Open Access Original Research Article

Association of dupA, iceA, homB Genes of Helicobacter pylori with Gastritis, Peptic Ulcer Disease and Gastric Cancer

Muhammad Akram Bajwa, Muhammad Idrees, Prem Kumar Maheshwari

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2020/v32i2530818

Objective: To determine the association of dupA, iceA, homB genes of Helicobacter pylori with gastro-duodenal diseases such as gastritis, peptic ulcer disease PUD and gastric cancer.

Materials and Methods: This cross-sectional analytical study was conducted at Gastroenterology Department, Shaikh Zayed Hospital Lahore. Patients with gastro-duodenal diseases and positive H. pylori were included. Gastric biopsies were taken from fundus, body and antrum. H. pylori DNA were removed utilizing Gentra DNA extraction Kit (Life Technologies, USA) as per the technique and Qualitative PCR for the recognition of H. Pylori DNA. The PCR primers sets were designed for the specific detection of dupA, iceA and homB genes of H. pylori. All the data was recorded in proforma and analyzed by SPSS version 20.

Results: Mean age of the cases was 41.22+8.04 years. Males were more affected 118(60.2%). HomB was the most common 76(38.8%) followed by dupA and iceA 28.6% and 24.5% respectively. Peptic ulcer disease and gastritis were higher among patients having dup A and iceA positive strains as compared to homB gene patients, while gastric cancer was significantly higher among HomB gene infected patients, p-values were quite significant.

Conclusion: It was concluded that homB gene was most frequent in H. pylori infected population. Peptic ulcer disease and gastritis are markedly associated with dupA and iceA genes, while homB gene infected patients are at high risk of gastric cancer.

Open Access Original Research Article

Effect of Grape Seed Extract in Minimizing the Harmful Effects of Monosodium Glutamate on the Chicken Embryonic Retina to Show Scientific Miracles In the Holy Quran

Fawzya Al- Gamdi, Nouf Al- Harbi

Journal of Pharmaceutical Research International, Page 7-18
DOI: 10.9734/jpri/2020/v32i2530819

In 1969, a Canadian laboratory announced that its studies on synthetic alkaline (cyclamate) proved to be a carcinogen despite its use for more than twenty years in the beverage industry. There are many additives that have raised the controversy about the large extent of safety to consumers and the most famous controversy and consumption is the article of monosodium glutamate (MSG) which touched research on the negative impact on samples of research experiments. This research aims to study the effect (MSG) on the formation of retina in chicken embryos and the potential improvement effects of GSE grape seed extracts during incubation as part of the solutions provided in the event of the long term use of MSG and its accumulation in the body Human. The experimental groups were divided into 4 groups based on the injection period and the injected substances. The first control group(Injected with saline), the second group, treated with  MSG, the 3rd group were treated with Monosoudim glutamate and grape seed extract at days 0,1 of incubation, whereas the 4thgroup,was treated with MSG and then the GSE (M – G) were given at3,4 days post MSG . The effect of the experimental materials on the development of the retina at the age of 14 was investigated in the current work. The results showed that the treatment of embryos with MSG dose (0.1 ml) caused many of the abnormalities at the level of tissue formation of the retina, and after the treatment of the fetus with GSE was noted to reduce the damage to the tissue of the retina. The results showed that the treatment of embryos with MSG dose (0.1 ml) caused many of the abnormalities at the level of tissue form of the retina, and after the treatment of the fetus with GSE was noted to reduce the damage to the tissue of the retina.

Open Access Original Research Article

Future Perspectives of Biomimetics in Restorative Dentistry

Nazwin Basheer, Manavalan Madhana Madhubala, Sekar Mahalaxmi

Journal of Pharmaceutical Research International, Page 19-28
DOI: 10.9734/jpri/2020/v32i2530820

