Open Access Case Study

Effect of Functional Electrical Stimulation on Upper Limb Motor Functions in Patient with Chronic Stroke - A Case Report

Rupa Zanwar, Pooja Motar, Minal Holani

Journal of Pharmaceutical Research International, Page 199-203
DOI: 10.9734/jpri/2021/v33i29B31605

Background: Literature shows that intensive Functional Electrical Stimulation facilitates upper limb motor recovery after Stroke.

Aim: To assess the effects of 4 weeks of FES therapy on right upper limb motor functions in patient with Chronic Stroke.

Materials and Methods: The participant was thirty year old male Right Hemiparesis who had experienced Chronic Ischemic Stroke. FES therapy was given for forty five minutes per session, three sessions a week for complete four weeks. The pre and post intervention score were measured with Fugl Meyer Assessment, Voluntary Control Grading and MAS.

Results: The Fugl Meyer Assessment score for right upper limb showed improvement with progression in stage of VCG for right upper limb and hand. Also improved MAS score was noted for right shoulder, elbow and hand muscles.

Conclusion: The current study confirms that application of FES therapy improves upper limb motor functions in Chronic stage of Stroke after 4 weeks.

Open Access Minireview Article

Therapeutic Role of Ginger (Zingiber officinale) - A Review

Tahreem Kausar, Sadaf Anwar, Entesar Hanan, Mifftha Yaseen, Shimaa M. H. Aboelnaga, Z. R. Azaz Ahmad Azad

Journal of Pharmaceutical Research International, Page 9-16
DOI: 10.9734/jpri/2021/v33i29B31584

Ginger (Zingiber officinale) is a common kitchen spice that belongs to the family Zingiberaceae. It is rich in phytochemistry that is promoting health benefits.  It is used as a home remedy to support the common cold, headaches, and pharmacological properties such as anti-inflammatory, antioxidant, antiemetic, antiulcer, and anti-cancer, antiplatelet, anti-diabetic and lipid-lowering activities. Gingerols are key ingredients found in ginger that convert into zingerone, shogaol, and parasols, giving flavor and odor. Zingerone and shogaol are present in limited quantities in fresh ginger and more in dried or extracted goods. Especially 6-gingerol and 6-shogaol  are pharmacological properties that are effective in antipyretic, analgesic, and hypotensive. The present review is about different therapeutic properties of ginger, including antioxidant properties, anti-diabetic properties, anti-cancer properties etc.

Open Access Minireview Article

Conducting Dermatological Operations in Patients Who Have Previously Undergone Cardiac Surgery

Argen Nabievich Irmatov, Ravan Seyfeddin Ogly Shukyurli, Rukizhat Gasbulakhovna Kurbanmagomedov, Diana Taymazovna Amirchupanova, Pavel Vladimirovich Nasonov, Vitaly V. Goncharov

Journal of Pharmaceutical Research International, Page 204-210
DOI: 10.9734/jpri/2021/v33i29B31606

Thoracic surgical procedures and the use of cardiac devices such as pacemakers are becoming increasingly common in the population. Therefore, dermatologists may be more likely to encounter previously implanted or discarded surgical material during a dermatological operation on the chest wall. A basic understanding of the types of wires and tunneling paths used in such procedures is essential to accurately predict the presence of these wires and effectively manage any chance encounters.

Dermatologists should be aware that temporary epicardial pacemaker electrodes and pacemaker electrodes often remain in the chest wall of many patients. All patients with a history of cardiac surgery should be asked about the possible presence of temporary epicardial electrodes in their body, and if such materials are found during the operation, it is necessary to immediately stop the procedure and do not undertake further manipulations with them until the material from which it is made is determined.

Specialists in cardiology and cardiothoracic surgery need to document any abandoned wire in the patient's list of problems and inform the patient about the abandoned wire so that he or she can be an important source of clinical information.

Trying to pull out the remaining pacemaker electrodes is a serious risk, so dermatologist surgeons should not attempt it under any circumstances. When detecting wire material, it is necessary to determine the type and location of the material before any manipulation or pulling attempts. Once it is established that this is a non-functional, abandoned wire, it is necessary to apply the correct technique for removing it, which consists in gently pulling and securing the wire at the exit point. Accurate identification of the material is required in order not to interfere with the operation of the active device and not to abandon the operation unnecessarily.

The aim of the work is to consider the implementation of dermatological operations in patients who have previously undergone cardiac surgery.

Open Access Original Research Article

To Determine the Mortality and Factors Responsible for Mortality in Patients Presenting with Acute Stroke within 5 Days of Admission at a Tertiary Care Hospital Hyderabad/Jamshoro

Muhammad Aslam, Iffat Jammal, Maria Nazir, Saleem Rind, Shehzad Shaikh

Journal of Pharmaceutical Research International, Page 1-8
DOI: 10.9734/jpri/2021/v33i29B31583

Introduction: Stroke is the third most common cause of death and the first leading cause of disability in developed and developing countries. Various clinical variables have been implicated as predictors of final outcome of acute stroke. These predictors are demographic characteristics, types of stroke, co-morbidities and therapy. Identification of modifiable predictors of death is of paramount importance for clinicians in resource poor-setting, so that specific therapies and management strategies can be applied to patients at high risk of dying.

