Open Access Original Research Article

Lower Limb Varicose Veins's Clinical Profile and Management

C. Z. Perdeshi, Kustub A. Kulkani, Revendra N. Yadav, Mayur Nagwakar, Niten H. Patil

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2020/v32i3030894

The lower limbs’ venous system has the pressure of posture, and blood has to be pushed against gravity into the heart cavity. This issue is generally approached either by a cautious approach or by surgical interference, all of which are constrained. Attempts to study different clinical manifestations of varicose veins are being made in the present study. The overall number of 50 varicose vein patients was analysed and the study results were reported. Varicosity veins of the lower limb is a fairly normal pathological entity. In the 20-50 age range, the condition is more common. The main modality of the procedure is surgery. The most common technique performed is Saphenofemoral flush ligation with stripping. 

Open Access Original Research Article

Factors Responsible for Late Presentation of STEMI Patients in our Population

Ghulam Fareed Shah, Shahid Hussain Memon, Anwar Ali Shaikh, Abdul Ghaffar Memon, Jagdesh Kumar, Tabassum Almas

Journal of Pharmaceutical Research International, Page 6-10
DOI: 10.9734/jpri/2020/v32i3030895

Objective: To determine the reasoning factors responsible for late presentation of ST elevation myocardial infarction patients at tertiary care Hospital.

Methodology: This cross-sectional study took place at cardiology department of Liaquat         University of medical and health sciences. Study duration was 6 months from June 2018 to November 2018. All the patients those were diagnosed as ST elevation myocardial infarction, reached delayed in Hospital and either of gender were included. Patients or their attendant were interviewed regarding demographic information including reasons of delayed reaching in Hospital. All the information was collected via self-made proforma. Data analysis was done by SPSS version 20.

Results: Total 64 patients were interviewed to assess the reasons of late arrival. Patients mean age was 55.90+12.88 years. Males were commonest 51(79.7%). Most of the cases 44(68.8%) were illiterate. According to the pain arising time most of the patients 84.4% reached after 24 hours. Most common reasons which were responsible for late arrival were lack of medical knowledge and late referral by local health care facilities; followed by 10.9% patients had financial issues, 12.5% due to negligence and 09.4% reached late due to unavailability of resources.

Conclusion: In these study causes of delayed arrival were lack of medical knowledge and late referral followed by financial problems, negligence and unavailability of resources.

Open Access Original Research Article

Presence of Cardiac Troponin I in Patients with Acute Exacerbation of COPD

U. T. Mane, Rahul S. Patil, A. T. Pardesi, Anil Bhattad, Vaibhav Agarwal

Journal of Pharmaceutical Research International, Page 11-15
DOI: 10.9734/jpri/2020/v32i3030896

Chronic obstructive pulmonary disease (COPD) is frequently associated with right ventricular loading and pulmonary hypertension. We aimed to evaluate a possible association between cardiac troponin I (cTnI) levels and adverse events in hospitalized patients with acute exacerbation of COPD. 120 Patients with acute exacerbation of COPD were studied between 18 months (October 2014 to March 2016). A Male preponderance was found with M: F ratio being 3:2. 35% were current smokers. In hospital mortality in group 1 was 14.3% and in group 2 was 1.9%. Thus cardiac troponin I can be taken as a marker to identify high risk patients during acute exacerbation of COPD.

Open Access Original Research Article

Public Stigma, Knowledge and Behaviors of the Attendees of Outpatient Clinics towards People with Mental Illness, Jeddah, Saudi Arabia

Nahla Khamis Ibrahim, Lamis Abdulrahman Wayyani, Ola Ahmed Alhusaini, Rakan Alotaibi, Jawaher Al- Ahmadi, Bahaa Abalkhail

Journal of Pharmaceutical Research International, Page 16-27
DOI: 10.9734/jpri/2020/v32i3030899

Background: Mental stigma represents a critical obstacle for delivering mental health care.

Aims: To determine public stigma, knowledge & behaviors of the attendees of outpatient clinics towards People with Mental Illness (PWMI), King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.

Methods: A cross-sectional study was done in 2018. A sample of 600 attendees of outpatient clinics of KAUH were included. A standardized interviewing data collection sheet was used. It included three scales namely: the Community Attitudes towards the Mentally Ill (CAMI), Mental Health Knowledge Schedule (MAKS) & Reported and Intended Behavior Scale (RIBS). Authoritarian, socially restrictiveness, benevolent & Community Mental Health Ideology of CAMI sub-scales were calculated. Descriptive, inferential, and multiple linear regression analyses were applied.

