Open Access Study Protocol

A Protocol for Treatment of Avabahuk (Frozen Shoulder) with Agnikarma and Topical Diclofenac Sodium Gel

Mahesh Kumar, R. K. Shinde, Reena Jaiswal

Journal of Pharmaceutical Research International, Page 45-52
DOI: 10.9734/jpri/2021/v33i32B31739

Background:  The Avabahuk is a disease described in ancient Ayurveda and is correlated with frozen shoulder of modern science. It is mainly due to vatadosha prakopa and the treatment adopted for this are for snayu-sandhi-asthi-gata-vata. Many treatment modalities mentioned in Ayurveda for treatment of Avabahuka. The treatment modality Agnikarma, the intentional therapeutic heat burn therapy is one among them.

Aim and objectives: The aim of the study is to compare efficacy of Agnikarma and topical Diclofenac sodium gel in Avabahuk (Frozen shoulder) treatment.

Methodology: The sample size will decide in pilot study and the patients will randomly divided equally into 2 groups. In Group A (Interventional) the Agnikarma will be done at weekly interval for 4 weeks along with physiotherapy. In Group B (comparator group) the topical diclofenac sodium gel application for 4 weeks with physiotherapy.

Results: The changes will observed and record in objective outcomes.

Conclusion: Agnikarma will be effective in lowering the pain and stiffness of frozen shoulder.

Open Access Study Protocol

Efficacy of Octreotide Versus Terlipressin along with Endoscopic Variceal Ligation (EVL) in Preventing Re-bleeding and Mortality in Acute Bleeding Esophageal Varices in Cirrhosis: A Randomized Prospective Study

Sunayana Lomte, Sourya Acharya, Vijendra Kirnake

Journal of Pharmaceutical Research International, Page 95-102
DOI: 10.9734/jpri/2021/v33i32B31748

Background: Octreotide and terlipressin are two pharmacologic drugs used as an adjuvant therapy in the treatment of acute esophageal variceal bleeding. Large enough clinical trial data is not available, in comparing the efficacy of octreotide versus terlipressin as an adjunct to EVL for control of variceal bleed. Still, there is a scarcity of data on which is the better efficient drug amongst terlipress in and octreotide to control 5 days rebleeding.

Aim: To compare efficacy of octreotide versus terlipressin in preventing the 6 weeks mortality (primary outcome) and 5 days rebleeding (secondary outcome) in cases of acute esophageal variceal bleeding.

Method: All the patients of cirrhosis of liver presenting with upper gastrointestinal bleeding admitted in the Medicine Intensive Care Unit(MICU) at Acharya Vinoba Bhave Rural Hospital (AVBRH) will be enrolled. In this Randomized Prospective study ,patients presenting with acute esophageal variceal bleed, after diagnostic endoscopy during a period of one year (august 2020 to july 2021) will be randomised into two group by simple randomisation with chits: Group A will receive Terlipressin while Group B will receive Octreotide for 5 days combined with esophageal variceal ligation. These two groups will be compared in terms of hemodynamic effects, child pugh score, MELD (Model for End stage Liver Disease) score to predict 6 weeks mortality as primary outcome and 5 day treatment failure as secondary outcome according to Bavino VI consensus statement.

Expected results: From our study we are anticipating that both octreotide and terlipressin will be equally efficacious in controlling the EVB when given along with EVL therapy and also there will be no difference in both the drugs in preventing 6 weeks mortality and 5 days rebleeding.

Conclusion: There will be no significant difference between Terlipressin and Octreotide in preventing 6 week mortality and 5 day rebleeding in bleeding esophageal varices when given along with EVL therapy.

Open Access Study Protocol

A Rare Case Report on Therapeutic Management of Wilm’s Tumour

Priya Rewatkar, Manoj Patil

Journal of Pharmaceutical Research International, Page 115-118
DOI: 10.9734/jpri/2021/v33i32B31750

Introduction: Wilms's tumour was named after Carl Max Wilhelm Wilms, a 19th century German surgeon. Wilm’s tumor is derived from primitive metanephric blastema and is a form of childhood carcinoma that begins in the kidneys (also called nephroblastoma). In infants, it is the most common form of kidney carcinoma. 9 out of 10 kidney cancers in kids is Wilms Tumor. Carcinoma can spread to other parts of the body. The incidence is around seven new cases per million children in the United States, with a peak incidence between the ages of 2 and 3 years.

Main symptoms and important clinical findings: A 11 yrs. old female child was admitted in Acharya Vinoba Bhave Rural Hospital, Wardha on 08/02/2021 with chief complaint of breathing difficulty, shortness of breath, blood in the urine, nausea and vomiting. After physical examination and investigations, doctors diagnosed it as a case of Wilm’s tumor.

The main diagnoses, therapeutic interventions and outcomes: After physical examination and investigations like MRI, doctor diagnosed it as a case Wilm’s tumour. Tab. Actinomycin D (Dactinomycin), tab. Vincristine (chemotherapy) were started and calcium and multivitamin supplements were given for 7 days to enhance immune function. Tab. Septran 160 mg OD and tab. Acenet 400 mg OD, tab. Bactrim 5mg OD was also prescribed. Patient took all treatment and outcome was good. Her signs and symptoms improved.