Objective: To determine the mortality and factors responsible for mortality in patients presenting with acute stroke within 5 days of admission at a tertiary care Hospital,  Hyderabad/Jamshoro.

Setting: Medical Unit-I, Liaquat University Hospital, Hyderabad/Jamshoro.

Duration: Six months from   01-02-2019 to 31-07-2019

Design: prospective, (non -interventional) study.

Subject and Methods: Two hundred and fourteen acute stroke patients confirmed by CT scan brain were included in the study. Patients were assessed through history and examination and brief history was taken about the disease and cigarette smoking. Blood Pressure was measured twice. Patients who died during admission were evaluated for the factors responsible for the mortality. The findings of variables were entered in a Pro forma.

Results: The average age of the patients was 55.65±8.38 years. Frequency of mortality in patients presenting with acute stroke within 5 days of admission in hospital was observed in 29.91% (64/214) cases. Regarding factors leading to mortality, Rate of mortality was 23 times more like in those patients who had dyslipidemia [OR= 23.13 95%CI= 1.86 to 7.98] similarly mortality in patients was 2 to 4 times more likely in diabetic, hypertensive cases and smokers.

Conclusion: Frequency of mortality was high and factors leading to mortality within 5 days were dyslipidemia, diabetic, hypertensive cases. Mortality associated with acute stroke needs prevention and control of risk factors. Treatment and control of diabetes mellitus and hyperlipidemia have contributed to the stroke mortality declines; however, the onset of these interventions is more recent, and thus their impact is less clear.

Open Access Original Research Article

Predictive Risk Factors for Post Tonsillectomy Hemorrhage in Children

Amrat Kumar, Ghulam Shabir Mehar, Junaid Hussain, Ahmed Ali, Abdul Waheed, Dileep Kumar

Journal of Pharmaceutical Research International, Page 42-47
DOI: 10.9734/jpri/2021/v33i29B31587

Objective: To assess the risk factors which determine the magnitude of post-tonsillectomy hemorrhage. 

Study Design: Prospective cross sectional study.

Setting: A study carried out at otolyrangical unit at a tertiary care Isra University hospital Hyderabad, from June 2018 to April 2019.

Materials and Methods: 110 pediatric patients age 5-17 years were included in this study. We administrated a structured questionnaire to parents of the patients. We selected cases for tonsillectomy as per criteria of the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS). Those patients with a history of recurrent tonsillitis presented at the otolaryngology department were included. Patients with a history of use of anticoagulant therapy, obstructive sleep apnea, patients with a history of a bleeding disorder, and patients not giving consent were excluded. We diagnosed patients selected for tonsillectomy included with recurrent tonsillitis, peri-tonsillar hypertrophy, and tonsillar hypertrophy. Patients were observed and followed for postoperative hemorrhage. Data were analyzed by using Statistical Package for Social Sciences version 21 (SPSS 21).

Results:  Among 110 children included in the study, 41.8% patients were in the age group of 5-10 years, 30% were in the age group of 11-15 years and 28.2% were over 15 years. Among 110 patients 21.8% underwent tonsillectomy were diagnosed as recurrent tonsillitis, 19% were diagnosed as having tonsillar hypertrophy, 40.0% were suffering from both recurrent tonsillitis and tonsillar hypertrophy and 19.2% had peritonsillar hypertrophy. This shows that 14.5% were admitted to the hospital after 1-5 days, 58.1% developed post-tonsillectomy hemorrhage after 6-10 days and 27.2% developed post-tonsillectomy hemorrhage after 10 days.

Conclusion: We conclude that age >10 years was significant predictive risk factors for post-tonsillectomy hemorrhage among children who undergo tonsillectomy.

Open Access Original Research Article

Frequency of Satisfactory Outcome after Surgical Management in Isolated Orbitozygomatic Fractures

Tarique Hussain Shaikh, Kashif Ali Channar, Aftab Ahmed Kumbhar, Wajid Ali Rajper, Farzana Lakho, Atiya Nayab, Hafsa Maqbool

Journal of Pharmaceutical Research International, Page 48-55
DOI: 10.9734/jpri/2021/v33i29B31588

Objective: To determine the frequency of satisfactory outcome after Surgical Management in Isolated Orbitozygomatic fractures.

Study Design: Case series Descriptive study.

Place and Duration: Oral Maxillofacial Surgery Department of Dentistry, Liaquat University of Medical Health Science, Jamshoro ,from 11thAugust 2020 to10thMarch 2021.

Methodology: Total 87 patients of Isolated Orbitozygomatic fractures with Enophthalmos and or Diplopia were included. All patients were operated, open reduction and internal fixation of zygoma at 3 points. Postoperatively Diplopia was ruled out by a range of eye movements and Enophthalmos was measured by Hertel Exophthalmometer. Final assessment was done after six weeks postoperatively. Descriptive statistics were calculated. Stratification was done and poststratification chi square test or t-test was applied. P-value ≤0.05 was considered as significant.

