Open Access Case Study

Treatment Modalities for Multiple Gingival Recession– A New Prospects

Ena Sharma, Amit Lakhani, Rasveen Kaur, Ravneet Kaur

Journal of Pharmaceutical Research International, Page 65-83
DOI: 10.9734/jpri/2021/v33i631190

This case series reports the various treatment modalities to treat the multiple recessions. Gingival recession is a widespread clinical manifestation affecting single or multiple root surfaces at all teeth types. Periodontal reconstructive surgery consists of various mucogingival procedures. The primary goal of these procedures is to benefit periodontal health through the reconstruction of lost hard and soft tissues, or by preventing its additional loss, and also enhancing the esthetic appearance. Platelet-rich fibrin is a second generation platelet concentrate and is defined as an autologous leukocyte and platelet-rich fibrin biomaterial. Care was taken not to extend the incisions till the tip of the interdental papilla. A full thickness mucoperiosteal flap was reflected, extending beyond the mucogingival junction. A wide range of surgical techniques has been proposed for the treatment of the gingival recessions, each with its advantages and disadvantages. To provide predictable and long-term results, it is of paramount importance that the surgical technique is individually selected, taking into account several crucial factors such as the size of the defect, the width of the keratinised gingiva apical to the defect and the thickness of the flap.

Open Access Original Research Article

Dengue Virus: Infection, Immunological Response, and Vaccine Development

Nariman Sindi

Journal of Pharmaceutical Research International, Page 1-19
DOI: 10.9734/jpri/2021/v33i631185

In the tropics and subtropics climates worldwide, the dengue virus (DENV) is the most common of arboviruses and a significant public health threat. The severe disease usually occurs during the primary infection, but more serious cases begin after the second instance of infection with a different serotype. Humans' innate immune system is composed of monocytes, macrophages, and dendritic cells, and they are capable of mounting rapid inflammatory responses. These cells are also called primary antigen-presenting cells, and they are essential for the formation of the immune system's long-term memory mechanisms. Through scientific advances, valuable knowledge into the pathogenesis of more serious diseases, and new methods to the production of dengue vaccines and antiviral drugs have been provided. We summarized details in the current literature review, including references, abstracts, and full text of journal articles. So that, we tried to review all available studies that projected existing awareness about the immune response to the dengue virus and the current status of the vaccine. Such information was selected and extracted from the PubMed, Web of Science, and Google Scholar databases for published data from 2000 to 2020 using relevant keywords containing a combination of terms, including dengue fever, epidemiology, clinical manifestation, immune response, and vaccine.

Open Access Original Research Article

Synthesis, Characterization and Preliminary Biological Evaluation of New 3 and 4-nitro Isoindoline-1, 3-dione/phthalimide Analogues

Sharad Sankhe, Nitesh Chindarkar

Journal of Pharmaceutical Research International, Page 20-27
DOI: 10.9734/jpri/2021/v33i631186

Aims: To synthesize new nitroisoindoline-1,3-diones analogues and evaluate their preliminary biological activities

Methodology: New isoindoline-1,3-diones analogues were synthesized by coupling phthalic anhydride derivatives with appropriate aromatic amines. Newly synthesized heterocyclic compounds were evaluated for their in vitro antibacterial activity against gram-positive bacterial strains and gram-negative bacterial strains. They were also tested for their in vitro antifungal activity against fungi strains. Determination of the preliminary antibacterial and antifungal activity were investigated using agar-dilution method. The structures of newly synthesized analogues were elucidated by 1H and 13C-NMR techniques.

Results: Bioassay indicated that some of the newly synthesized isoindoline-1,3-dione analogues shows moderate biological activities.

Conclusion: Newly synthesized analogues can be used as antibacterial or antifungal agents on modifications.

Open Access Original Research Article

Mouth Dissolving Tablets of Favipiravir using Superdisintegrants: Preparation, Optimization and In-vitro Evaluation

D. Avinash, Madhu Gudipati, M. V. Ramana, Pallavi Vadlamudi, Rama Rao Nadendla

Journal of Pharmaceutical Research International, Page 28-39
DOI: 10.9734/jpri/2021/v33i631187

To formulate and evaluate the mouth dissolving tablet dosage forms of favipiravir using various superdisintegrants by using wet granulation technique.

