Journal of Pharmaceutical Research International

A Pioneering Physiotherapeutic Approach to the Treatment of a COVID Affected Patient – A Case Report

2021-06-11T13:02:35+00:00

The Coronavirus (SARS-CoV-19) originated from Wuhan, China and has affected globe since 2019. The virus spread to India in January, 2020. It is highly contagious. In its severe form, the victims of the virus suffered from symptoms such as breathing difficulties, fever, weakness, loss of taste and smell, amongst others. Patients were put on mechanical ventilators and as a result, the requirement of the role of cardio-respiratory physiotherapists became more and more essential. Even after weaning off from the ventilators and being detected Coronavirus negative, the role of the physiotherapists still remained indispensable in order to bring about improvement in the muscle strength of the affected weakened muscles, especially for patients whose movements were limited for extended periods of times due to being dependent on the ventilators; physiotherapists were also required to bring about improvement in the lung capacities and function, to teach gait training for those who find it difficult to walk, to improve in-coordination and overall allow the patients to come back to normal and carry out all the ADL independently and well. He had a severe difficulty in breathing and coughing, along with a generalized weakness all over his body, specifically both his lower limbs. He was admitted in the ICU immediately and was on mechanical ventilator. After all the physiotherapy sessions, the patient was able to carry out his activities of daily living independently; he regained his muscle strength and improved his coordination and ability to walk with a proper gait. He was also able to breathe independently with adequate respiratory muscle strength; and did not feel fatigued as quickly as he used to when he was detected positive for Coronavirus.

Pharmaceutico-Analytical Study of Muktashukti Pishti and Muktashukti bhasma and Comparative Evaluation of their Relative Oral Bioavailability

2021-06-11T12:45:40+00:00

Background: Shukti (Oyster) is a very commonly occurring calcium form. It is rich source of calcium & minerals. As per text it can be converted into two forms which are bhasma (calcinated ash) and pishti (powdered form without agni).These forms may have different rate of absorption. This needs to be studied.

Aim: To study Pharmaceutico-analytical study of Muktashukti pishti & Muktashukti bhasma and comparative evaluation of their relative oral bioavailability.

Materials and methods: The two formulations will be prepared from shukti (oyster). By triturating with Gulabjala Muktashukti pishti will be prepared and by traditional puta method Muktashukti bhasma will be prepared. The prepared formulations will be assessed for Bhasma Pariksha mentioned in Ayurveda. Organoleptic characters, physicochemical parameters and Particle size distribution analysis, SEM-EDX (Scanning Electron Microscopy, Energy Dispersive X-Ray Analysis), FTIR (Fourier-transform infrared spectroscopy), XRD (X-Ray Diffraction), GCMS (Gas Chromatography Mass Spectrometry) will be evaluated. To assess the relative oral bioavailability of Muktashukti pishti & Muktashukti bhasma study will be conducted in healthy volunteers and will be compared with the standard calcium supplement. The study will be conducted in between two test groups and standard group.

Observation and results: The analytical parameters will be assessed and compared in Muktashukti bhasma and Muktashukti pishti. For relative oral bioavailability Blood serum calcium will be assessed in all three groups. By applying unpaired “t” Test, One-way ANOVA the statistical significance can be measured.

Conclusion: The pharmaceutical & analytical study of Muktashukti pishti and Muktashukti bhasma will provide the standard parameters and clinical comparative evaluation with standard will generate evidence for better bioavailability.

A Comparative Study on the Efficacy of Kantkari and Vasa Lozenges in Children with Kasa (Cough)-Study Protocol

2021-06-11T13:11:59+00:00

Background: Kasa is the outcome due to release of obstructed Vayu resulting in the production of abnormal sound, which may be productive or dry. Kasa is one of the primary diseases of Pranavaha srotas, and can cause disturbances in other body functions. Prevalence of cough in India is 5% to 10% while acute cases of cough is 39% and chronic cases of cough is 29% reported in Maharashtra. This research drug is taken to check its efficacy on both the types of cough, dry as well as productive with acute or chronic origin. It has a good palatability and liked by children as it appears as candy. Many studies have been carried out on Kasa with different formulations so far like vati, churna, ghrita but they have no fast and long lasting action with different level of efficacy. Many lozenges are also available in the market but no studies have been done.