Conclusion: Accurate diagnosis and timely initiation of treatment speeded up recovery.

Open Access Study Protocol

DNA Methylation Patterns in Saliva of Tobacco users with High-Risk Oral Potentially Malignant Disorders

Mimansha Patel, Madhuri Nitin Gawande, Minal Shashikant Chaudhary, Alka Harish Hande

Journal of Pharmaceutical Research International, Page 129-137
DOI: 10.9734/jpri/2021/v33i32B31754

Background: “Oral Potentially Malignant Disorder (OPMD)” is a well-known symptom that, if untreated, can be carcinogenic. It includes leukoplakia, erythroplakia or erythroleukoplakia. One of the typical premalignant lesions of the oral cavity is “oral leukoplakias (OLs),” which frequently precedes “OSCCs.”OLs with dysplastic characteristics are considered to be at a higher risk of “malignant transformation.” So, early diagnosis of "oral squamous cell carcinomas (OSCCs)" is desperately required to enhance patient prognosis and quality of life (QOL).As a result, we examined the distinctive promoter methylation presence in high-risk OLs.

Objectives: To detect, compare & correlate “DNA methylation” patterns in normal individuals, tobacco users without disease and tobacco users with the disease.

Methodology: With the participants' full consent, 48 saliva samples were obtained and prepared. DNA isolation, restriction digestion of genomic DNA, extraction of restriction enzyme digested genomic DNA, Polymerase Chain Reaction (PCR), and Agarose Gel Electrophoresis (AGE) were all carried out.

Expected results: This study will help us to assess the use of Saliva as an aid to identifying both high and low risk “Oral Potentially Malignant Disorders.”

Conclusion: Peculiar promoter methylation of various genes was related to a high possibility of malignant transformation in OLs.

Open Access Study Protocol

A Pilot Study Investigating the effect of Glycemic Control on Electrodiagnostic Parameters in Type II Diabetic Patients

Parikshit Ashok Muley, Dalia A. Biswas, Avinash Taksande

Journal of Pharmaceutical Research International, Page 146-153
DOI: 10.9734/jpri/2021/v33i32B31756

Background: Diabetes is a chronic metabolic abnormality due to either decreased secretion of insulin or decreased tissue sensitivity of insulin resulting in elevated blood glucose. Most common complication of diabetes is peripheral neuropathy. In this research project, we will be conducting a pilot study to observe the effect of glycaemic control on physiological functioning of nerve with the help of neurophysiological parameters, independent of duration of diabetes.

Objectives:

  • To investigate relationship of quality of glycemic control & severity of neurological changes.
  • To find out whether glycemic control acts as an independent risk factor for progression of diabetic neuropathy despite the duration of diabetes.
  • To validate the HBA1C at 10 for future longitudinal study to understand the association between glycemic control & progression of neuropathy.

Methodology: 60 type II diabetic patients visiting diabetic OPD (Medicine) will participate in the study. The patients will be divided in to 2 groups of Group number 1 with (30 subjects) HBA1C < 10 and Group number 2 having (30 subjects) HBA1C >10. Electrodiagnostic study will be conducted on motor (tibial nerve) and sensory (sural nerve) will be performed in Neurophysiology lab. Neurophysiological parameters data of two groups will be analysed and compared.

Expected Results: The pilot study will help to find out whether glycaemic control acts as a separate risk factor for progression of diabetic neuropathy despite duration of diabetes.

Conclusion: This pilot study will help to establish the association between quality of glycaemic control and severity of neurological changes. Also, this will help to validate the HBA1C at 10 for further longitudinal study to know whether poor diabetes control is an independent risk factor associated to the severity of neuropathy in type II diabetes.

Open Access Study Protocol

A Prospective Study on Clinico-Radiological Correlation and Conservative Management of Non-Traumatic Acute Abdomen at a Tertiary Care Centre

Rajat Mahawar, Suresh Chandak, Meenakshi Yeola

Journal of Pharmaceutical Research International, Page 119-124
DOI: 10.9734/jpri/2021/v33i32B31758

Background: Acute abdomen is a condition in which the patient complains of a sudden or gradual attack of abdominal pain over a duration of several hours and presents with a set of symptoms which indicatea life threateningillness that needs an urgent or quick diagnosis for early treatment. Delay in diagnosis will worsen the condition of the patient and can even have a fatal outcome. It is crucial to recognize situations where laparotomy can be avoided in order to bring down morbidity and financial costs. Hence this study is being conducted to evaluate various clinical presentations, accuracy of clinical diagnosis, causes, better imaging studies and effectiveness of conservative management of non-traumatic acute abdomen.

Objectives:

  1. To study various clinical presentation of non-traumatic acute abdomen.
  2. To study the accuracy of clinical diagnosis of non-traumatic acute abdomen
  3. To study different causes of acute abdomen.
  4. Compare different imaging studies in cases of acute abdomen and to evaluate their accuracy in diagnosing the condition.
  5. To study the effectiveness of conservative management (OchsnerScherren regimen) in cases of acute abdomen.

