Open Access Case Study

Successful Management of Sickle Cell Disease Patient with Covid-19 Infection in a Low Resource Setting: Case Study

Akaba Kingsley, Edu C. Betta, Akaba Edakabasi, Essien Ofonime, Bibia Glory Philemon

Journal of Pharmaceutical Research International, Page 110-114
DOI: 10.9734/jpri/2021/v33i26A31475

Background: Sickle cell disease (SCD) patients have greater susceptibility to infections, they are reckoned to be vulnerable patients during the current COVID-19 pandemic. SCD patients are commonly affected by pulmonary complications such as acute chest syndrome (ACS), pulmonary embolism (PE) and pneumonia that contribute significantly to mortality risks.

Aim: The study was aimed at showing the impact of SARS-COV viral pandemic on SCD patients.

Presentation of Case: A 42-year-old male known sickle cell disease patient, who presented with a 5 days’ history of chest pain and difficulty in breathing with a pain score of 8/10. Pain was said to be localized and, subside on the ingestion of analgesics (Tab DF118/60mg and PCM 1000mg) with no known aggravating factor, but there was associated history of difficulty in breathing. The patient was being managed as a case of vaso-occlusive crises R/O acute chest syndrome, and was commenced on adequate hydration, oxygen saturation was between 95-85%. On examination, respiratory rate was 20 cycles per minute, pulse rate – 96 beats/minute, BP and chest examination were essentially normal. CBC showed the Packed Cell Volume of 31%, White Blood Cells 15.04 x 109/L, Neutrophils 7.51x103/µL Lymphocyte 6.50 x103/µL, Monocyte 0.76 x103/µL Eosinophils 0.20x103/µL, Basophils 0.05x103/µL, Platelet 358. The electrolytes (Na-135 mmol/L, K 3.5mmol/L, HCO3-20), urea -10 mmol/L and creatinine (88mmol/L) were normal, the chest x-ray showed cardiomegaly but the lung fields were clear. The patient was administered ceftriaxone (prophylactic antibiotics – 1 g daily).  The patient tested positive to COVID-19 and was immediately transferred to the isolation centre for proper management. He was commenced on oral medication, azithromycin, dexamethasone, ivermectine, amoxicillin/clavulanic acid, vitamin C, clexane and the analgesic was changed to paracetamol and dihydrocodeine to alternate 3 hourly with accordance to the national guidelines. In addition, he was administered subcutaneous enoxaparin due to the hypercoagulability state of SCD. The patient’s health status improved within 24hours of commencement of the above medications and remained stable all through the period of isolation and a repeat covid-19 test was done 15 days of admission using and reverse transcriptase PCR and was discharged home according to the National protocol.

Conclusion: Studies and clinical trials are essential to evaluate effective diagnostic and management options for SCD patients and other high-risk conditions like diabetes hypertension, cancer patients and so on that are associated with fatal complications when infected with COVID-19 and similar diseases.

Open Access Original Research Article

Management of Pediatric both-bone Forearm Fractures by Titanium Elastic Nailing System: A Prospective Study of 60 Cases

Masood Ahmed Qureshi, Nuresh Kumar Valecha, Niaz Hussain Keerio, Syed Sajid Hussain, Hassan Amir us Saqlain, Muhammad Faraz Jokhio, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i26A31466

Intramedullary nailing procedure is highly appreciated by many phsyicians for treating pediatrics forearm fractures. Minimum operating time, fewer chances of incisions, faster bone healing, and accuracy in bone alignment less rigid fixation made this technique more popular and preferable. This study was specially designed to observed the management of pediatric both forearm fracture by using the titanium elastic nail technique.

Methodology: Our prospective descriptive study was conducted in King Abdul Aziz Hospital Makkah Saudi Arabia from march 2018 to march 2021. Total 60 patients were enrolled which were treated with titanium elastic nail system (TENS). In this study patients with close displaced and open type 1 fractures with age range of 4 to 14 years were included.

Results: Total 42.5% of participants were under the age of 10, and  57.5% of patients were above 10 years or equal to 10 years age. We reported 58.9% prevelance of injury among male patients. Along with these, we reported 53.4% cases with left side fractures and 60.3% had middle bone fractures. In our study, we reported that the overall average union time  was 9.10±1.8.