The main goal of tooth restoration aims at achieving mineralization of initial enamel and dentinal lesions in native form.  Most of the restorative materials and remineralization adjuvants for enamel and dentin mineralization are evidenced in the literature. Although commercially available restorative materials exhibit superior esthetics, mechanical properties and cost effectiveness, durability of the restoration threatened by the occurrence of inadequate strength, long-term solubility, and weaker adhesion to tooth and accelerated degradation after being bonded to tooth structure. Recently, the role of biomimetic science in restorative dentistry aims at creating a restoration that can be highly compatible with the structural, functional and biologic properties of dental tissues to reproduce and emulate the original performance of the intact tooth with high durability. In order to recover the prismatic structure in mineral-depleted enamel and to achieve interfibrillar mineralization in dentin, non-collagenous protein analogues have been proposed as templates for apatite deposition. Biomimetic analogues must be necessary to achieve functional mineralization and to recover the dynamic mechanical properties of teeth. The use of these analogues associated with ion-releasing materials seems to be a promising approach for both enamel and dentin remineralization. This review enlightens the current and future perspectives of biomimetic analogues used for enamel and dentin remineralization as the clinical translation of this biomimetic research can be considered as the boon to restorative dentistry.

Open Access Original Research Article

Olive Oil Based Organogels for Effective Topical Delivery of Fluconazole: In-vitro Antifungal Study

Mohammad Muqtader Ahmed, Farhat Fatima, Abdul Bari Mohammed

Journal of Pharmaceutical Research International, Page 29-36
DOI: 10.9734/jpri/2020/v32i2530821

The objective of the study was to formulate olive oil based organogels for the topical application of fluconazole (FLZ), to ensure the efficient delivery of the drug deeper in to the skin layers.

Methods: Nine formulations developed by hot-melt method using olive oil, sorbitan monostearate (SMS) and FLZ. Prepared formulations characterized for macro evaluations, pH, spreadibility, viscosity, gel-sol transition, in-vitro diffusion study. Further optimized formulation evaluated for ex-vivo percutaneous permeation, in-vitro antifungal studies and stability studies by similarity index. Results: The results of evaluated parameters ensure the stability and effectiveness of the prepared olive oil based organogels. In-vitro diffusion studied reflects decrease in drug release with increase in surfactant concentration due to increase in viscosity. Moreover, ex-vivo permeation studies revealed that the permeation of FLZ was enhanced for optimized formulations (F6) as compared to the marketed gel formulation. Further, the optimized formulation exhibits the broad zone of inhibition against fungal strains in comparison to control and marketed product during in-vitro antifungal study.

Conclusion: The olive oil based organogels formulation shown the enhanced permeation of FLZ from organogel network structure with good antifungal activity as compared to the marketed formulation. Henceforth, the FLZ organogel formulations could be used topically for the effective treatment of fungal infection.

Open Access Original Research Article

An Exploratory Study of Consumers’ Social Behavior towards Role of Malaysian Community Pharmacists in Providing Healthcare

Alamin Hassan Mohamed Alamin Alabid, Mohamed Izham Mohamed Ibrahim, Mohamed Azmi Hassali, Subish Palaian

Journal of Pharmaceutical Research International, Page 37-51
DOI: 10.9734/jpri/2020/v32i2530822

Aims: Consumers’ awareness, perceptions, expectations and experiences are integral components of their satisfaction towards the quality of care provided by community pharmacists. This study aims to assess consumers’ awareness, perceptions, expectations and experiences about the role of Malaysian community pharmacists in providing healthcare.

Study Design:  Cross-sectional study.

Place of Study:  Penang state in the north of Malaysia. 

Methodology: A survey was carried out by conveniently selecting the consumers patronizing the community pharmacies.  A pretested and validated survey tool with different domains (Cronbach’s alpha ranged from 0.577 to 0.774) was used. Descriptive and inferential statistics (Chi-Square, Mann-Whitney and Kruskal-Wallis tests) were used for analyzing the data using SPSS program, Version 26.

Results:  Of the total 424 questionnaires distributed, 195 (46%) were returned and usable.  The median age of the consumers was 30 (IQR = 28-38).  Majority of them were female, Chinese, living in urban area and having a bachelor degree. The mean awareness score was 8.39 (± 2.00), mean perception score was 2.95 (± 0.83), mean expectation score was 3.70 (± 0.13), and mean experience score was 3.17 (± 0.97). Trusting a pharmacist’s advice about medicines was significantly associated with the consumer’s age (p= 0.030). age of the consumers was a significant determinant in their perception of community pharmacists suggestions about the use of certain prescription medicines to patients and physicians (p = .001 and p = 0.014, successively).  The strongly anticipated that community pharmacists should monitor responses to drug therapy and        be more concerned with the patient rather than being profit-oriented (medians = 5 and 4, respectively).