Methods: The study will be doneat Dept. of General Surgery, J.N.M.C and AVBRH, Wardha. The duration of the study will be 2 years from September 2020 to August 2022. In this study, 80-100 Patients of acute abdomen attending the routine OPD and Emergency room at AVBR Hospital will be studied. Thorough clinical examination will be done and Patients with Abdominal pain will be categorized according to inclusion and exclusion criteria. Clinical findings with Radiological findings will be correlated and the sensitivity of imaging studies in diagnosing acute abdomen will be evaluated. The outcome of conservative management of non-traumatic acute abdomen will be observed.

Results: We expectto study various clinical presentations of acute abdomen, causes, evaluate the accuracy of imaging studies and to study the effectiveness of conservative management all of which in turn would lead to early and better management of acute abdomen.

Conclusion: Better understanding about presentation, causes, the accuracy of radiological studies and effectiveness of conservative management would help in identification of cases in which laparotomy can be avoided to prevent unnecessary surgery with its associated morbidity and financial burden.

Open Access Study Protocol

MRI Evaluation of Seizures in Pediatric Age Group Patients in a Rural Hospital of Central India

Nishant Raj, Rajasbala Pradeep Dhande

Journal of Pharmaceutical Research International, Page 167-172
DOI: 10.9734/jpri/2021/v33i32B31759

Background: Seizures are a common presenting complaint in pediatric patients. There are many underlying causes which may present as seizures in pediatric population, for example: febrile seizures, hypoxic ischemic encephalopathy, congenital malformations, certain neoplasms etc. Magnetic resonance imaging(MRI) plays a fundamental role in evaluation of these causes and is especially of use in identifying the structural lesions presenting as seizures.

Objectives: To assess the role of MRI(1.5 Tesla) in evaluation pediatric seizures and to study spectrum of MRI findings associated with various causes.

Methodology: A prospective study will be conducted at “Acharya Vinoba Bhave Rural Hospital, Sawangi”, involving 138 pediatric patients coming to Radiology department.

Results: After statistical analysis, we expect to find effectiveness of MRI in evaluation of pediatric seizures.

Conclusion: In this study we expect to find usefulness of MRI as a diagnostic tool in assessment of pediatric seizures especially in those with structural lesions.

Open Access Study Protocol

Diagnostic Accuracy of Red Reflex Test (RRT) for Early Detection of Ocular Abnormalities in Newborn

Kshitij Aviraj Singh, Amar Taksande

Journal of Pharmaceutical Research International, Page 185-191
DOI: 10.9734/jpri/2021/v33i32B31761

Background: The Red Reflex is described as the red to orange reflection of light from the fundus of the eye, observed while using a retinoscope or an ophthalmoscope. Red Eye Reflex Test is determined by the optical media transparency which includes vitreous humor, aqueous humor, cornea and tear film and reflection of light from the  back of the eye (fundus) through optical media and into the aperture of the ophthalmoscope. Factors that will block or impede the passage of light through this transparent media or affects its reflection back from fundus will produce an abnormal Red Eye Reflex. Red Eye Reflex (RER) testing is important & effective tool for early detection of ocular abnormalities such as retinal abnormalities, cataract, retinoblastoma and glaucoma. Red reflex is cost effective, can be performed very easily, requires minimal setting, can screen important ocular abnormalities and facilitate their early detection with prompt intervention to prevent long term sequelae associated with the disease.

Aim: To find out the diagnostic accuracy of Red Reflex test for diagnosing ocular abnormalities in newborns.

Methodology: Ours will be a prospective cross-sectional study where RER examination will be performed within one week of birth of a newborn in a darkened and will correlate the examination findings with respect to ocular findings determined by ophthalmologist to determine its efficacy, sensitivity and specificity in detecting neonatal ocular abnormalities.

Expected results: After completion of the study we will be able to determine the accuracy of RRT for ocular abnormality detection in the neonates. We will be able to determine the sensitivity, specificity, PPV & NPV of the red reflex test. If the specificity and the sensitivity is good then we can use RRT as a routine screening method for detection of intraocular abnormalities.

Conclusion: To find the Red reflex Test efficacy in screening of the ocular abnormalities in the new born.

Open Access Study Protocol

Comparison of Sarcopenia with Modified Frailty Index as a Predictor of Adverse Outcomes in Critically Ill Elderly Patients

Shrirang Bhurchandi, Sachin Agrawal, Sunil Kumar, Sourya Acharya

Journal of Pharmaceutical Research International, Page 200-206
DOI: 10.9734/jpri/2021/v33i32B31763

Background: Ageing is a global fact affecting both developed and developing countries.It brings out various catabolic changes in body resulting in frailty(i.e. the person is not able to with stand minor stresses of the environment, due to reduced reserves in psychologicalreserve of several organ system).Thus causing a great burden of disease, dependence & health care cost. Sarcopenia is the leading component for frailty in the elderly population, but very few studies have been done in India for correlating frailty with sarcopenia.

Aim: To compare sarcopenia with modified frailty index (MFI) as a predictor of adverse outcomes in critically ill elderly patients.