Conclusion: Titanium elastic nailing is the most effective technique for managing unstable fractures among pediatrics. The male population was more prone to forearm fracture, especially at the middle third shaft.  Overall meantime 9 weeks were reported for bone unification. Titanium elastic nailing is more effective technique for patients less than 10 years old. Mean unification time of bone was less among them with little compliactions. 

Open Access Original Research Article

Assessment of Patient’s Response about Adverse Drug Reactions Receiving AC (Adriamycin, Cyclophosphamide) Therapy: A Survey Research

Jameela Jamali, Abdullah Dayo, Naheed Memon, Ubed-ur-Rehman Mughal, Muhammad Akram Khatri, Shaib Muhammad, Yasmeen Qureshi, Tooba Khan

Journal of Pharmaceutical Research International, Page 8-13
DOI: 10.9734/jpri/2021/v33i26A31467

Background: Adverse drug reactions (ADRs) are most common among cancer patients receiving treatment. AC therapy which is a combination protocol of Adriamycin (doxorubicin) and Cyclophosphamide are the common therapies used for breast cancer treatment due to their effectiveness and cost of therapy breast cancer. AC combination is administered every 3 weeks, and 4 cycles are given.

Objectives: To assess various ADRs reported by patients on AC combination therapy and their severity to ensure safe and effective treatment.

Design: Prospective observational.

Setting: Cancer hospital Jamshoro Pakistan.

Patients and Methods: A hospital based observational study included 160 female patients suffering from breast cancer and receiving AC combination for treatment by purposive sampling method from June 2015- January 2018 at cancer hospital Jamshoro Pakistan. ADRs reported were compared against international standard references of drug literature such as British National Formulary (BNF) 2017 and ADR severity assessment scale (Modified Hartwig and Siegel scale).

Main Outcome Measures: Frequency and severity of ADRs.

Results: The common ADRs reported were, nausea and vomiting, acidity, fatigue, hair fall as common non-hematologic and leukopenia among hematologic ADRs. Those patients reported high severity ADRs according to severity scale persist for longer duration and required antidote for management with medical intervention.

Conclusion: The present study shows that a patient’s response towards AC therapy is critical and therefore each patient must be monitored and those at high risk of developing ADRs from this therapy must be provided additional care.

Open Access Original Research Article

Disinfection of Tank Water Using Biogenic Silver Nanosilica as Anti-Microbial Agents in Jeddah City

Hayam S. Abdelkader, Nuha M. Alhazmi

Journal of Pharmaceutical Research International, Page 14-34
DOI: 10.9734/jpri/2021/v33i26A31468

The need for clean water is becoming urgent all over the world. The risk of microbial contamination of drinking water and its growing ability under poor nutritional conditions occur frequently and existing water management systems do not efficiently eliminate these micropollutants. The major goal of this research is to analyze and test the drinking water quality at random locations in Jeddah City and to investigate the integration of polyurethane foam coated nano-silica silver nanoparticles (NSAgNPs) into the water purification system. The study was conducted in Jeddah city at random intervals during August to December 2020. Twenty-five samples (n = 25) of drinking water (tank water) were collected from different locations in Jeddah. The water samples were found contaminated with E. coli, Klebsiella pneumoniae. and the most prevalent yeast species was Candida albicans. The multi-drug resistance isolates were positively identified by PCR amplification of 16S rDNA gene fragments. The antimicrobial activity of nano-silica silver nanoparticles (NSAgNP) was analyzed and their optimal concentrations that remove potentially harmful microbes were determined. The cytotoxicity of NSAgNPs by Sulforhodamine B colorimetric (SRB) assay against breast adenocarcinoma cell line (MCF-7) showed no cytotoxic effect at concentrations ≤100 µg/mL. The 50% growth inhibition concentration (IC 50) of NSAgNPs after 72 h was 35.8 µg/mL. The excellent performance of NSAgNPs can be attributed to the capping surface functional groups and smaller particle size 8.931 nm, as verified by TEM. In conclusion, the purified water obtained by using 100 mg/L NSAgNPs is free from microbial contaminants and completely safe to drink. We recommend the integration of biosynthesized foam coated silver nanoparticles with water purification system to achieve the desired final water quality.