Results: There was 85.1% male and 14.9% female. Mean age was 33.45±7.93 years. 73.6% were classified as ASA-I and 26.4% were classified as ASA-II. At first, third and sixth week, 4.6% patients were found with positive upward gaze, 2.3% with positive down gaze, 0% with positive horizontal gaze and 2.3% with positive secondary peripheral gaze while 85.1% with < 3 mm Enophthalmoson Hertel Exopthelmommeter and 13(14.9%) with >3 mm Enophthalmoson Hertel Exopthelmommeter. The satisfactory outcome was 88.5%.

Conclusion: Our study results showed 88.5% satisfactory outcome. The long-term prognosis after repair of zygomaticomaxillary complex fractures is very good.

Open Access Original Research Article

Diabetes Mellitus with Silent Myocardial Ischemia: A Single-Center Cross-Sectional Study of Karachi, Pakistan

Muhammad Zohaib Siddiq, Shahid Hussain Memon, Anwar Ali, Tabassum Almas, Atiya Razzaq, Farhan Ahmed

Journal of Pharmaceutical Research International, Page 56-60
DOI: 10.9734/jpri/2021/v33i29B31589

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients.

Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan.

Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia.

Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.

Open Access Original Research Article

Comparing the Rate of Perineal Tears with and Without Episiotomy in Primigravida Women

. Neelam, Kiran Batool, Sadia Kadir, Kaneez Fatima, Afshan Nadeem, Tahira Afzal Durani

Journal of Pharmaceutical Research International, Page 61-66
DOI: 10.9734/jpri/2021/v33i29B31590

Objective: To compare the frequency of perineal tears (3rd and 4th degree) with and without episiotomy in primigravida women.

Setting: Department of Obstetrics and Gynecology at peoples Medical College Hospital (PMCH) Nawabshah.

Duration of Study: Six month from March 2015 to September 2015.

Study Design: Randomized control trial.

Subject and Methods: In this study 322 primigravida women with singleton pregnancy and cephalic presentation were included. The patients were kept in labour room till the second stage of labour. The patients were divided into two groups equally. In Groups-A, right mediolateral episiotomy was performed after infiltration with local anaesthesia at the time of crowing. The Group B in which episiotomy was not given. After delivery, patients were examined for extension of episiotomy in Group A and 3rd and 4th degree perineal tear in both groups.

Results:  Mean age was 27.83±6.27 years in group A and 27.60±4.93 years in group B (p=0.724). Mean gestational age was 38.17±1.25 weeks was in group A and 38.11±119 weeks in group B (p=0.644). The rate of 3rd and 4th degree perineal tear was significantly higher in group A as compare to group B [60.87% vs. 47.83% p=0.019] and [39.13% vs. 26.09% p=0.013] respectively.

Conclusion: Episiotomy was found to be an important risk factor for extension of the perineal tear. It should be practiced only where it is indicated like rigid perineum, any instrumental delivery and shoulder dystocia.

Open Access Original Research Article

Effect of Gender and Risk Factors in Complications of Type 2 Diabetic Mellitus among Patients Attending Diabetic Clinic in Mnazi Mmoja Hospital, Zanzibar

Chukwuma J. Okafor, Said A. Yusuf, Salma A. Mahmoud, Salum S. Salum, Sonia C. Vargas, Adu E. Mathew, Emmanuel I. Obeagu, Husna K. Shaib, Hashima A. Iddi, Masoud S. Moh’d, Warda S. Abdulrahman

Journal of Pharmaceutical Research International, Page 67-78
DOI: 10.9734/jpri/2021/v33i29B31591

Diabetes type 2 (T2D) had caused the loss of millions of lives all over the world. About 50% of the patients with T2D die because of cardiovascular disease (CVD), primarily myocardial infarction and stroke. Many of the leading risk factors for CVD coexist and act synergistically to increase cardiovascular events. The purpose of this descriptive cross-sectional study was to determine the prevalence, patterns, and certain predictive factors in the complications of T2D patients attending diabetic clinics at Mnazi Mmoja hospital. A total of 138 respondents made up of 58 females and 80 males within the age brackets of 30-40, 41-50, 51 – 60, and 61 above were recruited for this study. Data were analysed and interpreted based on certain predictive factors and variables, including smoking, alcohol, excessive salt intake, lipid intake, sedentary lifestyle, family history of diabetes, and hypertension, on how they relate to the development of complications of type 2 diabetes. Pearson Chi-Square test was used to compare the levels of significances. Probability values of less or equal to 0.05 were accepted to be significant. The combination of salt intake, sedentary lifestyle, family history of diabetes, and lipid intake was the commonest risk factor for developing complications of T2D. However, alcohol and cigarette smoking had the most negligible impact on developing complications in T2D. The result also shows the patients between the age bracket of 30 and 40 have more risk factors for developing complications. The result showed no gender difference in the number of risk factors. There was a statistically significant association between some of the risk factors (smoking, alcohol, sedentary lifestyle, and salt intake) and the gender of respondents (p<0.05). Males smoked (43.8%) and consumed alcohol (32.5%) than females, while females were prone to a sedentary lifestyle (63.8%) and consume salt (82.8%) than males. On the other hand, this research showed that the significant complication for both males and females are numbness, pain sensation, and dry skin (diabetic neuropathy). Gender and certain predictive risk factors like salt intake, sedentary lifestyle, and family history of diabetes, and lipid intake are fundamental parameters to be tackled to reduce the complications of type 2 diabetes mellitus. There is a greater need now for awareness of the risk factors through effective health promotion in Zanzibar. Also, secondary prevention through regular screening, early detection, and appropriate treatment of chronic complications could reduce the morbidity and mortality caused by diabetes mellitus.

