Medicine and Health Sciences Commons^™

Evaluation Of The Compliance Of Ultra-Low Dose Drugs Available In Local Iraqi Markets With Regulatory Weight Variation Test, Yousif K. Younis

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Mixing and formulation of drugs with very low dose is a brutal challenge to formulators sometimes due to all kinds of difficulties like segregation, content uniformity and physicochemical stability issues. A careful consideration of all related factors is essential during manufacturing of very low dose drug products. The aim of this study is to evaluate the quality control of ultra-low dose drugs of different companies available in local Iraqi and their compliance with regulatory weight variation test. Quantitative analysis conducted to five drugs using weight variation technique with 20 randomly selected tablets for each drug. All of these drugs passed …

A Comparative Study Examining The Effects Of Nifedipine And Minoxidil On Stimulating Hair Growth Using A Mouse Model, Nihad Hussein Ahmed, Rabei Abdullah Salih, Shereen M. Mekkey

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Hair loss is a common human scalp condition caused by chemotherapy, chronic diseases, and aging. Currently, it is estimated that approximately 50% of males and 15–30% of females experience hair loss issues. Minoxidil is considered a preferred treatment for hair loss in men and women. Nifedipine is effective in improving blood circulation and blood supply via its vasodilator action. To compare nifedipine and minoxidil in terms of their effect on stimulating hair growth using a mouse model. Fifteen female albino mice, aged 8 to 10 weeks, were randomly assigned to three groups of five mice each, all with shaved dorsal …

Buccal Films As An Emerging Drug Delivery System: A Comprehensive Review, Syed Faizan Syed Nizamuddin, Nishan N. Bobade, Vikrant P. Wankhade, Sandeep C. Atram, Shrikant D. Pande, Nakul S. Dhore, Shraddha P. Malpani, Ashwin A. Pahurkar

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Oral administration through the digestive tract is still the most common means by which drugs are given, as it is simple and cheap. However, it has some biopharmaceutical limitations in general, such as varying gastrointestinal conditions, enzymatic degradation, and extensive hepatic first-pass metabolism, which decrease drug stability and bioavailability To address these challenges, drug delivery through the oral mucosa (OMDD) has emerged as a potential non-invasive option. The buccal mucosa is well supplied with blood, provides a relatively mild environment, and avoids hepatic first-pass metabolism, thereby resulting in a faster onset of action and improved bioavailability. Mucoadhesive buccal films have …

Ethnopharmacology, Phytochemistry, And Pharmacological Potential Of Philenoptera Laxiflora: An Emerging African Medicinal Plant For Drug Discovery, Albashir Tahir

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Medicinal plants remain an important source of therapeutic agents and play a significant role in modern drug discovery. Philenoptera laxiflora (Fabaceae) is a tropical African plant widely used in traditional medicine, but the scientific evidence supporting its therapeutic potential remains fragmented. This review aims to comprehensively summarize the current knowledge on the ethnomedicinal uses, phytochemical composition, pharmacological activities, and toxicological profile of P. laxiflora, while highlighting research gaps and future directions for drug discovery. A comprehensive literature search was conducted using electronic scientific databases, including PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect. Relevant publications on the ethnobotany, …

Prevalence Of Medication Prescription Patterns For Iraqi Outpatients Visiting Otolaryngology Clinics, Mirna. K. Faiq

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Objectives: To assess the prevalence of drug use patterns among ENT outpatient settings in Kirkuk, Iraq. Methods: This retrospective observational study was conducted in Kirkuk, Iraq, involving the collection of data from the e-Prescribing system and the review of written prescriptions, including 582 outpatient records from ENT clinics, from January 2024 to December 2024. Results: Most patients were below 20yr age (18.73%), with a male predominance (57%). Ear-related complaints like otitis media were the most frequent (35.22%). The average number of drugs per prescription was 2.82. The percentage of prescriptions in which an antibiotic was prescribed was 84.7%. The percentage …

Preparation And In-Vitro Evaluation Of Tizanidine Flash Oral Dispersible Tablet, Ahmed Yousif Fadhel, Yousif K. Younis

