Open Access Original Research Article

Fibrinogen and C-Reactive Protein Significance in Children Infected by Plasmodium falciparum Species in Enugu, Enugu State, Nigeria

Linda Nnenna Ogbonna, Silas Anayo Ufelle, Emmanuel Ifeanyi Obeagu, Pat Uzo Okpala, Bessie N. Esimai, Chekwube C. Agu, Adaobi Maryann Ibekwe, Daniel Chinenyeike Offie

Journal of Pharmaceutical Research International, Page 1-8
DOI: 10.9734/jpri/2021/v33i1531280

Malaria accounts for a considerable mortality and morbidity rate with children bearing the greatest burden. The study investigated fibrinogen and C-reactive protein (CRP) value alterations in children infected by Plasmodium falciparum (P. falciparum) species. A case control study with a total of ninety-five microscopically confirmed P. falciparum malaria infected children and fifty apparently healthy age and gender matched controls from Enugu State University Teaching Hospital, Parklane, Wesley Specialist Hospital and Akpugo Community Health Centre, Enugu were recruited for the study. Fibrinogen level was determined by clauss clotting time method using sodium citrated plasma. Giemsa stained thick and thin blood film was used for parasite identification and calculation of parasite density. Serum CRP values was determined by immunoturbidimetric method. Fibrinogen levels were significantly increased (p < 0.05) in P. falciparum infected children (324.03 + 59.87) mg/dl as compared to the control (224.74 + 34.88) mg/dl. Parasite density showed a weak positive correlation between fibrinogen (p < 0.01, r = 0.461) and CRP (p < 0.01, r = 0.232). CRP was significantly increased (p < 0.05) in P. falciparum malaria infected children (21.52 + 35.59) mg/l as compared to the control (2.43 + 0.97) mg/l. In conclusion, P. falciparum malaria infection demonstrated a significant impact on fibrinogen and CRP.

Open Access Original Research Article

Effect of Stretching Exercises Plus Caflam on Flexibility of Female Athletes

Sajjad Ali Gill, Samavia Noor, Abida Naseer, Saeed Javed, Sumeria Rajab, Fehmida Ayoob, Rana Adil, Hira Shahid, Shahbaz Ahmad, Qurban Ali

Journal of Pharmaceutical Research International, Page 9-15
DOI: 10.9734/jpri/2021/v33i1531281

The present study investigated how stretching exercises (Static, Dynamic and Proprioceptive neuromuscular facilitation (PNF)) along with Caflam (diclofenac potassium) affect the flexibility of female athletes at Punjab University Level. It is a controlled experiment with (n=40) female athletes, aged 18-24 years, divided into two groups intervention (N=30) and control group (N=10) randomly. Stretching exercises were conducted through 6 weeks divided into two sessions that consisted of both static and dynamic exercises in each session. Flexibility was measured with sit and reach test in pre and post evaluation sessions. The study purpose was to identify the effect of stretching exercises on flexibility of female athletes (N=40) by using different stretching exercises techniques (static and dynamic stretching exercises) on female athletes. Paired sample t-test used and found that it showed highly significant results using “Statistical Package for Social Sciences” (SPSS) V.22 utilized. The effect size was also calculated through Cohans’D which was 1.41. The subjects were followed for 4 months to check the recurrence rate of the control & intervention groups and found that 19% having injuries of lower extremity (control group) and 11% having after post-exercise evaluation (intervention group).  

Open Access Original Research Article

Role of Pharmacological Therapy and Surgical Intervention in Breast Carcinoma

Ahsan Ali Laghari, Faiza Hameed, Shah Nawaz Abro, Ambreen Muneer, Anwar Ali Jamali, Nusrat Fozia Pathan, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 16-20
DOI: 10.9734/jpri/2021/v33i1531282

Objective: To determine the Role of medical therapy and surgical intervention in carcinoma of breast.

Study Design: Prospective observational study.

Place and Duration: Two years study from January 2018 to December 2020 was conducted at Liaquat university of Medical and Health Sciences Jamshoro.

