Open Access Study Protocol

Comparative Study between Open Surgical Drainage and Closed Technique of Percutaneous Aspiration under Image Guidance for Management of Breast Abscess

Chetna Dilip Rathi, Meenakshi Yeola (Pate)

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i33A31765

Background: The conventional surgical management of breast abscesses consists of an incision taken over the point at which there is maximum fluctuation (or pain) and breaking of the abscess septa by digits. Now antibiotics and repeated abscess aspiration under USG guidance is new minimally invasive method which is on rise

Objectives:

  1. To study the outcome of open technique of breast abscess management.
  2. To study the outcome of closed technique of breast abscess management.
  3. To compare the outcome of open v/s closed technique of surgical management of breast abscess.

Methodology: Sample will be divided into two groups and type of treatment i.e open incision and drainage or percutaneous aspiration under guidance will be decided randomly by chit system.

Expected Results: Feasibility and outcome of Percutaneous drainage is better than incision and drainage

Conclusion: First line management of Breast abscess will soon be percutaneous drainage under USG guidance.

Open Access Study Protocol

Critical Appraisal of National Accreditation and Assessment Council Accreditation Guidelines with Reference to Medical Sciences Universities/ Institutions as Against US and UK and Proposing an Upgraded Model of Accreditation Guidelines – A Study Protocol

Gaurav Mishra, Tripti Srivastava, Rajasbala Dhande, Rohan Kumar Singh, Prerna Patwa

Journal of Pharmaceutical Research International, Page 8-12
DOI: 10.9734/jpri/2021/v33i33A31766

Background: Accreditation forms chief platform to the fact that higher education should be accurately directed towards betterment, sharpening, honing and nourishing intellectual persona of learners.

There is palpable need to critically analyze manuals embodying accrediting guidelines for Medical Sciences Universities / Institutions prescribed by NAAC as against guidelines in vogue in U.S. and U.K. with reference to any identifiable inadequacy pertaining to meaningful accreditation of Medical Sciences Universities / Institutions and proposing an ideal model towards meaningful accreditation .

Aim and Objectives: To critically evaluate manuals of accreditation of Medical Sciences Universities / Institutions notified by National Accreditation and Assessment Council with reference to those in vogue in U.S. and U.K. and generate updated manual for accreditation of Medical Science Universities / Institutions in India.

Methods:

Type of study: Descriptive study.

Duration of study: 2 years.

Place of study: Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha.

Expected Results: Generation of upgraded manual of accreditation of Medical Universities / Institutions in India.

Conclusion: Updated manual of accreditation of medical Sciences Universities / Institutions in India could be availed by National Assessment and Accreditation Council for its utilization as a basal / referral document towards the necessary policy frame.

Open Access Short Research Article

Cardiosurgical Care in Case of Congenital Heart Defects: Modern Approaches and Features of the State of Patients' Health

Linda Anzorovna Enginoeva, Isa Shapievich Gaidarov, Djeneta Reyzulahovna Mirzebalaeva, Tatiana Timokhina, Fedorina Alena Georgievna, Aleksandra Alekseevna Sokolova

Journal of Pharmaceutical Research International, Page 218-224
DOI: 10.9734/jpri/2021/v33i33A31790

Congenital heart defects today, despite the early intrauterine diagnosis, are still quite common, and their danger to the patient's health is significant. The article discusses the features and modern approaches to the provision of cardiac surgical care for this congenital disease. The author comes to the conclusion that modern cardiac surgery technologies, rooted in the distant 50s of the twentieth century, allow us to conclude that at the present stage, surgical intervention in case of congenital heart defects has advanced far. Despite the challenges in this area, cardiac surgeons continue to make progress in reducing the mortality and multiple comorbidities of patients with congenital heart defects.

Open Access Short Communication

Features of Rehabilitation Therapeutic Treatment of Patients who have come through Coronavirus Disease

Aishat Iskhakovna Gimbatova, David Avakovich Gabrielyan, Tatiana Timokhina, Andrey Petrovich Kostikov, Anastasiia Viktorovna Shekhovtsova, Aleksandra Alekseevna Sokolova

Journal of Pharmaceutical Research International, Page 69-75
DOI: 10.9734/jpri/2021/v33i33A31773

The purpose of the article is to consider the features of restorative therapeutic treatment of patients who have suffered a coronavirus infection. This disease can cause respiratory, physical and psychological dysfunction in patients. Therefore, restorative therapeutic treatment and rehabilitation are critical for both hospitalized and discharged patients with COVID-19.

The author believes that many patients who have a history of a previous coronavirus infection note that they experience various unpleasant symptoms even six months after receiving negative tests. So, such patients may experience weakness, shortness of breath, tachycardia, instability of mental states, and so on. At the same time, against the background of an active fight against the spread of COVID-19, measures related to the rehabilitation of convalescents are receding into the background, which is fundamentally wrong. The paper analyzes the literature devoted to the problem of rehabilitation treatment after a coronavirus infection, and also applies comparative and comparative research methods.