Al-Mustaqbal Journal of Pharmaceutical and Medical Sciences

Background: Oral administration is the most common and preferred route for drug delivery. Oral dispersible tablets (ODTs) are solid dosage forms that disintegrate into saliva without the need for water. Tizanidine is a centrally acting muscle relaxant used to manage spasticity from spinal or brain injuries. Preparing it as a flash (ODT) tablet may enhance patient compliance and potentially improve bioavailability by bypassing part of the first-pass metabolism. Methods: Six formulations of tizanidine flash tablets were developed using varying concentrations of mannitol (bulk-forming agent), glycine (to aid tablet collapse), and gelatin (matrix-forming agent). The formulations were evaluated for weight variation, …

Bioactive Constituents And Pharmacological Activities Of Curcuma Zedoaria: A Mini-Review, Abdulmutalib Allaq, Muneer M. Saleh Mohammed Saleh Alsayadi, Mustapha Salihu, Hasan M. Agha, Amena Hassan Hassan Gheeth, Fatimah Salim, Norrizah Jaafar Jaafar Sidik

AUIQ Complementary Biological System

Curcuma zedoaria Rosc. (white turmeric) is a rhizomatous medicinal plant in the Zingiberaceae family, widely used in traditional Asian medicine. In recent years, increasing scientific attention has focused on its diverse pharmacological properties and bioactive constituents. This mini review summarises current knowledge of the phytochemical composition and biological activities of C. zedoaria, with particular emphasis on its antimicrobial, antioxidant, anti-inflammatory, and anticancer effects. Phytochemical investigations using analytical techniques such as GC–MS and HPLC have revealed the presence of numerous bioactive compounds, including sesquiterpenes (example, germacrone, curzerenone, and curdione) and curcuminoids, which contribute to its therapeutic potential. Experimental studies demonstrate …

Evaluation Of Circulating Hpg80, Ca15-3, Estrogen And Progesterone As Biomarkers In Breast Cancer Patients, Safa Khaldoon, Emad Yousif, Khawla A. Kasar, Muna Bufaroosha, Rahimi Yusop

AUIQ Complementary Biological System

It is very important to find reliable biomarkers for early detection and monitoring of treatment response because breast cancer is still one of the most common cancers in women around the world. The goal of this study was to find out how clinically important different biochemical markers are in Iraqi women with breast cancer. Some of these signs are progesterone (PG), oestrogen (E2), cancer antigen 15-3 (CA15-3), and circulating progastrin (hPG80). There were 100 women in this study, and they were all between the ages of 20 and 70. There were three groups of people who took part: a healthy …

Synergistic Endocytic Receptor Ligand Receptor Protein 2 In T2dm, Wafaa Raji Alfatlawi

AUIQ Complementary Biological System

Purpose: The glycoprotein molecule known as megalin is present on the proximal renal tubular epithelial cells. With an emphasis on megalin and cubilin levels in T2DM and IR patients, an area that obviously needs more research, this study attempts to give an outline of current knowledge of megalin function in relation to vitamin D and its metabolite (vitamin D receptor and vitamin D binding protein). Materials and Methods: This was a case control comparative study conducted at a endocrine and diabetes center in AL-Imamain Kadumain teaching hospital in Baghdad-Iraq. Study subjects were divided into three groups: 25 with T2DM with …

Optimizing Glycemic Control In Type Ii Diabetes: Continuous Glucose Monitoring : A Scoping Review, Sarah Poe, Bsn, Rn, Bailey Li, Bsn, Rn, Tracy Mcclinton, Dnp, Aprn, Ag-Acnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Individuals with Type II diabetes mellitus (T2DM) experience increased risk of cardiovascular disease and higher mortality rates relative to non-diabetic populations. Continuous glucose monitoring (CGM) enables more precise analysis of glucose patterns and trends compared to conventional self-monitoring of blood glucose (SMBG). CGM provides frequent measurements and generate meaningful metrics, such as time in range (TIR), time above range (TAR), and time below range (TBR), allowing evaluation of glucose stability and variability. Despite these advantages, evidence comparing CGM and SMBG remains inconsistent. This scoping review aims to evaluate how CGM compares with SMBG across reported outcomes, including TIR, TAR, …

Diagnostic Overlap In Hus: An Atypical Case, Ryan Daily, Med, Do, Andrea Roast, Md

Books, Presentations, Posters, Etc.