Open Access Original Research Article

Study of Malondialdehyde Level and Glutathione Peroxidase Activity in Patients Suffering from Malaria

Shalaka Prabhu, Sachin A. Patharkar, Neelam J. Patil, Alka V. Nerurkar, Umesh R. Shinde, Kalpana U. Shinde

Journal of Pharmaceutical Research International, Page 35-41
DOI: 10.9734/jpri/2021/v33i26A31469

Introduction: Malaria is one of the most common Parasitic infection prevalent worldwide especially in India, South Asia and Africa. About 250 million cases and approximately One million deaths of malaria reported per year worldwide. Oxidative stress (O.S.) has been implicated as possible mediator of thrombocytopenia in malarial patients. All eukaryotic cells, specially immune effector cells generate reactive oxygen species (ROS) and reactive nitrogen species (RNS) as a mean to combat invading microbes i.e. via the ' Oxidative burst', which increases the oxidative burden on the microbe to lethal levels. An excess of ROS such as superoxide anions, hydrogen peroxide (H2O2), hydroxyl radicals and /or RNS, such as nitric oxide (NO) and peroxynitrite (ONOO-) creates a potentially dangerous situation known as oxidative or nitrosative stress respectively.

Aim: Present study aims to study the status of serum Malondialdehyde and Glutathione Peroxidase activity in hemolysate among the patients with Malaria.

Materials and Methods: This is cross-sectional observational study on 200 non-treated malaria patients, compared with 100 normal individuals. Out of total 200 malaria patients 96 were plasmodium (P) vivax & 104 were P falciparum diagnosed cases.

Results: Mean MDA level in the P. Vivax malaria cases was 12.29 + 0.32 micromole/L which was found to be higher compared to the controls with mean MDA level is 6.55+ 0.24 micromole/L, whereas the mean MDA level in P. Falciparum malaria cases was 13.5+ 0.18 micromole/L which was higher compared to the controls with mean MDA level of 6.55+ 0.24 micromole/L.

Conclusion: The present study on malaria explains the role of oxidative stress in the pathophysiology of malaria which is a multifactorial phenomenon and represents an important aspect of the intricate and complex host- parasite relationship. Oxidative stress is aggravated by reduced effectiveness of the antioxidant defence system; hence it is advised to provide antioxidant supplements through diet that can reduce the disease severity and risk of death during infection.

Open Access Original Research Article

Evaluation of Antidiabetic Activity of a Novel Polyherbal Preparationagainst Streptozotocin Induced Diabetes Rat Model

K. Jyothsna Jayaraju, B. Mohammed Ishaq

Journal of Pharmaceutical Research International, Page 42-54
DOI: 10.9734/jpri/2021/v33i26A31470

Background: Diabetes Mellitus is a chronic disorder characterised by abnormally elevated glucose levels in the blood. Diabetes is caused by one of two mechanisms: insufficient insulin synthesis (which is produced by the pancreas and reduces blood glucose) or insufficient response of cells to insulin action. The current aim of this research project was to formulate and evaluate the Polyherbal preparation (PHP) of the plants constituted with Cinnamonum zeylanicium (CJ) bark, Eugenia jambolana (EJ) seeds, Vinca rosea (VR) whole plant, Gymnema sylvestre (GS) leaves and determination of the anti-diabetic potential of the formulation in the animal model induced by Streptozotocin.

Methods: Plant components in the current study used were Cinnamonum zeylanicium (CJ) bark, Eugenia jambolana (EJ) seeds, Vinca rosea (VR) whole plant, Gymnema sylvestre (GS) leaves were collected.Using a hydroalcoholic solvent, physico-chemical parameters and active chemical constituents were evaluated. The active components present in the extracts were identified by Preliminary phytochemical screening. The PHP acute toxicity analysis was conducted in compliance with OECD Guideline 423, with 200 mg/kg and 4000 mg/kg administered orally to rats over 28 days.