The author concludes that complications after COVID-19 can significantly worsen the quality of life of patients. For this reason, specialists need to identify the degree and level of complications and patients who have suffered a coronavirus infection as early as possible in order to prescribe appropriate medication or physiotherapy.

Open Access Original Research Article

Formulation Development and Optimization of Sustained Release Microspheres of Acebrophylline

Niyati Shah, Ayesha Sheikh, Hitesh Jain

Journal of Pharmaceutical Research International, Page 13-28
DOI: 10.9734/jpri/2021/v33i33A31767

Objectives: Aim of present work is to prepare and evaluate Sustained release microspheres of Acebrophylline for treatment of Asthma.

Experimental work: In present investigation, attempt was made to prepare sustained release microspheres of Acebrophylline with different polymer ratio using Ionic gelation method. Drug- excipient compatibility studies were performed by FTIR. The best suited Microspheres formulation was found on the basis production yield, entrapment efficiency and in vitro release study. Optimized batch of microspheres (B2) was characterized for FTIR, DSC, and SEM analysis. The drug release data of optimized batch was fitted into different release kinetic models. The optimized batch of microspheres (B2) was subjected for the short term stability study at 40 ± 2°C with RH of 75% for a period of 1 month.

Results and discussion: There was no interaction found between drug and excipients. Sodium alginate (2%) concentration, Eudragit RS-100 (1:2) ratio gave highest sustainable property and CaCl2 (2.5%) concentration had a good cross linking property. This observation done on the basis of production yield, entrapment efficiency and In vitro release study. The Microspheres prepared from Ionic gelation method had Drug : Eudragit RS100 (1:2), 2 % Sodium alginate and 2.5 % CaCl2 (B2) give 99.2 % drug release over the periods of 12 hr. The drug release from optimized microspheres formulation (B2) follows first order release kinetic. DSC study showed the melting behavior of drug present into microspheres. SEM studies showed that optimized microspheres were spherical and rough surface.  Stability study proved that optimized formulation (B2) was stable.

Conclusion:  Drug: Polymer ratio and Volume of CaCl2 had significant effect on % Entrapment efficiency and Drug release. From the Scanning Electron Microscopy (SEM) study observed that microspheres was spherical and rough surface. Non Fickian diffusion was the mode of drug release from Acebrophylline- loaded microspheres. After stability study no physical changes & almost same drug release was observed in microspheres. Hence, the formulation B2 was stable.

Open Access Original Research Article

Effect of Metformin and Its Combination with Probiotic on Menstrual Irregularity and TSH Levels in Patients with Polycystic Ovarian Syndrome: A Randomized Controlled Trial

Urooj Zafar, Nasima Iqbal, Faizah Mughal, Faiza Quraishi, Ali Nawaz Bijarani, Mariam Muneer

Journal of Pharmaceutical Research International, Page 29-38
DOI: 10.9734/jpri/2021/v33i33A31768

Background: Polycystic ovarian syndrome (PCOS), the far most common endocrine disorder among sexually active women. The disease is typically characterized by irregular menstrual cycles and appears to be influenced by associated thyroid dysfunction.

Aim: The goal of this research was to assess and compare the effects of Metformin and its combination with Probiotic on monthly cycle irregularity and TSH levels in PCOS women.

Methodology: This was a single-center study conducted at Karachi's Gynecological Outpatient department from January 2019 to September 2019. A total of 52 PCOS patients aged 18 to 40 years were included in this trial, which followed Rotterdam criteria. After providing written and consent form, individuals were randomized into one of the two groups and received Metformin 500 mg TD (n = 26) or Metformin Combination (n = 26).

Results: After three months of treatment, both groups improved in terms of menstrual cycle irregularity and TSH levels, but the combination treatment improved the most.

Conclusion: Probiotics may be considered in conjunction with Metformin for improving TSH levels to achieve better results.

Open Access Original Research Article

Outcome Analysis of Osteosynthesis Versus Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Young Elderly Patient

Muhammad Rafique Joyo, Nizam Ahmed, Ghazanfar Ali Shah, Aftab Alam Khanzada, Tanveer Afzal, Niaz Hussain Keerio, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 53-59
DOI: 10.9734/jpri/2021/v33i33A31771

This study was designed to compare the osteosynthesis and hemiarthroplasty treatment among the elderly population and evaluate the postoperative functional performance of these two recommended treatments of a displaced femoral neck fracture.

Methodology: This retrospective study was conducted in Bone Care trauma center Heerabad  Hospital Hyderabad Pakistan from March 2019 to March 2020. A total of 74 patients of age between  60 to 70 years were selected. All the selected patients were diagnosed with femoral neck fractures (Garden’s III and IV). Harris's hip score was used to evaluate the clinical status of patients with pain, whereas we used Palmer and Parker's mobility to access mobility. Implant breakage, screw cut, and nonunion were considered as parameters of osteosynthesis failure. At the same time, hemiarthroplasty failure was defined as two or more recurrent dislocation, aseptic loosening, periprosthetic fracture, and infection.

