Open Access Case Report

Impact of Movement with Mobilization and Triceps Eccentric Strengthening in Tennis Elbow: Case Report

Nabeela Fatema, Bodhisattva Dass, Rinkle Hotwani

Journal of Pharmaceutical Research International, Page 10-14
DOI: 10.9734/jpri/2021/v33i23B31412

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy.

Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department.

Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell.  There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength.

Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.

Open Access Original Research Article

Azithromycin Pulse Therapy with Oral Doxycycline in the Treatment of Acne Vulgaris, a Randomized Group Study

C. Sadhana, N. S. Muthiah

Journal of Pharmaceutical Research International, Page 1-9
DOI: 10.9734/jpri/2021/v33i23B31411

Acne vulgaris is a common dermatological problem. The choice of proper treatment is determined by the severity and extent of acne. Moderate to severe acne vulgaris cases respond well to systemic antibiotics. Antibiotics execute their anti-propionic bacterium effect by inhibiting the bacterial growth and colonization of pilosebaceous glands and thus further inflammation is prevented. The efficacy and possible side effects of various oral antibiotics has been the subject of numerous studies for at least the last twenty years in an effort to understand, which products are likely to produce better efficacy with least possible side effects. The new emerging problem is antibiotics resistance to propionic bacterium. There has been a constant increase in search of safe medications to overcome the side effects and resistance of existing formulations for the treatment of acne vulgaris. The study duration was 8 weeks. A total of 200 study participants of both sexes with complaints of acne vulgaris were included in the study and randomized into two groups. Group I (100 study subjects) – 500 mg Azithromycin once daily for three consecutive days in a week for 2 months and Group II (100 study subjects) –100 mg Doxycycline once daily for 2 months. After doing initial laboratory tests treatment was initiated. Three scheduled visits – Baseline, at the end 4th week and at the end of study were done and the response to treatment was evaluated. The efficacy of the drugs was assessed by the change in grading of acne from baseline and at follow up visits. Doxycycline was found to be better than azithromycin pulse therapy in reducing acne severity. During the visits gastrointestinal, dermatological and other side effects were also noted and recorded. Adverse event profile of both the drugs showed that there was no non- compliance incidence due to adverse event. But the number of adverse events was higher in doxycycline group.

Open Access Original Research Article

Detection of Gram Negative Bacilli Producing Extended Spectrum Beta Lactamase on Intensive Care Unit at Tertiary Care Hospital

M. Nishanthy, Chitralekha Saikumar

Journal of Pharmaceutical Research International, Page 15-21
DOI: 10.9734/jpri/2021/v33i23B31413

Antimicrobial resistance is a budding threat worldwide. The every class of antibiotic agents must have resistance mechanisms.The principal mechanism for resistance to the β-lactam antibiotics in gram-negative bacteria is the production of β-lactamase. The creation of extended-spectrum β-lactamases (ESBLs) is a vital mechanism which is responsible for the resistance to the cephalosporins. During the last 2 decades, ESBL producing gram-negative bacilli have arose as a major problem in many settings. Resistance to 3rd generation cephalosporins by attainment and manifestation of extended spectrum beta lactamase (ESBL) enzymes among gram-negative bacilli is on a rise. To isolate the ESBL strains from various clinical samples in ICU. To find out the prevalence of ESBL producing gram negative bacilli during the period of December 2017 - December 2018 in the Intensive care unit of Sree Balaji Medical College and Hospital. Totally 27 out of 139 gram negative bacilli (19.42%) were found to be ESBL producers. ESBL triggering gram negative bacilli spiteful the biological sample like blood,  urine, wound  swab, sputum  were 36.36%, 16.00%, 10.00%, 9.09% individually Though Meropenem is 100% sensitive to all ESBL beginning gram negative bacilli, but still sensitivity also witnessed with some cheaper drugs like Cotrimoxazole (33.33%), Amikacin (48.14%), Gentamicin (40.7%), Ciprofloxacin (22.22%). Hence we care and will provide an analysis and treatment for affected patients with Extended Spectrum Beta Lactamase producing organisms.