Methodology: Cross-sectional study will be performed on all the critically ill geriatric subjects/patients coming to all the ICU's of AVBRH, Sawangi (M), Wardha who will satisfy various inclusion and exclusion criteria for selection and all standard parametric & non-parametric data will be assessed by using standard descriptive & inferential statistics.

Expected Results: In our study, we are anticipating that the Modified frailty index to be a better predictor of adverse outcomes in terms of mortality as compared to sarcopenia in the critically ill elderly patients. Also, we are anticipating that sarcopenia to be the most important contributor of frailty in critically ill elderly patients and the prevalence of frailty will be high in critically ill elderly patients.

Limitation: Due to limited time frame & resources we will not be able to follow up the patients.

Open Access Minireview Article

Antipyretic Activity of Gudduchi (-Tinospora cordifolia)- A Review

K. A. Haseena, Neha Gadgil, Snigdha Das Mandal

Journal of Pharmaceutical Research International, Page 125-128
DOI: 10.9734/jpri/2021/v33i32B31752

Pyrexia is defined as elevation of body temperature. It is a response due to tissue damage, inflammation, alignancy etc. Fever is associated with symptoms of lethargy, depression, anorexia, sleepiness etc. In Ayurveda, many drugs are attributed with jwaragna property. Among these described drugs gudduchi (Tinospora cordifolia) has the best antipyretic activity. Indian medicinal plants and their derivatives are having invaluable source of therapeutic agents to treat various disorders. Nowadays, many drugs have been developed from plants which are active against a number of diseases.

Open Access Original Research Article

Comparative Study between Modified Transverse and Hayman Suture Regarding the Efficacy and Purperium Complications in Thi-Qar

Aseel Mosa Jabber

Journal of Pharmaceutical Research International, Page 22-33
DOI: 10.9734/jpri/2021/v33i32B31737

Background: Main causes of death post-partum is the uncontrolled hemorrhage, that managed by different modalities, whereuterine compression suture had different efficacies as a main interventional tools of sever postpartum hemorrhage.

Aim: comparing different sutures types (modified transverse and Hayman suture) regarding their efficacy through its impact and in determining the final outcome and complications of post-partum hemorrhage.

Materials and methods: A prospective comparative analytical study including 122 females , who underwent delivery between march 2017and December 2019, all of them followed for , 1 week, 6,weeks 6 months. Were the samples collected from Bent-Al-Huda teaching hospital and Al-Rehman private hospital-Thi-Qar, 2 groups of study; 1st one (52) underwent modified B-lynch suturing (Hyman suturing) while the 2nd group(70) underwent transverse sutures of modified Ouahba suture, written consent had taken from all patients, SPSS version 24 used for analysis.

Results: Among 122 delivered women suffer from primary post-partum hemorrhage, 52 (42.63%) were sutured by Hayman suture, and 70 (57.37%)were sutured by transverse suturing,There was significant statistical difference between the types of intervention and blood loss P value <0.05. There was significant statistical difference between the types of intervention and complication development (p value=0.0001). There was no significant independent predictors or determinant for the complication development except the type of intervention. Only follow-up period and complication were truly to be correlated with type of intervention, the other variable were confounders

Conclusion: Even though the hemostasis had been achieved in both maneuver with excellent success rate, the transvers suture carrying high rate of persistent pain but the Hayman suture carry higher rate of serious complication such hysterectomy and intestinal obstruction. several factors determine the choosing of the suture type such as site, severity and cause of bleeding and the surgeon experience.

Open Access Original Research Article

Knowledge and Attitude of Recent Dental Graduates towards Smart/Bioactive Dental Composites

Fatin Hasanain, Hanin Yeslam, Soud Khaleefa

Journal of Pharmaceutical Research International, Page 34-44
DOI: 10.9734/jpri/2021/v33i32B31738

Aims: The purpose of this study was to explore the knowledge and attitude of dental interns vs newly graduated dentists (NGD) towards recently introduced smart/bioactive dental resin composites (SDCs).

Study Design: Cross-sectional study.

Place and Duration of Study: Restorative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia from March 2018 to June 2018.

Methodology: An online questionnaire was distributed among randomly chosen interns and NGDs in multiple countries (n= 164). The questionnaire was formulated using Google Forms. Statistical analysis of the results was conducted using percentages and frequencies and compared using Chi-square test (P<0.05).

Results: 59.15% of all respondents expressed interest in perusing restorative dentistry as a specialty.  A statistically significant lower proportion of NGDs compared to interns reported a good understanding of dental restorative materials (P=.022), hearing of SDCs (P=.033), or ever using SDCs (P=.006). 50% of NGDs reported thinking that SDCs effectively regenerate dental hard tissue was significantly (P=.016) lower than interns (70.5%). 97.6% of NGDs and 96.7% of interns reported willingness to attend a training workshop and/or a continuing education course about SDCs.

Conclusion: Interns showed a significantly higher positive attitude towards SDCs use. Knowledge and effective use of SDCs by interns and NGDs could be improved by more training such as that offered in workshops/courses.

