراج مع 3 ساعات).
بناء على النتيجة الكلية ، يمكن تحضير البيتاسايتوسترول بنجاح علىشكل هلام مائي موضعي
25 بتركيز ٪ باعتباره أفضل صيغة محضرة.

Spectrophotometric Method for Determination of promethazine Hydrochloride in Pharmaceutical formulation Based on coupling with 2-choloraniline in Presence of N-BromoSuccinimide

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 49-62

A simple, rapid and sensitive spectrophotometric method for determination of trace amounts of Promethazine hydrochloric in aqueous solution is described. The method is based on using the oxidative coupling reaction of Promethazine hydrochloride with 2-Chloroaniline reagent in acid medium in the presence of N-bromoSuccinimide. The red color product is quickly converted to green colour, water soluble, the product which exhibit maximum absorbance at 595 nm, coefficient of determination 0.9974 Beer's law is obeyed over concentration range of (4-24µg/ml), with a molar absorptivity 7765.78 l/mol.cm, Sandal index of 0.04132 µg/cm2. The average recovery is 99.837% and Detection Limit (D.L) of 0.0435µg/ml, relative standard deviation does not exceed 2.185%, The proposed method was applied successfully for determination of PMZH in it’s pharmaceutical formulations..

Effects of formulation variables on the Candesartan cilexitil nanoparticles properties using polyvinyl pyrroledone

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 63-72

Candesartan celexitil (CC), a non-peptide angiotensin II type 1 (AT1) receptor
antagonist, is used in the treatment of hypertension. It has low solubility with low
bioavailability thus nanoparticles approach is one of the recently technique used to
enhance the solubility of drugs. The aim of this study is to improve the solubility of CC
by preparing nanoparticles. Seven formulas of nanoparticles were prepared by antisolvent
precipitation method utilizing polyvinylpyrrolidone (PVP) as polymer. Three formulas
were prepared at different drugs: polymer ratio and another three formulas were at
different solvent: anti solvent ratios. The prepared nanoparticles were characterized
regarding the particle size by nano laser particle size analyzer, saturated solubility, and
thermal analysis by differential scanning calorimetry (DSC). The prepared nanoparticles
reveal that all formulas produce nanoparticle in range of (50 – 706) nm. Formula (F2)
which utilizes (PVP) as polymer at polymer: drug ratio of (1:1) and solvent: anti solvent
ratio of (1:10) was considered as the best formula which shows good evaluation
parameters in addition to increment in solubility (10.54) times than that of pure drug. The
thermal analysis of nanoparticle of the selected formula (F2) shows reducing of intensity
of endothermic peak of the drug indicating reduced crystallinity of candesartan celexitil.
Finally, it could be concluded that the selected formula is promising for preparation of
candesartan cilexetil nanoparticles with improved solubility.كانديسارتان سيليكسيتيل هو عقار غير مثبط غير ببتيدي لمستقبلات الانجيوتنسينوجين الثاني من النوع الأول يستخدم في علاج
ارتفاع ضغط الدم العقار له قابلية ذوبان منخفضة في الماء مع انخفاض التوافر البايولجي وبالتالي تقنية النانونوتكنولوجي هي
واحدة من التقنيات في الآونة الأخيرة التي تستخدم لزيادة ذوبان الأدوية . والهدف من هذه الدراسة هو تحسين ذوبان
الكانديسارتان سليكسيتيل من خلال إعداده على شكل جسيمات نانويه . وقد أعدت سبعة صيغ من الجسيمات النانوية بطريقة
الترسيب بمضاد المذيب واستخدام بولي فنيل بايروليدون على صيغ مختلفة من نسب الدواء إلى البوليمر ونسبة المذيب إلى
المضاد للمذيب . وقد تم تقييم الجسيمات النانوية المحضرة بشان حجم الجسيمات باستخدام جهاز النانو الليزري المحلل للجسيمات , ودرجة الذوبان, والتحليل الحراري باستخدام .النتائج أظهرت أن كل الصيغ أنتجت جسيمات متناهية الصغر في
2) فيها نسبة البوليمر إلى الدواء هو ( 1:1 ) ونسبة المذيب إلى مضاد المذيب F) 709 ) نانو متر.واعتبرت الصيغة - قيم من ( 50
هي ( 1:10 ) باعتبارها أفضل صيغة مع مواصفات جيدة بالإضافة إلى زيادة في الذوبان ( 10.5 ) مرات مقارنة بالدواء
2) إلى قلة في شدة ذروة إشارة الدواء في F) النقي.ويظهر التحليل الحراري للجسيمات المتناهية الصغر من الصيغة المختارة
التحليل مشيرا إلى انخفاض التبلور في الدواء . وأخيرا يمكن القول إن الصيغة المختارة واعدة لإعداد الصيغة النانوية
الكانديسارتان سيليكسيتيل مع تحسن واضح بالذوبان .

