Journal of Pharmaceutical Research International

A Prospective Study on Polypharmacy in Tertiary Care Teaching Hospital

C. Mohana — 2026-03-02

Background: Polypharmacy, the concurrent use of multiple medications, is increasingly prevalent among middle-aged and geriatric populations due to the rise in chronic comorbid conditions. This study to evaluate the prevalence and patterns of polypharmacy, identify associated comorbidities, assess related risk factors, and estimate survival rates using validated clinical scales in a tertiary care hospital setting.

Aims and Objectives: To assess the burden of comorbid illnesses among middle-aged and elderly patients. To study the association between comorbidities and polypharmacy. To identify risk factors contributing to polypharmacy. To promote awareness regarding comorbidity-driven polypharmacy. To evaluate survival outcomes using the Charlson Comorbidity Index (CCI) and Comorbid Polypharmacy Scale (CPS).

Materials and Methods: A prospective study was conducted over six months (November 2024–April 2025) in the departments of General Medicine, Surgery, Respiratory Medicine, and Orthopedics at Sri Balaji Medical College Hospital, Tirupati. Of 320 screened patients, 72 met the inclusion criteria. Demographic, clinical, and prescription data were collected and analyzed. The number and types of drugs, associated comorbidities, and scores from CCI and CPS were used to evaluate the extent and impact of polypharmacy.

Results: Among the 72 subjects, 61% were male and the majority (37%) were aged between 60–69 years. Hypertension (89%) and diabetes (67%) were the most common comorbidities. Most patients (67%) had three comorbidities, and 32% were taking six different medications. The most commonly prescribed drug classes were anti-hypertensive (89%) and anti-diabetics (74%). Using the Charlson Comorbidity Index, most patients fell under moderate mortality risk (score 3: 25.4%), with estimated survival rates decreasing as scores increased. Based on the Comorbid Polypharmacy Scale, 79% of patients experienced moderate polypharmacy (score 8–14), while 18% had mild and 3% had severe polypharmacy.

Conclusion: This study identified a high prevalence of polypharmacy among middle-aged and elderly patients, particularly in males aged 60–69 years. Hypertension and diabetes mellitus were the most common comorbidities contributing to increased medication use. Most patients exhibited moderate polypharmacy and moderate mortality risk based on the Charlson Comorbidity Index and Comorbid Polypharmacy Scale. These findings highlight the importance of regular medication review, rational prescribing, and multidisciplinary involvement to minimize drug-related risks and improve therapeutic outcomes in patients with multiple chronic conditions.

Comprehensive Toxicological Evaluation of Nanoparticles in Food on Organic/Inorganic Nanostructure Frame Work

Basanta Kumar Panigrahi — 2026-01-28

Food science has seen a revolution because of nanotechnology, which uses materials at the nanoscale to improve quality, safety, and usefulness. With sizes ranging from 1 to 100 nm, nanoparticles (NPs) have special physical and chemical characteristics that set them apart from their bulk counterparts. These substances are used in packaging for antibacterial and preservation reasons, as well as in food systems to enhance texture, stability, colour, and nutrition delivery. However, there are serious safety and toxicological issues, frame work and risk Factors with the increasing use of engineered nanomaterials (ENMs) in food and feed items. Both inorganic (like silver, titanium dioxide, iron oxide, and zinc oxide) and organic (like lipid, protein, and carbohydrate- based nanoparticles) food-related nanoparticles are classified in this review, along with their fate and possible toxicity in the gastrointestinal tract (GIT). Organic nanoparticles are often less harmful because of enzymatic breakdown, whereas inorganic nanoparticles have demonstrated variable levels of accumulation and organ toxicity based on size, solubility, and reactivity. Limited and contradictory toxicological data highlight the urgent need for thorough long-term studies on nanoparticle exposure through diet, medicines, despite promised functional improvements. The fast-developing nano-enabled food technology and feed, it is crucial to comprehend the risk factors, the nanoparticles interact with biological systems in order to create appropriate regulatory frameworks and guarantee consumer safety.