Open Access Original Research Article

Development and Validation of a New RP-HPLC Analytical Method for the Simultaneous Determination of Luliconazole and Clobetasol Propionate in Synthetic Mixture

Binal Solanki, Hirak Joshi

Journal of Pharmaceutical Research International, Page 53-60
DOI: 10.9734/jpri/2021/v33i32B31742

Aim: To develop new selective and sensitive reverse-phase high-performance liquid chromatography (RP-HPLC) approach for the quantification of antifungal drug Luliconazole integrate with corticosteroid drug Clobetasol Propionate in a synthetic mixture.

Methods: The method was validated to achieve International Conference Harmonization (ICH) requirements. Chromatographic separation was carried out by isocratic technique on a reversed-phase Inertsil C18 column (5 µm, 250mm x 4.6mm i.d with the mixture of Acetonitrile: Water pH adjusted with H3PO4 (60: 40) and UV detection at 264 nm. The compounds were eluted at a flow rate of 1.0 mL/min with an injection volume of 20μL.

Results: The calibration curves were linear (r2 > 0.999) over the concentration range 10-200 μg/mLfor Luliconazole and 5-100 μg/mL for Clobetasol Propionate. The average retention times for Luliconazole and Clobetasol Propionate were 3.16 and 6.94 min, respectively. The % RSD   for the proposed method was found to be less than %2. The % recovery was found to between 99.22-99.48% for the developed method.

Conclusion: The developed method is simple, rapid, precise, and accurate and hence was successfully applied for the determination of Luliconazole and Clobetasol Propionate in a synthetic mixture.

Open Access Original Research Article

Clinical Assessment: Short Term Retention of Giomer and Compomer Restorations in Class V Non-Carious Cervical Lesions

Abdul Qadir Khan Dall, Imdad Hussain Domki, Mahwish Memon, Batool Bibi, Munir Ahmed Banglani, Sarwat Batool

Journal of Pharmaceutical Research International, Page 61-67
DOI: 10.9734/jpri/2021/v33i32B31743

Objective: To compare the retention rate of giomer and compomer in Class V restorations in non-carious cervical lesions (NCCL).

Materials and methods: In this experimental study patients with non-carious cervical lesions were divided in to two groups (Group A and B). In group A (n=60), restoration was done with Giomer type of material and in group B (n=60) Compomer type of material was used for filling by the same operator. Cvar & Ryge Criteria were used to evaluate the retention of both materials as: Alpha (restoration fully retained), Bravo (restoration partially retained) and Charlie (restoration completely missing) at follow-ups 1st, 2nd, 3rd, 4th, 5th and 6th months. The data was analyzed using SPSS version 17.

Results: Males were 72% and females were 28%. The Mean age was 30.62 ±3.89 ranges from 13–85 years. Charlie score was observed at 5th and 6th months. The comparison between Giomer and Compomer at follow-up of 1st, 2nd, 4rd, 4th, 5th and 6th showed no statistical difference.

Conclusion: Giomer and compomer both have same retention rate in clinical trials.

Open Access Original Research Article

Synthesis, Analytical Characterization and Anti-Diabetic Activity of Some Heterocycles of Quinazolin-4(3H)one

Pratik G. Modh, Mitali H. Jasani, Laxman J. Patel

Journal of Pharmaceutical Research International, Page 68-79
DOI: 10.9734/jpri/2021/v33i32B31744

Aim: Novel quinazolin-4(3H)-one heterocycles were synthesized and assessed for their anti-diabetic activity. Non-enzymatic glycosylation of haemoglobin assay was carried out to identify their potential as anti-diabetic. The cyclization of quinazolinone-4(3H)-one heterocycles was achieved, whereas carbon-carbon cross coupling reactions were carried out using Sonogashira and Suzuki-Miyaura reaction conditions and characterized with analysis. This synthesis method afforded corresponding 2, 3 and 6 substituted quinazolin-4(3H)-ones (3a to 3m) with excellent yields.

Methods: 2-Amino-6-bromobenzoic acid was used as a substrate which was converted to corresponding benzamide derivatives (1a-1b)  by reaction with benzylamine or cyclohexylamine using acid-amine reaction, followed by cyclization and oxidation using suitable aldehyde in DMSO under microwave condition to give bromo substituted quinazolin-4(3H)-ones (2a-2c), which were cross coupled to suitable terminal alkyne with palladium catalyst as well as copper co-catalyst using Sonogashira condition to obtain desired (3a-3h) and suitable boronic acid with palladium catalyst using Suzuki-Miyaura condition to obtain desired (3i-3m). All synthesized compounds were characterized by FTIR, proton NMR, LC-MS analysis and evaluated for in vitro anti-diabetic activity using non-enzymatic glycosylation of haemoglobin assay.

Results: Compounds 3m showed good inhibition of glycosylation of haemoglobin which in turn suggest good anti-oxidant potential on metabolism of glucose and hence lower glucose concentration. It showed IC50 value of 35.91±0.82 µg/mL which was comparable to the standard alpha tocopherol (34.47±0.87µg/mL).