Results: About two-thirds of the participants agreed that mental illness causes lacking self-discipline & will power. Gender was significantly associated with all CAMI sub-scales (P < 0.01). An increasing level of knowledge about mental illness was associated with lower stigma towards PWMI (P< 0.001). After controlling confounders in regression analyses, gender and knowledge were significant predictors of all CAMI sub-scales. Concerning MAKS, about half of participants incorrectly identified stress & grief as types of mental illness. Regarding RIBS, living with (30.2%), and having a neighbor (28.8%) with mental illness were the commonest reported experiences.

Conclusions: Negative attitudes towards PWMI still prevailed. Mental stigma was higher among males, older people, lower-educators, lower-income & those with poor mental knowledge. Participants had a moderate intention to accept PWMI. Anti-stigma intervention educational programs are required.

Open Access Original Research Article

Diagnostic Utility of Electrocardiogram and Transthoracic Echocardiography in Diagnosis of Left Ventricular Hypertrophy among Known Hypertensive Patients

Amit C. Botre, U. T. Mane, Dilip P. Patil, A. T. Pardesi, Anil Bhattad

Journal of Pharmaceutical Research International, Page 28-32
DOI: 10.9734/jpri/2020/v32i3030900

The purpose of the study is to find out presence of LVH by 2D Echo in all cases of hypertension in relation to their duration and severity. In this study it was observed that 59% subjects were males and 41% were females and the mean age of males and females was 64 yrs. Majority of them 36.5% were in the age group of 61-70 yrs, out of them majority of females 48.6% were from age group 71-80 yrs and majority of males 76.5% were from age group of >80 yrs. Study showed that occurrence of LVH by Interventricular septal thickness criteria and Left ventricular posterior wall thickness criteria of 2D Echo in relation to duration of hypertension was statistically not significant. Occurrence of LVH by interventricular septal thickness criteria and Left ventricular posterior wall thickness criteria of 2D Echo in relation to severity of hypertension was statistically not significant.

Open Access Original Research Article

The Prescribing Trends of Vitamin D Supplements and the Concurrent Use of Medicines for Chronic Conditions

Nehad J. Ahmed, Menshawy A. Menshawy

Journal of Pharmaceutical Research International, Page 33-39
DOI: 10.9734/jpri/2020/v32i3030901

Aim: This study aims to determine the prescribing patterns of vitamin D supplements in a public hospital in Al-Kharj.

Methodology: This cross-sectional drug utilization study was conducted at a public hospital in Al-Kharj that included a review of the outpatient electronic prescriptions in 2018. Therefore, inclusion criteria included the outpatient prescriptions that contain Vitamin D supplement in 2018. The data were collected using Microsoft Excel® and the descriptive data were represented as numbers and percentages.

Results: In 2018, 311 patients were prescribed Alfacalcidol. Most of the patients who received Alfacalcidol were females (76.21%), aging 40-69 (58.85%). The majority of Alfacalcidol drugs were prescribed by Internal Medicine department (56.91%). In 2018, 127 patients were received Cholecalciferol. Most of the patient were females (79.53%), in the age level between 30-39 (21.26%) followed by patients less than 10 years (18.90%). The majority of Cholecalciferol drugs were prescribed by Internal Medicine department (30.71%).

Conclusion: Vitamin D supplements were used frequently with other medicines for chronic conditions. More studies are needed to know the effect of Vitamin D supplements in the prevention or treatment of chronic diseases. Moreover, in order to use vitamin D supplements correctly, it is important to know the prescribing trends of these supplements.

Open Access Original Research Article

High Sensitive C- Reactive Protein in Patients with Angiographically Proved Coronary Artery Disease

Anil Bhattad, A. T. Pardesi, Nitin Jadhav, Vaibhav Agarwal, Jabbar Desai, R. J. Kapale

Journal of Pharmaceutical Research International, Page 40-45
DOI: 10.9734/jpri/2020/v32i3030902

Introduction: Atherosclerosis is associated with increased inflammatory activity and risk of vascular disease. The hypothesis is that, the hs-CRP testing might have prognostic usefulness for patients with CAD. Considering a major role of hs-CRP in atherothrombosis, its measurements can provide a novel method to detect individuals at high risk of rupture of plaque.