Batches of favipiravir Mouth dissolving tablets were formulated by using the wet granulation technique. The formulated granules were evaluated for their flow properties as a pre-compression parameter and the friability, hardness, disintegration, wetting ratio, wetting time, dissolution, and drug release parameters were evaluated as post-compression parameters. The effect of the varying concentrations of superdisintegrants on the formulation for disintegration time was ascertained and the results were compared.

The tablet had friability and hardness values ranging from 0.60  to 0.68 % and 3.9  to 4.3 (kg/cm2). Tablet weights did not vary significantly but the disintegration time varied from 44.66  to 142.66±2.51 min and the wetting time varied from 45.33  to 144 min and the optimal batch of tablets shows a drug release of 98.8% within 60 min and first-order release kinetics of the formulations are compared.

Open Access Original Research Article

Determination of Predisposing Factors in Developing Candida albicans Associated Urinary Tract Infection and Antifungal Sensitivity Profile

Sham Lal, Om Parkash, Pardeep Kumar, Zulfiqar Ali Malik, Khalida Unar, Zuheeb Ahmed, Marvi Maitlo, Ayaz Ali Unar, Sapna Sapna

Journal of Pharmaceutical Research International, Page 40-49
DOI: 10.9734/jpri/2021/v33i631188

Aim: Candiduria is very common in hospitalized patients. It poses a clinical challenge for the physicians since it is usually asymptomatic. The aim of this study was to identify risk factors associated with nosocomial candiduria in urinary tract infection (UTI) suspected patients in Methodology: Intensive Care Unit (ICU) and to determine their antifungal sensitivity profile.

The urine specimens (168) were collected, microscopically screened for presence of yeast, cultured and analyzed for counting, isolation, phenotypic identification of Candida albicans. and testing antifungal resistance profile. Data regarding age, gender, use of catheter, use of antibiotics, diabetes mellitus among patients was also recorded.

Results: Out of 168 specimens, C. albicans were isolated from 69 specimens, whereas 20 specimens showed other Candida spp. Age >45 years, gender female, previous use of antibiotics, urinary catheterization, stay in ICU >1 week were found the main predisposing factors (p<0.05) responsible for developing nosocomial candiduria. All C. albicans isolates were found either susceptible or susceptible-dose dependent to fluconazole, amphotericin B and voriconazole; however, 62.32% of the isolates were resistant to itraconazole.

Conclusion: Most frequent candiduria, possible predisposing factors in ICU patients and resistance of C. albicans towards itraconazole is alarming and highlights the need of candiduria surveillance.

Open Access Original Research Article

The Potential Anti-Obesity, Anti-Diabetic and Anti-Oxidant Effects of Vitamin a in Streptozotocin-Induced Diabetic Mice

Yosra Alhindi, Anwar Bafaraj, Abeer Barasain, Massarah Hadidi, Norah Bajandooh, Ruba Al-Sulami, Shahad Alahmadi, Rawabi Alzelaai, Lama Aljahdli, Arwa Fairaq, Sahar Elashmony

Journal of Pharmaceutical Research International, Page 50-64
DOI: 10.9734/jpri/2021/v33i631189

Background: Evidence suggests that there is a link between diabetes mellitus and Vitamin A. Moreover, it has been reported that diabetes induces oxidative stress. Lately, a wide attention has been developed to the protective biochemical function of natural antioxidants contained vitamins, which can reduce the oxidative damage caused by free radical species.

Objective: To investigate the anti-obesity, anti-diabetic and anti-oxidative effects of vitamin A in streptozotocin (STZ)-induced diabetic mice.

Methods: Male mice were randomly divided into three groups: Control- nondiabetic, received a normal diet and water; Control-diabetic, received STZ 45mg/kg once intraperitoneally; and Treated-diabetic, received both STZ as before plus Vitamin A (4-IU/day) orally daily for 16 weeks. Food intake, body weight, fat mass, fasting blood glucose, serum insulin, and lipid profile were estimated. Also, superoxide dismutase (SOD), glutathione peroxidase (GPO), catalase (CAT), and malonaldehyde (MDA) were measured.