Open Access Original Research Article

Association between Working Memory and Obesity among Secondary School Children

S. Dorcas Christina, A. Sangeetha, M. Kumaresan, B. Varadharaju, C. Hemachandrika

Journal of Pharmaceutical Research International, Page 79-84
DOI: 10.9734/jpri/2021/v33i29B31592

Introduction: Obesity is not just a term but a threat faced by the younger generation. It affects the vital systems of our body and very importantly impairs the cognitive functions of our brain. Lack of exercise, lethargy, increased usage of electronic gadgets is some of the notable reasons for childhood obesity. This study has been designed to find out how obesity is playing a role in a child’s short term memory skills.

Materials and Methods: A Cross sectional epidemiological study was conducted among 125 secondary school children from random urban south Indian population. The students were asked to fill in their general details along with height, weight, hip circumference, waist circumference and asked to play a set of matching games and put in their score to measure working memory.

Results: Association between corresponding memory task scores and BMI indicates a strong negative correlation (r = -.008) and (r = -.07).

Conclusion: The present results therefore indicate that there is an association between obesity and poorer working memory performance in secondary school children. Therefore to conclude, the extent to which children are physically active is influenced by a multiple and interrelated factors. Addressing physical inactivity and its contribution to childhood overweight obesity requires a broad and holistic approach.

Open Access Original Research Article

Complications of Advanced Stage of Various Types of Thyroid Tumors at Tertiary Care Hospital

Ahsan Ali Laghari, Ghulam Akbar Khaskheli, Amjad Ali Bhurt, Amjad Ali Bhurt, Amjad Ali Bhurt, Tufail Ahmed Baloch, Rafique Ahmed Pathan

Journal of Pharmaceutical Research International, Page 105-109
DOI: 10.9734/jpri/2021/v33i29B31594

Objective: To determine the complications associated various types of tumors of advanced stage of thyroid disease at tertiary care hospital.

Study Design: Descriptive study.

Place and Duration: Two years study from April 2018 to March 2020 was conducted in Liaquat University of Medical and health sciences Jamshoro.

Patients and Methods: All patients were admitted from Outpatient department (OPD) with advance stage of tumor of thyroid and either of gender were included. The patients were evaluated fully after history and clinical examinations berries sign and specific investigations of thyroid profile (T3,T4,TSH), ultrasound of thyroid,  fine-needle aspiration cytology FNAC, image guided biopsy,  frozen section biopsy  for confirmation  of diagnosis, indirect laryngoscopy,  x - Ray neck  and MRI. All the patients were assessed for pre-operative evaluation (complications) with advanced stage of thyroid tumors. All the data regarding developed complications was recorded via study proforma. Data was analyzed by using the SPSS version 20.  

Results: Most of the patients were found with age groups of 20 to 34 years and 35 to 55 years. Out of all, 25 patients were diagnosed papillary carcinoma, 12 patients were diagnosed as follicular carcinoma, 7 patients had Anaplastic carcinoma, 4 patients were diagnosed lymphoma and 2 patients were diagnosed as medullary carcinoma. As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were  presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea.

Conclusion: Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease.

Open Access Original Research Article

Development of a Validated Stability Indicating Rp-Hplc Method for the Estimation of Pirfenidone in Bulk Drug and Tablet Dosage form

C. Vanitha, Sravani Singirikonda

Journal of Pharmaceutical Research International, Page 110-118
DOI: 10.9734/jpri/2021/v33i29B31595

Objective: The present work focused on developing a validated stability indicating RP-HPLC method for the estimation of pirfenidone in bulk drug and tablet dosage form.

Methods: The chromatographic separation was performed on symmetry C18 (150 mm x 4.6, 5 micron) with a 1 ml/min flow rate at 315nm. The mobile phase employed was orthophosphoric acid buffer: acetonitrile (65:35). Column temperature was maintained at 30ºC. Pirfenidone was subjected to different forced degradation conditions according to ICH guidelines, including acid, base and neutral hydrolysis, oxidation, photolysis and thermal degradation. 

Results: In alkali, acidic, oxidation and UV degradation conditions the drug shows considerable degradation. Pirfenidone was stable under neutral hydrolysis and thermal degradation. Pirfenidone was stable under extreme degradation conditions showing less than 8% of degradation in all degradation conditions. This result showed that pirfenidone was stable under stress degradation. Then the optimized method was validated for the parameters like linearity, accuracy, precision and robustness as per ICH guidelines.

Open Access Original Research Article

Knowledge Regarding Contraceptive Methods among Married Women Attending Tertiary Care Hospital

Kaneez Fatima, Sadia Kadir, . Neelam, Kiran Batool, . Kalsoom, Shahid Hussain

Journal of Pharmaceutical Research International, Page 119-125
DOI: 10.9734/jpri/2021/v33i29B31596

Objective: To determine frequency of adequate knowledge of contraceptive methods among married women attending tertiary care hospital for antenatal care.

Study Design: Cross sectional study.

