6^th International Conference on Advanced Clinical Research and Clinical Trials September 10-11, 2018 Zurich, Switzerland

Antibacterial activity of some Palestinian plants against seven human pathogenic bacteria using the agar disk-diffusion method was studied. Evaluation of the antibacterial activities of plant saps based on the width of the bacterial inhibition revealed that Eucalyptus camaldulensis (0.3 cm), Allium sativum (0.2 cm), Ceratonia siliqua (0.15 cm) and Amygdalus communis (0.15 cm) have the best antimicrobial activities against the bacterial mixture compared with the other fourteen tested plants. Furthermore, E. camaldulensis showed the strongest antimicrobial activity among the four plants. Also, A. sativum have the maximum anti-microbial action against all types of the tested bacteria. In addition, saps of E. camaldulensis and the mixture of E. camaldulensis and A. sativum have a strong ability to kill all types of the tested bacteria followed by the mixture of C. siliqua and A. sativum, the mixture of C. siliqua, A. sativum and E. camaldulensis and the mixture of A. communis, A. sativum and E. camaldulensis that have significant results as anti-microbial agents against most types of the tested bacteria. The results showed that A. sativum and the mixture of A. sativum and C. siliqua have the maximum antimicrobial affectivity against Staphylococcus aureus, whereas, Micrococcus luteus was strongly inhibited by E. camaldulensis, A. sativum, the mixture of E. camaldulensis and C. siliqua, the mixture of E. camaldulensis and A. sativum, and the mixture of E. camaldulensis, A. sativum and C. siliqua. Escherichia coli were efficiently inhibited by A. communis, A. sativum, and E. camaldulensis and also by the mixture of A. sativum and E. camaldulensis. Pseudomonas aeruginosa was inhibited in a significant amount by E. camaldulensis and A. sativum, whereas, Proteus vulgaris was strongly inhibited by the A. sativum. Bacillus subtilis was strongly inhibited by A. sativum, while, for the Klebsiella pneumoniae, most saps revealed an intermediate inhibition except the A. communis, which showed the lowest inhibition value. Therefore, the current study elucidated that E. camaldulensis, A. sativum, C. siliqua and A. communis are the best tested Palestinian plants containing the antibacterial agents against the tested bacterial types.

W O Chu has graduated from the Department of Pharmacy Taipei Medical University (TMU) and Institute of Biomedical Engineering National Yang Ming University. She is an Adjunct Instructor at TMU and a Pharmacist in Taipei City Hospital, Department of Pharmacy. She has published more than 10 papers in the journal of Taiwan, 2 posters in International Pharmaceutical Federation (FIP), 1 poster in European Association of Hospital Pharmacists (EAHP), and got best poster award in the international pharma and clinical pharmacy congress.

Objective: Polypharmacy and potentially inappropriate medications (PIM) in the elderly complicates therapy, increases cost and is a challenge for healthcare agencies. Computerized warning system to reduce polypharmacy and PIM is a drug optimization process.

Methods: Using the healthcare information system (HIS) in Taipei City Hospital, we used a prospective before-and-after design among patients aged 80 years or older who had been prescribed 10 or more chronic medications (drugs prescribed for ≥28 days), visited three or more different physician office visits from November 1, 2013, through January 31, 2014 before the addition of the warning system and from April 1, 2014 through June 30, 2014 after the warning system was added. The EU(7)- PIM list was used to determine the potential inappropriateness of prescribed medications. Data were analyzed polypharmacy using Pair t test and PIM using multiple regressions by the SPSS 22. Value of P<0.05 was considered statistically significant.

Results: We enrolled 159 patients in our study after warning system setting, where the ratio of males: females were 89:70. The mean (SD) age of our patients was 85.8 (10.2) years. After the warning system was deployed, there was an immediate and sustained decrease in the rate of orders for the medications and PIM. The mean rate of prescribing medications dropped from 14.1 to 11.4 orders per day (SD 2.7; P<0.001) and physician visits number decreased from 3.5 to 3.1 per month (SD 0.5; P<0.001). PIM use was significantly associated with number of prescribing medications (p<0.001) and number of physician office visits in older adults (p=0.028). There was no evidence that this effect waned over time. Conclusions: Computerized warning system embedded into the healthcare information system (HIS), used in patients, can decrease the medication number and PIM quickly and specifically. The financial cost of polypharmacy involves both the direct expenditures for prescription medications as well as significant indirect costs related to hospitalization and treatment of severe adverse drug reactions. Pharmacovigilance is required by the patient, physician and pharmacist in thoroughly reviewing and reconciling the patient's medication regimen at every opportunity.

Moawiah Khatatbeh has his expertise in public health and epidemiology and passion in improving the health and wellbeing. His philosophy is that our health is within the reach of our hands. In other words, most of health problems are avoidable. He has built this philosophy after years of experience in research, evaluation, and teaching both in hospitals and education institutions.

Statement of the Problem: There is abundant research about the effects of lipids on heart diseases in many countries, however, research about the association between fast food consumption and liver functions is lacking, especially in Arab countries. Therefore, detecting the extent to which students consume fast food meals highlights the way for people to encounter the associated risks. The purpose of this study is to highlight the magnitude of this risk factor among Jordanian university students.

Methodology & Theoretical Orientation: Data will be collected from voluntary subjects (students, n = 200) at Yarmouk University at two stages: The first stage involves using data collection tool asking about socio-demographic variables including age, gender, educational status and eating habits. In the second stage, 10 ml whole blood samples will be collected from each volunteer in the second day to test for lipid profile and liver function tests.