Review Metabolism: A review

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 73-79

Metabolism is a biochemical process in which the body converts
food into energy through a series of chemical reactions, in which nutrients are
destroyed within the digestive system and converted to energy by building
and destroying cells and tissues. Food has been converted into energy
through a series of chemical reactions in which basic food is broken down into
the debris, resulting in energy. These molecules are also used in the
formation of more complex materials, so as to build cells and tissues
Metabolism is divided into catabolism whether
carbohydrate, protein, or fat, are broken down in different ways from biological
reactions to simple molecules. This results in access to energy. Anabolism ,
Small particles resulting from the demolition can be used as a nucleus to build
more complex materials, whether protein or nuclear acids. This happens
through a series of interactions so as to build tissue and consume energy in
those interactions..

Review Diabetes Mellitus: A review

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 80-91

Diabetes is one of the most important disorders of metabolic and chronic diseases
affecting small and large ages, which result from lack of insulin production of beta cells
present in the pancreas of Lancherhans in the pancreas or result from the inability of human
cells to respond to insulin, which leads to a rise in the blood glucose levels . There are two
main types of diabetes: the first type (the type I ) that is produced when the human body is
unable to produce insulin due to a defect in the work of the immune system, where the
immune cells attack the cells producing insulin (beta cells) in the pancreas, while type (II)
The most common result is the inability of the body's cells to respond to insulin, despite the
efficiency and ability of the pancreas to produce insulin, due to an unknown reason ..

The effect of maternal body mass index on clinical and ultrasonic estimations of fetal weight

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 92-102

Background assessment of fetal weight (clinically or by ultrasound) has an
important issue to decrease maternal and fetal complications during labour.
Objective: To assess the effect of maternal body mass index on clinical and
sonographical estimation of fetal weight. Patients and methods: (80) Eighty
pregnant women were studied from the start of October 2007 to the end of September
2008 in Al-Kadhymia teaching hospital. These women had single, cephalic and term
pregnancy. About 24 hour prior to delivery of the fetus, clinical estimation of fetal
weight using Leopold's maneuver was done followed by sonographic estimation of
fetal weight using Hadlock's equation. Then a comparison of clinical and
sonographical estimation of fetal weight with the weight of the newborn baby was
done. The accuracy of fetal weight estimation was done in obese and non obese
women. Results: Clinical estimation of fetal weight has a better agreement with true
birth weight than sonographic estimation in low and high BMI pregnant women. Both
clinical and sonographic estimation of fetal weight under-estimate true birth weight in
women with low and high BMI. , the agreement between clinical estimation of fetal
weight and birth weight was higher than sonographical estimation, both in high and
low BMI groups. Sonographical estimation of fetal weight tended to under estimate
the true fetal weight in both low and high BMI groups. Clinical estimation of fetal
weight tended to under estimate true fetal weight in both low and high BMI groups,
but had a better correlation with true fetal weight than sonographical estimations.
The accuracy of clinical estimation of fetal weight was better than sonographical
estimation and was not influenced significantly by maternal BMI.