Objective: Comparative Study on the efficacy of Kantakari lozenges with Vasa lozenges in the clinical features of Kasa by subjective criteria such as Peenasa-(running nose), Kasa, Aruchi-(taste impliedness), kanthkandu(throat itching), kaphnishthivan (Sputum) and objective criteria as adventitious sound and AEC-absolute eosinophil count, TLC-total leucocytes count, and DLC-differential leucocyte count.

Materials and Methods: The present study is designed as a Double Blind, Randomized Controlled Study in which total 60 patients will be enrolled. Patients will be randomly divided (by computer generated sequence method) in two with 30 patients in each group. In group A, Vasa lozenges and in group B Kantkari lozenges will be given for 7 days. Assessment of the patients will be done on 3^rdand 7^thday during study after intervention and post treatment follow up will be taken on 14^th& 21^st day from the enrolled date.

Results: Efficacy of both the lozenges will be observed in subjective and objective outcomes. Conclusion: Kantkari lozenges (trial group) is expected to be more effective than Vasa lozenges (control group) in the management of Kasa as Vata, Kapha are more dominant in the pathology of Kasa in children and Kantakari is a good Vatakaphahar drug added with Pippali to act synergistically.

Comparative Pharmaceutical Standardization and Oral Bioavailability Study on Praval Pishti and Praval Bhasma

2021-06-12T09:54:33+00:00

Background: Praval (coral) is a very usually occurring calcium form. It is rich source of calcium & minerals. As per text it can be converted into two formulas which are bhasma (calcinated ash) and pishti(powdered form without agni).These forms may have different rate of immersion. This needs to be studied.

Aim: Pharmaceutical Standardization study of Praval Pishti & Praval Bhasma and comparative evaluation of their relative oral bioavailability.

Materials and methods: The two formulations will be prepared from Praval (coral). By triturating with Gulab jala Praval Pishti will be prepared and by traditional Puta method Praval Bhasma will be prepared. The prepared formulations will be assessed for Bhasma Pariksha mentioned in Ayurveda. Organoleptic characters, Physicochemical parameters and Particle size distribution analysis, SEM –EDX (Scanning Electron Microscopy, Energy Dispersive X-Ray Analysis), FTIR (Fourier-transform infrared spectroscopy), XRD (X-Ray Diffraction), and GCMS (Gas Chromatography Mass Spectroscope) will be evaluated. To assess the relative oral bioavailability of Praval Pishti & Praval Bhasma study will be conducted in healthy volunteers and will be compared with the standard calcium supplement.

Observation and results: The study will be assessed for its relative oral bioavailability in healthy Volunteers by using unpaired “t” Test, One-way ANOVA.

Conclusion: The pharmaceutical study of Praval Bhasma and Praval Pishti will provide the standard parameters and comparative evaluation with standard will generate evidence for better bioavailability.

Atlanta Classification for Acute Pancreatitis- A Study Protocol

2021-06-12T10:10:23+00:00

Background: Acute pancreatitis is one of the most common abdominal pathologies having variable outcome ranging from self limiting abdominal pain to high mortality and morbidity due to organ failure, over the past five decades, various classification systems have emerged to classify pancreatitis according to its severity , and the associated complications have emerged to classify acute pancreatitis and its various complications, such as Apache Scoring , Ct Severity , Modified Ct Severity ,Ransen and Atlanta Classification.

Objectives: We in our study will be classifying patients suffering from acute pancreatitis according to the revised Atlanta classification to divide them into interstitial edematous pancreatitis and necrotizing pancreatitis. The local complications will be classified according to CT imaging findings into acute necrotic collection, psuedocyst, acute necrotic collection and walled of necrosis. Organ failure will be assessed according to modified marshal scoring system into transient or persistent organ failure.

Methodology: We will be carrying forward our study on Siemens 16 slice computer tomography machine over a sample of 140 patients coming to the outpatient department of our hospital which will be followed by a routine clinical follow up of the patient to find out their prognosis.

Results: Will be tabulated at the end of the study using SPSS version 26 software.

Conclusion: The revised Atlanta classification for acute pancreatitis, in conjunction with the Modified Marshall Scoring System for organ failure, if found useful, in our series in improving the prognosis of the patients, then it can be incorporated in management.