Results:  In the first three postoperative months, the mean score of the hemiarthroplasty group was reported as 74.44±8.480, which was comparatively high than the osteosynthesis group (66.44±8.520). After six months, this score reached 80.12±7.005 in the hemiarthroplasty group and reached its maximum of 92.14±7.125. After the first three months, the increment ratio was relatively slow with six ratios, but in the last visit, we observed a sudden increase in score in both groups. Regarding Palmer and Parker's mobility score, the hemiarthroplasty group reflected better outcomes than the osteosynthesis group.

Conclusion: Our study concluded that management of displaced femoral neck fracture with osteosynthesis revealed a high probability of nonunion, screw cutout complications and enhanced the risk of reoperation. Patients treated with osteosynthesis showed delay rehabilitation.

Open Access Original Research Article

Assessment of the Deficiency of Vitamin D among the Tuberculosis Patients at People Medical College Hospital Nawabshah, Pakistan

Sikander Ali Sial, Bhojo Mal Tanwani, Anwar Ali Jamali, Farheen Shaikh, Asad Ali Zardari, Laxmi Kajal, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 76-80
DOI: 10.9734/jpri/2021/v33i33A31774

Objective: The objective of this study is to assess deficiency of Vitamin D among the Tuberculosis Patients at People’s Medical College Hospital (PMCH) Nawabshah, Pakistan.

Methodology: This was a case-control study in which 184 new diagnosed tuberculosis patients aged between 30 to 50 years were selected and 200 were taken as control. The study was conducted from June 2020 to May 2021. Well-structured questionnaire was administered to both case and control groups. Body mass index (BMI) was recorded as (kg/m2). Blood samples were collected for the presence of Vitamin D3 levels. Statistical Software for Social Sciences (SPSS) version 23 was used to analyze the data.

Results: The mean age and standard deviation (SD) of the patients was 45.11 ± 7.99 years and gender distribution was females 94/184 (51%) and males 90/184 (49%) in patients. There was Vitamin D deficiency in 79/184 (39%) patients.

Conclusion: Vitamin D deficiency was common among tuberculosis patients in contrast to control group. The female patients with low Body Mass Index (BMI) (kg/m2) were having the more deficiency of Vitamin D. Vitamin D supplementation has vital role in tuberculosis treatment and prevention. 

Open Access Original Research Article

Development and Validation of Novel Ultra Performance Liquid Chromatography Technique for the Simultaneous Determination of Metformin and Repaglinide in Bulk and Formulation

H. K. Sundeep Kumar, Suman Acharyya, Pratap Kumar Patra

Journal of Pharmaceutical Research International, Page 115-124
DOI: 10.9734/jpri/2021/v33i33A31778

A novel ultra-performance liquid chromatographic technique for the estimation of metformin and repaglinide in a API and tablet dosage form. The chromatographic separation was achieved using DIKMA Endoversil (2.1 x 50mm, 1.7µm) column with a mobile phase of phosphate buffer, pH 4.2 and methanol as a mobile phase (38:62) with a flow rate of 0.3 mL/min and the detection wavelength was monitored at 241 nm. The method was validated in accordance with International conference on harmonization guidelines. In this present method metformin was eleued at 0.516 minute and repaglinide was eluted at 1.152 min. Limit of detection was 0.05 μg/ml for metformin and1.152 μg/ml for repaglinide limit of quantification was found 0.5 μg/mL. Calibration curve plots were found linear over the concentration ranges 1-50 μg/mL for both the analytes. The % assay of the marketed dosage form was found 99.45 % for metformin and 97.08 % for repaglinide. The present study approach was found to be effective in the analysis of both analytes in force degradation conditions, because both the analytes has been specifically eluted in presence of other chromatograms. The experiential evidences of all the study results revealed the suitability of the estimation of metformin and repaglinide in API and tablet dosage form.

Open Access Original Research Article

Prevalence of Urinary Tract Infection and Drug Resistance among Infants and Children in Pakistan

Muhammad Sohail, Maisam Ali Shahid, Kumail Sajjad, Muhammad Ayub, Qasir Akram, Sobia Alyas, Yousma Javed, Muhammad Asim Rana, Qurban Ali, Muhammad Mansoor Hafeez

Journal of Pharmaceutical Research International, Page 125-131
DOI: 10.9734/jpri/2021/v33i33A31779

In infancy most common and a serious disease is known as Urinary tract infection (UTI). The aim of the current study is to evaluate the frequency and antibiotic resistant among infant presenting with UTI in Lahore General hospital, Lahore-Pakistan. The current observational study comprised 100 (n=100) cases diagnosed with UTI. The study was conducted at Lahore General Hospital, Pakistan, between March 2019 and January 2020. Data were collected and recorded on specified proformas that had information on demographics, biochemical analysis, and complaints, as well as the antibiotic used and blood cultures. The most common gram-negative bacilli (GNB) causing UTI was E. coli constitute about 72% followed by Klebsiella (11%), Enterobacter (7%) and Enterococcus (4%). Most of the isolated pathogens are highly resistant to ampicillin, cotrimoxazole, and cephalexin (72%–95%), have intermediate sensitivity to third- generation cephalosporins, and high sensitivity to amikacin, nitrofurantoin and ciprofloxacin. Similarly, the other pathogens showed different degree of occurrence and resistance against empirically used antibiotics. The most prevalent UTI causative organism among children was E. coli. The insulated microorganisms were highly resistant to ampicillin, and highly sensitive to amikacin.

