Open Access Clinical Practice Article

A Prospective Observational Study on Prevalence and Prognostic Indicators among Tuberculosis and Multidrug Resistance Tuberculosis Patients in Tertiary Care Teaching Hospital

A. Noorjahan, B. Bhargavi, K. Mallikarjuna, B. Mohammad Ishaq, L. Siva Sankar Reddy, R. E. Ugandar

Journal of Pharmaceutical Research International, Page 43-48
DOI: 10.9734/jpri/2021/v33i19A31326

Tuberculosis (TB) is a communicable systemic infectious disease with high morbidity and mortality associated with it. Resistance to medications used to treat tuberculosis has been on the rise in recent years. (multidrug-resistant tuberculosis)  (MDR-TB)  is a significant challenge to (TB) control around the world. An observational research was conducted in a tertiary care teaching hospital to determine the interim pharmacological and microbial results of Rifampicin resistance TB patients. Data from Santhiram Medical College and General Hospital, Nandyal, Kurnool Dist. Andhra Pradesh were obtained from Aug 2020 to Feb 2021, after receiving ethical approval from the Institutional Ethics Committee. The effects of the regimen are determined in terms of cure, finished treatment, treatment failure, number of patients moved to MDR-TB, number of patients who died in long-term MDR-TB regimen patients. Microsoft Excel 2007 was used to analyse the data. There were 82 male and 23 female out of 105 patients included in the study. Of these 75 patients were from rural areas and 40 from urban areas Using the Chi-square test and X2=12.1026, p=0.0005, which was important, the correlation between geographical spread and treatment result was determined. Out of 115 patients, 99 (86.09 percent) were cured of their disease, 06 (5.22 percent) died, 10 (8.69 percent) developed MDR-TB, and 2 (1.74 percent) were deemed medication errors. Males between the ages of 51 and 70 are more vulnerable to TB than females, according to our results. Compared to females of the same age, male patients over 40 years of age are more vulnerable to MDRTB. this was not part of the research objectives, emphasis should not be placed on this as either conclusion or recommendation.

Open Access Short Communication

Detecting the Disease before it’s Too Late

. Utkarsh

Journal of Pharmaceutical Research International, Page 82-89
DOI: 10.9734/jpri/2021/v33i19A31331

Specific trials or examination exists in detecting deadly diseases. Various facilities are provided these days for determining many chronic diseases, like in detecting cancer, tuberculosis, keratin level (dialysis), coronary artery disease, etc.   But delaying in diagnosing emergency cases which need very quick action will lead to adverse situations. The process of this early detection of disease starts with a special test and further process depends on the special test result whether it is positive or negative. The sad reality of modern technology in the medical industry is that there is very less availability of vanguard doctors, who can help patients in diagnosing their disease, which can be treated successfully as soon as possible diagnosis has been done. Therefore, Hong Kong University (HKU) scientists discovered “Biomarker” which is being rapidly used by physicians, Neuroscientists and epidemiologists in measuring the intensity of disease provided with the details of its cause and treatment. Biomarkers possess possibilities in making wishes of doctors and scientists into reality, to identify that person who is at high risk of any disease so that doctors can take protective measures in saving that life within time. Nevertheless, according to Global data “Biomarkers” are a useful instrument in examining COVID-19 vaccine and fastening the process of clinical trials, decreasing the development cost and decreasing patient security risk. They also can be utilized to find the drug which can help in treating Covid-19 patients and can also be used to determine which drugs might be able to treat COVID-19 patients.

Open Access Original Research Article

Development and Characterization of Mitoxantrone-Loaded Glutaraldehyde Crosslinked Sodium Alginate Nanoparticles for the Delivery of Anticancer Drugs

Muhammad Wahab Amjad, Maria Abdul Ghafoor Raja

Journal of Pharmaceutical Research International, Page 18-24
DOI: 10.9734/jpri/2021/v33i19A31321

Every year millions of new cases of various types of cancers are diagnosed, leading to an alarming rate of fatalities. Mitoxantrone is an anthracenedione antineoplastic agent which is used in the treatment of various types of cancer, mostly acute myeloid leukemia and prostate cancer. In spite of its therapeutic applications, it possesses numerous limitations and side effects including specific targeting and systemic toxicity. Sodium alginate is a biodegradable, mucoadhesive and biocompatible polymer commonly used in drug delivery applications. Glutaraldehyde is a saturated dialdehyde and is used as a polymer cross linker. In this study, mitoxantrone-loaded glutaraldehyde-sodium alginate nanoparticles were developed by ionic gelation method and characterized (determination of particle size, drug entrapment efficiency, drug release and its kinetics) for the delivery of anticancer drugs. The nanoparticles mean particle size was found to be within the acceptable range. The entrapment efficiency was also on the higher side with sustained drug release. The findings of this study reveal promising potential of delivery system and project the way forward for further in vitro and in vivo investigations.

