Showing posts with label Counterfeits Medicines. Show all posts
Showing posts with label Counterfeits Medicines. Show all posts

Friday, 23 July 2021

Lupine Publishers | Development and Characterization of Herbal Formulation Containing Aqueous Extract of Clitoria Ternatea Linn. (Flowers) for the Treatment of Vaginal Infection

 Lupine Publishers | LOJ Pharmacology & Clinical Research


Abstract

Among several gynecological problems, vaginal infection (vaginitis) is the most common problem that women face in their life span, caused by Candida species. Candida albicans, a fungus which is responsible for the vaginal infection and to cure it, innumerable herbs are available which were earlier frequently used by the local civilization but now their demand is increasing in global market also. Numerous studies have confirmed the use of Clitoria ternatea as an antimicrobial agent, so the present work has been undertaken to explore the anti-candida activity of the plant. Along with that, formulation of herbal cream was aimed. In this study, the herbal creams (HC1-HC8) were formulated and evaluated possessing aqueous extract of flowers of Clitoria ternatea Linn. and the results revealed the satisfactory results when compared with standard drug. The results of formulation with code HC5 were found to be very promising and excellent of all herbal cream formulated. Ensuring biological activity for any formulation is of prime interest to reveal and prove the efficacy of formulated dosage form. In view of the same, Herbal Creams (PHC) were prepared and subjected to anti-candida activities, where PHC of HC5 was evaluated for anti-Candida activity as an optimized preparation. From the results obtained, it was concluded that the PHC (HC5) have optimum anti-candida activity when compared with standard formulation (MCC) and may be used for the treatment of vaginal infection. Moreover detailed clinical approaches need to establish for the formulation of safe and effective drugs

Keywords:Clitoria ternatea; Anti-fungal; Vaginal infection

Introduction

Over the course of a lifetime, 75% of all women are likely to have at least a vaginal Candida infection and up to 45% have experiences it two or more, making it the commonest gynecologic diagnosis in primary care. As women tend to be more prone to vaginal yeast infections because of several reasons such as stress, poor nutrition, poor hygiene, lack of sleep, illness, hormonal imbalance or while pregnant or taking antibiotics. Women with immunosuppressive diseases such as diabetes and HIV infection are also at greater risk [1] and This infection also known as Vaginitis is characterized by symptoms, including discharge, odor, itching, irritation, or burning (Figure 1). Often causes by Candida species especially Candida albicans that accounts for 85% to 90% of cases [2]. From the ancient era, many plants and herbs are being used to treat various infirmities; one of them is Clitoria ternatea L, commonly known as Aparajita. In all ancient scriptures of Ayurveda, it is mentioned as one of the important herb [3]. Clitoria ternatea, also known as butterfly pea, is a perennial twinning herbaceous plant which belongs to the Fabaceae family. Major phytoconstituents of the plant responsible for several activities are flavonols namely kaempferol, 7-rhamnoside, quercetin, anthocyanins such as ternatin and delphinidin and the pentacyclic triterpenoids viz. taraxerol and taraxerone. The herb is being used for the treatment of diabetes, pain, inflammation, vaginal irritation and infections and worm infections [5].

Figure 1: Flower of Clitoria ternatea (Linn)[5].

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Materials and Methods

Selection of plant material

The herb Clitoria ternatea Linn. is being used for the treatment of gynecological disorders especially vaginal infection from so long by the folks but till date no systematic investigation has been carried out to formulate the effective herbal formulation using the flower alone or in combination to treat gynecological disorders (vaginitis), therefore, this herbs were selected for the research work [6-10].

Collection and authentication of plant

The plant material selected for the present investigation was flowers of Clitoria ternatea Linn. and were collected in the months of Dec 2020 to Jan 2021 from various sites of Malwa region of Madhya Pradesh and identified & authenticated by Dr. S.N. Dwivedi, Professor and Head, Department of Botany, Janata PG College, A.P.S. University, Rewa, (M.P.) The specimen was deposited in Laboratory, with Voucher specimen No. P/CT-F/1403.

Preparation and characterization of extracts [5]

Preparation of extracts:- 250 gm of the air dried coarsely powdered flowers of Clitoria ternatea Linn. was placed in soxhlet apparatus and was extracted with distilled water until the extraction was completed (till 24 hr.). After extraction, the filtrate was evaporated, and percentage extract was determined.