Surveillance of Antimicrobial Resistance in Wound Infections: Insights from a Tertiary Care Hospital

Zaid A. Thawaba — 2026-02-05

Background: Wound infections are a common cause of morbidity in both inpatient and outpatient settings. Increasing antimicrobial resistance (AMR) among wound pathogens complicates empirical treatment and highlights the need for localised surveillance. Stratified analyses by sex, age, and clinical setting are crucial for optimising antimicrobial stewardship and informing clinical decision-making.

Aim: The present study investigated the spectrum of bacterial pathogens isolated from wound swabs and their antimicrobial resistance profiles in a large cohort of patients. The study further explored resistance patterns stratified by sex, age group, and patient setting (inpatient vs outpatient) to identify clinically relevant trends and support rational antibiotic use in wound management.

Methods: We conducted a retrospective cross-sectional study analysing 2,577 wound swab cultures collected from January 2022 to December 2023. Bacterial isolates were identified and classified as Gram-positive or Gram-negative. Antimicrobial susceptibility was determined using standard disc diffusion methods. Resistance patterns were compared across sex, age groups (<12, 12–40, 41–60, >60 years), and patient settings (inpatient vs outpatient) using chi-square tests with a significance threshold of p < 0.05.

Results: Gram-positive bacteria accounted for 52.5% of isolates, with Staphylococcus aureus being the most prevalent (42.1%). Gram-negative isolates included E. coli (17.0%) and Pseudomonas aeruginosa (8.8%). Resistance rates were significantly higher in male patients for several antibiotics, including oxacillin, amoxicillin, and cefotaxime (p < 0.05). Age-stratified analysis revealed increased resistance to ciprofloxacin and clindamycin among older age groups. Inpatients demonstrated significantly higher resistance to key antibiotics such as ceftriaxone (78.9% vs 61.2%), gentamicin (52.2% vs 22.2%), and meropenem (33.1% vs 20.7%) compared to outpatients (p < 0.00).

Conclusions: High rates of AMR in wound infections—especially among inpatients, males, and older adults—highlight the need for stratified local surveillance to guide empiric therapy. These findings support the integration of culture-guided treatment, antimicrobial stewardship, and infection prevention measures to curb resistance and improve wound care outcomes.

Bacterial Etiology and Antimicrobial Resistance Patterns of Urinary Tract Infections in Sana’a, Yemen

Ali A. Al-Mehdar — 2026-02-06

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, significantly impacting morbidity and contributing to antibiotic misuse.

Objective: This study aimed to investigate the bacterial etiologies and antimicrobial resistance patterns of UTIs in Sana'a, Yemen, to inform effective empirical treatment strategies.

Methods: This retrospective study was conducted using microbiological test records from four major medical laboratories and two tertiary hospitals in Sana'a between January 2022 and December 2023.A total of 3,829 urine samples from individuals with suspected UTIs were evaluated. Standard microbiological techniques were used to identify bacterial isolates, and antibiotic susceptibility testing was carried out using the Kirby-Bauer disc diffusion method in accordance with CLSI standards.

Results: Among the 3,829 samples analyzed, 72.2% of the isolates were identified as Gram-negative. The most prevalent uropathogen was Escherichia coli, accounting for 65.7%, followed by Pseudomonas spp., Klebsiella pneumoniae, and Staphylococcus aureus. High resistance rates were observed to commonly used antibiotics, including amoxicillin (94.1%), ampicillin (85.9%), and ceftazidime (79.6%). Notably, resistance to carbapenems such as imipenem (11.8%) and meropenem (16.6%) remained relatively low. Multidrug resistance (MDR) was prevalent among both Gram-positive and Gram-negative isolates.