Setting: Department of Gynaecology and Obstetrics, Jinnah Postgraduate Medical Center, Karachi.

Duration: From June to December 2016.

Materials and Methods: Total 118 married women presented for antenatal care were included. Women were evaluated by administering a questionnaire to assess knowledge about contraception methods. Knowledge was labeled as adequate if responders correctly answered >70% of the questions. Descriptive statistics and Stratification were performed. Post-stratification Chi-square test was applied and p-value ≤0.05 was taken as significant.

Results: The mean age was 29.25±5.08 years. Mean gestational age was 11.52±4.54 weeks. Mean duration of marriage was 4.50±2.77 years. 61% study subjects were found with adequate knowledge of contraception. Adequate knowledge had a significant correlation with age, duration of marriage, parity, residence, and education level.

Conclusion: Around 61% of the married females were observed with adequate knowledge regarding contraceptive procedures. The female knowledge was significantly associated with age, duration of marriage, parity, residence, socio-economic status, and education level.

Open Access Original Research Article

Fish Singgang Extracts as a Potential Anti-Proliferative against Colon Cancer Cell Lines (HT-29, HCT-116, CT-26)

Anis Nafisah Jamain, Nur Atikah Anwar, Norhaslinda Ridzwan, Mimie Noratiqah Jumli, Norhayati Abd Hadi, Roslan Arshad, Mohd Adzim Khalili Rohin, Che Abdullah Abu Bakar, Ahmad Zubaidi A. Latif

Journal of Pharmaceutical Research International, Page 126-136
DOI: 10.9734/jpri/2021/v33i29B31597

Aim: To investigate anti-proliferative effect of three types of Terengganu singgang extracts on colon cancer cell lines (HT-29, HCT-116, CT-26).

Study Design: Experimental study.

Place and Duration of Study: Central Laboratory, Tissue Culture Laboratory, Universiti Sultan Zainal Abidin, Terengganu between April 2019 and July 2019.

Methodology: Samples comprised three types of singgang dish, which were prepared, cooked, and then extracted with distilled water and ethanol (EtOH) in different strengths, 50%, 70%, and 100%.These singgang samples were chub mackerel (ST), Indian mackerel (SK),and a control sample with no fish (SC). Extracts were analyzed for their anti-proliferative effect by MTT-based assay. Then, the morphological of cell apoptotic changes was observed using light inverted microscope.

Results: Experimental assays showed that the SC sample extracted in 100% EtOH produced the highest yield (3.7%).The extract of ST in aqueous (0.27 (0.11)) yielded the most cytotoxic value, followed by extract SK in 100% EtOH (0.28 (0.10)) and extract SC in 50% EtOH (0.20 (0.08)). Then, the anti-proliferative effect was confirmed with morphological changes of cell which were characterized by cell shrinkage, membrane blebbing, and fragmentation of apoptotic bodies after 24, 48 and 72 hours of treatment.

Conclusion: In conclusion, the ST extract showed the best anti-proliferative effect.

Open Access Original Research Article

Frequency of Involvement of Different Head and Neck Sites in Referred Otalgia

Ashfaq Hussain, Salman Baig, Mohammad Farooq Bhutta, Nasima Iqbal, Ali Nawaz Bijarani, Mariam Muneer

Journal of Pharmaceutical Research International, Page 137-142
DOI: 10.9734/jpri/2021/v33i29B31598

Aim: To find out the most frequent head and neck sites of origin of referred otalgia.

Study Design: Descriptive cross-sectional.

Place and Duration of Study: Study was conducted at the ENT department of Bahawal Victoria hospital Bahawalpur during January 2019 to December 2019.

Methodology: About 500 patients with ear ache were examined and after exclusion 150 were finally analyzed. Detailed history of the patient and clinical examination were done along with radio imaging and endoscopic studies wherever needed. Diagnosis of referred otalgia was made after having normal ear examination along with pathology lying at different head and neck region which share common sensory innervation. For analysis SPSS version-20 was used.

Results: The mean age of the study participants was 28.23 ±13 years. The majority of participants were having otalgia of tonsillar origin followed by dental origin and pharyngitis with 31.3%, 23.3% and 16% respectively. Very few of them having otalgia originating from hypopharyngeal carcinoma and laryngeal carcinoma i.e. 3.3% and 2% respectively. While only 4.7% of otalgia were of unknown origin. Female participants were having higher frequency of otalgia which is originated from diseases of temporomandibular joint, hypopharyngeal carcinoma and otalgia of unknown origin in comparison to male participants but differences were insignificant. Otalgia originated from tonsillar and dental causes and due to pharyngitis were most common among the younger age group but having non-significant p-value.

Conclusion: It has been concluded that the patients presenting with ear pain, have sometimes no underlying ear pathology. If the ear examination is normal then it is important to examine all other sites of head and neck which share sensory innervation with the ear including teeth, tonsils, pharynx, larynx, nose and paranasal sinuses to find out the exact cause of referred otalgia.