Open Access Original Research Article

A Prospective Observational Study to Find out Prevalence of Polypharmacy, Co-Morbidities and Drug-Related Problems among Type 2 Diabetes Patients at a Tertiary Care Teaching Hospital

Rajesh Hadia, Mihir Thakkar, Shivani Shah, Prati Patel, Kushalkumar Gohel, Dhaval Joshi, Trupal Rathod, Jitendra Lakhani, Hemraj Singh Rajput, Rajesh Maheshwari

Journal of Pharmaceutical Research International, Page 132-140
DOI: 10.9734/jpri/2021/v33i33A31780

Background: Presently India, depicts 49% of the world’s diabetes burden, with an approximated 72 million cases in 2017. Comorbidities make type 2 Diabetes Mellitus (DM) management complicated for health care providers. Therefore, patients have been prescribed multiple drugs. As a result of polypharmacy, the chances of the occurrence of drug-related problems (DRPs) increase.

Objective: The present study aimed to find out the prevalence of comorbidities, polypharmacy, and drug-related problems among type 2 DM patients.

Methodology: A prospective observational study was conducted for six months among 110 patients having type 2 DM. Based on inclusion and exclusion criteria data were collected. All collected cases were analysed for the number of medications prescribed and comorbidities present. Prescriptions were further assessed to find out the drug-related problem.

Results: Comparing the gender proportionality, male represents 59% (n=65) and female represents 41% (n=45) of the study population. The present study evaluated that 91% (n=100) of patients were having at least one comorbid condition or complication along with diabetes, the most common being cardiovascular disorders. The average number of drugs prescribed is 7.86±7.83 per patient. Polypharmacy was observed in 84.54% (n=93) of the patients. A total of 180 DRPs were found among 110 patients.

Conclusion: The present study concluded that the increase in the number of co-morbidities significantly increases the burden of polypharmacy which can further lead to DRPs. Reducing the number of pills and the presence of a clinical pharmacist in prescription monitoring can help to alleviate the problems of polypharmacy and its consequences.

Open Access Original Research Article

Synergistic effect of Ocimum Sanctum and Andrographis Paniculata against Diabetic Complications

Lalit Gupta, Mandeep Kumar Arora, Ritu Tomar, Anuj Pathak, Vardan Gupta, Anchal Garg, Jagannath Sahoo, Parul Grover

Journal of Pharmaceutical Research International, Page 151-163
DOI: 10.9734/jpri/2021/v33i33A31782

The present study explored the effect of Ocimum sanctum, Andrographis paniculata and their combination for the management of experimental diabetic vascular complications. Diabetes associated dyslipidemia and free radical generation have been connected to the pathogenesis of diabetes-induced vascular complications.  Ocimum sanctum, Andrographis paniculata, possess hypolipidemic and antioxidant property, thus we evaluated their vaso-protective potential. Hydroalcoholic extract of Ocimum sanctum (200 mg/kg p.o) and hydroalcoholic extract of Andrographis paniculata (400 mg/kg p.o) were noted to possess vascular protective potential in experimental chronic diabetes. Experimental diabetes mellitus was induced by Streptozotocin (55 mg/kg i.p., once) to Wistar rats. The induction of diabetes and its associated vascular complications were assessed biochemically. Diabetes-associated dyslipidemia and tissue oxidative stress were also assessed. Treatment of combination of Ocimum sanctum + Andrographis paniculata (300mg/kg p.o) was noted to be more efficient against the diabetes-induced vascular endothelial dysfunction and renal impairment as compared to either treatment with Ocimum sanctum (400mg/kg p.o) or Andrographis paniculata (200mg/kg p.o) or Lisinopril (1 mg/kg/day p.o.) (a reference agent). To conclude, diabetes associate oxidative stress and dyslipidemia are majorly accountable for the induction of vascular and renal impairment. The combination of Ocimum sanctum + Andrographis paniculata (300mg/kg p.o) shown the synergistic effect and may have prevented the progression of diabetes-induced vascular endothelial dysfunction and nephropathy by preventing the alteration lipid profile, restoring the serum nitrate/nitrite concentration, and decreasing the renal oxidative stress.

Open Access Original Research Article

Leaves of Stereospermum suaveolens DC Exhibit Anti-inflammatory and Anti-arthritic Potential Action in Experimental Animals

R. R. Chanshetti, D. D. Bandawane

Journal of Pharmaceutical Research International, Page 164-175
DOI: 10.9734/jpri/2021/v33i33A31783

Aim: The experimental investigation of current research work was to identify traditional rich claim of Stereospermum suaveolens DC leaves for anti-inflammatory and anti-arthritic potential action in animals.

Study design: Ethyl acetate fraction of Stereospermum suaveolens DC (Bignoniaceae) methanolic extract of leaves evaluated at 125mg/kg, 250mg/kg and 500mg/kg (p.o.) doses for anti-inflammatory and anti-arthritic activity.

