Open Access Case Report

Ayurvedic Management of Chronic Pancreatitis in Adolescent Girl: A Case Report

Gaurav Sawarkar, Punam Sawarkar

Journal of Pharmaceutical Research International, Page 58-67
DOI: 10.9734/jpri/2021/v33i33B31797

Background- Chronic pancreatitis is the primary life-threatening nutritional & metabolic condition of gastrointestinal system that becomes a significant threat to the children's growth and induces educational loss due to recurrent hospitalization. Its mortality rate in childhood is up to  10 %. Malnutrition is one of the primary causes of pancreatitis in children. Modern science provides various types of medical and surgical therapies for Chronic pancreatitis, but it is realized that more research is needed for its management satisfactorily.

Aim - To study the efficacy of Ayurvedic management of chronic pancreatitis induced due to Malnutrition in an adolescent girl.

Material & Methods- It is a single case study of 12 years old teenage girl who was presented herself predominantly with pain in the epi-gastric region (recurrent attacks-especially after intake of the fatty or heavy meal), tenderness in the epi-gastric area, loss of appetite, fever on and off, general malaise, loss of weight, constipation (intermittent), anxious & uncomfortable mental irritation since one & half month. After taking conservative treatment from modern science for one & a half months, she did not get satisfactory relief & therefore; she was advised to under ERCP. However, the patient & her relative was not willing to undergo the same, that’s they approached Panchakarma OPD. After examination, she was advised for Shodhana(Panchtikta & Guduchyadi Niruha Vasti)  & Shaman Chikitsa(Amruttotara  Kashayam, Arogyavardhini Vati, Kumariasava; Dhanvantara Kashayam, Avipattikar Churna), Panchatikta Ghrita with Vasant Kusumakar Rasa- 10tab+Guduchi Satva- 20gm + Shatavari Churna- 15gm+ Ashwagandha Choorna-15 gm with honey.

Observation & Results- After 16 months of regular treatment, the patient has become entirely symptom-free & to date, there was no need for hospitalization. There was no educational loss due to ill-health.

Discussion:-Utilizing the basic concepts of Ayurveda(Nidanpanchaka), Jirna Jwarahara, Yakrutottejak, Pramehaghna, or pancreatic-protective, Mrudu Virechak, Bruhana (Shamana & Bruhana Snehapana), Rasayana Chikitsa was planned in this case which showed the promising result.

Conclusion- Ayurvedic management with Shodhana & Shamana Chikitsa based on the fundamentals of Ayurveda is effective in Chronic pancreatitis induced due to Malnutrition in children, which may become a ray of hope for pediatric patients.

Open Access Case Report

Impact of Physical Therapy on a Patient with Bell’s Palsy: A Case Report

Nikita S. Deshmukh, Vaidehi V. Kannao, Pratik Phansopkar, Om C. Wadhokar

Journal of Pharmaceutical Research International, Page 97-102
DOI: 10.9734/jpri/2021/v33i33B31800

Affecting the seventh cranial nerve, known as Bell's palsy and its neuropathy.  It is a disfiguring disorder with significant impact on patient’s physical mental and social health. It is normally caused by inflammation caused by traumatic, infectious, inflammatory or compressive conditions, and cranial nerve edema may lead to compression and eventual ischemia. In comparison with the central cause peripheral cause leads to more serious form of Bell’s palsy. The symptoms usually include reduced production of tears, altered taste, facial pain, otalgia and aural pressure. the recovery is usually complete while in some cases incomplete recovery is seen. For treating Bell’s palsy a multidisciplinary approach is required to completely return back to normal. A case of female patient whose age 43 year old came to the right hemifacial palsy department has been identified. There was a affected movement of right side eyebrows and affected right forehead movement during clinical evaluation, spontaneously opening and closing of the right eye, difficulty to close the right eye. No conclusive etiology could be traced out after a series of investigations, hence diagnosed as right side Bell’s palsy. We address the clinical characteristics and modalities of care for Bell’s palsy in this article. Education, facial muscle strengthening exercise, eye defense exercises, modalities and acupuncture were included in the physiotherapy intervention.

Open Access Case Report

Rehabilitation in Duchenne Muscular Dystrophy: A Case Report

Ruchika Zade, Gunjan shende, Priyanka Sahu, Tejaswini Fating, Shruti Deshpande, Pratik Phansopkar

Journal of Pharmaceutical Research International, Page 114-120
DOI: 10.9734/jpri/2021/v33i33B31802

Background: Duchenne muscular dystrophy (DMD) seems to be the most common X-linked muscular dystrophy condition in children marked by proximal muscle weakness and calf hypertrophy and affected mostly in boys. In more than 20 muscular dystrophies                                            the most prevalent form is Duchenne muscular dystrophy. Each 1/3500 male births,                                      the presence of DMD worldwide, indicating that in the UK alone there are approximately 2400 people living with DMD. Assessing improvements in severity, range of motion and                              functional mobility, implementation of therapies and guidance on positioning are important key factors.

Clinical Finding: Mostly in proximal muscles around the hips and shoulders, which are those around the trunk of the body, muscle weakness occurs mainly. In the lower extremities, weakness usually begins proximally, and then passes distally. Symptoms typically begin about the age of 1-3 years. To see the child run and get up off the floor while searching for signs of DMD is necessary.

Diagnosis: A very common physical finding in boys with Duchenne's is Gower's Sign. In order to get up, it requires using their hands to 'climb' their legs. It is because of a weakness in the boy's hip muscles, which was seen in this patient in progressive in nature. The proper examination and evaluation the symptoms the child presented to the physiotherapy clinic played an important in reaching to the diagnosis of the condition.