Results: Treated diabetic mice with Vitamin A showed a significant improvement in their body weight, fat mass, lipid profile as well as SOD, GPO and CAT compared to Control-diabetic mice. However, Vitamin A caused no significant change on fasting blood glucose and insulin levels. Furthermore, plasma level of MDA was significantly elevated in diabetic mice compared to normal mice. Diabetic mice treated with vitamin A had a significantly reduced level of MDA, suggesting that vitamin A might have a vital role in the protection of tissues from damage by free radicals.

Conclusion: Supplementation with vitamin A may be a useful treatment strategy for diabetic patients to reduce/prevent the pathological complications of diabetes.

Open Access Original Research Article

Effect of Platelet Rich Plasma Injection Effect on Knee Osteoarthritis in Elderly: Single Dose versus Double Dose Randomized Clinical Trial

Hassan Amir Us Saqlain, Syed Sajid Hussain, Niaz Hussain Keerio, Masood Ahmed Qureshi, Nuresh Kumar Valecha, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 84-89
DOI: 10.9734/jpri/2021/v33i631191

Objective: This study aims to evaluate the effect of platelet rich plasma (PRP) and compare between single and double dose regimens among patients diagnosed with osteoarthritis admitted to the orthopedic department of Al Qassimi Hospital Sharjah, United Arab Emirates.

Methods: 200 patients were allocated into two groups in this randomized clinical trial. Patients were chosen to participate in this study after an informed consent. The trial took place at the Al Qassimi Hospital Sharjah, United Arab Emirates from July 2019 to July 2020. All patients had knee osteoarthritis, half of them received single dose PRP (group A) and the other half received double dose PRP (group B). All patients were adults and older than 18 years of age. Patients were followed up using Western Ontario and McMaster Universities Arthritis Index (WOMAC). The follow up was done prior to the administration of PRP, at 1 month, 3 month and 6 months after administration. Data was analyzed using SPSS program. Ethical approval was gained from the hospital as well as from patients.

Results: The mean age of the patients was 48.5 ± 8.3 years. The study included 200 participants, among them, 60 were females and 140 were males. There was improvements in all parameters of WOMAC at 3 and 4 weeks following administration of PRP. The effect of PRP continued until 6 months of follow up with no differences between the two groups. Group A baseline WOMAC parameters (pain, stiffness, physical function and total score) mean score were 15.8, 6.24, 43.01 and 65.22 respectively. At the follow up, the mean scores were 4.73, 1.78, 13.88 and 19.56 respectively. This shows significant improvement. On the other hand, group B baseline mean scores were 16.31, 6.81, 40.89 and 64.77 respectively. At the final follow up of group B, the parameters mean scores were 4.40, 1.11, 13.64 and 20.27 respectively. Both groups were compared to each other and no benefit for the double dose over the single dose (P value, 0.66).

Conclusion: Previous results suggests improvement in functionality in both groups of the trial. There was pain and stiffness relief among all patients. It is concluded that double dose has no additional effect to the single dose regimen.

Open Access Original Research Article

Screening of Secondary Metabolites Produced by Streptomyces Species from a Soil Sample that Can Produce Anti-Nematodal and Antiprotozoal Avermectins

Rajesh Sharma, Poonam Magdum, Tejashree Jadhav, Samruddhi Berge, Bharat Shinde

Journal of Pharmaceutical Research International, Page 90-98
DOI: 10.9734/jpri/2021/v33i631192

Avermectins are a group of secondary metabolites produced by Streptomyces avermitilis, which act on invertebrates. They activate glutamate-gated chloride channels in their nerves and muscles which in turn disrupt pharyngeal function and locomotion. Avermectin ingested insects are paralyzed and starve to death. Ten isolates identified as avermectin producers were characterized by morphological, colony characters and biochemical tests. Secondary screening leads to the identification of four isolates PM2; PM4; PM7 and PM10 which produced 10, 8.4, 3.8 and 6.9mg respectively as identified by HPTLC. Bio-autography illustrated their anti-nematodal and antiprotozoal activity; the zone of clearance (turbid) was recorded 43, 24, 32 and 37 mm respectively for PM2 through PM10.