Pharmaceutical Development, Standardization and Clinical Evaluation of Efficacy of a Polyherbal Hair-Pack and Hair Gel in Dandruff Control

2021-06-12T10:26:01+00:00

Introduction: Dandruff is a commonly found hair problem affecting all age groups with high recurrence and is considered a social stigma. In Ayurved it is compared with Darunak falling under the category of kshudrarogadhikar and is caused due to the vitiation of vaat and kapha. Traditionally the treatment comprises of application of oil, steaming, applying packs, washing of hair etc. According to modern science dandruff is a non-treatable disease condition which is prevented by use of anti-dandruff shampoos, creams and hair masks. The available products are expensive and results are not very satisfactory and recurrence is common. Currently treatment available for dandruff is found to be expensive with unsatisfactory results in terms of recurrence of symptoms.

Aim and objective: Pharmaceutical development, standardization and clinical evaluation of efficacy of a polyherbal Hair pack and Hair gel in dandruff control

Materials and methods: Hair pack will be made with selected drugs like Amalki, Bibhitaki, Haritaki, Japa, Yashtimadhu, Musta, Brahmi and it will be converted into gel form. Analytical study for standardization of powder and gel dosage form will be done. Clinical evaluation of both dosage forms for efficacy will be done.

Observations and results: Observation will be done on the basis of photographic evaluation of the condition of pre and post severity of symptoms and duration of recurrence time of dandruff will be noted. Results will be drawn on the basis of observations and applying suitable tests. It will be noted and presented in form of table, charts, graphs etc.

Conclusion: Currently available treatment for dandruff does not provide complete remission of symptoms for long duration and it is very expensive too. Thus the newly designed herbal formulation is aimed to provide significant result in controlling dandruff and its associated symptoms and modified dosage i.e. gel will overcome the limitation of powder and provide a cost effective cosmetic product in controlling dandruff.

Outcomes of Newly Diagnosed Patients of Peripartum Cardiomyopathy at Liaquat University Hospital, Hyderabad, Sindh, Pakistan

2021-06-11T12:53:03+00:00

Objective: To determine the outcomes of newly diagnosed patients of peripartum cardiomyopathy at Liaquat University Hospital, Hyderabad.

Methodology: Total 91 patients of peripartum cardiomyopathy were included. A detailed medical history and base line equitable investigations were done. Patients were kept under observation for 7 days during their hospital stay and study outcomes were recorded. Descriptive statistics were calculated. Stratification was done and post stratification chi square test or fisher exact test was applied. Two sided P-value ≤0.05 was considered as significant.

Results: The overall mean age was 29.06±4.71 years. Total 73.6% patients were belonged to urban and 26.4% belonged to rural areas. 52.7% patients had normal delivery while 40% had C-section and 6.6% had instrumental assisted deliveries. As far as outcomes are concerned, 65.9% patients had congestive heart failure, 12.1% patients had arrhythmias, 35.2% patients admitted in ICU, 64.8% patients admitted in recovery and 7.7% patients were died.

Conclusion: In a prospective cohort with PPCM, most women recovered; however, rates of CHF were observed significantly in patients with diabetes mellitus and hypertension. In-hospital mortality was comparatively less frequent but it was significantly associated in women having age less than 30 years.

Semibarbula orientalis (Web.) Wijk. and Marg: A Potential Source of Bioactive and High Value Phytochemicals

2021-06-12T08:50:24+00:00

Aims: Present study aims to evaluate the presence of bioactive compounds of Semibarbula orientalis (Pottiales: Pottiaceae), a bryophyte whole plant methanolic extract by Gas Chromatography-Mass Spectrometry (GC-MS) which are important medicinally as well flavouring and colouring agents.

Study design: Qualitative preliminary phytochemical and GC-MS analysis.

Place and duration of study: The study was carried out at Department of Botany, Center of Advanced Study, Jai Narain Vyas University, Jodhpur-Rajasthan (India) from January 2017 to December 2020.

Methodology: The Preliminary phytochemical screening of S.orientalis was carried out qualitatively following the standard methods of Harbourne, Trease and Evans. GC-MS analysis was performed by GC-MS-QP 2010 Shimadzu, Japan equipped with thermal desorption system TD 20.

Results: Preliminary phytochemical analysis revealed the presence of carbohydrates, proteins, phenols, sterols, flavonoids and terpenoids. GC-MS analysis of methanolic extract of whole plant revealed the presence of 49 bioactive phytoconstituents which include mainly n-Hexadecanoic acid, Cis-vaccenic acid, Azulene, Hexadecanoic acid metyl ester, 1,3-Propanediol, 2-(hydroxyl methyl)-2-nitro, 9-12 Octadecadienol chloride (z,z), Octadecanoic acid etc.

Conclusion: Preliminary phytochemical and GC-MS profiling of methanolic extract Semibarbula orientalis whole plant showed the presence of high value bioactive compounds with important medicinal properties and other uses in food industries as flavouring and colouring agents.