Methods: The study comprises 50 patients. Data was collected from all who were admitted at OPD. The patients were evaluated fully after history & Clinical examinations and Specific investigations of Fine Needle Aspiration Cytology (FNAC), Tru cut biopsy  for Histology ERPR Receptor and Herceptin receptor, ultra sound of breast, and Abdomen, Mammography, C T scan, M R I, Tumor marker CA15.3. CA 125 for ovary and breast, X ray chest and Bone scan. Sentinel lymph node biopsy for lymphatic involvement, Liver Function Test, serum calcium, Complete Blood Picture (CBP), blood sugar, blood urea. HBSAG, HCV, HIV and COVID-19   Evaluated patients were evaluated fully after history, clinical examinations & specific investigations.

Results: In this study 50 patients of Carcinoma of breast. The maximum numbers of patients were in age group 20 to 80 years. 15 patients were in age group 20 to 39 year, 24 patients were in age group 40 to 59 years, 11 patients were in age group 60 to 80 year.  Out of 50 patients 29 patients were presented with breast lump, 8 patients were presented with bloody discharge, 7 patients were presented with nipple destruction and 6 Patients were presented with pricking sensation Out of 50 patients 21 patients were presented with stage I, 13 Patients presented with stage II, 9 patients were presented with stage III and 7 patients were presented with stage IV.  Out of 50 patients 22 Patients  were diagnosed duct cell carcinoma, 11 patients were diagnosed Phyllodes tumor, 9 patients were diagnosed lobular cell carcinoma, 5 patient were diagnosed tubular cell carcinoma and 3 patients were diagnosed Paget’s type of carcinoma .Out of 50 patients 25 patients were  ERPR positive treated by Nolvadex (tamoxifeen) 16 Patients were ERPR negative  treated by chemotherapy drugs and Aromatase inhibitors, 9 Patients were Her2neu receptor  positive treated by Herceptin (Trastuzumab) Out of 50 patients 34 patients were treated by  Modified  radical mastectomy, 16 patients were initially were treated neo adjuvant therapy. Then Modified Radical Mastectomy, Out of 50 patients 25 patients were treated with Nolvadex (tamoxifeen) after Modified Radical Mastectomy better outcome seen in those patients.

Conclusion: Carcinoma of breast is a common problem all over the word, patient can present with lump over the breast, bloody discharge, destruction  of nipple or areola   if not diagnosed and treat early stage, patient can die within a year without Medical and surgical treatment.

Open Access Original Research Article

Activation of Sirtuin 1 by Ellagic Acid Ameliorates Cisplatin-Induced Apoptosis, Oxidative Stress and Nephrotoxicity

Thikryat Neamatallah, Basma G. Eid, Amina M. Bagher, Mohammed Z. Nasrullah, Soad S. Ali, Zuhair M. Mohammedsaleh, Nagla A. El-Shitany

Journal of Pharmaceutical Research International, Page 21-32
DOI: 10.9734/jpri/2021/v33i1531283

Background: Cisplatin (Cis) is a chemotherapeutic agent commonly applied in treating different cancers. However, acute renal injury remains a major side effect of Cis that limits its clinical use. Oxidative stress in renal tissues play a key role in Cis-induced toxicity. This research aimed to investigate the impact of ellagic acid (Ella) on Cis-induced apoptotic renal injury and the possible involvement of sirtuin 1 (SIRT1) and oxidative stress as a possible protective mechanism.

Methods: Twenty-four Sprague Dawley rats were divided into four groups (n=6) and treated as follows. The control (Cont) group (0.9% saline), Ella group (10 mg/kg), Cis group (7.5 mg/kg), Ella + Cis group (10 mg/kg + 7.5 mg/kg). Ella was administered 7 days prior to Cis injection. Seventy-two hours later, the rats were sacrificed, and blood and kidney samples were collected.  Biochemical analyses were performed on serum and kidney homogenate. The histopathological and immunohistochemical analyses were performed on the formalin preserved kidneys.