Open Access Original Research Article

Phytochemical Profiling and Antioxidant Activity of Aqueous Leaf Extract of Vitex negundo

Govindarajan Umamaheswari, Kuppusamy Selvam, Palanisamy Prakash

Journal of Pharmaceutical Research International, Page 22-32
DOI: 10.9734/jpri/2021/v33i23B31418

Natural products from plants, animals and minerals are the basis for treating human diseases. The present investigation explains that the antioxidant potential of aqueous extract of vitex negundo leaves.  Phytochemical constituents, total phenolic and flavanoid content of aqueous analysis and   vitro methods such as 1,1-diphenyl-2picrylhydrazyl (DPPH), 2,2-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) radical scavenging assays and GC_MS studies are reported.  In addition, TPC and TFC of the extract were evaluated. It was observed that the leaf extract total phenol (14.3 mg) and flavanoids (8.5 mg) Quercetin equivalent (Q/g)  high level of Phenolic and flavonoid content that might have accounted for the strong activity observed ABTS 62% of inhibition  µg/ mL almost equivalent to that of standard vitamin C  and DPPH value of 66.32 µg/ mL almost equivalent to that of standard vitamin C  results revealed that leaves of vitex negundo have  Since this investigation is a preliminary study, a detailed study of the antioxidant mechanisms of specific phenol components is an absolute necessity. Many phytochemical constituents which may be responsible for many pharmacological activities.

Open Access Original Research Article

A Bone Marrow Aspiration Study in Evaluation of Severe Anemia in Adults

T. Ayeesha Sithika, Priavadhana Rajan Prasaad, Vindu Sivastava

Journal of Pharmaceutical Research International, Page 33-43
DOI: 10.9734/jpri/2021/v33i23B31419

Anemia is a global health challenge and is the most significant health problem encountered in the developing countries especially in India. According to the World Health Organisation (WHO), 1.62 million !! billion people per year are affected globally with anemia which constitutes 24.8%  of  the  world population. To evaluate the clinical presenting features and the basic haematological parameters in adult patients with severe anemia, the morphological alterations of Bone marrow aspirates in these patients were studied. To correlate these morphological alterations of Bone marrow aspirates with the clinical and the basic haematological parameters in severe anemia.

Open Access Original Research Article

Detection of Antimicrobial Activity of Cranberry Fruit Extract against Methicillin Resistant Staphylococcus aureus and Extended Spectrum Beta Lactamase Escherichia coli

Ali Nawaz Bijarani, Muhammad Owais Ismail, Zahida Memon, Faisal Afridi, Shabana Qabulio, Akhtar Ali

Journal of Pharmaceutical Research International, Page 44-52
DOI: 10.9734/jpri/2021/v33i23B31420

Objective: Antibacterial effects of Cranberry fruit extract on Methicillin Resistant Staphylococcus aureus and Extended Spectrum beta lactamase producing E. coli and its comparison with Linezolid and Meropenem.

Materials and Methods: It is a Pre Clinical (in-vitro) study conducted in Ziauddin University from January 2020 to October 2020. All samples were collected from Ziauddin University.  All clinical samples were collected inform of pus, urine, blood, tracheal aspirations, patients admitted in surgical and medical wards, intensive care units and outdoor patients who were attending clinics. All these samples were transported to Clinical Microbiology Laboratory, Ziauddin hospital, North Nazimabad campus and then culture and sensitivity test were performed there. Sample showing double growth and contamination on agar plates were excluded from study.

Results: Out of 80 samples included in this study 46(57.5%) were female and 34(42.5%) samples were male; female to male samples ratio of 1.35:1.The mean age was 45.71±11.83 years. MRSA commonly found in pus swab 15(37.5%) and 21(52.5%) ESBL producing E. coli found in urine samples. 14(35%) samples were observed anti-bacterial activity of cranberry fruit extracts against Extended Spectrum Beta Lactamase Producing Escherichia coli at 50 mg/ml concentration, followed by 10(25%) and 9(22.5%) samples at  60 mg/ml, 40 mg/ml were respectively. While resistance of Extended Spectrum Beta Lactamase Producing Escherichia coliwere observed high at different concentration level of cranberry fruit extracts. Good anti-bacterial activity of cranberry fruit extracts observed  against Methicillin Resistant Staphylococcus aureus at different                      levels of concentration 20(50%), 23(57.5%), 21(52.5%), 26(65%), 29(72.5%) samples were 20 mg/ml,30mg/ml,40mg/ml, 50mg/ml, 60mg/ml respectively. Most superior and best dose of cranberry fruit extract against Staph Aureus in about 72.5% (29) at 60mg/ml and their Comparison with linezolid and meropenem against Methicillin Resistant Staphylococcus aureus and found best positive results as compared with Linezolid and found significant p value 0.005.

Conclusions: Cranberry extract has a lot of potential to prove itself to be a good antimicrobial agent. The cranberry fruit extract has high antimicrobial activity against methicillin resistant S.aureus and resistant strains of E. coli in comparison to linezolid and meropenem.