Methodology: Ethyl acetate fraction of Stereospermum suaveolens DC (Bignoniaceae) methanolic extract of leaves was evaluated for phytochemical investigation for total flavonoid content using UV spectroscopy and TLC study. Carrageenan induced rat paw edema (Acute method) and Freund’s complete adjuvant (FCA) induced chronic arthritis in wistar rats were used as an animal models to claim Stereospermum suaveolens DC leaves for anti-inflammatory and anti-arthritic potential.  The rat paw volume and percentage inhibition of the paw edema were evaluated for anti-inflammatory activity. The assessments of arthritis in rats were measured by haematological values and radiological examinations.

Result: Ethyl acetate fraction of Stereospermum suaveolens DC (Bignoniaceae) methanolic extract of leaves showed presence of total flavonoids and saponins. The significant inhibition in paw volume and edema (p < .01) obtained at 250mg/kg and 500mg/kg oral dose. These obtained results were established confirmation outcome for presence of rich flavonoid contents in Stereospermum suaveolens DC leaves and provides valuable source of bioactive phytocomponents. 

Conclusion: Ethyl acetate fraction of Stereospermum suaveolens DC (Bignoniaceae) methanolic extract of leaves  showed significant inhibition of inflammatory reaction as compared to standard drug indomethacin Sterospermum Suaveolens DC leaves were showed potential therapeutic role in treatment of inflammation and arthritis cases.

Open Access Original Research Article

A Questionnaire-Based Examination of Placebo Prescribing Patterns among the Doctors at Tertiary Healthcare Services

Mahnoor Nazir, Sameena Gul Memon, Atif Ahmed, Kanwal Abbas Bhatti, Fahmida Gul

Journal of Pharmaceutical Research International, Page 176-182
DOI: 10.9734/jpri/2021/v33i33A31784

Background: The major theme of the research is relieving the patients by prescribing the placebo prescription by the health care provider of tertiary health care services.

Materials and methods: Descriptive cross-sectional research was conducted for the period of one year from February 2020 to January 2021 at various government and private tertiary care institutes of Nawab Shah, Kotri, Jamshoro and Hyderabad Districts after approval of the ethical committee of concern institutes and total 238 study subjects were selected.

Results: The consequences of placebo prescription were approximately 80%. 137 were males and 101 were females. 130(54.62%) Doctors were from the government sector, 108(45.37%) were from private institutes. 21(8.8%) placebo prescriptions was assumed as alternative medicine, 52(21.84%) as Prebiotics, 63(26.47%) as saline injections. 41(17.22%) placebo was prescribed because patients need them, 67(28.5%) placebo was prescribed for psychological therapy. 41(17.22%) placebo was usually effective, 129(54.2%) were sometimes effective, 20(8.40%) never had any effect and 48(20.16%) had other outcomes for the placebo prescriptions.

Conclusion: Descriptive cross-sectional research was conducted for the period of one year from February 2020 to January 2021 at various government and private tertiary care institutes of Nawab Shah, Kotri, Jamshoro and Hyderabad Districts after approval of the ethical committee of concerned institutes

Open Access Original Research Article

Implications of Aerobic Exercises and Walking Parallel to Diabetes Medications on Diabetic Sportspersons

Fehmida Ayub, Abida Naseer, Saeed Javed, Adnan Asghar, Abd Rahim Mohd Shariff, Hafiz Shamshad Ali, Naila Nazar, Imtiaz Ashraf, Sabita Yasin, Ali Sher, Waheed Javed

Journal of Pharmaceutical Research International, Page 197-204
DOI: 10.9734/jpri/2021/v33i33A31786

Objective: Diabetes have a central contribution with type I or type II towards the healthy lifestyles of sportspersons. Aerobic exercise and daily walking stay them fit and control their glucose levels in their bloodstream. The aim of this study was to find out the effects of aerobic exercises and walk on the sportspersons of type I and II diabetes.

Methodology: The existing research has experimental design itself wherein pre-tests and post-tests were employed to make sure the novelty of results. The data was collected from the diabetic sportspersons dividing them equally into control group (N-20) and experimental group (N-20). Both groups had type I (N-20) and type II (N-20) diabetic individuals. Aerobic exercise and walk protocol was applied for six weeks on experimental group, whereas, control group continued their routine activities. Afterwards, the data was collected through pre and post treatments and edited into SPSS (v-26). The collected data was analyzed through descriptive statistics using frequencies and percentages, whereas, T-test was applied to make the differences of pre and post treatments.

Results: The findings has shown that aerobic exercises and walk decrease the higher levels of glucose in blood and enable to stable glycemic balance, weight loss maintenance, decrease insulin resistance, blood pressure decrease, and blood glucose control.

Conclusion: The prominent differences were observed between control and experimental groups either type I or type II. It was concluded that the sportspersons may reduce the excessive glucose engaging in aerobic exercises and walk on daily basis rather than using medications. They should spend their happy lives and get rid of medications and insulin through spending their spare time using light exercises and maintain their glucose levels in blood as well.