Results: Ella significantly decreased serum creatinine and urea levels compared to the Cis group. Furthermore, Ella protects the kidney cortex and medulla against most Cis-induced histopathological changes. Ella significantly decreased kidney contents of malondialdehyde (MDA). Moreover, Ella reversed the Cis-induced reduction of kidney antioxidants, including glutathione peroxidase, superoxide dismutase, and catalase. Ella decreased kidney protein expression of both cyclooxygenase-2 (COX-2) and Bax proteins while increased SIRT1 and Bcl2 expression.

Conclusion: The results revealed a reduction in SIRT1 protein expression in rat renal medullary and cortical tissues following Cis treatment. However, Ella significantly enhanced SIRT1 expression, antioxidants levels, and reduced Cis-induced apoptosis, inflammation, and oxidative stress by increasing the ratio of Bax/Bcl-2 and reducing the expression of COX-2 and MDA, respectively. These findings provide additional evidence of the antioxidant and antiapoptotic effect of Ella in Cis-induced renal toxicity.

Open Access Original Research Article

Development and Characterization of Anti-alzheimer Drug-loaded Chitosan Nanoparticles for the Enhanced Penetration of Blood Brain Barrier

Maria Abdul Ghafoor Raja, Muhammad Wahab Amjad, Nawaf Mohamed Alotaibi

Journal of Pharmaceutical Research International, Page 33-39
DOI: 10.9734/jpri/2021/v33i1531284

Nanotechnology facilitated drug delivery has been used to enhance the drug bioavailability, efficacy, reduce toxicity and improve patient compliance aiming to targetthe cells and tissues to produce anticipated pharmacological action. The aim of the present study was to formulate and evaluate rivastigmine (RT) loaded chitosan (CS) nanoparticles for sustained release. RT is a short actingreversible acetylcholinesterase inhibitor used for the treatment of mild to moderate Alzheimer's and Parkinson's disease. In current research RT loaded CS-tripolyphosphate (TPP) nanoparticles were prepared by usingionic gelation method in fourdifferent polymer concentrations (0.1%,0.2%,0.3%,0.4%). The prepared nanoparticles were evaluated by Zeta sizer in order to determine particle size, PDI and zeta potential. Further, drug entrapment efficiency and in vitro release studies were carried out. The results showed that particle size decreased by loading drug within nanoparticles when compared with unloaded nanoparticles. The particle size of RT loaded CS nanoparticles ranged from 125.9 ± 2.5 to 356.0 ± 7.9 by varying CS concentration from 0.1% to 0.4% w/v. Among different ratios studied, 0.4% ratio showed highest drug entrapment efficiency (80%). In vitro release studies showed that RT loaded CS nanoparticles could sustain release the drug.In conclusion, the current research results showed that the chitosan nanoparticles can be used as a potential carrier for providing sustained delivery of RT.

Open Access Original Research Article

Alterations in Serum Myostatin Levels via Swimming Exercise in High Fructose Mediated Metabolic Syndrome Model

Muhammed Emre Karaman, Cengiz Arslan, Mehmet Ferit Gürsu, Zelal Arat, Furkan Türkoğlu

Journal of Pharmaceutical Research International, Page 40-44
DOI: 10.9734/jpri/2021/v33i1531285

Aims: Metabolic syndrome is a table of abdominal diseases characterized by insulin resistance, obesity, dyslipidemia, and hypertension, and it is a serious risk factor for the development of cardiovascular diseases. The purpose of this study was to understand how metabolic syndrome causes a change in myostatin levels, and to understand if swimming exercise have protective and therapeutic effects in fructose mediated metabolic syndrome model by regulating serum myostatin level.

Methodology: A total of 21 Sprague Dawley male rats were used in the study. Metabolic syndrome was induced by adding 30% fructose into drinking water for 5 weeks The rats (6-8 weeks old, weighing 200-250 g) were randomly divided into 3 groups as 7 rats in each cage. Swimming exercises were applied three days a week for six weeks. On exercise days, rats were exercised for 20 minutes in a day. Blood was collected from all animals in aprotinin tubes to be used in the necessary analysis with decapitation. Serum samples obtained after centrifugation were kept at -80 ℃ until the assay were performed. In serum samples, myostatin was measured by ELISA method.