Conclusion: The high prevalence of E. coli and significant levels of antimicrobial resistance underscore the urgent need for antimicrobial stewardship and updated local treatment guidelines. Stratified analysis revealed higher resistance in hospital-acquired infections, emphasizing the need for setting-specific guidelines. Methodological differences and the inclusion of potential duplicate isolates may have influenced resistance estimates. These findings underscore the urgent need for antimicrobial stewardship, carbapenem-sparing protocols, and national surveillance. Future studies should incorporate clinical outcomes and expand to other regions to inform national policy. Regular surveillance of uropathogens and their resistance profiles is crucial to combatting the rising trend of antibiotic resistance in Yemen.

Development and Validation of an ADR Awareness and Reporting Questionnaire for Pharmacovigilance in India

Athira P K — 2026-02-06

Introduction: Under-reporting of adverse drug reactions (ADRs) remains a major challenge in pharmacovigilance, particularly in low- and middle-income countries like India. Accurate assessment of knowledge, awareness, and reporting practices among healthcare students and professionals requires valid and reliable measurement tools.

Methods: A 25-item questionnaire was constructed based on pharmacovigilance guidelines, literature review, and expert input. Validation followed a multi-step process:

Face validity: evaluated by 9 educational experts using a 4-point clarity scale; Item-level and Scale-level Face Validity Indices (FVI) were calculated.
Content validity: assessed by the same expert panel using Lawshe’s Content Validity Ratio (CVR) and overall Content Validity Index (CVI).
Construct validity: examined through Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s test of sphericity.
Reliability: determined via Cronbach’s alpha in a pilot sample (n=10).
Pilot testing: conducted with 10 representative participants to assess feasibility, completion time, and acceptability.

Results: Face validity was excellent (average FVI = 0.9511; all items ≥ 0.78). Content validity was strong (21 items CVR = 1.00, 3 items CVR = 0.78; overall CVI = 0.9736), supporting retention of all 25 items. Sampling adequacy for factor analysis was meritorious (KMO = 0.812) with highly significant sphericity (Bartlett’s χ² = 2845.67, p < 0.001). Internal consistency was moderate (Cronbach’s α = 0.6849), acceptable for exploratory research. Pilot testing confirmed feasibility (completion time 10–15 minutes) with high participant-reported clarity and relevance; no major revisions were required.

Discussion: The developed 25-item questionnaire demonstrates excellent face and content validity, strong preliminary construct validity indicators, and acceptable reliability for early-stage pharmacovigilance research. It is a feasible, clear, and theoretically sound instrument suitable for assessing ADR awareness and reporting practices among healthcare students and professionals in India and similar settings. Further validation in larger samples and confirmatory factor analysis is recommended to strengthen psychometric properties.

Rheological Behavior of Pharmaceutical-grade Cellulose Ethers and Its Impact on Excipient Selection in Drug Formulations

Chinna Reddy Palem — 2026-02-09

Background & Scope: Pharmaceutical-grade cellulose ethers, such as hydroxypropyl methylcellulose (HPMC) and hydroxypropyl cellulose (HPC), are widely used as excipients due to their effects on viscosity, mechanical strength, hydration behavior, and drug release performance. In formulation development, excipient selection is commonly based on nominal viscosity grades; however, steady shear viscosity alone does not adequately describe the time dependent and deformation sensitive behavior that governs critical quality attributes and in-process performance.

Methodology: A comprehensive rheological evaluation of multiple HPMC and HPC grades obtained from different manufacturers was performed by preparing different concentrations of polymeric dispersions using steady shear and oscillatory rheometry. Flow sweep, amplitude sweeps, and frequency sweep analysis were conducted to characterize viscosity, viscoelastic behavior, and structural response under varying deformation conditions.

Results & Discussion: All cellulose ether samples exhibited non-Newtonian, shear thinning behavior. Distinct differences in viscoelastic properties were observed between polymer types and grades. HPMC demonstrated molecular weight and concentration dependent transitions toward elastic dominated, gel like behavior, while HPC remained predominantly viscous dominated under comparable experimental conditions. The observed differences in rheological behavior highlight the limitations of relying solely on nominal viscosity grades for excipient selection. Advanced rheological parameters, particularly viscoelastic characteristics, provide deeper insight into polymer structure property relationships and their impact on formulation performance.