Open Access Original Research Article

Application of Percutaneous Screw Fixation and Closed Reduction for Tibial Plateau Fractures in Karachi, Pakistan

Muhammad Azeem Akhund, Muhammad Latif, Rahat Zahoor Moton, Zohaib Khan, Zohaib Nawaz, Nusrat Rasheed

Journal of Pharmaceutical Research International, Page 25-30
DOI: 10.9734/jpri/2021/v33i19A31322

Objective: Objective of this study is to assess the application of percutaneous screw fixation and closed reduction for tibial plateau fractures in Karachi, Pakistan.

Methods: The study design of this study is case series with sample size of 58 patients calculated by WHO calculator with functional outcome of 80-100%. The duration of the study was about 6 months.Non-probability sequential technique was adopted for data collection.

Results: The average patient age was 35.35±6.84 years however male patient were high in numbers (83.8%). Types of fractures (type I, II and IV) and functional outcomes (un-satisfactory and satisfactory) showed 17(29.3%), 33(56.8%) and 12(20.6%) and 4(6.45%) and 58(93.5%). The mean Rasmussen Score was 24.6(4.9%) however significant relationship between age and functional group were observed (p<0.05). The Rasmussen Functional Scoring System and Schatzker classification were also evaluated w.r.t ache, capability of walking normally, extension lag, stability as well as range of motion. Scores ranging from 28 up till 36 stipulate excellent, from 20 to 27 good, considering score of 10 to 20 fair and 6 to 10 poor.

Conclusion: The application of Percutaneous screw fixation and closed reduction for tibial plateau fractures in Karachi, Pakistanis less invasive, decrease hospital stays and charges, escalation of early mobilization along with satisfactory outcomes.

Open Access Original Research Article

Evaluation of the Toxicological Profile of Commiphora opobalsamum in Wister Rats for Its Safety and Rational Use

Mai A. Alim A. Sattar Ahmad, Akram A. Al-Salmi, Fatemah O. Kamel, Lateef M. Khan

Journal of Pharmaceutical Research International, Page 31-42
DOI: 10.9734/jpri/2021/v33i19A31324

Aim: To study acute and chronic toxicity profile of Commiphora opobalsamum (CO) in rats.

Methods: Acute oral lethal effect and single oral dose toxicity of CO was determined in rats by comparison with standard control. In contrast repeated dose oral toxicity in rats were performed in four groups of rats, CO was orally administered to three groups of rats in graded doses (250, 500 and 1000 mg/kg/day) once daily for 14 daysVs standard control. The sub-acute toxicity of CO was observed on hematological, coagulation and biochemical parameters.

Results: Acute oral lethal dose of CO in rats was demonstrated to be safe and higher than the tested dose i.e., 2000 mg/kg, moreover, single oral dose toxicity revealed no symptoms of toxicity. Furthermore, sub-acute toxicological effect on hematological analysis of CO rats groups treated withgraded dosed after 14 days treatment revealed insignificant decrease in complete blood count (CBC)in contrast with the control group (p>0.05) additionally the biochemical parameters includedanalysis of urea, creatinine, glucose; lipid profile and thyroid function markers fairly demonstrated insignificant differences utilizing the same methodology.

Conclusion: Our current explorative study strongly substantiates that the CO extract have no significantoral toxicity in rats and even the results of 14 days oral treatment indicated that there were no obvious toxic effects at the dosage of 1000 mg/kg/day. The comprehensive sub-acute toxicological effect of CO extracts on hematological and coagulation parameters and biochemical parameters included analysis of urea, creatinine, glucose; lipid profile and thyroid function markers fairly demonstrated no significant harmful outcome even after 14 days treatment with CO.

Open Access Original Research Article

Clinical Presentation of Mandibular Impacted Teeth and Associated Pathologies in the Unaizah, Al Qaseem; Saudi Arabia

Khaled Ramzi Shora, Kashif Ali Channar, Irfan Ahmed Shaikh, Abdul Bari Memon, Abdul Hayee Shaikh, Bhavesh Maheshwari, Ram Pershad, Mahnoor Memon

Journal of Pharmaceutical Research International, Page 49-55
DOI: 10.9734/jpri/2021/v33i19A31327

Aim: The aim of this study was to evaluate the clinical presentation of mandibular impacted teeth and associated pathologies in Unaizah, Al Qaseem; Saudi Arabia.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), King Saud Hospital Unaizah Saudi Arabia from March 2019 and December 2020.