Open Access Original Research Article

Outcomes of Bacterial Meningitis Treatment and its Associated Risk Factors among the Children of Nawabshah, Pakistan

Sikander Ali Sial, Awais Bashir Larik, Anwar Ali Jamali, Laxmi Kajal, Dileep Kumar, Qurat-Ul -Ain, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 205-210
DOI: 10.9734/jpri/2021/v33i33A31787

Background: Meningitis happens all the more ordinarily during the main month of life than during some other ensuing period and it is related with high horribleness and mortality.

Objective: The objective of this study is to assess the outcomes of meningitis treatment and its associated risk factors among the children.

Methodology: A cross-sectional retrospective study was conducted on 400 children, sample size was calculated by using Slovin’s Formula “n=N÷(1+Ne2)” at 0.05 margin of error and by using convenience sampling. Patients who were diagnosed with bacterial meningitis aged from 0 to 18 years were included in the study. Data was collected by well-structured questionnaire. SPSS version 23.0 was used to analyze the data. Multivariate logistic and Bivariate regression analyses was performed to analyze the data. P value 0.05 was considered as statistical significant. Results: 262 (65.5%) males were reported and females were 138 (34.5%). Sepsis was found in 24 (6%) patients due to meningitis. Outcomes of the treatment of meningitis patients were found good among 308 (77%) patients.

Conclusion: It was concluded that adjustments of starting anti-toxin routine, level of obviousness at hospitalization and season of show to the medical care office from indication beginning altogether affected therapy results of intense bacterial meningitis in youngsters.

Open Access Original Research Article

Role of Panretinal Photocoagulation in Improvement of Visual Acuity of Patients with Proliferative Diabetic Retinopathy

Shabeer Ahmed Bhutto, Zakaullah Gopang, Safder Ali Abbasi, Naeem Akhtar Katpar, Muhammad Yusuf Depar, Vijay Nagdev

Journal of Pharmaceutical Research International, Page 211-217
DOI: 10.9734/jpri/2021/v33i33A31788

Objective: To determine the improvement of visual acuity in patients having proliferative diabetic retinopathy undergoing panretinal photocoagulation therapy.

Study design: This is a descriptive case series study.

Setting: Study carried out at Ophthalmology Department, ShaheedMohtarma Benazir Bhutto Medical University Larkana, from 01-10-2019 to 31-03-2020 (06 months).

Materials and methods: We selected patient with proliferative diabetic retinopathy from the retina clinic after taking a careful history and clinical examination including visual acuity anterior and posterior segment examination and then patient selected for panretinal coagulation with the  help of frequency-doubled Nd: YAG laser in three or four sittings.

Results: The total of 158 eyes of 110 patients with proliferative diabetic retinopathy were included in this study out of which improvement of visual acuity was found in 38 (24%) eyes and 120 (76%) eyes have no improvement or same vision.

Conclusion: Proliferative Diabetic Retinopathy (PDR) can successfully be treated with panretinal coagulation with the help of frequency doubled Nd: YAG laser therapy.

Open Access Review Article

Association between Dietary Pattern and Insulin Resistance

Manal Murad, Abdullah Al Alhareth, Mohammed Alnassir, Haifa Alkheledan, Arafah Alsayed, Sarah Nayyaz, Ibrahim Almansour, Shaya AlOtaibi, Abdulilah Alqarny, Majed Alotayfi, Abdullah Alsunidy

Journal of Pharmaceutical Research International, Page 39-45
DOI: 10.9734/jpri/2021/v33i33A31769

The current evidence supports the fact that obesity is directly involved in a significant correlation with insulin resistance and type 2 diabetes mellitus (T2DM). Many studies have been published to report the role of many micronutrients, including carbohydrate, lipids and proteins which enhance or worsen the sensitivity of insulin. Thus, this literature review aims to assess the potential association between the different dietary components and insulin resistance based on the findings from the current studies in the literature. It has been suggested that replacing the consumption of fructose with other carbohydrates substances as fibers and starch might reduce such events and enhance insulin sensitivity as these substances pass intact through the gastrointestinal tract to the colon where they begin to be fermented. Additionally, carbohydrates substances reduce the utilization of free fatty acids by enhancing G-coupling through inhibition of the hormone-sensitive lipase, while the effect of overconsumption of glucose and fructose on insulin resistance is still controversial. Moreover, the quality of lipids is far more important than the quantity. Therefore, frequent ingestion of vegetable oils is suggested to enhance the sensitivity. As for proteins, high protein diets have been proposed for their useful effects. However, they should be carefully described to avoid their potential adverse events.

Open Access Review Article

Dry Cupping Therapy: A Way Forward in the Management of Primary Dysmenorrhoea

Huda Nafees, Arshi Anjum

Journal of Pharmaceutical Research International, Page 46-52
DOI: 10.9734/jpri/2021/v33i33A31770

Dysmenorrhea is a common gynaecological problem in women of reproductive age; in general, it begins with the first ovulation cycle and occurs about two years after menarche and most of the severe episodes occurs before 25 years of age. Primary dysmenorrhoea (Usre Tams Tashannuji) is one of the most common gynaecologic disorders, refers to painful menstruation. In classical Unani texts dysmenorrhoea is defined under topics like Ehtebas-e-tams and Waja-u-zahar and aujae rehm. Hijama (dry cupping) over the umbilicus removes the blood and fluid from the site of inflammation to give relief from the menstrual pain. It also diminishes swellings.