Results: There was a statistically significant difference resulting from G2, which had the highest value in glucose and triglyceride levels between groups. G2 had the lowest HDL levels. Myostatin levels were significantly higher in G2 compared to other groups.

Conclusion: Moderate swimming exercises are protective and therapeutic in preventing chronic diseases such as diabetes, obesity and metabolic syndrome. In line with these results, it can be said that swimming exercise is a therapeutic practice that regulates impaired fasting serum glucose, increased TG levels and decreased HDL levels and downregulates serum myostatin levels.

Open Access Original Research Article

Pediatric Functional Constipation and Whey Protein: A Randomized Clinical Trial

Fateme Motavasselian, Majid Emtiazy, Mehrdad Shakiba, Majid Aflatoonian

Journal of Pharmaceutical Research International, Page 45-55
DOI: 10.9734/jpri/2021/v33i1531286

Background: Functional constipation is a chronic gastrointestinal disease in children. Pharmacological treatment of constipation is mostly based on the prescription of laxatives. In addition to this treatment, complementary therapies were also proposed to treat constipation. In this study, the effect of whey protein in the treatment of constipation was investigated.

Method and Materials: A total of 56 children with functional constipation within the age range of 1 to 16 years were included in the study. Patients were randomly divided into the intervention (n=28) and control (n=28) groups. The intervention group received 15 g whey protein and the control group received 15 g placebo. Both groups received 0.4 - 0.8 gr/kg PEG powder. The amount of PEG was adjusted every four days based on having soft stools. Demographic information were collected and recorded. Furthermore, fecal consistency, stool frequency, symptoms of stool retention, fecal incontinence, and abdominal pain were recorded prior to the intervention and at the second and fourth weeks of the intervention.

Results: All patients had soft daily stools at the end of the intervention. At the end of the fourth week, the mean required amounts of PEG powder were respectively 0.62 and 0.28 g/kg in the control and intervention groups, which showed a significant difference (p value ≤0.001).

Conclusion: Based on these findings, whey protein is safe and can improve constipation. However, more studies with larger sample size and longer follow-up period are needed to confirm the results of this study.

Open Access Original Research Article

Impact of COVID-Pandemic on the Mental Health of Medical Students of Sindh Province, Pakistan

. Dur-re-Shahwar, Marvi Metlo, Zuheeb Ahmed, Zaheer Mughal, Bilawal Shaikh, Arslan Ahmer, Razia Sultana, Noor ul Ain, Farkhanda Kobab, Tahseen Ahmed

Journal of Pharmaceutical Research International, Page 56-60
DOI: 10.9734/jpri/2021/v33i1531287

Introduction: Severe Acute Respiratory Syndrome is group of viral disease associated with respiratory infection and it has similar symptoms of COVID-pandemic. The first case of SARS was reported in ancient remote areas of China in 2003 and spread throughout the world within short period of time. World Health Organization coordinated with numerous health experts around the globe in order to overcome the pandemic condition.

Methodology: The descriptive cross-sectional study was conducted for the period of 06 months from June 2020 to December 2020 at different medical universities of Sindh province. Total 374 study samples were selected and data was collected from the medical students of numerous medical universities of Sindh province and well designated questionnaire was filled by all participants through proper guidelines provided to them. Data was analyzed by using statistical software SPSS version 24.00.

Results: Impact of Covid Pandemic on the mental health of medical students was evaluated by compiling the data from questionnaire filled by them. Frequency of males were 216(%) and females 158(%), mostly people were resident of rural areas with the frequencies of 226 (%) and only 148(%) belongs to urban areas. 114 participants belongs to MBBS degree, 49 belongs to BDS, 72 Nursing, 83 Pharmacy and 56 students belongs to Public Health department of numerous medical universities.

Conclusion: It was concluded that there was bad impact of Covid-19 pandemic on the mental health of medical students of Universities from Sindh province. Level of anxiety among the students totally depends upon variables were online classis, examination, ward visits and Assignments. Academic activities along with financial matter had direct impact on the mental health of students.