Conclusion: This study underscores the importance of comprehensive rheological profiling beyond steady shear viscosity to support rational excipient selection and the design of robust pharmaceutical formulations involving cellulose ether polymers.

Protective Effect of Irvingia gabonensis leaf Extract and Fractions on N-methyl-Nitrosourea (NMU) and Testosterone Induced Prostate Cancer in Rats

Oluwasayo Esther Ogunjinmi — 2026-02-24

Background: The urgency of alternative, effective and less toxic treatment options has driven research towards natural products of plant sources. Irvingia gabonensis possesses promising anticancer properties due to its rich phytochemical content and antioxidant potential.

Objective: This study investigated the antioxidant properties and anticancer effect of I. gabonensis leaf extract and its fractions in a rat model of prostate cancer.

Method: Prostate cancer was induced in Wistar rats using N-methyl-nitrosourea (NMU) and testosterone. Prostate specific antigen (PSA) levels, liver function enzymes, and antioxidant markers (catalase, GSH, SOD) were evaluated, and histological analyses of prostate and liver tissues were performed by Hematoxylin and Eosin staining. Phytochemical characterisation of the crude extract was conducted using Gas Chromatography-Mass Spectroscopy. Data analysis was performed by ANOVA at 95% confidence level.

Result: Treatment with the I. gabonensis extract and fractions led to consistent weight gain and decreased PSA levels that were significant (p<0.05) to the cancer control group. The dichloromethane fraction significantly (p<0.05) increased catalase activity, and the methanol fraction significantly (p<0.05) increased GSH levels. Histological examination revealed preserved prostate tissue integrity in the treated groups compared to the untreated cancer group, although the treated groups exhibited some changes in liver function markers and histology. Phytol (17.07%), hexadecanoic acid, methyl ester (16.28%), 9-hexadecenoic acid, methyl ester (5.36%), 7-octadecenoic acid, methyl ester (7.11%), n-hexadecanoic acid (7.45%), and oleic acid (5.84%) were identified in abundance.

Conclusion: I. gabonensis leaf extract and fractions exhibited anti-prostate cancer effects by modulating antioxidant defence mechanisms, but the observed effects on liver function require further investigation.

Knowledge, Attitude, Pain Perception, and Dietary Patterns among Orthodontic Patients Treated with Conventional and Self-ligating Brackets: A Questionnaire-based Study

Rashi Tated — 2026-02-25

Background: Orthodontic pain is a common adverse effect that can influence treatment acceptance, oral hygiene, and dietary habits. Self-ligating brackets have been proposed to reduce discomfort compared with conventional brackets, potentially improving patient compliance and overall experience.

Aim: To assess and compare orthodontic knowledge, attitude, pain perception, and dietary modifications among patients treated with conventional versus self-ligating brackets.

Methods: A single-center, cross-sectional questionnaire-based study was conducted in the Department of Orthodontics, Chhattisgarh Dental College and Research Institute (CDCRI), Rajnandgaon, among 56 orthodontic patients (28 in each group) undergoing fixed appliance therapy. Data were collected using a pre-validated, self-administered questionnaire covering socio-demographic variables, pain characteristics, pain perception using a Visual Analog Scale (VAS), orthodontic knowledge, patient attitude, and dietary patterns. Intergroup comparisons were performed using Chi-square and Fisher’s exact tests for categorical variables and the Mann–Whitney U test for continuous variables. A p-value ≤ 0.05 was considered statistically significant.