Open Access Review Article

Astrocytes and their Phenomenal Possibilities in the Treatment of Various Neurodegenerative Disorders: An Overview

Alina Yuryevna Maslova, Kheda Lechaevna Bazaeva, Zaira Arazovna Abdullaeva, Shuainat Omarovna Khazamova, Karina Akhmedovna Zeusheva, Tatiana Alekseevna Grechkina, Evgeniya Nikolaevna Semkina, Maksim Alekseevich Abramov, Artem Evgenevich Mishvelov, Sergey Nikolaevich Povetkin

Journal of Pharmaceutical Research International, Page 60-68
DOI: 10.9734/jpri/2021/v33i33A31772

At present, research in the field of the brain does not cease to surprise us with new facts and discoveries that no one could have suspected about 30 years ago. But it was at the time when it became clear that the cerebral neurons are not the only cells that can respond to changes in the external environment. A real scientific boom began to study a heterogeneous group called glia. And scientists are paying close attention to the largest of them – astrocytes. Understanding the importance of astrocytes in the mechanisms of repair and damage to brain cells in various forms of CNS pathology determines the possibility of targeted search for drugs that affect the rate of development of reactive astrogliosis in response to various brain injuries. At the same time, pharmacological modulation of activated astrocytes and other components of glia can be an integral part of the therapy of neurological diseases.

Open Access Review Article

Effectiveness of Standard post-operative Care on Post-operative Outcome Evaluation among Women Undergone Lower Segment Cesarean Section in Selected Hospital: A Narrative Review

Prabha Kumari, Maharaj Singh, . Sunita

Journal of Pharmaceutical Research International, Page 81-90
DOI: 10.9734/jpri/2021/v33i33A31775

Background: Present study focuses on effectiveness of standard post-operative care on post-operative evaluation among women undergone lower segment cesarean section in selected hospitals. Standard post operative care basically stands for list of non-pharmacological or pharmacological measures, procedures and methods adopted by the investigator/care giver during post-operative period of women undergone lower segment cesarean section for the reduction of negative post-operative outcomes or complications and to fasten recovery. Present study encompasses articles on post-operative care in terms of one, two or more than two or three measures or interventions as post-operative care measures adapted to reduce post-operative complications like use of music therapy, foot-hand massage therapy, planned early ambulation, planned ambulation techniques etc. for post-operative complications and pain relief.

Objective: To identify various post-operative measures or care which can be included in standard post-operative care list and its effectiveness on post-operative outcome evaluation among women undergone Lower segment cesarean section in selected hospitals.

Methods: Articles were searched in Google scholar, Pub-med, Medline and research gate by using keywords post-operative care of cesarean section, post-operative outcomes of cesarean section and Cesarean mother.

Result: Review includes seven articles showing different non-pharmacological or pharmacological measures or techniques to overcome post-operative complications for early recovery and better outcomes. These measures can be included in standard post-operative care list for positive post-operative maternal and fetal outcomes. These measures include early planned ambulation, planned ambulation techniques, music therapy, Foot and hand massage therapy and use of certain analgesia for pain management in post cesarean women if needed, as per the patient’s condition.

Conclusion: Conclusion of the review revealed that there are various measures which can be standardized in post-operative outcome evaluation among women undergone lower segment cesarean section.

Open Access Review Article

Pharmaceutical Marketing Transformation due to COVID-19 Pandemic

Aseel Bin Sawad, Fatema Turkistani

Journal of Pharmaceutical Research International, Page 91-99
DOI: 10.9734/jpri/2021/v33i33A31776

Background: Since COVID-19 spreads from one person to others, it is necessary to stay away from others or reduce contact. This habit or practice is called social distancing. It encourages people to stay at their homes and to avoid crowded and/or public places.

Objective: To evaluate and discuss changes and shifts in the pharmaceutical marketing strategies due to COVID-19.

Methods: This is a narrative review articles and we use triangulation method to collect the related information from multiple electronic database. The results and findings of the selected articles were summarized and synthesized.

Results: As the number of COVID-19 infected people grows and the uncertainty of finding a cure continues, the people are becoming more apprehensive. Pharmaceutical companies made changes to their marketing strategies. From being too invested with in-person marketing, most companies are now exploring options that do not require as much physical interaction. Pharmaceutical companies have been reliant on telemarketing, digital marketing, and miscellaneous offers. This change is primarily driven by fear of being infected by the virus and self-preservation.

Conclusions: Based on the studies collected and reviewed in this paper, the changes appear to be successful especially with regard to digital marketing. This review provides an insight to marketing managers in the pharmaceutical industryto continue adjusting and modifying theirmarketing strategies due to COVID-19.Because this study focused on a specific sector (i.e., pharmaceutical)the results cannot be generalized and extended to other sectors.Future studies are needed to investigate the trends of changes and shifts of the pharmaceutical marketing strategies due to COVID-19.