Introduction: Atypical HUS (aHUS) is a rare type of Thrombotic Microangiopathy distinguished by complement dysregulation and overall clinical progression. We present a diagnostically ambiguous case with early intervention that preserved end-organ function with discussion of future pregnancy implications. Case Presentation: A 36yo F (G2P1) with hypothyroidism, Small Intestinal Bacterial Overgrowth (SIBO), and intermittent urticarial rashes presented with fever, abdominal pain, and 3 days of bloody diarrhea. Discussion: This case highlights an atypical presentation of aHUS with diarrheal prodrome and normal complement function, features that typically suggest Shiga toxin–mediated HUS. We saw clinical change after admission, allowing real-time monitoring. Maintaining a …

Optimizing Behavioral Health Integration In Primary Care Through A Targeted Didactic, Ravneet Dhaliwal, M.A., Behavioral Health Intern, Joshua Morris

Books, Presentations, Posters, Etc.

Background: The integration of behavioral health into primary care settings is an essential strategy for improving patient outcomes, increasing access to mental health services, and achieving the Triple Aim of healthcare.1, 2 To maximize this integration and bridge the gap for primary care providers (PCPs), targeted didactic training and continued education are pivotal. National surveys indicate that PCPs often report low comfort levels in managing psychological concerns due to a lack of formal training, despite the high prevalence of these issues in primary care. 3, 4 Brief didactics facilitated by embedded behavioral health psychologists offer an accessible, adaptable method for …

Mindful Tea Drinking As A Low-Cost Sensory Intervention For Reducing Stress In College Students, David Gabel

Honors Projects

The proposed study would investigate the effects of a tea-based sensory mindfulness exercise on stress in college aged participants. Participants would listen to a mindful tea exercise and a non-mindful tea exercise after a mild stress-inducing Stroop test. For both conditions, the participants would report their current state of distress on the Subjective Units of Distress Scale (SUDS) before and after each tea exercise and their heart rate variability (HRV) would be measured during each segment of the experiment.

Descriptive statistics and a paired samples t-test would be used to compare the mindful tea condition with the non-mindful condition following …

Raising The Barb: Evaluation Of Phenobarbital Use For Alcohol Withdrawal In Patients On General Medicine Floors, Seth Arakawa, Jason Frederick, Anthony Le

Books, Presentations, Posters, Etc.

Abstract: Alcohol withdrawal syndrome (AWS) can present as a spectrum of symptoms such as a mild headache, gastrointestinal issues, and diaphoresis. However, if not treated properly, it can progress to severe hallucinations, seizures, or delirium tremens. Current guidelines from the American Society of Addiction Medicine (ASAM) recommend benzodiazepines as first line agents for alcohol withdrawal with phenobarbital recommended as an adjunct agent or replacement to benzodiazepines by providers who are familiar with its use. Although most evidence supporting phenobarbital in AWS comes from critical care settings, emerging data suggest it may also be safe and effective in general ward patients. …

An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders

Books, Presentations, Posters, Etc.

RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, …

A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker

Books, Presentations, Posters, Etc.

Introduction: Hemophagocytic Lymphohistiocytosis (HLH) is a rare syndrome characterized by overactive immune activation, cytokine storm, and uncontrolled hemophagocytosis. Primary HLH is familial and most often seen in infants, whereas secondary HLH occurs more frequently in adults and is triggered by infections, malignancies, or autoimmune disorders. Clinically, secondary HLH often mimics sepsis but fails to respond to standard therapies, contributing to delayed diagnosis and treatment. Without timely intervention, HLH can result in extensive tissue damage, multiorgan failure, and death. In rare cases, central nervous system (CNS) involvement may occur, manifesting as histiocytic infiltration that can be misinterpreted as malignancy or infection. …

Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor, Matthew Moritz, Md, Linh Tang Taylor, Md, Olivia L Snir, Stephanie Griffith, Md

Books, Presentations, Posters, Etc.

Introduction: Autoimmune encephalitis is a rare immune-mediated disorder characterized by neuropsychiatric symptoms. Anti-NMDA receptor (NMDA-R) encephalitis, the most common subtype, affects approximately 1 in 1.5 million people annually. We present a case of a young female with new-onset hallucinations, behavioral changes, and personality disturbance. Case Presentation: A 32-year-old female with remote methamphetamine use and recent trauma presented with acute mental status changes, aggression, emotional lability, and hallucinations. Vitals were normal; on exam she appeared confused, agitated, and displayed unusual behavior, including hallucinations. Initial evaluation revealed mild leukocytosis, but otherwise normal urine drug screen, chest radiograph, TSH, ANA, VDRL, heavy metal …

Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md

Books, Presentations, Posters, Etc.