Open Access Original Research Article

Effect of Metformin on C-reactive Protein in Type 2 Diabetes Mellitus Patients

P Selvi, Arul Amutha Elizabeth

Journal of Pharmaceutical Research International, Page 53-61
DOI: 10.9734/jpri/2021/v33i23B31421

Diabetes mellitus (DM) is a complex endocrinology disease which requires a meticulous understanding of its pathogenesis and its complications to subdue it. It has been riddled with extensive micro and macro vascular complications which by itself has its own set of pathogenesis. There is a link between DM and cardiovascular disease (CVD), which is the most important cause of morbidity and mortality in diabetic patients. Cardiovascular risk factors such as obesity, hypertension and dyslipidemia are more common in patients with DM, placing them at increased risk for cardiac events.  In addition, they have found biological mechanisms associated with DM that independently increases the risk of CVD in diabetic patients.Metformin is the most commonly used antidiabetic agent derived from Gallegaofficinalis. Metformin provided greater protection against macro vascular complications than would be expected from its effects upon glycemic control alone. Hence this study evaluated the anti-inflammatory effect of metformin on C Reactive Protein (CRP) in patients. In this study fifty type 2 diabetes patients were enrolled in the study including 23 males and 27 females with mean age 40±4.33. FBS and PPBS baseline values expressed as Mean ± SD were 138.06±17.12 mg/dl and 223.12±30.63 mg/dl respectively. After 6 months of metformin therapy, FBS and PPBS were 91.64±10.55 mg/dl and 133.88±7.99 mg/dl respectively. HBA1C baseline value expressed as Mean ± SD was 7.966±0.85 %. After 6 months of metformin therapy, HBA1C improved to 6.8±0.93.hs-CRP baseline value expressed as Mean±SD was 3.4±1.16 mg/L. After 6 months of metformin therapy, hs - CRP effectively reduced to 1.7±0.81 mg/L. Prompt treatment intensification in such cases may thus be sensible. Further studies are needed to identify predictors of metformin treatment response, especially focusing on hs-CRP levels, lipid levels and genetic factors.

Open Access Original Research Article

Study of Serum Lipoprotein (a) in Hypothyroidism

Leishangthem Rina, V. S. Kalaiselvi, B. Shanthi

Journal of Pharmaceutical Research International, Page 72-80
DOI: 10.9734/jpri/2021/v33i23B31423

Hypothyroidism occurs when your body doesn’t produce enough thyroid hormones. The thyroid is a small, butterfly-shaped gland that sits at the front of your neck. It releases hormones to help your body regulate and use energy. To this study compare Serum lipoprotein levels in hypothyroid patients and in control group. To find the correlation of Lp(a) with thyroid hormones status in hypothyroid patients. To find the hypothyroid patients. Levels of serum Lp (a), FT3, FT4, TSH, TC and TG were all estimated from the samples of the study group. The results of this study provide ample evidence that the levels of Serum Lp(a) are increased in hypothyroid patients.

Open Access Review Article

Antimicrobial Stewardship Interventions: Narrative Review

Nehad J. Ahmed, Abdul Haseeb, Azmi Ahmed Hassali, Amer H. Khan

Journal of Pharmaceutical Research International, Page 62-71
DOI: 10.9734/jpri/2021/v33i23B31422

Antimicrobial resistance is a serious health concern with significant economic and clinical sequelae. Antimicrobial stewardship programs are increasingly being promoted and mandated in order to rationalize and reduce the use of antimicrobials in healthcare institutions and as a result decrease antimicrobial resistance. Several interventions could be used to improve antibiotic use that includes broad, pharmacy driven and infection and syndrome specific interventions. Each hospital should prioritize interventions based on its needs as well as based on the availability of resources and content expertise.

Open Access Review Article

Review of the Appropriateness of Surgical Antimicrobial Prophylaxis

Nehad J. Ahmed, Ziyad S. Almalki, Abdul Haseeb, Azmi Ahmed Hassali, Amer H. Khan

Journal of Pharmaceutical Research International, Page 81-92
DOI: 10.9734/jpri/2021/v33i23B31424

Aim: This review aims to describe the appropriateness of surgical antimicrobial prophylaxis during the last decade.

Methodology: The review included a searching web of science for articles focused on “the appropriateness of surgical antimicrobial prophylaxis”. The searching process was conducted on 29 Nov 2020 and included original articles so the review articles were excluded.

Results: The review included 57 articles; 38 articles were published after 2015 and the rest before 2015. Most of the articles that were included in the review showed a high rate of inappropriate surgical prophylaxis and showed inappropriate duration and time of the antibiotics used.

Conclusion: It can be concluded that the rate of surgical prophylaxis inappropriateness was high and the main cause for this result was inappropriate timing and duration. Numerous interventions including educational interventions such as one-time seminars and online e-learning modules are needed to improve the adherence to the guidelines.