Findings: The research is ongoing and results are still not ready.
Conclusion & Significance: Junk and fast food is associated with increased BMI and impaired liver functions. This can

contribute to an increase risk of both hepatic and cardiovascular diseases.

Zaid Altaany has completed his PhD in 2013 from Canada. After his PhD he perused his postdoctoral training in the Department of Biochemistry at Schulich School of Medicine & Dentistry, Western University, Canada. After completion of his postdoctoral training he was appointed as an Assistant professor in the Department of Medical Laboratory Sciences at Al Balqa University for one year. He was then appointed in 2016 as an Assistant Professor in the Department of Medical Sciences at the Faculty of Medicine at Yarmouk University in Jordan until know. His interests are focused on gasotransmitters, including hydrogen sulfide and nitric oxide and their impact on human health and cell signaling.

Statement of the Problem: Hydrogen sulfide (H2S) is well known gas that can endogenously produce in human body and have diverse impact on human health. However, the exogenous H2S is present in air and water, especially the sulfur spring in various concentrations. The long term exposure of exogenous H2S and its effect on inflammation control is not well studied. In our study we will examine the effect of H2S- emitted from sulfur spring and its correlation to anti-inflammatory response.

Methodology & Theoretical Orientation: Whole blood samples were collected from 100 individuals (exposed group) who lived permanently nearby El-HAMA springs for the last 10 years. Another 100 sample (control group) will be collected from Irbid area for analysis. Blood samples will be taken to measure inflammatory markers, H2S and NO concentration, proinflammatory cytokines including tumor necrosis factor α (TNF- α), interleukin IL-1β, interleukin IL-6, and interleukin IL-8).

Conclusion & Significance: This study would provide us with novel insight if cross-talk does in fact occur between long term H2S exposure and the anti inflammatory status and the development/or prevention of inflammatory diseases. Meanwhile we are conduction this research and results still in progress.

Osama Yousef Abo Alrob, graduated from university of Alberta (PhD in basic medical sciences). I was supervised by Prof. Gary Lopaschuk and our lab is interested in heart and metabolic diseases such as obesity and diabetes. Currently, i am assistant professor in faculty of pharmacy. I teach courses related to Physiology and Pathophysiology.

Beneficial effects of resveratrol have attracted increasing interest in the last few years. The worldwide epidemic of diabetes has greatly increased the cost of treating both the disease and its numerous debilitating complications. We investigated the effects of weight loss and resveratrol on glucose homeostasis. Obesity was induced by feeding mice a high-fat (HF) diet (60% kcal from fat) for 10 weeks. After 10 weeks, mice were switched to a low-fat (LF) diet (12% kcal from fat; HF-LF) and treated with Resveratrol or maintained on an HF (HF-HF) and treated with Resveratrol for a further 6 weeks. After 16 weeks, HF-LF mice weighed less than HF-HF mice. cardiac hypertrophy was decreased and accompanied by increased SIRT1 and PGC1α expression in HF-LF mice. Impaired glucose tolerance had developed in HF mice at 10 weeks, as area under the curve (mmol/L · min) was significantly increased. At 16 weeks, glucose tolerance was improved in HF-LF mice compared with HF-HF group (43.1± 1.8 [n = 8] vs. 70.19± 1.4 [n =8]; P, 0.05). Western blot analysis showed a decreased phosphorylation of Akt as well as a decreased protein level of GLUT 2 in skeletal muscle of HFD fed mice. Treatment with Resveratrol enhanced insulin signaling and glucose uptake in HF-LF mice. Thus, lowering body weight by switching to LF diet and treatment with resveratrol is associated with decreased cardiac hypertrophy and improvements in both overall body insulin sensitivity and glucose homeostasis.

Kaushal Kapadia is an expert clinical research professional with an experience of more than 10 years in clinical research operations. Apart from that an author for the book titled “Perspective on Clinical Research, India” also a best poster award winner at an international conference organized by OMICS in the year 2015 organized in Florida, USA.

Statement of the Problem: Clinical Research (CR) in developing countries, sponsored by developed countries has been under the lens since few years. However, hardly any empirical studies have been conducted on ethical issues in India. Hence limited knowledge is available to the public regarding the guidelines, ethical conduct, and also the ethical issues involved in clinical trials in India.

The Purpose of this Study: Considering the recent criticism on CR scenario in India, to encourage clinical trial participation, every individual should be entitled to complete information about the trial before involvement and about the outcome on completion. The purpose of this study is to explore and understand the perception, and understanding of clinical research amongst that population of India who are fit to directly or indirectly participate in CR.

Methodology & Theoretical Orientation: This ethics committee approved pan-India multi-strata study used multivariate questionnaire-based survey among 8416 individuals selected with snowball sampling; the participant population consisted of three groups: potential trial patients, parents of minor subjects, and healthy volunteers.

Findings: The study revealed lack of awareness in multiple parameters of clinical research among participants. Moderate awareness on questions of clinical trials benefit to society (67%) or new drug development (57.5%); face direct challenge from lack of knowledge (30% of the participants) about subject rights & safety measures taken by government regulatory authorities. Almost 58% of subjects were unaware of the amendments of guidelines regarding adequate compensation in case of adverse outcomes.

Conclusion & Significance: Ethical and scientific benefits are always intertwined in clinical research involving humans. Effective collaboration of ethics committee and sponsor’s team should be practiced to regain public faith and better conduct of trials. The study results call for initiatives like organizing trial summits involving patients, NGOs, sponsor’s representatives, apart from other stakeholders.