Characterization of extract:- The aqueous extract of dried plant material of Clitoria ternatea Linn. (flowers) CTF were characterized for their color, odor, taste and pH and were recorded in present investigation.

Anti-candida activity of extracts

Fungal strain:- Fungal strain i.e., Candida albicans (ATTC 10231) was obtained from Medical College and was used for the present investigation.

Screening of antifungal activity by disc diffusion method:-

Preparation of disc: Disc of Whatman filter paper of one quarter inch in diameter was prepared and the same was sterilized using autoclave.

Preparation of samples entrapped disc: The accurately weighed extracts were dissolved in methanol and different stock solutions (10, 20, 30, 40, 50 μg/ml) solutions were prepared. All the dilution prepared was applied to Whatman filter paper disc using a micropipette. The discs were then dried and sterilized.

Preparation of culture plate: The Sabouraund’s agar and Mueller Hinton agar media were prepared by dissolving media in 1000ml of distilled water and sterilized by autoclaving at 121oC for 1 hour. The media were cooled and poured in sterilized Petri plates to solidify at room temperature.

Collection of fungal strains: The fungal strains (Candida albicans) were obtained from Index Medical College, Malwanchal University, Indore. The inoculums of strain were transferred to the re-cultured before starting the lab work.

Evaluation of zone of inhibition: The re-cultured fungal strains were used for antifungal evaluation. The strains were streak on the Mueller Hinton media and the drug entrapped discs were placed. For negative control, disc of distilled water and for positive control clotrimazole disc (10 μg/ml) were used. The disc of aqueous extract of dried flower of Clitoria ternatea Linn. was prepared having 10μg/ ml concentration. The petri plates were kept in incubator for 24 hrs. After 24 hrs, the petri-plates were checked for zone of inhibition. The zone of inhibition diameter was recorded with the help of zone reader scale. The zone of inhibition was calculated by subtracting diameter of sample or standard or control by diameter of disc. The more the zone of inhibition the more will be antifungal activity.

Statistical analysis: All the reading obtained were analyzed using one way analysis of variance i.e., ANOVA. Student t-test was used. The values were found to be statistically significant (*P<0.00, **P<0.01). All the values obtained were expressed as mean± standard error means (SEM).

Formulation of herbal cream[6,7]

The herbal cream was prepared using fusion method and the various steps involved in formulation of herbal cream were as described below.

Preparation of oil phase: Stearic acid, cetyl alcohol, almond oil were taken in desired quantity in porcelain dish as per the Table 1 and were melted at 700C.

Table 1: Formulation of Herbal Cream Containing Aqueous Extract of Clitoria ternatea L.

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Preparation of aqueous phase: Aqueous extract of dried plant material of Clitoria ternatea Linn. glycerol, methyl paraben, triethanolamine and water as per Table 1 were taken in another porcelain dish and were heated at 700C.

Addition of aqueous phase to oil phase: The aqueous phase was added to the oil phase with continuous stirring at room temperature. Perfume was added at last and the formulation was transferred in a suitable container.

Physical evaluation: The prepared creams were evaluated for physical characteristics by evaluating clarity and transparency which was determined through visual inspection by observing the sample in light at white background (Tables 2 & 3).

Table 2: Antifungal Activity of Clitoria ternatea Linn.

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Table 3: Results of Evaluation Parameters of Formulated Herbal Creams.

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Determination of pH

pH of the prepared formulations was determined using digital pH meter. The pH meter was first calibrated, and zero reading was recorded. The samples were diluted with water to make suspension and were taken in the beaker and the readings were taken from calibrated electrode. The procedure was repeated, and reading were taken in triplicate and recorded.

Determination of viscosity

The viscosity of the herbal cream was determined by Brookfield Viscometer using spindle no. 1 working at 20 rpm at temperature 4oC and 37oC. About 15ml of the samples from each batch was taken in beaker and spindle was immersed in the formulation (Figure 2). The reading was recorded at initial and after rotation at different temperature. The reading was recorded thrice.

Figure 2: Drug Release of Formulations and Standard.