Open Access Original Research Article

Frequency of Incidental Ageing-Related Lung Findings in an Elderly Population: A Saudi Teleradiology CT Study

Amr M. Ajlan, Ayman A. Eskander

Journal of Pharmaceutical Research International, Page 99-103
DOI: 10.9734/jpri/2021/v33i631193

Objectives: To assess the frequency of ageing-related lung changes seen on computed tomography (CT) chest examinations performed on teleradiology cohort of elderly patients.

Materials and Methods: An experienced radiologist retrospectively assessed at a 3-month worth of teleradiology data of CT chest, abdomen and pelvis performed for detection or staging of malignancy is in asymptomatic patients 60 years old and older, residing in Saudi Arabia. Patients with known smoking history or obscuring abnormalities were excluded. Lung windows were analyzed to detect bronchial wall thickening, mosaic attenuation, linear scars, reticulations and pneumatocoeles. Bronchial thickening and mosaic attenuation were stratified by severity, while the scars and pneumatocoeles were stratified by number.

Results: A total of 26 cases were collected out of 137 patients, with a mean age of 67 years old (61% males). Bronchial wall thickening was detected and 56%, with 35% being of moderate degree. Mosaic attenuation was detected in 26%, with 70% being of mild degree. Linear scarring was seen and 61%, in the absence of reticulations. Pneumatocoeles were detected in 26%, with 22% being more than 2 in numbers.

Conclusion: In a select teleradiology cohort of asymptomatic CT chest imaging in elderly patients, bronchial wall thickening, mosaic attenuation, linear scarring pneumatocoeles are frequently encountered. Such findings should not lead to clinical or imaging misinterpretations.

Open Access Original Research Article

Role of Pharmacist in Addressing the Adverse Drug Reactions and Improving the Knowledge of Patients Regarding Their Drug Therapy at Government Civil Hospital Khairpur, Sindh, Pakistan

Zuheeb Ahmed, Marvi Metlo, Sajid Ali, Shahzad Ali, Hetesh Kumar, Tahseen Ahmed, Arslan Ahmer, Sabit Ali, Jabbar Abbas, Syed Shafqat Ali Shah Rizvi

Journal of Pharmaceutical Research International, Page 104-110
DOI: 10.9734/jpri/2021/v33i631194

Adverse Drug Reactions are among the major problems that cause mortality and morbidity in patients worldwide. In this study, Adverse Drug Reactions with common medicines were addressed, and the knowledge of pharmacist for prescribed medicine was also evaluated before and after educating the patients by pharmacist. The duration of this study was one year from October 2016 to October 2017. A descriptive cross-sectional study was designed and completed on 150 patients admitted to the hospital's medical ward. Patients whose ages were between 18-60 years, either male or female, who reported chronic diseases and took medication for a long time were selected for the study. Children or patients having < 18 years and taking medicine for a short period were excluded from this study. Selected patients were evaluated, and results were collected. Finally, the collected data was analysed with the 21st version of IBM’s Statistical Package for Service Solutions (SPSS v23). Of 150 selected patients, 61% were male, and 39% were female. Most patients were from the 18-30 age group, i.e., 28%. 60% of the patients hail from rural areas, and 40% from an urban areas. Of the 150 patient studied, 36.7% were illiterate, and only 4.7% of patients were above intermediate. Most of the patients were working in different government and private sectors. 8% of those taking the combination of Amoxicillin+Omeprazole+Salbutamol reported side-effects, whereas minimum side effects (2.0%) with Cholorothiazide+Atenolol+ Paracetamol. Reported adverse drug reactions (ADRs) in patients were Headache (14.9%), nausea (13.8%), vomiting (10.3%), abdominal pain (12.6%), constipation (8.0%), diarrhea (10.3%), skin rashes (5.7%), loss of appetite (4.6%), dizziness (6.9%), tiredness (6.9%) and confusion (5.7%). The knowledge of patients regarding therapy was compared before and after counseling that shows increased awareness in patients after counseling the patients. Before counseling average knowledge of patients was 27.5% that increased to 50.3% after counseling. After analyzing the results, it is concluded that pharmacist counseling and providing education to patients can significantly decrease the ADRs and increase the compliance of drugs that will ultimately enhance patients' quality of life. It was recommended that the hospital should appoint the pharmacist, especially a clinical pharmacist, and Hospital administration should arrange the programs for the awareness of patients on appropriate uses of drugs and their side effects.