Conclusion:  The consumers in this study were aware of the role of community pharmacists in community pharmacies and healthcare settings.  They also reported high perception, expectation and positive experience with the community pharmacists.

Open Access Original Research Article

18β-glycyrrhetinic Acid Induces Cell Cycle Arrest and Apoptosis in HPV18+ HeLa Cervical Cancer Cells

Mohd Saeed

Journal of Pharmaceutical Research International, Page 52-66
DOI: 10.9734/jpri/2020/v32i2530823

Aims: In recent years, natural products have received great attention to cancer prevention owing to their various health benefits, lack of toxicity, and side effects. Accumulating evidence shows that 18β-glycyrrhetinic acid (GRA) has antiproliferative and apoptotic activities on many cancer cell lines, while its role in cervical cancer remains unknown. Thus, the current research was         conducted to illustrate GRA's cytotoxic effect against the HeLa cell line of HPV18 + human cervical cancer.

Methodology: The effect of GRA on HeLa cell line was tested by MTT and Trypan blue dye exclusion assay. Cell cycle analysis was carried out by flow cytometry after PI staining. Apoptosis was assessed after annexin V / PI double staining by flow cytometry. The Caspase activation assay kit analysed caspase activation. Reactive oxygen species (ROS) generation was measured by fluorimeter after DCFDA dye staining.

Results: Results of the current study have shown that GRA exposure significantly inhibited the cell viability of HeLa cells in a dose- and time-dependent manner. GRA induced growth arrest of HeLa cells at G0/G1 phase of the cell cycle. Moreover, GRA's antiproliferative action was mediated through apoptosis, as evident from caspase-3 and -9 activation. Caspase inhibitors blocked the GRA-induced caspase activation and ameliorated the GRA-induced cytotoxicity. This suggested the role of the intrinsic pathway of apoptosis stimulated by GRA.  The intracellular ROS generation assay showed a dose-related increment in ROS production induced by GRA. Co-culturing of HeLa cells with N-acetyl cysteine (NAC), a ROS inhibitor, completely abrogated GRA-induced cell cycle arrest and apoptosis. Thus, the effect of NAC suggested the involvement of intracellular ROS in the GRA-induced cytotoxicity.

Conclusion: In summary, GRA exhibited strong antiproliferative and apoptotic properties and, thus, could act as an adjunct in the prevention and management of cervical cancer.

Open Access Original Research Article

Selected Plant Extracts Attenuates Dimethylamine and Sodium Nitrite Induced Liver Injury in Experimental Mice

Adewale Adetutu, Olusoji Abiodun Owoade, Ifewumi Racheal Aderibigbe, Olubunmi Simeon Oyekunle, Peter Ifeoluwa Adegbola, Biodun Bukunmi Aborisade, Temitope Deborah Olaniyi, Fatima Aluko Abubakar

Journal of Pharmaceutical Research International, Page 76-88
DOI: 10.9734/jpri/2020/v32i2530825

Dimethylamine (DMA) and sodium nitrite (NaNO2) are present in numerous foods, food additive and environmental factors, which enhance chemical driven liver damage by inducing oxidative stress and cellular injury. Therefore, this study evaluated the possible therapeutic and protective effects of selected plant extracts on dimethylamine (DMA) and sodium nitrite (NaNO2)-induced hepatotoxicity in mice.

The selected plants (Morinda lucida, Securine gavirosa, Xylopia aethiopica, Piper guineense and Calotropis procera) were extracted by maceration in distilled water and concentrated using freeze dryer. Swiss male albino mice were divided into  Group I (control group) received distilled water; group II were administered orally with DMA (150 mg/kg body weight) and NaNO2 (100 mg/kg body weight) twice every  week for 4 weeks, group III were treated orally with  extract every 48 hrs simultaneously with DMA and NaNO2  and continued until the end of the experiment, group IV  were treated orally with extract and fractions (150 mg/kg body weight) every 48 hrs for four weeks after the administration of DMA and NaNO2  and continued until the end of the experiment (4 weeks) and group V were given 5-flourouracil every 48 hours after induction of liver toxicity in mice. Liver function (alanine amino transferase, aspartate amino transferase, gamma glutamyl transferase and alkaline phosphatase) tests were done in the serum of mice using standard method. Extract of P. guineense exhibited the best activity and was fractionated for further hepatoprotective studies. Liver sections of the mice treated with fractions of P. guineense were used for immuno-histochemical studies for p53, BCl-2, COX-2 and Ki-67 expression, and liver histological analysis. The antioxidant status of the mice treated with fractions of P. guineense was determined by measuring the catalase activity, sodium dismutase activity, reduced glutathione and malondialdehyde concentrations in the liver homogenates. Data were expressed as mean and considered significant at p<0.05 by one-way Analysis of Variance using Graph Pad Prism 5.