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Determination of homogeneity

Homogeneity of various formulations was tested by visual observation and reported. The formulations were also evaluated for presence of any aggregates or gritty particles (Tables 4 & 5).

Table 4: Drug Content of Herbal Cream containing Aqueous Extract of Clitoria ternatea L. (Flowers).

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Table 5: In-Vitro Drug Release of Herbal Cream Containing Aqueous Extract of Clitoria ternatea L.

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Determination of spreadibility

The formulations were placed on the glass slide and the empty glass slide was place on the top of cream containing slide. The herbal cream placed between slides was pressed to form thin uniform layer. The two slides were fixed and on the upper glass slide, the weight of 20 ± 0.5 g of the weight was tied. Due to weight, both the slides were separated, and the time required to separate the two slides, i.e., the time in which the upper glass slide moved over the lower plate was taken as measure of spread ability. The three readings were recorded, and mean time was taken. The spread ability was calculated using the formula:

S= m x l/t

Where,

m = weight tide to upper slide

l = length moved on the glass slide

t = time taken.

Determination of wetness

The prepared herbal creams were determined for wetness by applying on skin surface. The amount of cream taken from each batches must be the quantity sufficient to apply at 10 mm2 area of skin surface.

Determination of type of smear

The prepared herbal cream was applied on the skin surface and after the application the type of film or smear formed on the skin was recorded. The amount of cream taken from each batches were quantity sufficient to apply at 10 mm2 area of skin surface.

Determination of emolliency

The prepared formulation was checked for emolliency, slipperiness and amount of residue left after the application of cream. To determine emollinecy, the sufficient quantity of cream was taken from each batches and applied at 10 mm2 area of skin surface and the results were noted.

Determination of Type of Emulsion

Dilution test: The prepared herbal cream was diluted with oil or water depending upon the type of emulsion whether o/w or w/o the results obtained were noted down.

Dye solubility test: The prepared herbal cream was mixed with a water-soluble dye i.e., amaranth and was observed under the microscope. The results obtained were interpreted.

Determination of drug content: The drug content of the herbal creams was estimated using UV-Visible spectrophotometer. Nearly about 1g of the formulation was taken in 50 ml of volumetric flask and the solution was made up to mark with methanol. The solution was shaken and filtered through what man filter paper and about 0.1ml of the filtrate was further diluted to 10ml with solvent and estimated at suitable wavelength.

In vitro drug release/dissolution test: The semi permeable dialysis membrane bag (7cm long) was prepared, and the herbal cream was placed in the membrane. The dialysis bag was then suspended in 50ml of ethanol: water (1:1) at temperature 37°C ± 0.5°C in water bath. About 1ml of sample was withdrawn from the membrane at predetermine regular intervals (2, 4, 6 and 8 hr.) and the fresh equal volume was replaced simultaneously. The samples were withdrawn, diluted and analyzed by UV Visible spectrophotometer at suitable λmax for herbal cream containing aqueous extract of Clitoria ternatea Linn. The experiment was repeated thrice, and the cumulative drug release was calculated from the reading.

Anti-Fungal activity of optimized formulation: The antifungal activity (anti-candida activity) of optimized herbal cream and standard cream formulations was determined by disc diffusion method and results obtained for Zone of inhibition were compared. Marketed Clotrimazole cream (MCC) 1% w/w IP was used as a standard.

Results and Discussion

The herbal cream containing aqueous extract of Clitoria ternatea flowers was prepared and evaluated on various parameters. All the preparations gave satisfactory results on all the defined parameters and the results are shown in Table 2. From the results of drug content of formulated herbal cream containing aqueous extracts of dried plant material of Clitoria ternatea Linn. (Flowers) CTF and different proportion of excipients, it was found that HC5 has maximum drug content in combination therefore, HC5 were evaluated for anti-Candida activity. From the results (Table 3) obtained it was concluded that the PHC (HC5) have optimum and significant anti-candida activity when compared with standard formulation (MCC) and hence, it may be used for the treatment of gynecological disorders (vaginitis). Moreover detailed clinical approaches need to establish for the formulation of safe and effective drugs.