Open Access Original Research Article

Antibiotic Cement Coated Nailing in Infected Nonunion of Tibia

Muhammad Faraz Jokhio, Ghazanfar Ali Shah, Raheel Akbar Baloch, Mohsin Aijaz Soomro, Najeeb Ur Rehman, Niaz Hussain Keerio, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 143-148
DOI: 10.9734/jpri/2021/v33i29B31599

Non-union infected bone is a chronic impairment disorder that causes severe complications for surgeons. In Pakistan a very limited literature was produced in recent years to evaluate the role of antibiotic impregnated cemented nail in infected non-union of tibia. To fill this gap this prospective study was designed to investigate the role of antibiotic Cement Coated Nailing in Infected Nonunion of Tibia in the Orthopedic Department of Liaqat University of medical and health science, Jamshoro, Pakistan, from February 2019 to February 2020. A total of 30 patients with infected "nonunion of the tibia" was enrolled during the research period. Patients within the age range of 22-61 years were part of this research. For surgery, polymer beads were added into the 40 gm cement which was prepared by adding 2 gm vancomycin and 2 gm teicoplanin. After that endotracheal tube was cut by a surgical knife to recover antibiotic and cement coated k nail. The nail was then inserted into the tibia. Resuts demonstrate that in 28 patients 93% utilization of antibodies cement coated nails helped to eradicate the infection. 24 patients achieved complete bone unification without any need for further procedure. The overall ratio of single-time antibiotic cement coated nail was observed as 70%. The infected nonunion tibia can be effectively treated if the protocol of debridement is correctly followed. Results demonstrate that bone stability can be regained with 22 to 44 weeks. We concluded that antibiotic-impregnated cemented nail is an ideal procedure to control the postoperative infection and achieve reunion.

Open Access Original Research Article

Frequency of Haemoglobin Genotype Variants, ABO and Rh ‘D’ Antigen among Madonna Undergraduates of South East Origin, Nigeria

Richard Eze, Emmanuel Ifeanyi Obeagu, Arvin Nwakulite, C.C.N. Vincent, Sylvester Ogbonna Ogbodo, Adaobi Maryann Ibekwe, Chukwuma J. Okafor, Ejike Felix Chukwurah

Journal of Pharmaceutical Research International, Page 149-157
DOI: 10.9734/jpri/2021/v33i29B31600

Haemoglobin genotype variants, ABO and Rh blood groups are known to vary from one population to another.  Standard electrophoretic and haemagglutination techniques were employed in testing the blood samples. Of the 150 test subjects screened, HbAA in the male subjects were 58(48.0%) and 63(52.0%) in the female counterparts. The frequency of distribution of HbAA, HbAS, and HbSS in the subject were 121 (80.7%), 28 (18.7%) and 1 (0.6%). Also HbAS in the female was 16(57.1%) while in male subjects was 12(42.9%). Blood group A (41.7%), group B(21.7%), group AB(28.6%) and  group O(57.1%) were results for male subjects as against Group A(58.3%), Group B(78.3%), Group AB (71.4%) and Group O(42.9%) respectively in the female subjects.90% were Rh ‘D’ positive while 10% were Rh ‘D’ negative. Knowledge of the distribution of ABO, Rh ‘D’ blood groups and haemoglobin genotype variants in any population is useful in health care planning, medical diagnosis and targeting the population that need counseling. If such information is well managed it can make a difference in the quality of decisions that individuals will make especially as it concerns marriage, blood transfusion and other medical demands.

Open Access Original Research Article

Evaluation of Changes Induced in the Probiotic Escherichia coli M17 Following Recurrent Exposure to Antimicrobials

M. J. A. Mbarga, I. V. Podoprigora, E. G. Volina, A. V. Ermolaev, L. A. Smolyakova

Journal of Pharmaceutical Research International, Page 158-167
DOI: 10.9734/jpri/2021/v33i29B31601

Introduction: It is already well known that the exposure of certain bacteria, pathogenic or not, to antimicrobials is likely to increase their virulence and induce the development of direct or cross resistance to antimicrobials, but there is almost no information available regarding probiotics.

Aim: To assess the changes induced in susceptibility to antibiotics, biofilm formation, growth rate and relative pathogenicity in the probiotic Escherichia coli M17 (EC-M17) after long exposure to antimicrobials namely ampicillin, kanamycin, cefazolin and silver nanoparticles (AgNPs).

Methods: After determining the minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of the 4 antimicrobials above-mentioned by the microdilution method, EC-M17 was exposed to increasing subinhibitory doses ranging from MIC/8 to MIC for 8 days. The susceptibility to antibiotics of the mutants obtained was assessed by the Kirby Bauer disc diffusion method, biofilm formation by the Congo red agar method and with crystal violet bacterial attachment assay, and relative pathogenicity was assessed using a Galleria melonella waxworm model.

Results: Exposure to antimicrobials induces noticeable changes in EC-M17. The highest adaptation to antimicrobials was observed on AgNPs with 8-fold increase in MIC and 16-fold increase in MBC of AgNPs. EC-M17 exposed to ampicillin, kanamycin and silver nanoparticles became resistant to ampicillin, ceftazidime, ceftazidime/clavulanate and tetracycline while exposure to cefazolin induced a significant decrease in sensitivity to tetracycline and ampicillin and resistance to ceftazidime/clavulanate and ceftazidime. The strain exposed to ampicillin was the only one to produce more biofilm than the control strain and except the EC-M17 exposed to cefazolin, all other EC-M17 strains were more pathogenic on G. melonella model than the control.