Conclusion: In-vitro non-enzymatic glycosylation of haemoglobin method is one of important assays to judge the control of diabetes. The haemoglobin present in RBCs has an affinity to bind with glucose. The greater the glucose level in blood, more amount of glucose-bound (called glycosylated) haemoglobin will be formed. Accordingly, presence of lower concentration of glycosylated haemoglobin is a sure guide to the lower concentration of glucose in the blood. Synthesized compounds (3a-3m) lower the blood glucose level and 3m has highest potential among those which can be further developed as potent anti-diabetic.

Open Access Original Research Article

Assessment of the Association between Hypertention & Body Mass Index in Patients Visiting at Department of Medicine Pmch Nawabshah

Sikander Ali Sial, Jagdesh Kumar, Attia Ayoob, Anwar Ali Jamali, Amir Hamzo Dahri, Sanum Ali, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 80-88
DOI: 10.9734/jpri/2021/v33i32B31745

Background: Hypertension is a common health issue all over the world; increased Body Mass Index (BMI) is alone one strong risk factor for the HTN.

Objective: To assess the relationship between HTN & BMI in patients visited at department of Medicine PMCH Nawabshah.

Methodology: This cross sectional study was conducted at PMC Hospital Nawabshah during March 2019 to February 2020. Sample size was 385. This study was conducted after ethical approval of institutional committee and willing male and female subjects with hypertension were included in present study after consent. Age ranges from 15 years and above. Those having other co morbidities like, DM, IHD, stroke and other metabolic and endocrine disorders were excluded from the study. Patients with history of drugs causing weight gain were also excluded.

Results: there were total 385 subjects included, 130 were females and 245 were males1:2 ratio of female and male. Mean age of patients was 46.50 sd ± 8.65 years, mean BMI was 26.18 sd ± 4.73, mean systolic HTN was158.35sd ± 30.40 and mean diastolic blood pressure was 95.75 sd ± 12.91 mmHg.

Conclusion: There is strong association between hypertension and BMI, as the BMI will increase the risk of HTN will increase.

Open Access Original Research Article

Prevalence of Needle Stick Injury among Surgeons

Nasima Iqbal, Faiza Quraishi, Muhammad Aslam Bhatti, Faizah Mughal, Tayyaba Mumtaz, Muhammad Salman Khan

Journal of Pharmaceutical Research International, Page 89-94
DOI: 10.9734/jpri/2021/v33i32B31747

Aim: To find out the prevalence of needle stick injury, its reporting system and the reasons behind it.

Study design: Descriptive cross-sectional

Place and duration of study: Study was conducted at Jinnah post-graduate medical center (JPMC) Karachi during the period of March to September 2019

Methodology: A self-designed, self-explanatory questionnaire was used, consisting of two parts, the first part was about demographic information while second part is for information related to needle stick injury like probable cause, frequency, response after injury, post-exposure prophylaxis and about reporting of the incident. Questionnaire was validated by calculating the Cronbach’s alpha which was 0.78. data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20.

Results: Majority of the study participants were female (67.2%) and about 50% were postgraduate students. Out of total 134 doctors about 64.2% of the doctors had needle stick injury during their career. Finding out the most probable cause of needle stick injury during the survey it was found out that increased work load and prolonged working hours were the main reasons. Majority of the cases occurred in emergency department (41.9%). About 95.5% of the doctors didn’t get any post-exposure prophylaxis. Majority of the participants (96.3%) did not report to any authority because of the lack of knowledge about the reporting policy, it was noted that about 38.8% were confused either the reporting system exist or not. Most of the injuries occur during the procedure of suturing followed by recapping syringes.

Conclusion: It has been concluded that majority of the doctors had faced needle stick injury during their career and a very negligible number of them got any post-exposure prophylaxis. Majority of them did not report to any authority. So there is a need of implication of safety measures and reporting policies for early detection and treatment of infections after needle stick injury.

Open Access Original Research Article

Role of the Novel Integrated Clinical Pharmacist Menu Software in Improving Medication Therapy Management

Muhammad Tahir Aziz, Tofeeq Ur-Rehman, Sadia Qureshi, Kashif Sajjad

Journal of Pharmaceutical Research International, Page 103-114
DOI: 10.9734/jpri/2021/v33i32B31749

Background: Medication therapy management (MTM) continues to offer pharmacists the opportunity to use their knowledge, assist patients and caregiver in improving therapeutic outcomes, however the change is slow. Health information technology has been noted as an important driver in the success of MTM and has a potential role in improving therapeutic outcomes and reducing medication errors.

Objective: This research aimed to design an integrated clinical pharmacist menu (CPM) software along with clinical decision support tools, optimizing MTM services and reducing medication errors.

Methods: The integrated CPM software was designed abridged with decision support tools. A comparative study was conducted in a setting of integrated CPM software versus paper-based clinical pharmacy services (P-CPS) for the evaluation of MTM services. Clinical decision support systems (CDSS) and automated significant laboratory and medication alerts were analyzed for the improvement of MTM and impact on the identification and resolution of medication errors.

Results: MTM improved after the application of the CPM software with a difference of 100% in “medication history generation” and “patient care plan,” with a reduction in medication errors by 39.8%. The identification of medication errors and verification of medication order significantly improved from 49% to 82% (p = 0.00) and from 4.5% to 7.0% (p = 0.00), respectively, in the CPM setting. The CDSS tool in the CPM software generated 730, 1802, and 198 auto alerts for “drug–drug interaction,” “inappropriate dose,” and “dose adjustment in an abnormal clinical laboratory test,” respectively, which improved the resolution and identification of medication errors.