Results: A total of 56 patients participated, equally divided between conventional and self-ligating bracket groups. Socio-demographic variables showed no significant differences (p > 0.05), though treatment stage distribution varied (p = 0.019). Pain duration was significantly longer in the conventional group (p < 0.001), with throbbing/shooting pain and continuous pain more common, while dull and intermittent pain predominated in the self-ligating group (p = 0.001, p = 0.031). VAS scores indicated higher separator-related pain in the conventional group (p = 0.001), with no differences for other procedures (p > 0.05). Patients with self-ligating brackets demonstrated significantly better orthodontic knowledge and more positive attitudes (p < 0.05), whereas dietary patterns were comparable across groups (p > 0.05).

Conclusion: Self-ligating brackets demonstrated advantages in reducing pain duration and enhancing patient knowledge and attitude, while dietary patterns remained comparable. Appliance selection and patient-centred education are essential for optimizing orthodontic outcomes.

An Assessment of Knowledge, Attitudes and Perceptions of Pharmacy Education Programs between Pharmacy Students in Libya

Mahmoud Elderbi — 2026-03-05

Background: In Libya, pharmacy education has traditionally followed a product-focused model, emphasizing pharmaceutical sciences and dispensing, with limited changes over the past decades despite evolving healthcare needs. The global shift towards patient-centered pharmacy practice has led to adoption of clinically oriented Doctor of Pharmacy (PharmD) programs in many countries, including recent curricular reforms in Libya. This study explores pharmacy students' knowledge, attitudes, and perceptions of Bachelor of Pharmacy (BPharm) and PharmD programs at Assalam International University (AIU) to inform ongoing educational development responsive to regional demands.

Study Design: The study is a cross-sectional survey involved 60 pharmacy students.

Place and Duration of Study: from the 2nd to 8th semesters at AIU during the 2024-2025 academic year.

Methodology: Using a validated self-administered questionnaire, the study assessed students' understanding of program curricula, professional outlook, and future career ambitions. Descriptive statistics summarized students’ responses.

Results: The students were generally aware of both BPharm and PharmD programs, showing strong preference for the patient-centered PharmD model aligned with modern healthcare roles. While confidence in clinical skills gained through the BPharm was moderate, students recognized the PharmD program as better suited for emerging pharmacy practice demands. Interest was high in postgraduate clinical pharmacy training.

Conclusion: The study concludes that pharmacy education at AIU is progressing towards a patient-centered, clinically focused PharmD framework, reflecting global trends. To bridge gaps in practical competence and enhance education quality, recommendations include increased experiential learning, national accreditation enforcement, faculty development, and expansion of postgraduate training pathways. These reforms aim to elevate pharmacy education and practice standards in Libya, ultimately benefiting healthcare delivery and patient outcomes.

Global Developmental Delay Associated with Microcephaly and Left-Sided Hydroureteronephrosis: A Pediatric Case Report

Rahul Shil — 2026-03-10

We report a child with typical clinical features of GDD alongside microcephaly and hydroureteronephrosis. Global development delay generally affects children in multiple developmental domains, which require a multidisciplinary treatment approach for diagnosis and treatment. It is pivotal to understand the relationship between global development delay (GDD) and associated conditions such as autism. With early diagnosis, targeted intervention, and supportive strategies, children with GDD can achieve significant milestones. The central nervous system (CNS) findings show bilateral exaggerated reflexes in the biceps, triceps, knee, and ankle and bilateral extensor reflex in the plantar side. Microcephaly was present in the head along with nystagmus in the eyes. Furthermore, the patient was also suffering from congenital talipes equinovarus (CTEV) in the lower limb. Prolonged use of aminoglycoside medications such as gentamicin and tobramycin can cause nephrotoxicity. Clinicians should be well-informed about potential side effects. Novel biomarkers like KIM-1 may offer earlier detection of nephrotoxicity. Additionally, surgical correction options such as cystoscopic ablation and pyeloplasty are also worth considering. In this case, a plaster cast was applied, and the child responded well during the follow-up period. After conservative treatment, the child’s vital signs remained stable, and there were no signs of infection.