Conclusion: Data in this investigation suggest that repeated exposure of the probiotic EC-M17 to antimicrobials may induce changes in antimicrobials susceptibility, biofilm formation, growth rate, and relative pathogenicity. Therefore, as far as possible, the probiotic E. coli M17 should not be used in combination with antibiotics and further investigations are required to expand similar work on more probiotics in order to avoid resistance build-up which might be transmitted by horizontal transfer.

Open Access Original Research Article

Development of Validated Stability-indicating High Performance Thin Layer Chromatography Method for Estimation of Rabeprazole Sodium and Aceclofenac in Bulk Drug

Sunil Shewale, Vaishali Undale, Maruti Shelar, Vrushali Bhalchim, Atul Deshmukh

Journal of Pharmaceutical Research International, Page 168-185
DOI: 10.9734/jpri/2021/v33i29B31602

Objective: To develop a validated stability-indicating high performance thin layer chromatography method for the estimation of Rabeprazole Sodium (RZL) and Aceclofenac (ACF) in bulk drugs.

Methods: A high performance thin layer chromatographic (HPTLC) method has been developed for the separation of RZL & ACF on plates precoated with aluminium back silica gel 60 F254. Different mobile phases were used on trial and error basis for separation of two drugs. The final mobile phase selected for analysis was toluene: ethyl acetate: methanol: acetic acid: ammonia in the ration of 6:4:1:0.2:0.1 (v/v). Both the drugs showed maximum absorbance at 279 nm which was selected as the detection wavelength throughout the experimental work. Developed method was validated as per ICH guidelines. Forced degradation of drugs was carried out under various stress conditions and HPTLC method was used for analysing the stability of drugs.

Results: HPTLC method was successfully developed for separation of RZL and ACF with clear separation of bands of the drugs. Method validation after assessment of various parameters indicated low % RSD within an acceptable limit of < 2.0 and the stability studies indicated the satisfactory separation of both the drugs from that of degraded products with considerable % recovery profile.

Conclusion: The developed method is rapid, reliable, precise, and reproducible and demonstrates the suitability of the method for stability determination of rabeprazole and aceclofenac.

Open Access Original Research Article

Vitamin D is a New Promising Inhibitor to the Main Protease (Mpro) of COVID-19 by Molecular Docking

Ghassab M. Al-Mazaideh, Mohammed H. Shalayel, Farhan K. Al-Swailmi, Saleem H. Aladaileh

Journal of Pharmaceutical Research International, Page 186-191
DOI: 10.9734/jpri/2021/v33i29B31603

In this study, vitamin D has shown greater efficacy of binding with Mpro of COVID-19 compared to the recently recommended drugs. The docking study was simulated to streamline interaction effects of Vitamin D, Remdesivir, Chloroquine, Hydroxychloroquine, Aspirin, and Azithromycin complexes with the active site of Mpro. Vitamin D is found to have the highest potential interaction in terms of total H-bond, van der Waal, torsional, and desolvation energy which were the lowest among all the selected drugs. The hydroxyl group of vitamin D and the thiol group of Mpro cysteine had played a leading role in increasing Vitamin D binding and stability with the Mpro pocket by contribution to the inception of three hydrogen bonds. The study recommend that vitamin D can be added to the COVID-19 treatment protocol, which may have the desired effect on viral replication inhibition and decreases mortality.

Open Access Original Research Article

Comparison of Fissurectomy and Lateral Internal Sphincterotomy in the Surgical Management of Chronic Anal Fissure

Kazim Ali Memon, Shahnawaz Khatti, Ahmed Hussain Pathan, Shahida Khatoon, Abdul Salam Memon, Sandesh Kumar, Muhammad Usman Khatti

Journal of Pharmaceutical Research International, Page 192-198
DOI: 10.9734/jpri/2021/v33i29B31604

Background: The anal fissure is a small spilt in the distal anoderm, and it most commonly occurs in the posterior midline of anal canal. Anal fissure causes severe sharp pain on defecation, occasionally accompanied by streak of blood on outside of stool or blood on toilet tissue. Fissures are classified as acute or chronic, acute fissure usually heal spontaneously within six weeks. Fissurectomy had been used as separate technique in the treatment of chronic anal fissure with favorable result. Parallel inside sphincterotomy produces an enduring fall of anal resting pressure, that reestablish mucosal perfusion bringing about recuperating, yet genuine drive component is obscure, and the instrument that travel from intense to constant gap stay dark. This study is design to assess the outcome between two groups, than better modality of the two could be chosen.

Objective: To compare fissurectomy and lateral internal sphincterotomy in the management of chronic anal fissure.

Patient and Methods: The Randomized controlled trial was conducted during 18-02-2015 to 17-08-2015 at Department of surgery,Liaquat University of Medical & Health Sciences, Hyderabad. A total of 218 patients with chronic anal fissure were included in this study. Patients were randomly divided into two groups. Patients in Group A were underwent fissurectomy and patients group B was underwent lateral internal sphincterotomy. Surgery was performed and patients were followed for 8 weeks on regular basis and satisfactory out comes was noted. Information along with demographics was entered in the proforma.