Enhancement of Solubility and Dissolution Rate of BCS Class-II Fluvoxamine Tablets using Solvent Evaporation Solid Dispersion Technique

2021-06-12T08:57:27+00:00

Aim: This research work was aimed to formulate Enhancing the solubility of Poorly soluble drug i.e. Fluvoxamine tablets by the solvent evaporation method, Fluvoxamine medicament is a selective serotonin reuptake inhibitor (SSRI) antidepressant agent.

Purpose: The BCS class II drug Fluvoxamine consist low aqueous solubility and low oral bioavailability, for this reason to improve the biological performance of Fluvoxamine drug by solid dispersion mechanism.

Methodolgy: The drug Fluvoxamine was formulated by using solvent evaporation technique, solid dispersions of Fluvoxamine were prepared with different carriers in different ratios of PEG 6000 & Mannitol (1:1, 1:2 and 1:3).

Results: Results of prepared solid dispersions of Fluvoxamine by solid dispersion method Finally by comparing all the formulations, formulation (SF3) containing Fluvoxamine and PEG 6000 (1:3) shows better results.

Conclusion: Here we concluded that the poorly soluble drug solubility improving by solvent evaporation solid dispersion mechanism, and also developed six Fluvovamine formulations (FDF1-FDF6) during this FDF4 shows maximum (98.9±0.8%) drug release at the end of time.

Correlation of Glycosylated Hemoglobin and Complexity of Coronary Artery Disease among Aged ≥45 Years Population with Diabetes Mellitus

2021-06-12T13:41:16+00:00

Objective: Cardiovascular diseases are 1.7 times more prevalent in patients with diabetes mellitus. The aim behind this study was to examine the correlation of glycosylated hemoglobin and complexity of coronary artery disease among middle aged population with diabetes mellitus

Patients and Methods: This was a clinical prospective hospital-based comparative study carried out in the department of the cardiology department of Isra University Hospital Hyderabad for 10 months. 153 participants with diabetes mellitus having age ≥45 years both male and female and undergoing their first coronary angiography were included. Data were entered and analyzed by using Statistical Package for the Social Sciences version 21.0.

Results: A total of 153 patients were finally analysed. Patients were divided into two groups; group I (HbA1c <6.5%, normal) and group II (HbA1c >6.5%, impaired). The mean age was slightly higher in group II 54.60 as compared to group I 53.65 years, respectively. The Syntax score was correlated with HbA1c levels in patients older than 45 years of age (r = 0.001; p >0.05). Moreover, the higher HbA1c levels were observed in every three categories of Syntax score but they were insignificantly associated with each other in patients with diabetes mellitus and having age more than 45 years.

Conclusion: The HbA1c is insignificantly correlated with the complexity of coronary artery disease in diabetic patients having age more than 45 years. While only two factors, hypertension and increased triglycerides are significantly different among the HbA1c groups.

Quality of Life after Ablation vs Medication Therapy in Patients With Supraventricular Tachycardia

2021-06-12T14:29:07+00:00

Objective: Supraventricular tachycardia (SVT) is the most common presentation of patients at cardiac emergency department. This study aims to determine the quality of life in patients with supraventricular tachycardia after they treated with medicines vs. ablation therapy.

Methods: This prospective clinical comparative study was held at the National Institute of Cardiovascular Diseases (NICVD). Patients 18 years or older of either gender presenting with the two most common variants of SVT i.e. Atrioventricular nodal reentry tachycardia (AVNRT) and Atrioventricular reentry tachycardia (AVRT) were eligible to be included into the study. Once stabilized at the emergency department (ED) the patients were given the option to undergo electrophysiology study and radiofrequency ablation (EPS and RFA) (group A) or opt for medications only (group B). Quality of life (sense of personal well being, impact on social life, fear of mortality or anxiety about the disease, recurrence of episodes of arrhythmia, and visits to ED) was assessed through a questionnaire filled after six months of receiving treatment.

Results: A total of 120 patients were included into our study. Group A and group B were evenly divided with 60 patients each. The overall mean age of the participants and duration of cardiac illness were 44.67±18.91 and 5.42±3.13 years, respectively. Patients who received EPS and RFA (group A) had superior and statistically significant scores (better QoL) for sense of personal well being, impact on social life, fear of mortality or anxiety levels, recurrence of arrhythmia, and visits to the ED as compared to those who received medications alone, p<0.05.