Conclusion: The CPM is user-friendly, which improved the MTM services. Medication error identification and resolution were significantly improved by the CPM software.

Open Access Original Research Article

Analysis of the Specificity, Sensitivity and Accuracy of Goniometry Method Compared to Tape Method for Measuring Trunk Mobility in Normal Adults

Purvi Patel

Journal of Pharmaceutical Research International, Page 138-145
DOI: 10.9734/jpri/2021/v33i32B31755

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.

Open Access Original Research Article

Preparation and Evaluation of Zafirlukast Compression Coated Tablets for Chronotherapeutic Drug Delivery

M. S. Neeharika, B. Jeevana Jyothi

Journal of Pharmaceutical Research International, Page 154-166
DOI: 10.9734/jpri/2021/v33i32B31757

The objective of the present study was to formulate and evaluate an oral, time-controlled drug delivery system of Zafirlukast. Zafirlukast belongs to BCS class II drugs as it has poor aqueous solubility and good permeability. Hence an attempt has been made to improve its aqueous solubility by solid dispersion technique so that its dissolution, bioavailability, and therapeutic effect can be optimized. The optimized solid dispersion was then formulated into a chronotherapeutic drug delivery system by compression coating technology. FT-IR study revealed that there was no chemical interaction between the drug and polymers used. Tablets were prepared by direct compression method using different super disintegrants and then followed by compression coating using natural polymers. Pre-compression and post-compression parameters complied with the Pharmacopoeia limit for the tablets. In vitro release studies were performed and the results indicated the formulation Z9F9 to be the optimized formulation.

Open Access Original Research Article

Anti-Aging Effectiveness of Avocado Peel Extract Ointment (Persea americana Mill.) against Hydration, Collagen, and Elasticity Levels in Wistar Rat

I. Nyoman Enrich Lister, Hena Liana Amiruddin, Edy Fachrial, Ermi Girsang

Journal of Pharmaceutical Research International, Page 173-184
DOI: 10.9734/jpri/2021/v33i32B31760

The skin is a complex organ that protects the body from the external environment. The skin has a variety of functions such as providing a physical permeability barrier, protection from infectious agents, thermoregulation, sensation, protection against ultraviolet (UV) rays, regeneration, and wound healing. Clinically, aging skin is characterized by loss of hydration, rough texture, irregular pigmentation, yellowish discoloration, telangiectasia, deep wrinkles or wrinkles, thinning of the skin, and fine lines. One of the plants that can be used as natural ingredients that are rich in antioxidants and interesting to study is avocado (Persea americana Mill.) from the Lauraceae family, which is a plant that has medicinal properties and contains a variety of nutrients. Besides being consumed as food, avocados are also used as a mixture of cosmetic products. This study aims to assess the anti-aging effectiveness of avocado peel extract on increasing collagen levels, elasticity, and hydration in male rats. A total of 25 rats were divided into 5 groups, each group consisting of 5 white rats; control group (ointment base), avocado peel extract ointment group 2.5%, 5%, 7.5%, and 10%. The entire group of rats will be measured the condition before treatment with the Skin Analyzer EH 900 U including levels of collagen, elasticity, and hydration. After measuring the initial skin condition, the treatment was started by applying ointment until it was evenly distributed over the marked area, the ointment was applied according to the groups that have been set above, the application was carried out 2 times a day for 4 weeks. Changes in skin condition were measured weekly for 4 weeks using the EH 900 U skin analyzer. The results of this study indicate that the methanol extract of avocado peel contains phytochemicals in the form of alkaloids, tannins, phenols, flavonoids, and glycosides. Then the phenolic, flavonoid, and tannin content of the avocado peel methanol extract was 59.55 GAE mg/gram extract, 2.96 QE mg/gram extract, and 22.63 TAE mg/gram extract. After 4 weeks of treatment, there was a significant change in the level of hydration, collagen, and skin elasticity (p<0.05) in all treatment groups, this can be seen from the P-value <0.05, with the group of rats receiving the highest concentration of ointment (10%) showed the highest average, namely hydration 49.60%, collagen 40.20%, and elasticity 68.20%. Changes in hydration levels, collagen, and skin elasticity before and after treatment also showed significant changes (P-value < 0.05) with the highest changes found at a concentration of 10%, namely hydration 88.40%, collagen 60.0%, and elasticity 68.20%. In conclusion, the results of this study showed that administration of avocado peel extract ointment could increase hydration, collagen, and skin elasticity levels compared to controls groups, positively correlated with the increase of the duration and the quantity of avocado peel extract ointment were given. The best formulation that gives the most significant effect is 10% avocado peel extract ointment by increasing levels of hydration, collagen, and elasticity the most significantly.