Abstract: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by abnormal accumulation of surfactant within alveoli. Vaping of electronic cigarette smoke has recently been described as a cause of pulmonary alveolar proteinosis in two case reports. We add to this rare literature by describing a case of pulmonary alveolar proteinosis induced from vaping in a young woman with confirmed granulocyte/macrophage colony-stimulating factor (GM-CSF) autoantibodies as the proposed mechanism. Introduction: Pulmonary alveolar proteinosis (PAP) results from inappropriate accumulation of pulmonary alveolar surfactant due to dysregulated granulocyte/ macrophage colony-stimulating factor (GM-CSF) signaling.1 Its incidence is approximately 0.2 cases per million with …

Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair

Books, Presentations, Posters, Etc.

Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is most frequently associated with dermatomyositis with various degrees of clinical manifestations including rapidly progressive interstitial lung disease (RP-ILD), inflammatory arthritis, vasculopathy, and other cutaneous findings. Clinically amyopathic dermatomyositis (CADM) is frequently associated with RP-ILD and has high mortality rates. Here we present a case of anti-MDA5 associated RPILD but without other features of dermatomyositis that did not respond to standard immunosuppressive therapy. A 41-year-old woman with recently diagnosed interstitial lung disease and polyarthritis previously on methotrexate presented with progressive dyspnea and worsening hypoxemic respiratory failure. She was previously admitted for respiratory failure two …

Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp

Books, Presentations, Posters, Etc.

No abstract provided.

Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair

Books, Presentations, Posters, Etc.

Introduction: Treating sepsis involves timely antibiotics, adequate fluid resuscitation, and vasopressor support if shock develops. Plasma concentrations of nitric oxide and hydrogen sulfides are elevated in early sepsis, contributing to vasoplegia,1 a pathology that isn’t addressed by vasopressors. High-dose hydroxocobalamin (vitamin B12) does, and therefore, has long been explored as a potential adjunct to vasopressors, though no consensus or official guidelines for its use have been published. Case Report: A 26-year-old man who was diagnosed with acute myeloid leukemia a few months prior presented to the emergency room for fever, weakness, and emesis. He was found to be profoundly hypotensive …

Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino

Books, Presentations, Posters, Etc.

59. Hypercalcemic Crisis After Open Mitral Valve Replacement Andrew Sunwood, DO Background: Hypercalcemic crisis is a rare manifestation of primary hyperparathyroidism characterized by a sudden increase in serum calcium levels to >14 mg/dL with symptoms of hypercalcemia including adverse gastrointestinal symptoms, abdominal pain, and even predisposition to cardiac arrhythmias. There is only one other documented case of hypercalcemic crisis occurring after open heart surgery. Case information: 69-year-old female with a history of primary osteoporosis on alendronate and valvular heart failure presented for mitral valve replacement. Preoperative lab work did not show evidence of electrolyte abnormalities. She under- went open bioprosthetic …

A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md

Books, Presentations, Posters, Etc.

Introduction: Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are becoming increasingly more common.1 They are associated with a variety of cutaneous immune-related adverse events which can range from drug eruptions to life-threatening Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) spectrum reactions.2 As use of these ICIs and PD1 inhibitors expands, the incidence of severe dermatologic toxicity can be expected to rise. Early recognition is critical, as SJS/TEN spectrum reactions carry substantial morbidity and mortality compared with drug eruptions. Case report: An 80-year-old female with a history of triple-negative breast cancer on pembrolizumab presented to the ED for evaluation of a …

Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker

Books, Presentations, Posters, Etc.

The transition from medical student to intern is widely recognized as a challenging period, and numerous curricula have been developed to support this transition. However, the transition from intern to senior resident receives far less attention despite presenting its own unique challenges. Anecdotal feedback from internal medicine residents and emerging literature suggests that the transition to senior resident is associated with feeling emotionally overwhelmed from simultaneously being a learner, leader and educator.1,2 To address this gap, the Transition Series was developed as a novel curriculum to support internal medicine residents as they advance into their senior roles. Building on the …

Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma, Natalie Bolton, Md, Linh Tang Taylor, Md, Kristy Poonyagarlyagorn, Md, Cameron Long, Md

Books, Presentations, Posters, Etc.