Conclusion: EPS and RFA vastly improved the quality of life in patients with SVT post treatment. Medications alone are associated with a high number of post treatment sequels and adverse events; therefore they are best avoided in patients with SVT.

Medical Students’ Attitudes and Beliefs toward Chronic Low Back Pain (CLBP) at King Abdulaziz University, Jeddah, Saudi Arabia

2021-06-14T03:02:50+00:00

Background: Low back pain (LBP) is one of the most common reasons for long-term disability among the world. Up to 70–85% of people develop a back pain during the course of their lives. It affects people of all ages and is generally caused by sedentary jobs, obesity, smoking and low socioeconomic status. Chronic low back pain (CLBP) harms one’s work effectiveness, psychological condition and social responsibilities, such as family life. LBP is considered an indication for medical rehabilitation and is increasingly becoming a significant factor in rising healthcare costs. The current LBP guidelines recommend health care professionals to encourage patients to conduct daily physical activity, which includes remaining in purposeful work and staying active daily. Health care practitioners (HCPs) who hold negative beliefs toward CLBP are likely to suggest advice against the present guidelines, including longdays absence from their jobs.On the other hand, HCPs holding positive beliefs are more likely to appreciate the guidelines.

Objective: We aimed to evaluate the beliefs and attitudes toward CLBP among medical students in Jeddah, Saudi Arabia at the King Abdulaziz University (KAU), between June–July 2018.

Methods: We conducted a qualitative cross-sectional study among 370 medical students at the KAU using an online HC-PAIRS questionnaire. We entered the data using an Excel sheet (2013)and then analyzed it using SPSS (version 23). We used chi-square, one-way ANOVA and summary and independent t-tests.

Results: In this study, we used the mean and standard deviation of the total score to compare our study (µ = 64.43 ± 11.34) with a previous study that focused on functional restoration HCPs at the Tufts University, USA (µ = 38 ± 7) using summary t-test (t = –25.316). The p-value was significant (<0.001).

Conclusion: We demonstrated the differences between KAU students and HCPs at Tufts University regarding the HC-PAIRS questionnaire score, which revealed a higher mean score among our participants. This led us to conclude that KAU medical students hold negative attitudes and beliefs concerning the application of CLBP guidelines. In light of this, we recommend raising awareness about CLBP guidelines among the medical students and the society at large.

Use of Virtual Reality (VR) as an Audio-Visual Distraction Tool in the Reduction of Dental Anxiety during Local Anesthesia

2021-06-14T05:28:57+00:00

Aims: Dental anxiety is a relatively common problem and it leads to undesirable distresses, such as postponement or avoidance of dental treatment thereby resulting in poorer quality of treatment and reduced oral health related quality of life. Dental anxiety is especially seen in patients undergoing dental injections. To evaluate the effectiveness of audiovisual distraction in the reduction of dental anxiety during la injection.

Study design: Cross-sectional study.

Place and duration of study: Patients visiting Penang International Dental College, Malaysia, between June 2017 and July 2018.

Methodology: A total of 176 patients (88 female and 88 male) requiring endodontic therapy or tooth extraction were recruited for this study. A 14-question long questionnaire using Hamilton anxiety rating scale; and a separate feedback questionnaire was used to evaluate patients’ anxiety level and the severity of anxiety symptoms. Paired t-test was used to analyze the data.

Results: There was a significant reduction in the anxiety scores (p<0.001) of the patients following the use of VR distraction during the la procedure. On an average, the pre-test scores were 1.932 points higher than post-test scores.

Conclusion: Virtual reality could be used as a possible non-pharmacologic means of reducing dental anxiety in patients receiving local anesthesia.

Study of Relationship between Self-rated Health and Objective Health in Different Socio-economic Groups of Tehran in 2014

2021-06-14T05:38:21+00:00

The evaluation of health by an individual or self-rated health is a popular international index which is widely practiced for evaluating the individuals’ health in the public health researches and epidemiology. Many studies have revealed that self-rated health is a reliable predictor of mortality, illness, and loss of physical capacity. In addition, it has close correlation with the objective health indexes. The findings of this study have revealed the strong relationship between self-rated health and objective health. As self- rated health can be used as a reliable tool in the evaluation of objective health, this questionnaire can be used as a probable tool of screening the individuals’ health in the society and determining the individuals who need care. Further studies are suggested to be done in other regions for studying the quality of the questionnaire and also the factors affecting the self-rated health.