Methodology: The record of patients attending dental section was reviewed from hospital record. Demographic data of patients were recorded through medical record Number by Medicapluse software. Orthopantamograms (OPGs) xrays were reviewed by maxillofacial surgeons on Dell LCD using software IMPEX enterprise unlimited Agfa. The variables like presence of impacted tooth, type of angulations, reason for extraction, caries on distal surface of 2nd molar tooth, and occlusal or mesial surface of 3rd molar were examined on OPGs. Data was analyzed using SPSS version-21.

Results: Males and females were 49% and 51% respectively. The most common type of impaction was vertical 45%, followed by horizontal 27% and mesio angular 22%. The impacted tooth on right side was observed as 51% and on left side as 49%. The relationship of gender with type of impaction was statistically insignificant (p value-0.157). The relationship was reasons and type of impaction was statistically insignificant (p value-0.317)

Conclusion: the both genders were almost equally affected. Vertical Impactions were more frequent and the pericoronitis was common reason for extraction of mandibular third molar. The relationship of gender and type of impaction was not significantly associated with type of impaction.

Open Access Original Research Article

Frequency of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver in Department of Medicine at People Medical College Hospital Nawabshah Pakistan

Jeando Khan Daidano, Amir Shahzad, Safdar Ali Pervez Tunio, Anwar Ali Jamali, Arslan Ahmer, Muhammad Saleem Rind

Journal of Pharmaceutical Research International, Page 56-60
DOI: 10.9734/jpri/2021/v33i19A31328

Introduction: Bacterial Infections in cirrhosis of liver is one of the main complications with increase mortality rate. Infection of ascitic fluid in cirrhosis of liver was introduced by Conn and fessel [2], termed as spontaneous bacterial peritonitis.

Objective: To determine the frequency of Spontaneous Bacterial Peritonitis (SBP) in patients presenting with cirrhosis of liver.

Methodology: It is a descriptive cross-sectional study which was performed in the Medicine Ward at People’s Medical College Hospital Nawabshah Pakistan from 1st June 2018 to 31 July 2020. Total 100 admitted patients were selected for this study, male patient were 58 and female patient were 42. Consent was taken from the patients and their relatives. Primary and secondary outcomes measured. All the patients with diagnosis of cirrhosis of liver were included for this study, ascites due to other causes and patients on antibiotic therapy were excluded from this study. Ascitic fluid aspirated for culture and DR. Blood CP, Urea, Creatinine, LFT and PT was performed.

Results: Among these 100 patients 13 were culture positive raised ascites PMN, 17 were culture negative raised ascites PMN. E. coli was detected in majority of the culture positive patients. 70 patients presented with sterile ascites. SBP patients presented with fever, abdominal pain, jaundice, Encephalopathy and raised prothrombin time.

Conclusion: SBP common complication of cirrhosis associated with high mortality. All cirrhotic Patients admitted in medical wards with history of abdominal pain, fever and Encephalopathy, diagnostic paracentesis is compulsory. Early management with intravascular expansion with albumin and antibiotics with good prognosis mortality can be reduced.

Open Access Original Research Article

Pattern of Use Unlicensed Medication in Pediatrics: A Retrospective Study at Major Tertiary Care Hospital in Saudi Arabia

Abdulaziz Alolayan, Basil Almansour, Yasmin Barnawi, Husam Munawar, Saad Almodamegh, Huda Aldossari, Wael Mansy

Journal of Pharmaceutical Research International, Page 61-68
DOI: 10.9734/jpri/2021/v33i19A31329

Background: Unlicensed medication use (off label use) is common in pediatrics practice. There are more than 75% of drugs which approved for using in adults, data of efficacy and safety in pediatric population is not completely available, and missed data might be due to some reasons mainly ethical consideration. Our study aimed to assess practicing of using of unlicensed medication in pediatrics at major tertiary care hospital in Saudi Arabia.

Methods: A retrospective review of pediatrics prescriptions that were prescribed as unlicensed medication use by collection of all unlicensed use forms that known as form B which approved by pharmacy and therapeutics (P&T) committee at Prince Sultan Military Medical city (PSMMC). Data collection stared from January 2018 until the end of 2020. Children up to 14 years of age and administered at least one medication were eligible to participate in the study.

Results: The total collected off label prescriptions (both in and out patients) was 128 from January 2018 till end of 2020. Prescription for females were 39.84% while their male counterparts were 60.16%. Ophthalmology, Oncology and both Otorhinolaryngology and general pediatrics were the most frequent specialties prescribed unlicensed medications by 34.38%, 19.53% and 8.59% respectively. Overall, unlicensed medicine use was highest (33.6%) for products belong to monoclonal antibodies class. Surgical intervention was the commonest indication for using unlicensed medication (35.94%) followed by infectious diseases treatment (14.06%). Represented as the cumulative off-label frequency percentage, the most common reason of off-label use was by indication (35.94%), frequency (33.18%), Dose (19.82%), while for the route was almost (11.06%). The highest frequency of off label prescriptions according to pharmacological class split by gender and age category showed significance level of 0.045 in males and 0.001 in infants respectively.