Introduction: Sulfhemoglobinemia is a rare dyshemoglobinemia which occurs when sulfur irreversibly binds to hemoglobin. Presents similarly to methemoglobinemia. Common offending medications: dapsone, acetanilide, phenacetin, and nitrates. Rarely observed secondary to phenazopyridine, an over-the counter medication used to treat dysuria. Few facilities are capable of testing for sulfhemoglobinemia Case Background: A 67-year-old woman with recurrent urinary tract infections and interstitial cystitis presented with encephalopathy and recurrent falls for three days. PMH: multiple sclerosis, recurrent urinary tract infections, asthma, neurogenic bladder, neuropathic pain, and obstructive sleep apnea. Chronically on multiple centrally acting medications. Not on medications for multiple sclerosis due to cost. …

An Atypical Presentation Of Metastatic Gastric Adenocarcinoma Due To Pulmonary Lymphangitic Carcinomatosis, Matthew Moritz, Omar Pandhair

Books, Presentations, Posters, Etc.

Pulmonary lymphangitic carcinomatosis (PLC) accounts for approximately 8% of pulmonary metastases and is primarily associated with breast, lung, and gastric cancers. Chest radiographs are often nonspecific and normal in approximately 50% of cases. We present a case of PLC as an initial presentation of metastatic gastric adenocarcinoma. A 57-year-old White woman with prior tobacco use, asthma, and multiple sclerosis on Natalizumab presented with three months of progressive dyspnea and cough. She was evaluated multiple times and treated with various antibiotics and inhalers for presumed bronchitis. Despite this, her symptoms worsened, prompting hospital evaluation. She was tachycardic and markedly hypoxemic on …

A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3

Books, Presentations, Posters, Etc.

Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive subtype of non-Hodgkin lymphoma characterized by selective proliferation of neoplastic cells within small vessel lumina. Cases in Western countries more commonly involve the central nervous system or skin, whereas patients in Eastern regions often present with hemophagocytic syndrome or medullary disease. The absence of lymphadenopathy, low circulating tumor burden, and subtlety of morphologic clues contribute to delays in diagnosis. By presentation, most have advanced disease, and a substantial proportion are diagnosed only at autopsy. We report a unique case with mixed features who manifested respiratory involvement and ultimately suffered cardiovascular …

Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair

Books, Presentations, Posters, Etc.

Introduction: Pseudomyxoma peritonei (PMP) is an intra -abdominal cancer occurring in one to four out of one million patients. It begins as a mucinous adenocarcinoma of the appendix that implants on other peritoneal surfaces, spreading into gelatinous ascites. Treatment consists of hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS). Extra -abdominal metastases are rare. We present the case of a patient who underwent treatment for PMP and was found to have lung nodules over a decade later. Case Presentation: A 73 -year -old woman with pseudomyxoma peritonei presented to the emergency department with progressive dyspnea and unintentional weight loss. Twenty …

Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md

Books, Presentations, Posters, Etc.

Introduction: There are an estimated 1.8 billion people that travel internationally every year [1]. Approximately 22-64% of those acquire an infectious disease during or after returning home that is not endemic to their home country [1]. This is especially concerning in our current political climate and declining vaccination rates in the United States which places more patients at risk for preventable diseases [2]. These factors present a unique challenge in diagnosing and treating a symptomatic returning traveler. Case Description: A 25-year-old incompletely vaccinated male returned from Kenya after volunteering for 5-weeks in a rural hospital. He was in his usual …

Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Schoepflin Sanders, Md, Facp

Books, Presentations, Posters, Etc.

Introduction: Physician burnout affects nearly 60% of physicians during their careers, leading to increased medical errors, reduced care quality, higher turnover, and lower patient satisfaction. ii. The widespread use of Electronic Medical Records (EMRs) has been identified as a key contributor, with poor usability, inbox overload, and documentation burden reducing direct patient interaction among cited factors iii. Institutions like UCHealth, OHSU, CHOP, and Mayo Clinic have implemented strategies that improved EMR confidence and reduced burnout vi. While Providence offers training to all providers, there are no initiatives specifically targeted to internal medicine (IM) residents. Methods: Providence St. Vincent Medical Center …