Results: Diabetes was induced by STZ and treated with PHF did not show any alterations in behavior and no mortality was observed up to the 2000 mg/kg dose level during the interventional period. By oral administration of PHP with a dosage of 200 and 400 mg/kg, OGTT resulted in a steady decrease in blood glucose levels of 68.74±4.63 mg/dl and 63.83±1.74 mg/dl at 180min after the trial which proves that PHP possess anti-diabetic activity. By mixing each extract in varying proportions, PHP was developed and evaluated. PHP (200 and 400mg/kg) antidiabetic activity wasdetermined for streptozotocin (STZ)-induced diabetes in rats and glibenclamide (5.0mg/kg body weight) was used as a standard drug.The investigational drug was administered for 28 days and the blood glucose level effect of the PHP was analysed on the 28th day after the intervention time.

Conclusion: The experimental study showed that a persistent and substantial decrease in the average blood glucose level of diabetic rats was observed with repeated administration of PHP and glibenclamide for 28 days. PHP demonstrated substantial antidiabetic and antihyperlipidemic activity similar to the standard drug. The formulation will emerge as a possible mixture that may challenge the synthetic drug.

Open Access Original Research Article

Comparison of the Fluoride Release of Silver Diamine Fluoride, Fluoride Varnish, Acidulated Phosphate Fluoride Gel on Extracted Teeth over Various Time Intervals in Artificial Saliva

Taniya Thakur, Pratik Kumar Lahiri, Madhumanti Karmakar, Bhumi Sarvaiya, Piyali Datta, Rajib Saha

Journal of Pharmaceutical Research International, Page 55-63
DOI: 10.9734/jpri/2021/v33i26A31471

Silver Diamine Fluoride (SDF) has been documented to effectively arrest dental caries and reduce dental hypersensitivity. SDF promotes remineralization and harden the carious lesion. SDF increases fluoride concentration in saliva and increase the bioavailability of fluoride in saliva. After SDF application, fluoride ion promotes remineralization and silver ion is available for antimicrobial action.

Aim: The study aims to determine and compare the amount of fluoride released from various fluoride releasing materials in artificial saliva after 24 hours, 7th day and 14th day of the study.

Materials and Methods: 96 premolars free of any caries, fractures, or any other defects were sterilized in 10% formalin for 2 weeks. Then they were rinsed in tap water to remove any fixative from its surface and then stored in deionised distilled water for a period of 30 days prior to testing. Tooth samples were divided into four groups- Group 1: 38% SDF, Group 2: 1.23% APF gel, Group 3: Fluoride varnish and Group 4: Control. All the teeth specimens were blot dried and subjected to their respective material. Fluoride release was analysed using a Fluoride ion-selective electrode after 24 hours, 7days and 14 days of suspension in artificial saliva.

Results: Mann-Whitney U Test for inter-group comparison was used for statistical evaluation. 24 Hours fluoride release: The maximum amount of fluoride was released from Fluoride Varnish followed by SDF then APF Gel and least by artificial saliva alone (control) (p<0.001). 7th Day fluoride release: The maximum amount of fluoride was released from SDF followed by Fluoride Varnish then APF Gel and least by artificial saliva alone (control) (p<0.001). 14th Day fluoride release: The maximum amount of fluoride was released from Fluoride Varnish followed by SDF then APF Gel and least by artificial saliva alone (control) (p<0.001).

Open Access Original Research Article

Evaluation of Hemidesmus indicus Plant Compounds for Anti-Cancer Studies – An In silico Approach

Pavan Kumar Tummala, Sreeja Nannapaneni, Sumana Pratyusha Durvasula, Supriya Chadalavada, Sunandini Venigandla, Srikanth Vemuru, Suryanarayana Veeravilli, Maheswara Reddy Mallu

Journal of Pharmaceutical Research International, Page 64-69
DOI: 10.9734/jpri/2021/v33i26A31472

Background: Phytocompounds in medicinal plants have a wide range of properties and are alternative medicines for those who cannot be helped by conventional medicine.

Objective: In this work we have selected bioactive compounds from Hemidesmus indicus medicinal plant extracts.

Methods: Gas chromatography and Mass spectrum studies were studied to identify the compounds present in the ethanolic extracts based on the retention time and area.

Results: The identified compounds were used for anti-cancer activity by insilico method with BCL-2 which plays prominent role in causing cancer.

Conclusion: Out of twenty selected compounds, docking results showedMethyl-1-Cyclohexane carboxylate and 1,2-diacetoxy-5-idohexane as best docked to the BCL-2.