Aim of the Work: This study was performed to find out the relation of high sensitive CRP (hs-CRP) with angiographically proved coronary artery disease (CAD) and its severity.

Methodology: Total 125 patients underwent CAG in present study, of them 36% were females and 64% were males, predominated by male sex (‘p’ <0.001.

Results: The mean for hs-CRP levels was 1.67(±0.85) mg/L and significantly high in patient with CAD. Strong correlation was formed between age ≥ 45 years and hs-CRP 1-3 mg/ L in present cohort of CAD. About one third of population with CAD had dyslipidemia of them majority (2/3rd) had hs-CRP 1-3 mg/L. Two-third of patients with CAD with tobacco consumption in any form had hs-CRP 1-3 mg/L and was significant than < 1 mg/L and >3 mg/L hs-CRP level. The hs-CRP level associated favorably with the frequency and extent of the CAD in present study (r=0.664).

Conclusion: High sensitive CRP offers better risk stratification, predictive and prognostic value, in patients with CAD. Further studies and interventions are mandatory to identify the independent role of hs-CRP as a CAD risk factor and its cost effectiveness in a population of a developing country like India. 

Open Access Original Research Article

A Study of Functional Outcome of Bimalleolar Fracture

Nitin S. Patil, Nishant K. Gaonkar, Shrikant K. Dalal, Avate Shivaji

Journal of Pharmaceutical Research International, Page 62-68
DOI: 10.9734/jpri/2020/v32i3030904

The results of bimalleolar ankle fractures are better with emphasis on anatomical reduction of fracture, stable internal fixation, regaining full fibular length and early active pain free mobilization, since the advent of A.O principles of management. This study analyzes the functional outcome of Ankle joint after Internal Fixation of bimalleolar fracture. This study was done to evaluate the functional outcome of ankle joint after internal fixation of bimalleolar fracture, those which were operated with different modalities. Classifications used were Lauge-Hansen Classification and Danis-Weber Classification. Road traffic accident, Twisting injury and Fall from height were major mode of injury. Cannulated cancellous screw, Malleolar Screw and TBW used for medial malleolus and semi tubular plate, cannulated cancellous screw and Rush Nail used for fibula are common mode of fixation. According to Baird and Jackson scoring system out of 40 cases, 92.5% were excellent and good, 5% were fair and 2.5% were poor. Anatomical correlations suggest reduction and stable internal fixation restore the articular congruity of ankle joint results in high percentage of excellent and good results.

Open Access Original Research Article

The Essential Oils-bearing Plant Containing Eugenol in Vietnam

Le Huy Hai, Le Mai Xuan Truc, Nguyen Quoc Trung

Journal of Pharmaceutical Research International, Page 69-74
DOI: 10.9734/jpri/2020/v32i3030905

Aim and Objectives: Eugenol is widely used in the pharmaceutical and aromatic industries, so the task of surveying to find essential oils containing eugenol is very important. The purpose of this study is to investigate essential oil-bearing plants containing eugenol in Vietnam for pharmaceutical and aromatic industries.

Materials and Methods: By the method of fresh sampling of essential oil plants, essential oils are extracted by steam distillation and then analyzed by high-resolution gas chromatography (HRGC) to identify eugenol sources.

Results: We have found that a lot of plants containing high eugenol content mostly grow wild in forests such as Hiptis suaveolens Poit. containing 62-67% eugenol, Cinnamomum verum Prest: 75-80%, Camellia sasanqua Thumb.: 90-95% can be used to exploit essential oils and extract eugenol. We also pointed out that essential oil plants containing high eugenol as Cestrum nocturnum L.: 50-55%, Ocimum sanctum L.: 60-65%, Ocimum gratissimum L.: 65-75% can be cultivated to obtain eugenol for the pharmaceutical and aromatic industry.

Conclusions: During the survey, we discovered and made a list of 10 plants as a source of essential oils containing eugenol in Vietnam. The rainy season in Vietnam is from June to September. During this season, the essential oil content in the fresh leaves is lower than in the dry season, therefore, the eugenol content in the essential oils is low. However, due to the strong-growth of plants in the rainy season, a lot of fresh leaves can be harvested, which mean there are more essential oils presented to be extracted.