Results: Rate of satisfactory outcome was significantly high in group B as compare to group A [92.66% vs. 76.15%; p=0.001].

Conclusion: Subcutaneous sidelong internal sphincterotomy is a significant surgery for patients with persistent anal fissure. It is compelling and safe, offers fast help of torment, and advances early gap mending without being gone to by any significant complexities.

Open Access Original Research Article

Comparative Analysis of Adverse Drug Reactions between Interferon Alpha 2B and Sofosbuvir in the Treatment of Hepatits C at GIMHS, Sindh, Pakistan

Sajid Ali, Marvi Metlo, Zuheeb Ahmed, Tahseen Ahmed, Arslan Ahmer, Muhammad Aslam Abbassi, Saima Samtio, Syed Adeel Ahmed Shah, Sham Lal, Rashid Ali Arbani

Journal of Pharmaceutical Research International, Page 211-218
DOI: 10.9734/jpri/2021/v33i29B31607

A descriptive cross-sectional study was conducted on 300 patients selected by random sampling who were reported with Hepatitis-C at GIMHS. Questions were asked from patients regarding symptoms and adverse drug reactions (ADR’S). Results were analyzed by using SPSS-22. Out of total patients (n=300) the frequency of male gender was (n=192) as compared to females (n=108). Among 300 patients some patients were on sofosbuvir (n=150), patients on interferon (n=150). Rate of ADR’S observed with interferon as fever (n=28), anemia (n=27), hair loss (n=21), headache (n=19), insomnia (n= 11), nausea (n=13), depression (n=14, 09), malaise (n=25), vomiting (n=06), ulcer (n=13), pain and redness at site of injection (n=17). While rate of ADR’S in patients who were on sofosbuvir, fever (n=33), chill (n=17), nausea (n=28), anemia (n=06), headache (n=14), insomnia (n=13), loss of appetite (n=5), diarrhea (n=1). This study concluded that as compared to Interferon, rate of ADR’S were less with Sofosbuvir.

Open Access Review Article

Ethnomedicinal Plant- A Review

Chandani C. Prasad, Nisha V. Khemchandani, Rani T. Bhagat, Awdhut D. Pimpale

Journal of Pharmaceutical Research International, Page 17-30
DOI: 10.9734/jpri/2021/v33i29B31585

The ethno-botanical study is having immense importance in the field of medical science; it has a unique importance in the branch of science with much attention. Ethno botany has a special relationship between people and plants. Traditional medicine and ethno plants are very important in the traditional community. The use of medicinal plants has been done since many ages and now it is also considered as a modern medicine. Medicinal plants have been used by various cultures and ethnic groups. Around 80% of conventional medicines used in primary healthcare are extracted from plants around the world. India is one of the world's mega biodiversity nations, with lush vegetation and a vast array of medicinal plants and herbs. Herbal medicines have a bright future in both developing and developed countries.

Open Access Review Article

Herbal Liposomes: Natural Network for Targeted Drug Delivery System

Vijay R. Salunkhe, Prasanna S. Patil, Ganesh H. Wadkar, Somnath D. Bhinge

Journal of Pharmaceutical Research International, Page 31-41
DOI: 10.9734/jpri/2021/v33i29B31586

Herbal medicines have tremendous therapeutic potential that can explored across various effective drug delivery system. Decoctions, herbal teas, tinctures, glyceritum, oxymel, and use much soap, herbal tablets, herbal capsules, and herbal cream, herbal books, and prepared the confection of the most commonly available forms of dosage. The less use of herbal formulations in recent decades due to their lack of standardization. It is possible to use plant extract and isolated constituents to overcome this problem. But these phytoconstituents are suffering from drawbacks, mostly due to problems with stability and low lipid solubility. Novel drug delivery such as liposomes plays an important role in problem solving. Infact, compliance with the patient also improves. The review article discusses the recent status of new herbal liposomal formulations and describes the different ways in which these formulations are prepared.

Open Access Review Article

A Review on Chemical Composition, Biosynthesis of Steviol Glycosides, Application, Cultivation, and Phytochemical Screening of Stevia rebaudiana (Bert.) Bertoni

Mylange Dona Kasundi Mekhala Gunasena, Rathnayaka Mudiyanselage Uththara Sachinthanie Senarath, Wathuge Thamara Priyanthi Sandun Kumari Senarath

Journal of Pharmaceutical Research International, Page 85-104
DOI: 10.9734/jpri/2021/v33i29B31593

Aims: Stevia rebaudiana which is commonly known as sweet leaf herb is used to extract non caloric sweet steviol glycosides. Thus based on available reports about its chemical composition, biosynthesis of steviol glycosides, application, cultivation, and phytochemical screening an attempt has been made to review to Stevia rebaudiana in context of its medicinal and pharmaceutical importance.

Methodology: Literature search have been done in the web using google scholar, PubMed as search platform. More than two-thirds of the references are within 15 years.

Results: According to the literature search S. rebaudiana leaves contain non caloric steviol glycosides and pharmaceutically important other phytochemicals. Miccropropagation is the best propagation method to overcome difficulties in conventional propagation methods.

Conclusion: It is concluded that in vitro cultures has potential to extract important phytochemicals used in various pharmaceutical, food (flavoring agents, food additives) and perfume industries.