Open Access Original Research Article

A study to Assess the Knowledge and Practice of Staff Nurses and Postnatal Mothers on Implementation of Baby Friendly Hospital Initiative in a Tertiary Care Hospital in Chennai

Ranadeep Mothukuri, Santosh Kumar, R. Sowndarya

Journal of Pharmaceutical Research International, Page 61-68
DOI: 10.9734/jpri/2021/v33i1531288

Aims: Breastfeeding is considered the ideal nutrition for neonates. It not only provides the essential micronutrients and macronutrients but also helps in building a bond between the baby and the mother apart from its long term effects. For the promotion of breastfeeding several steps have been initiated by the UNICEF and WHO of which BFHI is the most important initiative. This study is to assess Knowledge and Practice regarding breastfeeding of BFHI among Nurses and postnatal mothers.

Study Design:  A non experimental descriptive study.

Place and Duration of Study: Department of Neonatology and Department of obstetrics, Saveetha Medical College and Hospital, Saveetha University, Chennai, India. Between September 2020 and December 2020.

Methodology: A hospital based survey was done among 40 staff nurses and 40 postnatal mothers regarding their knowledge about BFHI and breastfeeding, demonstration of practice of breastfeeding and principles of BFHI and their perceptions on factors that hinder the implementation of BFHI. Data on knowledge of baby-friendly hospital initiative and breastfeeding was collected by using a self-administered structured questionnaire and practice of breastfeeding by observation checklist. Descriptive (frequency, percentage, mean, standard deviation) and inferential (Chi-square, normality test, and Spearman’s rank correlation) statistics were used for data analysis with SPSS version 20.

Results: Both the staff nurses and mothers were assed for knowledge using7 questions compared to the postnatal mothers the knowledge about BFHI and Breastfeeding was higher among the staff nurses. Successful practice of breastfeeding and principles of BFHI was studied using demonstration of proper positioning, attachment, expression of breast milk and skin to skin contact which again was higher among the staff nurses compared to the mothers. The findings show that out of 40nurses surveyed, more than (77.1%) of the respondents had a good level of knowledge and more than three-fourth had a good level of practice of breastfeeding. Among the mothers there was significantly lesser knowledge with less than half (45%) had knowledge about BFHI .Regarding the practice of breastfeeding and BFHI (89%) of the staff nurses demonstrated successful breastfeeding and principles of BFHI in comparison (75.5%) of the mothers showed successful breastfeeding. Regarding the hindrances to breastfeeding both the mothers and staff nurses had similar views.

Conclusion: There is still lack of complete awareness of some major recommended practices in the hospitals that will promote and sustain breastfeeding. The staff nurses and postnatal mothers need to be educated further on the importance of breastfeeding and principles of BFHI. This can be achieved by promoting antenatal and lactation counseling of the mothers and training of the staff nurses on the principles of BFHI. Policy changes in educating mothers and staff nurses on promoting breastfeeding should be implemented.

Open Access Original Research Article

Prevalence of Obesity and Trends of Body Mass Index in Azad Jammu and Kashmir

Kamran Abbas, Sajjad Ali Gill, Rehan Ahmed Khan Sherwani, Tabinda Qazi, Naveed Feroze, Rana Adil, Hira Shahid

Journal of Pharmaceutical Research International, Page 69-82
DOI: 10.9734/jpri/2021/v33i1531289

In the present study an attempt has been made to figure out the remarkable factors that were responsible for higher body mass index (BMI) and obesity as well as to observe the existing trends of BMI in Azad Jammu and Kashmir. The factors were age, sex, diabetes, blood pressure, total cholesterol, triglycerides, blood glucose and random glucose. The statistical analysis with both classical and Bayesian methodologies was carried out for the investigation of significant risk factors. The results showed that with the increase in age the BMI also increases i.e., respondents of age group > 60 have the highest percentage of 82.76% for BMI. Moreover, it was found that except sex and blood pressure all other factors had significant association with BMI. Additionally, four factors namely, age, diabetes, total cholesterol and triglycerides were selected for the development of the parsimonious model of BMI based on generalized linear model, step wise regression and Bayesian model averaging.