Open Access Original Research Article

Clinico - Hematological Profile of Nutritional Anaemia among Adolescent Girls in Rural Area

G. G. Joag, M. N. Karanjkar, Danesh B. Potdar, Jalinder M. Pawar

Journal of Pharmaceutical Research International, Page 75-79
DOI: 10.9734/jpri/2020/v32i3030906

Anaemia in adolescent girls contributes to prenatal morbidity and mortality in the future. The present study was undertaken with the aim of studying the clinical-haematological profile of anaemia in adolescent girls in the North Indian tertiary care hospital. Among 380 adolescent girls, hemoglobin concentration was less than 12 gm/dl among 172 (45.3%) girls which was classified as anemia. 91 (52.9%) girls were classified as having mild anemia (Hb- 11.0 to 11.9 gm/dl), 69 (40.1%) had moderate anemia (Hb- 8.0 to 10.9 gm/dl) and 12 (7.0%) girls had severe anemia (Hb- less than 8 gm/dl). Most common cause of anaemia was iron deficiency anaemia. Mean  age of study participants was 14 years with Standard deviation of 2.73. In the present study, prevalence of anemia increases with increase in socio- economic class of study participants. Prevalence of anemia was more in underweight girls in comparison to those girls who had normal range of BMI.

Open Access Original Research Article

Age-Related Prescribing Patterns of Antihypertensive Medications

Nehad J. Ahmed, Menshawy A. Menshawy, Ziyad S. Almalki

Journal of Pharmaceutical Research International, Page 80-85
DOI: 10.9734/jpri/2020/v32i3030908

Introduction: Hypertension is the most common modifiable risk factor for cardiovascular diseases, renal failure, and stroke. Previous studies showed that prescription patterns of antihypertensive drugs varied by gender.

Aim: This is a retrospective study that was conducted to describe the difference in prescribing antihypertensive drugs according to patients’ age.

Methodology: In this study, the electronic prescriptions of hypertensive patients that were dispensed from the outpatient pharmacy of a public hospital in Alkharj were revised.

Results: Generally, older patients are using antihypertensive drugs more than younger adults and their usage pattern of antihypertensive drugs is different according to age.

Conclusion: It is important to know the age-related prescribing patterns of antihypertensive drugs and to know the efficacy and safety of these agents in different patients in order to develop an evidence-based and age-appropriate antihypertensive pharmacotherapy.

Open Access Original Research Article

Effect of Resistant Starch (RS) Rich Sorghum Food Consumption on Lipids and Glucose Levels of Diabetic Subjects

T. V. Hymavathi, E. Jyothsna, T. Pradeepa Robert, V. Teja Sri

Journal of Pharmaceutical Research International, Page 86-92
DOI: 10.9734/jpri/2020/v32i3030909

Resistant starches are an important class, which gives benefits of fiber without affecting the sensory characteristics. Few studies reported the beneficial effect of resistant starch supplementation in reduction of lipid and glucose levels in diabetic subjects. In the present study we investigated the Resistant Starch (RS) rich millet food on lipid and glucose levels in diabetic subjects. Supplementation of 65 g of RS rich rawa (broken sorghum) for 90 days, significantly reduced Body Mass Index (BMI), Fasting Glucose (FG), TC (Total Cholesterol) and LDL-C (Low Density Lipo protein) (p,0.05) in diabetic subjects (n=15), while a non-significant reduction was found in HbA1c, eAG (estimated Average Glucose), TG, HDL-C and VLDL-C. The study indicated that regular consumption of RS rich foods might be beneficial for the diabetic population. Studies in larger population further strengthen the present understanding.

Open Access Original Research Article

The Prevalence of Bacteremia among Patients Admitted to a Military Hospital in Alkharj

Nehad J. Ahmed, Salwa Mahmoud, Menshawy A. Menshawy

Journal of Pharmaceutical Research International, Page 93-99
DOI: 10.9734/jpri/2020/v32i3030910

Aim: The aim of this study is to determine the prevalence of bacteremia among patients admitted to a military hospital in Alkharj and to know the causative organisms.

Methodology: Bacteria culture results were collected from the laboratory of the military hospital after the approval of the study by IRB ethical committee. The data were collected and analyzed using Excel spreadsheet 2016 and the descriptive data were represented as frequencies (n) and percentages (%).

Results: The total number of positive blood culture were 131 cultures, about 53.44% of the causative bacteria were gram positive bacteria. Generally, a high percentage of bacteremia was caused by Staphylococcus species, especially Coagulase-negative staphylococcus (25.19%) and Staphylococcus aureus (22.90%).