The results of this study showed that activities of liver enzymes were significantly (p<0.05) decreased in groups treated with aqueous extracts after liver toxicity induction in mice. Treatment with fractions of P. guineense enhanced the antioxidant status of the mice administered with DNA/NaNO2. Oral administration of fractions of P. guineense to mice conferred hepatoprotection as evident from normal serum enzyme levels and reduced injuries on hepatocytes. Immuno-histochemical analysis of the liver samples revealed reduction in the expression of anti-apoptotic protein BCl2 and COX-2 in the mice treated with fractions of P. guineense and non-expression of cell cycle regulator p53 and Ki-67 after toxicity induction in mice.

The ability of the selected extracts and fractions of P. guineense to impose certain ameliorative effects on DMA and NaNO2 induced toxicities in mice provided some scientific basis for their use in traditional medicine.  The extracts might be used for liver toxicity treatment and/or prevention.

Open Access Original Research Article

Gravity of Poisoning Cases in Shaheed Benazirabad Sindh, Pakistan: A Prospective Study

Shaib Muhammad, Narendar Kumar, Yasmeen Qureshi, Geeta Kumari, Jabbar Abbas, Razia Sultana, Muhammad Saleh Khaskheli, Arslan Ahmer, Jameela Jamali, Rafia Tabassum

Journal of Pharmaceutical Research International, Page 89-98
DOI: 10.9734/jpri/2020/v32i2530826

Aim: It is estimated that more than half a million of people die worldwide due to various incidences of intentional and unintentional poisoning and of them 84% occur in low- and middle-income countries. The clinical presentation of poisoning cases differs by age group, reason of poisoning, geographic region, substances involved and economic development of the country. The aim of present research was to estimate the incidence of poisoning in Shaheed Benazirabad based on above reasons.

Study Design: Cross-sectional prospective study.

Place and Duration of Study: Over a period of 6 months between July to December 2019 in a tertiary care hospital in Sindh, Pakistan.

Methodology: Study was carried out by enrolling poisoned patients admitted in a tertiary care hospital. A standardized questionnaire was designed based on different variables in surveys conducted by American Association of Poison Control Centers. In total 263 poisoning cases were presented during the study period. The data obtained was coded, entered and analyzed using SPSS 24.

Results: It was found that poisoning was more common in male (58.9%) in the age group of 16 to 30 years (48.7%) and single individuals (56.3%) with uneducated (55.1%) and jobless (54%) background. The common reasons of poisoning were suicide (36.5%) and substance involved in poisoning cases were pesticides (42.6%). Of the total cases reported during study period, 17.5% were admitted in Intensive Care Unit and death was reported in 5.3% of cases. 

Conclusion: It was found that improved regulatory controls for hazardous chemicals, establishing poison control centers and decreasing exposure and reporting time can decrease poisoning cases.

Open Access Original Research Article

Segments Associated with the Discernment of Risk and Information of Contracting the 2019-nCoV in India

L. Vijayakumar, J. Sharmila

Journal of Pharmaceutical Research International, Page 99-105
DOI: 10.9734/jpri/2020/v32i2530827

This examination explored hazard discernment and mindfulness among India grown-up members about Coronavirus Disease 2019 (COVID-19). Two self-managed online studies were led on 1000 respondents (320 and 680 members, individually) during the lockdown time frame in India at two separate time focuses from 26-31 March 2020 (early lockdown) and 11-16 May 2020 (late lockdown) by means of internet based life. Univariate and numerous straight relapse models were utilized to look in danger observation and information related elements toward COVID-19. Scores of mean information (8.4 versus 8.0, P=0.021) and impression of hazard (11.2 versus 9.4, P < 0.001) vary altogether among right on time and late lockdown. There was a huge reduction in saw hazard scores for contracting 2019-nCoV [β=-0.83, 95%CI: - 1.29, - 0.29], while information around 2019-nCoV diminished yet not critical [β=-0.21, 95%CI: - 0.45, 0.02] in late lockdown contrasted and early lockdown period. High rehearsed isolate and isolated in line with general wellbeing specialists during COVID-19 were regular variables related with expanded apparent hazard and information on contracting 2019-nCoV. Any activity in India to raise open information and comprehension of COVID-19 would then organize male who have performed low isolate and are less worried about the transmission of this sort of pathogen.