Open Access Original Research Article

Evaluation of Anticancer Action of Martynia annua Linn Root Extract on Different Human Cancer Cell Lines

Rahul Kumar Gupta, Renu Bharat Rathi

Journal of Pharmaceutical Research International, Page 96-109
DOI: 10.9734/jpri/2021/v33i26A31474

Background: In the last few decades, plants have been playing a vital role in treating cancer and infectious diseases. Natural products have been rediscovered as effective methods of drug production amid advances in combinatorial chemistry. Roots of Martynia annua are being used as a folklore remedy for the treatment of cancer and rheumatism successfully.

Aims of the Study: In the present study, ethanolic, aqueous and hydro-ethanolic root extracts of Martynia annua were screened for in vitro cytotoxicity activity using different cell lines.

Settings and Design: In the experiment, lung cancer cell lines (A549), leukemia cancer cell lines (K562), oral cancer cell lines (SCC-40), breast cancer cell lines (MCF-7) & cervix cancer cell lines (SiHa) were studied on the extracts.

Materials and Methods: The method used was Sulforhodamine B (SRB) assay technique in which growth inhibition of 50% (GI50) was analyzed by comparing it with standard drug Adriamycin (ADR) (doxorubicin).

Results: Aqueous & ethanolic extract of Martynia annua root had shown high anticancer activity with GI50 value 11.3µg/ml and 20.4µg/ml respectively on human leukemia cell line K-562 but for human breast cancer cell line MCF-7, human lung cancer cell line A-549, human squamous cell carcinoma SCC-40 and human cervical cancer cell line SiHa the extracts showed activity in more than 80µg/ml.

Conclusion: The anticancer activity of aqueous extract of Martynia annua root was found superior than the ethanolic extract in Human Leukemia Cell Line K-562. The study indicates that the Martynia annua root extracts are most effective against the fast proliferative cells (Leukemic cells) and possibly a cell cycle arrest (needed to be proved as future perspective) is the mode of action of the extract. To study its effect on targeted cancers, specific in vivo scientific studies and clinical trials should be carried out by further researchers.

Open Access Review Article

A Comprehensive Review and Perspective of Herbal Medicines in the Treatment of COVID-19

Afrasim Moin, S. Meenakshi, Syed Mohd Danish Rizvi, Nanhi Nandini, Talib Hussain, Arshad Hussain, G. S. Meghana, M. Manohar, P. Sathishbabu, D. V. Gowda

Journal of Pharmaceutical Research International, Page 70-95
DOI: 10.9734/jpri/2021/v33i26A31473

Background: An emergent COVID-19 outbreak originated in Wuhan City, in December 2019. The COVID-19 contamination has swiftly unfold from Wuhan to maximum different provinces and different 24 countries. WHO declared a public health emergency of global concern over this worldwide COVID-19 outbreak on 30th January 2020. Manifold research has been intensely initiated for immunization and drug development for COVID-19 till date no specific vaccine or approved drugs are accessible for COVID-19. Alternatively, therapy consists of supportive care and non-specific anti-viral, anti-malarial, and antibiotics are being testedas drugs for COVID-19. Though, novel approaches could play a crucial role to combat mortality rate and patient recovery in the treatment of COVID-19.

Objective: To reveal the epidemiology, pathophysiology, and comparison of promising synthetic and natural drug targets to avert and cure of COVID-19.

Method: This article sets a brief understanding of the viral characteristics, its life cycle, infection to humans, and the pathophysiology of the disease. It also throws light on the currently used synthetic medicines. we have reviewed the effect of natural products to prevent or treat COVID-19 infection. Their mechanisms of action have been elaborately discussed. literature research was undertaken using PubMed, Google Scholar, Scopus, and WHO website. The different herbal products (extracts) and their moieties which are promising as anti-SARS-CoV-2 by direct inhibition of the virus replication or entry has also been discussed.

Results and Conclusion: In conclusion we have highlighted that natural therapeutics either alone or in combinationcould be used as alternative medicines to treat/prevent COVID-19 infection. Moreover, their structures may offer clues for the development of anti-SARS-CoV-2 drugs.The integration of nanocarriers for effectively delivering the conventional as well as the herbal drugs becomes a key point for their efficacy and safety.