Conclusion: It can be concluded that the incidence of bloodstream infection in the present study is high and that the most common causative pathogens were Coagulase-negative staphylococcus and Staphylococcus aureus. It is important to know the incidence of bloodstream infection and to know the causative organisms both for clinical practice, especially to evaluate the effectiveness of interventions and also for research activities.

Open Access Original Research Article

Socio-Cultural Risk Factors of Anemia among Children under Five Years of Age in District Muzaffarabad, Azad Jammu & Kashmir, Pakistan

Nazneen Habib, Saif-Ur-Rehman Saif Abbasi, Aneela Afzal, Sheeba Arooj, Shahzad Farid

Journal of Pharmaceutical Research International, Page 100-112
DOI: 10.9734/jpri/2020/v32i3030911

Aims: This study is aimed to determine the prevalence of anemia and to analyze its socio-cultural determinants among under five children to devise targeted delivery plan for pharmaceutical interventions to combat anemia.

Study Design: To investigate the socio-cultural risk factors, a cross-sectional field survey was conducted to gather data from 384 women and their last child up to five years of age in Muzaffarabad district of Azad Jammu & Kashmir (AJK), Pakistan.

Methodology: A pretested interview schedule was constructed to collect socio-cultural characteristics of the women and their children. We use convenience sampling which is a non-probability sampling technique for data collection. Two government hospitals were selected for data and blood samples collection from respondents. We use univariate analysis for descriptive statistics and perform bivariate analysis to find the association of anemia with the socio-cultural risk factors. Binary logistic regression is used to calculate odd ratios and the corresponding 95% confidence intervals. The results were considered statistically significant for p-value <0.05.

Results: The overall prevalence of anemia is 47.7%, which is a severe health problem from public health perspective. Among anemic children 74(40.4%) are mildly anemic, 79(43.2%) are suffering from moderate and 30(16.4%) from severe anemia.  Major risk factors of anemia include residential area, parental education, father’s profession, lower family income, maternal knowledge about balanced diet and anemia.

Conclusion: It is concluded that anemia among under five children is a multifactorial problem and policymakers should devise targeted pharmaceutical interventions (iron and folic acid supplementation) to combat anemia.

Open Access Review Article

Antiseptic Use in Orthopaedic Wounds

Fahima A. Begum, Tiffanie-Marie Borg, Hamed Mazoochy, Nima Heidari

Journal of Pharmaceutical Research International, Page 46-61
DOI: 10.9734/jpri/2020/v32i3030903

Objectives: The aim of this study is to review the available literature addressing the safety and efficacy of antiseptics in surgical wounds. The different antiseptic solutions, irrigation volumes, time scales and delivery methods have been compared so that evidence-based recommendations on antiseptic use in orthopaedic, foot and ankle surgical procedures can be proposed.

Methods: A literature search was performed using the online databases Medline and EMBase to identify in-vitro and in-vivo studies pertaining to antiseptic use in an orthopaedic context. Terms including antiseptic, irrigation fluid, bacitracin, hydrogen peroxide, povidone-iodine and chlorhexidine were searched. Literature published in English from inception to July 2020 in which the full text was accessible was considered for inclusion. Cellular and animal studies were included on the basis that authors analysed antiseptic efficacy and/or toxic effect of antiseptic on cells present in orthopaedic wounds. Clinical studies that met the criteria for inclusion in this review assessed antiseptic use in a surgical context, with a focus on foot and ankle procedures.         These included case reports, case series, case control, prospective and retrospective studies as well as randomised controlled trials. Studies were categorised as in-vitro, animal and human studies. Twenty-three, eleven and forty-four studies were identified as in-vitro, animal and       human studies respectively. These have been summarised and presented herein in a narrative format.

Results: There is strong evidence that skin preparation with antiseptics before orthopaedic procedures reduces the risk of post-operative infection.

Conclusion: Routine prophylactic intra-operative antiseptic use should be performed with caution as they increase the risk of local and systemic complications. However, there is strong evidence supporting the use of antiseptics pre-operatively when preparing the skin. Determining the best antiseptic preparation remains a matter of debate since a single agent or solution is not effective against all organisms. Further research is therefore needed to assess the efficacy of antiseptics in prevention and treatment of infections.