Open Access Original Research Article

Evaluation of Neem (Azadirachta indica) Leaf Powder for Assessing Gustatory Function and Comparison with Other Tastants

Varsha Varghese, M. Sudha, Ashok Menon, D. Rajkumar, Navya Jith Jacob, J. K. Mukkadan

Journal of Pharmaceutical Research International, Page 192-199
DOI: 10.9734/jpri/2021/v33i32B31762

Aims: Azadirachta indica (meliacea), popularly known as neem has extreme bitter taste however it has high medicinal properties. The study aimed to use the bitterness property of neem leaf powder to assess the bitter taste along with other tastants and to check reliability of this newly introduced method.

Materials and methods: 60 healthy subjects were recruited in the present study. Bitter, sweet, salt, sour and umami taste solutions are prepared in three different concentrations. Gustatory recognition threshold was recorded against each concentration of five tastants solutions.

Results: A significant difference in the first concentration (.003) of neem between all age groups (p=0.026) but no significant difference in the second and third concentrations were observed. Males have higher gustatory recognition threshold in almost all levels of taste parameters. However, medium and higher concentrations of neem have no significant gender wise difference. An acceptable level of reliability was found in the test retest method conducted in a two week interval.

Conclusion: The neem leaf powder solution can be used for bitter taste assessment, is reliable, and can be safely used in the clinical setting.

Open Access Review Article

Some Opportunistic Infections in Childhood: Causes, Diagnosis and Treatment Methods

Sabina Muradovna Gulieva, Muradovna Akhverdiyeva Galina, Eugeny Kalinin, Shirvan Emirovna Mameeva, Anna Agasievna Harutyunyan, Tatiana Alekseevna Kabanova

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i32B31735

The article discusses the features of the emergence and development of the so-called opportunistic infections that occur in children with weakened immunity.

Such infections are often caused by non-tuberculosis mycobacteria, fungi, and herpesviruses, and such infections can also develop in children who are treated with immunobiological drugs. Since these are serious and rapidly developing diseases, the diagnosis should be made at the earliest stages of the development of the disease and be based on the features of clinical phenomena described in the literature and anamnesis data indicating the presence of such infections. The earlier an infection is detected, the faster it will be possible to start appropriate therapy.

The relevance of this topic is due to the fact that, despite the improvement in the diagnosis of opportunistic infections in recent years, they still are a problem for pediatricians, who are not always able to diagnose them in time. Accordingly, the pediatrician should, in case of suspicion of the presence of such an infection in a child patient, contact specialists who have experience in their treatment in order to take timely measures to stop the development of the disease.

The aim of the study is to consider the features of some opportunistic infections in childhood, their causes, diagnosis, and treatment methods.

Open Access Review Article

Antioxidant effects of Homoeopathic Medicines: Review Based on Preclinical and Clinical Research

Aditya Dilipkumar Patil, Parth Aphale, Dharmendra B. Sharma

Journal of Pharmaceutical Research International, Page 8-21
DOI: 10.9734/jpri/2021/v33i32B31736

Background: Antioxidants are rampantly studied due to their ability to trap the free radicals. Due to excessive stress these free radicals take part as fundamental components in oxidative damage leading to changes in SOD, CT, GSSH, GPx, GSH, LPO, GGT, LDH. High Dilution Medicines (HDM) are also being investigated in deciphering their antioxidant properties.

Methodology: The database for the research paper was screened from Google scholar, PubMed, and Web of Science. The search keywords used were Antioxidant, Homoeopathy, Homeopathy, In-vitro, In-vivo, Clinical trial in various permutation and combinations. The research article in original full text with English language is included in this manuscript. Score for assessment of biological experiment on homeopathy (SABEH) was referred for screening the research articles.

Results: Around 14 research manuscript showed the research conducted on HDM with respect to their antioxidant properties. Four In-vitro, Eight In-vivo studies and two Clinical studies were used in assessing the antioxidant activity. Out of 14, only 12 studies were included in SABEH criteria scores above 5/9. SOD, CT, GSH, GPx, LPO, GSSH, GGT, LDH, 2,2 DPPH were found to be explored with HDM with their antioxidant properties.

Conclusion: HDM can further be studied at to what extent they provide preventive role, interception role and repair role pertaining with their antioxidant properties, also comparing the efficacy of antioxidant properties through oral route and injectable in various stages of disease.  

Open Access Review Article

Immunoboosting Potential of Spices with Special Reference to North East India against the Novel Coronavirus Pandemic- A Review

Rahul Malakar, Amrit Kumar, Priyanka Das, Khusbu Pathak, Rajesh Dev Sarkar

Journal of Pharmaceutical Research International, Page 207-218
DOI: 10.9734/jpri/2021/v33i32B31764

Spices, which is key ingredient in every household products not only used for adding aroma to food but however, has health promoting and protective activity against foreign pathogens. Different spices used in day to day life boosts the immune system that leads to healthy and prosperous life. The commonly used spices not only have antimicrobial or antiviral activity, but also serve as a rich source of various vitamins, minerals, antioxidants etc. The medicinal importance of spices dates from ancient Ayurveda and many studies indicating the potential of spices as immunoboosting agent had been carried out in the recent years. Therefore, this review highlights the medicinal importance of commonly used spices in North-East India as immunobooster against the current coronavirus pandemic.