Conclusion

Candida albicans, a fungus which is responsible for the vaginal infection. Several literatures have suggested the effectiveness of Clitoria ternatea as antifungal agent for the treatment of vaginal infections. To prove it scientifically, anti-candida activity of aqueous extract of selected plant were evaluated. The zone of inhibition of extract on Candida albicans were investigated and results indicated that the selected extract have significant anti-candida activity when compared with standard drug Clotrimazole. From the results obtained, it was concluded that the extracts of selected herb have optimum anti-candida activity and may be used for the treatment of gynecological disorders (vaginitis) (Table 6). The results of formulation with code HC5 were found to be most promising and excellent among all herbal creams formulated when compared with standard formulation (MCC) and may be used for the treatment of vaginal infection. However detailed research study needs to be done to develop this as an effective formulation.

 https://lupinepublishers.com/pharmacology-clinical-research-journal/pdf/LOJPCR.MS.ID.000143.pdf

https://lupinepublishers.com/pharmacology-clinical-research-journal/fulltext/development-and-characterization-of-herbal-formulation-containing-aqueous-extract-of-clitoria-ternatea-linn.ID.000143.php

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Saturday, 17 April 2021

Lupine Publishers| Risk of Antimicrobial Resistance Development from Pet Animals to Humans: Case of Enterobacteriaceae Family

 Lupine Publishers | LOJ Pharmacology & Clinical Research


Antimicrobials are vital instruments for the treatment of contagious bacteriological infections in pet animals, as well as in humans. The demise of the effectiveness of antimicrobial substances can honestly deal with pet animal health and human health. A necessity for the enhancement of innovative antimicrobials for the treatment of multiresistant infections, specifically those caused by Gram-negative bacteria, has been recognized in human medicine, and an imminent subsequent demand in veterinary medicine is required. A distinctive feature associated with antimicrobial resistance and the risk of resistance development in pet animals is their close interaction in conjunction with humans. This generates chances for interspecies transmission of resistant bacteria. This review aims to recapitulate the current information on the use and indications for the Enterobacteriaceae family in pet animals and the spread of antimicrobial resistance among pet animals and their owners. The critical antimicrobial resistance microbiological threats from pet animals that directly or indirectly may cause adverse health effects in humans are carbapenemase-producing Enterobacteriaceae bacteria such as Escherichia coli, Klebsiella spp., Enterobacter spp. and Salmonella spp.

Keywords: Antimicrobial resistance; Antibiotics; Public health; Microbiology

Introduction

Throughout the last half of the century, the quantity of pet animals in contemporary civilization has considerably augmented, and a modification in their public part has arisen [1]. Awareness of their welfare has grown because of the close interaction between pets and their owners [2]. Humans could develop antimicrobialresistant bacteria or the consequent resistance genes from food animals [3,4] and interaction with their pet animals [5,6]. Enterobacteriaceae and multidrug-resistant Gram-negative bacteria have become apparent in healthy and sick pets, suggesting a possible threat of the spread of these bacteria to humans from contaminated or inhabited pet animals [7]. Additionally, there is also the possibility to transfer resistance genes vice versa. To evaluate the hazards contained by the framework of treatments for new antimicrobials for pet animals, could arise a necessity for further data requirements concerning antimicrobial resistance [8]. Antimicrobials are used commonly in the routine procedure for medicinal and preventative reasons in pet animals [9]. Nevertheless, antimicrobial intake data for dogs and cats are repeatedly deficient and typically addressed to drug company trades [10]. Even if trade data provide a challenging assessment of antimicrobial consumption’s enormity, data on the utilization of antimicrobials in various species are deficient [11]. Pet animal sales of antimicrobials are a small percentage of the global sales example of animals’ antimicrobial agents.

Various antimicrobial products approved for human use are also used in pet animals in the treatment of the “cascade” [12]. Prevalent use of broad-spectrum antimicrobials has been described in pet animal practice in Europe (Figure 1). The most used antimicrobials for dogs and cats are β-lactams, for example, amoxicillin and amoxicillin combined with clavulanic acid [13]. Shortage of verified diagnosis might take the lead to the abuse of antimicrobials [14]. Antimicrobial management has occurred to treat disorders in which effectiveness has not been demonstrated, for instance diarrhea in dogs for which antimicrobial treatment is generally not proposed [15,16]. Multidrug resistance bacteria have been described in pet animals, every so often cruelly conceding the therapy result. Since restricted reconnaissance and understanding of the zoonotic transmission of antimicrobial resistance between humans and pet animals, the level of spread and significance for public health is inadequately appreciated [17]. Within the next, the critical drug-resistant bacteria are assessed and the indication for their transmission among humans and their pet animals.