Open Access Original Research Article

Neonatal Bacterial Sepsis and Its Susceptibility Pattern in Neonatal Care Unit of Tertiary Care Hospital

Abdul Hameed Tunio, Delijan Mugheri, Muhammad Khan, Wasim Sarwar Bhatti, Abdul Majeed Soomro, Pir Bux Ghumro, Sultan Othman Alolayan, Waseem Abbas Malhani, Nadeem Baloch, Altaf Ali Mangi, Zehra Ahraf, Saika Lashari, Kanwal Baloch, Shumaila Parveen Arain

Journal of Pharmaceutical Research International, Page 106-111
DOI: 10.9734/jpri/2020/v32i2530828

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management.

Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases).

Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.

Open Access Original Research Article

Cytotoxicity of Iron Nanoparticles Synthesized Using Dried Ginger

Akifa Begum, M. Jeevitha, S. Preetha, S. Rajeshkumar

Journal of Pharmaceutical Research International, Page 112-118
DOI: 10.9734/jpri/2020/v32i2530829

Zingiber officinale (also called ginger) is commonly used for traditional treatment of various diseases and for culinary purposes. This plant species is a herbaceous and develops yearly pseudostems around one meter tall bearing limited leaf cutting edges. The synthesis of metal nanoparticles and nanocomposites is an emerging area of research and exploration in the field of material science for their unique size and shape and have reliant features that are different from the regular bulk structure. The aim of the present study was to synthesize iron nanoparticles using dried ginger and evaluate their cytotoxic effects against brine shrimp. The nanoparticles were synthesized using dried ginger and characterized by UV-vis spectroscopy. The cytotoxicity assessment was carried out using brine shrimp lethality assay. The iron nanoparticles did not show any cytotoxicity to the brine shrimp. This eco-friendly synthesis of iron nanoparticles from dried ginger has proved to be convenient, inexpensive and can be safely used in wide range of medicine and dental fields.

Open Access Original Research Article

Facilitators and Barriers to Self-Monitoring of Blood Glucose (SMBG) in Diabetic Patients

Asif Hakim Brohi, Arsalan Hakim, Shafi Muhammad Wassan, Abdul Majeed Soomro, Wasim Sarwar Bhatti, Abdul Hameed Tunio, Andeep Kumar, Nadeem Baloch, Waseem Abbas Malhani, Altaf Ali Mangi, Yaser M. Alahmadi, Kanwal Baloch, Muhammad Khan, Shumaila Parveen Arain

Journal of Pharmaceutical Research International, Page 119-127
DOI: 10.9734/jpri/2020/v32i2530830

Objective: To determine factors that facilitate and are barriers to self-monitoring of blood glucose in type 2 diabetic patients visiting family medicine clinics at a tertiary care teaching hospital Karachi Pakistan.

Methods: Approximately 255 patients were consecutively recruited from the clinics during April 2018 to May 2019 at Family Medicine outpatient clinics at the Aga Khan University Hospital. Data on socio-demographic status, facilitators and barriers to SMBG were extracted through a questionnaire, after obtaining an informed written consent. Data was entered and analyzed in SPSS version 19.

Results: Among study participants 47.5% were above 50 years and 51.4% were males. About 30.2% of the participants were practicing SMBG at least once a month and 26% were practicing it daily. Fear of complications was the biggest facilitator (80.1%) and being expensive (51.4%) was barrier for SMBG. Over half of the SMBG practicing participants (59.7%) were diagnosed with diabetes for more than 05 years (p: 0.63).

Conclusion: Assessment of blood glucose is a critical component of diabetes treatment and management. It can motivate patients to become active participants in their own care. Health care providers should communicate and educate the patients about the advantages of SMBG.