Association between the Low Density Lipoprotein Receptor (A370T) Gene Polymorphism with Lipid Profile in Type 2 Diabetes Mellitus

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 103-112

Background: determining the genetic profile of diabetic patients with dyslipidemia is considered
important in terms of reducing the risk of possible vascular complications. Recent studies have
shown that the low density lipoprotein receptor gene may have a direct effect on lipids level and one
of its important genetic variants is the common single nucleotide polymorphism (A370T) that’s
produced by a guanine to adenine substitution in exon 8 in the epidermal growth factor precursor
homology region.
Aim: To evaluate the association between the low density lipoprotein receptor (A370T) single
nucleotide polymorphism with lipid Profile in type 2 diabetic patients with dyslipidemia.
Method: A case control study for total 180 subjects. 120 patients with type 2 diabetes mellitus (80
males and 40 females) and 60 patients of them were diagnosed previously with dyslipidemia, these
diabetic patients were compared with 60 (40 male and 20 female) healthy control subjects. The
blood sample collection were done at the outpatient department of Al-Imam Al-Hussein (as) Medical
City in holy Karbala/Iraq during the period from January to June 2017.
Results: The results obtained demonstrate that there is no relationship between the low density
lipoprotein receptor (A370T) single nucleotide polymorphism and dyslipidemia in patients with
type 2diabetes mellitus with no significant association between this polymorphism and the lipid
profile in these patients .
Conclusion: In the current study, the genotyping analysis results agreed with much of studies which
revealed that there is no relationship between the low density lipoprotein receptor ( A370T) single
nucleotide polymorphism and lipid levels in patients with type 2diabetes mellitus with and without
ان تحديد الشكل الجيني للمرضى المصابين بالسكري واضطراب شحوم الدم يعتبر من المعايير المهمة في تقليل خطر الاصابة
بمضاعفات الاوعية الدموية لدى هؤلاء المرضى. وقد اظهرت الدراسات الجينية الحديثة بأن جين مستقبلات الدهون منخفضة الكثافة
والذي ينتج من (A370T) له تأثير مباشر على مستويات الدهون في الجسم وأحد اهم اشكاله الجينية هي تعدد الشكل النيوكليوتيدي
استبدال القاعدة النتروجينية الكوانين بالادينين في الموقع 8 من منطقة التماثل للعوامل البادئة .
تقييم الارتباط بين تعدد الشكل النيوكليوتيدي لمستقبلات الدهون منخفضة الكثافة مع مستويات الدهون للمرضى المصابين بالنوع
الثاني لداء السكري واضطراب شحوم الدم.
اجريت الدراسة على 180 شخص, منهم 120 مريض بالنوع الثاني لداء السكري و 60 مريض منهم مصاب باضطراب شحوم الدم
بالاضافة للسكري , هؤلاء المرضى تمت مقارنتهم مع 60 شخص سليم. تم جمع عينات الدم في مستشفى الامام الحسين عليه السلام
. التعليمي في محافظه كربلاء المقدسة للفتره من شهر كانون الثاني الى حزيران لسنة 2017
تتضمن النتائج عدم وجود علاقة بين تعدد الشكل النيوكليوتيدي لمستقبلات الدهون منخفضة الكثافة ومستويات الدهون في الاشخاص
المصابين بالنوع الثاني من داء السكري واضطراب شحوم الدم.
في الدراسة الحالية ,نتائج التحليل الجيني تتفق مع اغلبية الدراسات السابقة والتي تنص على عدم وجود علاقه بين تعدد الشكل
النيوكليوتيدي لمستقبلات الدهون منخفضة الكثافة ومستويات الدهون في الاشخاص المصابين بالنوع الثاني من داء السكري مع او
بدون اضطراب شحوم الدم.