 

Enterobacteriaceae as a Significant Public Health Concern in Human Medicine

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Representatives of the Enterobacteriaceae family comprise numerous species, for instance, Escherichia coli, Enterobacter spp., Salmonella spp., and Klebsiella spp. [18]. Countless bacteria belonging to these species are symbiotic organisms of the digestive tract [19]. Increasing antimicrobial resistance among Enterobacteriaceae is evolving as an essential public health apprehension in human medicine. Enterobacteriaceae, which produce ESBLs, extended-spectrum cephalosporinases, and plasmid-mediated AmpC β-lactamases (ESBLs) are particularly important. Around are quite a few articles on ESBL-producing bacteria in pet animals [6]. Escherichia coli, Salmonella spp., Enterobacter spp., and Klebsiella spp. as Potential Hazards Over the years, E. coli was reported continuously from the first recorded case in Japan in pet animals, followed by the emergence in humans in following years, to the incidence in ESBL-producing uropathogenic E. coli from pet animals in Spain [20]. Since that time, the number of statements relating to E. coli ESBLs in pet animals has grown precipitously [21]. CTX-M enzymes have developed a swiftly expanding family of ESBLs in bacteria from human infections. In pet animals, equally clinical and commensal isolates of E. coli frequently generate CTX-M type β-lactamases [22]. E. coli has lately become known as a global pandemic replicate in humans [23]. Descriptions of clinical infections in animals caused by E. coli are merger, which may be since its detection requires genotypic techniques. Various clinical E. coli isolates from pet animals are like human clinical E. coli isolates founded on their virulence genotype, and resistance characteristics, etc. Many E. coli strains such as ST156, ST405, ST410, and ST648 could be found both in humans and their pets [24]. The detection of duplicates in humans and dogs and cats may suggest their transmission through direct contact. Such transmission could likewise be a related component to the prompt and effective spreading of E. coli, even though, between humans, the incredibly critical transmission path is almost certainly "hand to hand" [25]. Salmonella spp. have been correlated with epidemics of nosocomial intestinal infections in pet animals in veterinary clinics and an animal sanctuary-some of the outburst as well engaged veterinary organization and other people in connection with pets [26].

In cases like this, pet animal sanctuaries could work as foci of transmission for Salmonella spp. among humans and animals if acceptable control measures are not provided [27]. Information on antibiotic resistance phenotypes and genotypes of Salmonella spp. in animals and humans in different countries and geographic regions is necessary to combat the spread of resistance [28]. This will improve the understanding of antibiotic resistance epidemiology, tracing new emerging pathogens, assisting in disease treatment, and enhancing the prudent use of antibiotics. However, the extent of antibiotic resistance in foodborne pathogens and humans in many developing countries remains unknown [29]. Among 25526 recorded isolates of salmonellae, 5086 isolated from humans, and 20440 from animals in 1994 and 1997 in France, the antibiotic resistance phenotype was determined for all human and 5336 animal isolates. In Salmonella enterica serovar typhimurium, one of the two most frequently isolated serovars from humans as well as animals, resistance to ampicillin was observed in 61% of both human and animal isolates in 1994 and in 73% of human and 53% of animal isolates in 1997.