Open Access Original Research Article

Adherence of Streptococcus mutans to Nanoceramic and Nanohybrid Resin Composites: An In vitro Study

Krishnakanth Jaju, Iffat Nasim

Journal of Pharmaceutical Research International, Page 128-133
DOI: 10.9734/jpri/2020/v32i2530831

Streptococcus mutans (S. mutans) is one of the cariogenic microorganisms. The restorative materials which harbor a biofilm with high number of S. mutans can accelerate the occurrence of dental caries. The purpose of this study was to evaluate the adherence of S. mutans to nanoceramic and nanohybrid resin composites. Fifteen discs of each material (Nanohybrid resin composite, Nanoceramic resin composite) were prepared, polished, and sterilized in a gamma radiation chamber. Specimens were exposed to the S. mutans bacterial suspension (0.5 McFarland) and were incubated for 4 hours. Specimens were rinsed and sonicated in normal saline, 10 μl of the obtained suspension was cultured in a sterile blood agar medium. After 24 hours, the number of colony forming units of S. mutans was counted. A sterility test control was considered for each group of materials. The data was analyzed by Independent t test. The means and standard deviations of the logarithmic counts of the colonies on the surfaces of nanohybrid resin composites and nanoceramic resin composite were equal to 3.2±0.87 and 2.8±0.324 respectively. Ceram X Universal did not show any significant difference in the bacterial adhesion compared to Filtek Z350XT. Both composites showed similar behaviour in terms of S. mutans colonization in a simple biofilm formation model.

Open Access Review Article

Cytokine Storm, Corticosteroids and İnterleukin-6 Receptor Antibodies in Context of Antiinflammatory Treatment in COVID-19

Ozgur Karcioglu, Goksu Afacan, Bilgen Ozkaya, Ebru Yilmaz, Eylem Ersan, Selman Yeniocak, Mandana Hosseinzadeh

Journal of Pharmaceutical Research International, Page 67-75
DOI: 10.9734/jpri/2020/v32i2530824

It is well established that cytokine storm is associated with more severe clinical course of COVID-19. Many clinical findings of COVID-19 and other severe viral infections (e.g. fever, muscle pain, respiratory distress, cough), are directly attributed to cytokine storm. For example, IL-6 and IL-10 can be used as predictors for expedient diagnosis of patients with higher risk of deterioration. Hyper-inflammatory status in patients with severe COVID-19 is to be mitigated to alleviate signs and symptoms in cytokine storm. In case of deterioration of oxygenation and rapid progression of imaging (CT) findings, glucocorticoids can be used for a short time (3-5 days) for patients in whom overactivation of the body's inflammatory response is suspected. On the other hand, interleukin-6 receptor antibodies tocilizumab, sarilumab, siltuximab can be used as immunomodulators, to suppress inflammation and to alleviate fever and other manifestations of immune response. Their beneficial efficacy is especially remarkable during the cytokine storm period. It should be kept in mind that the agents to be used in the management of any given patient should be tailored for each situation.

Open Access Review Article

Antiplatelets, Anticoagulants and Its Implications in Dentistry-A Review of Literature

Amanthi Ganapathi, Jagadish Vijayakumar

Journal of Pharmaceutical Research International, Page 134-146
DOI: 10.9734/jpri/2020/v32i2530835

Oral health care providers must be aware of the impact of bleeding disorders on their  patients during any dental procedure and management of such mishaps. Adequate knowledge of the mechanisms underlying hemostasis, and the optimised management of such patients, are therefore very important for these issues. Initial recognition of a bleeding disorder, in such patients with a systemic pathologic process, may occur in dental practice. The dental treatment of these patients might get complicated during the course of the treatment due to the use of anticoagulant and/or antiplatelet drugs raises a challenge in the daily practice of dental professionals. Adequate hemostasis is critical for the success of any invasive dental procedure, because bleeding problems can give rise to complications associated with important morbidity-mortality. Besides, prophylactic, restorative and surgical dental care of patients with any bleeding disorders is handled skilfully by practitioners who are well educated regarding the pathology, complications which could arise and treatment options associated with these conditions. The purpose of this paper is to review common bleeding disorders and their effects on the dental aspect. Many authors consider that patient medication indicated for the treatment of background disease should not be altered or suspended unless so indicated by the prescribing physician. Local hemostatic measures have been shown to suffice for controlling possible bleeding problems resulting from dental treatment.