Isolation of various local Bacteriophages via Simple Methods and their Effects against Multidrug Resistance Bacterial Isolates

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 113-121

Recently, dissemination of antibiotic resistant bacteria considered as a major public
health concern. Therefore, bacteriophages gained great attention as a promising
alternative therapy for resistant infectious diseases.
The current study aimed to isolate bacteriophages by simple methods and determining
their efficiency against bacteria isolated from clinical samples.
Bacteria were first isolated from clinical specimens and identified using standard
bacteriological and biochemical procedures. antibiogram of the isolated bacteria were
determined using different antibiotic discs and the results were interpreted according
to the clinical laboratory standards institute (CLSI) guidelines. Then sewage samples
were processed using two protocols to isolate specific bacteriophages. Finally,
antibacterial effect of bacteriophages was determined using Double Layer Agar(DLA)
The highest lytic activity of the isolated bacteriophages was seen using the first
protocol. However, both methods showed antibacterial effect.
In conclusion, bacteriophages could be isolated using very simple methods.ان انتشار البكتيريا المقاومة للمضادات الحيوية في الآونة الأخيرة ، يعتبر أحد الاهتمامات الرئيسية للصحة
العامة . لذلك ، اكتسبت العاثيات اهتماما كبيرا كعلاج بديل واعد للأمراضالمعدية المقاومة للمضادات.
تهدف الدراسة الحالية إلى عزل العاثيات البكتيرية بواسطة طرق بسيطة وتحديد فعاليتها ضد البكتيريا المعزولة
من العينات السريرية .
بداية , تم عزل البكتيريا من العينات السريرية وتمتشخيصها باستخدام الطرق البكتريولوجية والبيوكيميائية
النموذجية . كماتمتحديد مقاومة البكتيريا المعزولة للمضادات الحيوية باستخدام أقراص مضادات حيوية
وقدتم اخذ عينات من مياه الصرف الصحي لغرض عزل العاثيات (CLSI) مختلفة وتمتفسير النتائج وفقًا ل
. (DLA) باستخدام طرق مختلفة . وأخيرا ،تم دراسة التأثير المضاد للعاثيات المعزولة باستخدام طريقة ال
تم عزل عاثيات مختلفة لها تاثير مضاد للبكتريا المقاومة للمضادات الحيوية كما لوحظ أعلىتاثير للعاثيات
المعزولة باستخدام الطريقة الأولى. نستنتج انه يمكن عزل عاثيات بكتيرية من مياه الصرف الصحي بواسطة
طرق بسيطة .

A Comparative Study of Salbutamol Nebulizer versus Ipratropium Bromide plus Salbutamol Nebulizer in the Treatment of Children with Acute Asthma Exacerbation

karbala journal of pharmaceutical sciences, 2018, Volume 9, Issue 15, Pages 122-137

Background: Patients with asthma may develop acute attack due to different types
of triggering factors. Early recognition of an acute asthma exacerbation is crucial
for effective management.
Objectives: To evaluate the effects of salbutamol nebulizer versus salbutamol plus
ipratropium bromide nebulizer in children with acute asthma exacerbation attack.
Patients and methods: A randomized double blind standard control clinical study
was conducted in Karbala Teaching Hospital for Children from 1st of November
2015 to the end of November 2016 on patients presented to the emergency room
(ER) of the Hospital. The study was conducted on hundred patients presented with
mild to moderate acute attacks of asthma, assigned to take either nebulized
salbutamol or combination of salbutamol plus ipratropium bromide during their
stay. Assessment of asthma severity was done for each patient according to
pulmonary index score (PIS)
Results: There was significant reduction (p <0.05) in PIS for patients treated with
salbutamol alone and patients treated with combination therapy (ipratropium +
salbutamol) after 30,60 and 90 minutes from ER admission as compare with their
scores at baseline, 30 and 60 minutes respectively. After 30 minutes from ER
admission, patients who were treated with combination of ipratropium bromide +
salbutamol had significantly (p <0.05) lower PIS (5.60±2.77) than those treated
with salbutamol alone (PIS=7.32±2.18). The mean duration of stay in ER was significantly (p <0.05) shorter in patient treated with combination therapy
(57.60±21.71 min) than those with salbutamol alone (77.40±16.13 min).
Conclusion: Treatment of asthmatic children with mild to moderate acute
exacerbation attack with combination therapy of (ipratropium plus salbutamol
nebulizer) improved the clinical condition, lowered pulmonary index score, and
significantly shortened the duration of stay in emergency room as compared with
salbutamol nebulizer alone..