During these periods, resistance to co-amoxiclav was between 45% and 66% for both types of the isolate. Resistance to ampicillin was associated with resistance to streptomycin, spectinomycin, sulphonamide, tetracycline and chloramphenicol in over 70% of isolates [30]. Resistance to ampicillin as well as co-amoxiclav never exceeded 7% in Salmonella enteritidis. While Salmonella hadar was practically absent among the human isolates in 1994, this serovar was the third most frequent in 1997, and at that time, 92% were resistant to nalidixic acid. Among the animal S. hadar isolates, the prevalence of resistance to nalidixic acid increased from 3% in 1994 to 72% in 1997. None of these isolates manifested high-level resistance to ofloxacin. The levels of resistance to aminoglycosides (<3%) and trimethoprim-suphamethoxazole (<14%) remained practically unchanged in all three serovars. The resistance markers of 463 ampicillin-resistant S. typhimurium isolated in 1997 were determined. Among the 24 phenotypes observed, six multiresistant phenotypes, representing 82% of these isolates (as compared with 80% in 1994), were associated with the PSE-1 gene typically found in the lysotype DT104 of this serovar [30]. Being as by E. coli, extended-spectrum cephalosporinases and plasmid-mediated AmpC β-lactamases producing strains of Salmonella spp. are of disquiet [24]. Antibiotic of the cephalosporin type licensed for use in veterinary medicine resistance was detected in more than 10% of cats and 21% of dog Salmonella spp. isolates with detected β-lactamases, respectively [31]. The main issue and problem are that there is limited knowledge of ESBLs in other Enterobacteriaceae of pet animals. Klebsiella spp. from the human epidemic clone was isolated from dogs and cats in Spain [32]. It was found to be highly resistant to aminoglycosides due to the ArmA methyltransferase. The emergence and clonal spread of Klebsiella spp. in dogs were first reported in Germany [33]. While in Singapore, an analysis of 186 diagnostic reports collected from a veterinary clinic between 2014 to 2016 showed that sick companion animals could carry bacteria of significance to human health [34]. Among the 186 specimens submitted, 82 showed polymicrobial growth (45%, 82/186), and in total, 359 bacteria were isolated. Of the 359 bacteria reported, 45% (162/359) were multi-drug resistant, and 18% (66/359) were extended-spectrum-β-lactamase species. Resistance to broad-spectrum antibiotics was also observed among individual species. Namely, methicillin-resistance among Staphylococcus pseudintermedius (63%, 32/51) and Staphylococcus aureus (50%, 4/8); fluoroquinolone-resistance among Escherichia coli (40%,17/42) and carbapenem-resistance among Klebsiella pneumoniae (7%, 2/30) were noted [34].

This analysis suggests that sick pets may contribute to the pool of clinically relevant antibiotic-resistant bacteria and play a role in the spread of antibiotic resistance. Antibiotic-resistant bacteria such as Klebsiella pneumoniae are common in the digestive tract and upper respiratory tract of animals and humans [35]. Several studies have shown that this bacterium is found in humans and in animals, one of which is pigs that are known to be a reservoir for the spread of this bacteria [36]. Not only in pigs, but this antibiotic-resistant bacterium is also known to be found in other food-producing animals, as well as in pet animals. Many cases of Klebsiella pneumoniae in humans have been reported, but Klebsiella pneumoniae in humans related to animals or strains related to animals and humans were also reported [37]. Control and prevention are needed to prevent the spread of antibiotic-resistant bacteria from animal to animal, animal to human and vice versa, and the surrounding environment.

Conclusion

In humans, the control of resistance is based on hygienic measures: prevention of cross-contamination and decreased antibiotic usage. In animals kept together, sanitary measures, such as prevention of oral-fecal contact, are hardly achievable. Consequently, lessening the need for antibiotics is the only possible way of managing resistance in pet animals. This can be achieved by improving pet animal welfare systems and eradicating or vaccinating against infectious diseases. Furthermore, eliminating antibiotics as preventive measures in pet animals would decrease antibiotic use and minimize transmission from animal to human resistance. This would not only diminish the public health risk of dissemination of resistant bacteria or resistant genes from pets to humans but would also be of significant importance in maintaining the efficacy of antibiotics in human medicine and veterinary medicine as well. A more extensive study to better understand the extent of distribution and the factors affecting antibiotic-resistant bacteria’s transmission to and from pets is more than necessary.

Acknowledgment

This research was supported by COST Action “European Network for Optimization of Veterinary Antimicrobial Treatment”, grant number CA18217.

https://lupinepublishers.com/pharmacology-clinical-research-journal/fulltext/risk-of-antimicrobial-resistance-development-from-pet-animals-to-humans-case-of-enterobacteriaceae-family.ID.000138.php

https://lupinepublishers.com/pharmacology-clinical-research-journal/pdf/LOJPCR.MS.ID.000138.pdf

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