Open Access Review Article

An Overview on the Biosynthetic Pathways and Medicinal Values of Secondary Metabolites

Ashwini V. Armarkar, Divyani S. Mahure, Anita R. Pounikar, Rani T. Bhagat, Dhanashri N. Nagare

Journal of Pharmaceutical Research International, Page 100-114
DOI: 10.9734/jpri/2021/v33i33A31777

Nature is a treasure hunt of novel molecules which are extensively used by humans for their medicinal values for millennia. Herbal medicines have emerged as life savers all over the world due to their multifunctional and diverse array of activities on the human body. Plants supply numerous bioactive molecules which are capable of treating disease conditions. Plants produce varieties of phytochemicals which are commonly recognized as primary and secondary metabolites. Secondary metabolites are inimitable resources for exploitation for pharmaceuticals, food additives e.t.c. They are often involved in the control of abiotic or biotic stress. They play distinctive roles in the defense mechanism of plants, act as insect repellant, regulate signaling pathways, and also exhibit varied range of pharmacological actions such as antibacterial, antioxidant, anticancer anti-diabetic and others. Secondary metabolites are derived from one or mixed pathways that give rise to formation of various compounds i.e., alkaloids, volatile oils, tannins, glycosides and resins etc. which have great importance in modern medicine. Isopentenyl diphosphate and Shikimic acid pathway serve as primary precursors for the synthesis some of types of secondary metabolites. The present review deals with the brief introduction, significance of secondary metabolites in the plants, biosynthetic pathways, and therapeutic importance of some commonly known secondary metabolites.

Open Access Review Article

Modification in the Oncology Field during COVID-19 Pandemic

Fatema Turkistani, Aseel Bin Sawad

Journal of Pharmaceutical Research International, Page 141-150
DOI: 10.9734/jpri/2021/v33i33A31781

Background: COVID-19 outbreak impacted all healthcare specializations including the oncology field.

Objective: To discuss in detail the varied effects of COVID-19 on the oncology field.

Methods: For this narrative review, the researchers relied only on accredited and peer-reviewed resources. As such, the references of this paper were mostly taken from Google Scholar and online repositories, such as PubMed, which hosts the National Center for Biotechnology Information (NCBI), Science Direct, JSTOR, and The Lancet.

Results: COVID-19 and the necessity of physical distancing have significantly changed the practice in the oncology field. The use of telehealth is widely adopted, physicians are recommended to consider other forms of treatment, and decisions on immediate cancer treatment depend on the level of risk of progression with cancer care delay. Cancer treatment delay is causing the highest mortality rate for patients who are suffering from cancer of the bladder, lungs, ovary, stomach, and esophagus. COVID-19 has shifted the focus of healthcare professionals away from other life-threatening diseases, like cancer. In the United Kingdom, it has been projected that there is at least a 20% increase in the expected cancer-related mortality rate. This is due to abrupt changes in diagnosing and treating cancer patients, physical distancing protocols, economic downfall, as well as the public's behavior in opting for medical assistance.

Conclusion: With the spread of COVID-19, the situation has become more difficult for cancer patients. The mortality rate for cancer patients has worsened during COVID-19. Health professionals working in the oncology field are also devastated by COVID-19.

Open Access Review Article

Role of Hypouricemic Agents in Tumor Lysis Syndrome: A Meta-Analysis

Waleed Alshehri, Abdulrahman Aljohani, Reem Alhasani, Anood Alshammari, Jwael A. Alhamoud, Atheer Alruwaili, Omniah Altemani, Ali Bahabri, Hassan Alahmadi, Shaykhah Alderaan, Afnan Almutairi, Marwan Alsehli, Mohammed Almohammadi, Faisal Almaleki, Hamoud Alotaibi

Journal of Pharmaceutical Research International, Page 183-196
DOI: 10.9734/jpri/2021/v33i33A31785

Objective and background: Tumor lysis syndrome (TLS) is a life-threatening emergency and demands emergency care of effective outcome with minimal or no side effects. The Hypouricemic agents, including Rasburicase, Allopurinol and Febuxostate used for the management of TLS. This study was designed to evaluate the Role of Hypouricemic agents by analyzing TLS development rate, control of uric acid, and Creatinine levels.

Methods: An extensive electronic data search was conducted by using all leading scientific databases. Twenty-six studies were selected to conduct this study, as per the inclusion criteria.

Results: The Odd ratio of TLS development rate was 4.06, 1.24, and 1.49 by Rusbricase, Allopurinol & Febuxostate administration respectively. 95% confidence interval was reported by selected studies against TLS development rate, Uric acid, and Creatinine levels by administrating Rusbricase, Allopurinol & Febuxostate.

Conclusion: All Hypouricemic agents, including Rasburicase, Allopurinol and Febuxostate, are effective to manage Tumor lysis Syndrome. However, a suitable and most effective intervention dose needs to identify with better efficacy and minimal side effects both in Adults and Children.