Conclusion: Class variability of unlicensed medications in this study, sought us to confirm that physician using this therapeutic option yet ethically, but in a disorganized manner. Thus, prescribing unlicensed drugs specifically in pediatric needs to be better validated by current and new evidence. The findings of this study call for further research across the kingdom to start off label legislation process under SFDA authority. Current off-label dosage amounts pose concerns about drug safety exceptionally in children.

Open Access Original Research Article

The Serological Basis of the Correlation between Iron Deficiency Anemia and Thyroid Disorders in Women: A Community Based Study

Riazul Islam, Kazi Mahmuda Akter, Atikur Rahman, Nurun Nahar Khanam, Salauddin Al Azad, Md. Raihanul Islam, Mithila Farjana, Mohammad Habibur Rahman, Md. Nasir Uddin Badal, Sharmin Ahmed, . Assaduzzaman

Journal of Pharmaceutical Research International, Page 69-81
DOI: 10.9734/jpri/2021/v33i19A31330

Objectives: Iron Deficiency Anemia (IDA), a global public health problem may have an inimical effect on thyroid function, especially in women and children. This study was conducted to inspect the correlation between IDA and thyroid disorders in women of Bangladesh.

Methods: A cross-sectional study was conducted among 452 women of different age groups in particular regions of Bangladesh presenting anemic symptoms and were confirmed anemic after testing of serum hemoglobin levels less than 12 g/dL. To identify the correlation between iron deficiency anemia and thyroid disorders; serum samples were tested quantitatively through standardized methods considering serum iron, total iron-binding capacity (TIBC), ferritin, thyroid-stimulating hormone (TSH), free thyroxin (FT4), and vitamin D levels as parameters. Post clinical diagnosis statistical analysis, graphical presentations of the complex clinical data was generated using advanced computer programming language and bio-analytical tools.  

Results: A positive correlation between hypothyroidism and IDA in women was discovered in this study as 24.69% of patients with IDA from 0-60 years were found suffering from hypothyroidism simultaneously; with the highest percentage (38.46%) amongst the 31-40 years of age and 26% of iron-deficient females of reproductive age (15-49 years) were suffering from hypothyroidism. Moreover, the association between congenital hypothyroidism and IDA was noticed in 50% of cases above all.

Conclusion: Hypothyroidism was found quite common among the women of different age groups who were previously reported with acute to chronic anemia symptoms due to iron deficiency. 

Open Access Review Article

Application of Genome Editing Technologies for Disease Treatment: Review

Girum Tefera Belachew, Paramesh Hanumanthaiah, Bitaniya Abera Tekelemariam

Journal of Pharmaceutical Research International, Page 1-17
DOI: 10.9734/jpri/2021/v33i19A31320

The improvement of particularly versatile genome-modifying advancements has outfitted experts with the ability to rapidly and monetarily bring sequence-specific changes into the genomes of a wide scope of cell types and organisms. The CRISPR framework was first found as a protection system in Escherichia coli against infections. Short portions of unfamiliar DNA are coordinated inside the CRISPR locus and translated into CRISPR RNA (crRNA), which at that point toughen to trans-activating crRNA (tracrRNA) to coordinate sequence specific debasement of pathogenic DNA by the Cas9 protein. Many studies have now revealed insight into the primary premise of DNA recognition by Cas9, showing that the heteroduplex shaped by the gRNA and its complementary strand of DNA is housed in a positively charged groove between the two nuclease areas (RuvC and HNH) inside the Cas9 protein, and that PAM recognition is intervened by an arginine-rich motif present in Cas9.

Genome altering biological tools likewise bring healing chances. For instance, ZFN-interceded gene interruption has been taken to the clinic, particularly for the treatment of glioblastoma and HIV by Sangamo biosciences. ZFNs focused to the HIV co-receptor CCR5 for the medication of HIV/AIDS are in stage I clinical trials have been finished currently and are in advancement). In these clinical investigations, the security and possibility of autologous infusion of ex vivo extended CD4+ T cells treated with CCR5- specific ZFNs are assessed in patients with HIV/AIDS. Genome altering itself likewise holds huge potential for treating the fundamental hereditary causes for specific infections. Thusly, the point of this survey is to sum up the vital standards of genome altering, focusing a considerable lot of the designing advances that have laid the foundation for the creation, refinement, and usage of the current set-up of genome-changing biological tools.