Conclusion: Prevent the child from developing contracture, correct posture of the child and maintain quality of life these are important criteria in for the child suffered from Duchenne muscular dystrophy.

Open Access Case Report

Role of Snigdha Virechana with Chinchalavan Taila in the Management of Malavastambha: A Case Report

Gaurav Sawarkar, Punam Sawarkar

Journal of Pharmaceutical Research International, Page 132-139
DOI: 10.9734/jpri/2021/v33i33B31804

Background: Malavastambha (Constipation) is defined as the infrequent and difficult passage of stool. The main features of Constipation are infrequent or hard stool, abdominal pain, bloating, and feeling of unsatisfactory bowel evacuation. Contemporary laxatives, which are generally used in Constipation, become habitual after some duration and only symptomatic relief. Moreover, these medicines never alter the pathogenesis of the disease.  So, it is a need of hour to search effective, safe & alternative   formulations in Ayurveda, which can completely break the pathogenesis of Constipation. As per Ayurveda,  Vata Dosha is the main factor involved in this condition. Therefore, the prime treatment principle recommended by Ancient Acharyas is to pacify Vata by using Vatahara herbs medicated with Snigdha Dravya, Amla, and Lavana Varga. The Chincha Lavana Taila is one such combination that possesses the above principle & so; it can be effective in Malavastambha.

Aim: This case study is primarily carried out to study the role of oral administration of Chincha  Lavana Taila in Malavashtambha  

Objectives: To evaluate the efficacy of oral consumption of Chincha Lavana Taila in Malavastambha

Methods: A single case study. A 50 years old male patient approached Panchakarma O.P.D. with Malavsthambha for one year; he was advised to intake 15ml Chincha Lavana Taila orally at bedtime lukewarm water for consecutive 15 days. 

Observation and Results: The patient got 100% relief in his all chief & associated complaints and had regular and satisfactory bowel habits after 15 days. 

Conclusion: Chincha Lavana Taila is one of the best effective oral medicine for Constipation.

Open Access Case Report

Post-operative Physiotherapeutic Rehabilitation in a Rare Case of Avulsion Fracture of Tibial Attachment of Posterior Cruciate Ligament: A Case Report

Yukta J. Budhwani, Pratik Phansopkar, Om C. Wadhokar, Neha Chitale

Journal of Pharmaceutical Research International, Page 154-160
DOI: 10.9734/jpri/2021/v33i33B31806

Avulsion fractures of tibial attachment of PCL are not observed very often. PCL injuries are uncommon; especially those involving tibial aspect/fragment are rare. On the basis of the site of damage: Hyperflexion, Hyperextension, Pretibial trauma, etc. are the considered causes of injury. Injury to the PCL results changes in the kinematics of the knee. Changes in contact pressure have been demonstrated in both the patellofemoral and the medial tibiofemoral compartments after sectioning of the PCL, with significant increase in joint forces. This alteration in the normal kinematics may explain the tendency for the development of degenerative changes in the above mentioned compartments after PCL injury. Physiotherapy plays a very vital role in the treatment and management of such cases. Here, we report a case of a 25year old young man who was admitted to Acharya Vinobha Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS), Deemed to be University (DU), with an alleged history of slip and fall from two-wheeler due to RTA sustaining injury to the right limb, particularly on the knee and further complained of pain & swelling over the knee along with difficulty in walking. On examination and investigation it was diagnosed as the case of avulsion fracture of tibial attachment of PCL. And so was operated and treated with open reduction and internal fixation (ORIF). Thereafter, was referred to the Physiotherapy Department for further rehabilitation. The purpose of this study is to: Discuss the epidemiology& Operative method. Discuss the physiotherapeutic management and rehabilitation of PCL tears and their outcomes.

Open Access Case Report

Role of Argwadha Nitya Virechana in Madhumeha (Diabetes Mellitus-II): A Case Study

Shilpa Bhaskarrao Deshpande, Shweta Parwe, Milind Nisargandha

Journal of Pharmaceutical Research International, Page 170-176
DOI: 10.9734/jpri/2021/v33i33B31808

Diabetes Mellitus is now considered a pandemic. Especially in India, the number of patients increased at 14% prediabetic, becoming the capital of Diabetes. It is a clinical syndrome which is characterize by an increased level of blood sugar. In Ayurveda, the ṁadhumeha is explained as a type of prameha. The kinds of madhumeha is of two. One is dhatukshaya, and other is avaranjanya. The avaranjanya type of Madhumeha is allowed to be treated with the shodhana process. In which vamana and virechana are effective.

Objective: The objective of this study was to study the efficacy of Nitya Virechana in the management of madhumeha.

Case report: A single case study of a 59 yrs old male patient who was already diagnosed with madhumeha before 21 days. Symptoms such as pippasa, shramdaurbalya, Bahumutrata were present; after investigation, he was advised for Nitya Virechana.

Result: Symptomatic assessment of the patient was carried out after treatment i.e. after Nitya Virechana and outcome was satisfactory, and the quality of life of patient was significantly improved.

Conclusion: Nitya Virechana brought about good relief in symptoms in patients with Madhumeha and controlling the blood sugar level.

Open Access Case Study

A Case Study on Management of Tinea Cruris with Classical Vaman Karma

Sourabh G. Deshmukh, Trupti Thakre, Jaya Gupta, Rohit Waskar

Journal of Pharmaceutical Research International, Page 195-202
DOI: 10.9734/jpri/2021/v33i33B31811

Tinea Cruris is the disease of fungal infection of groin by dermatophyte fungi. It is commonly seen in men, and also called as Jock Itch as the other name. It is the condition which shows characteristics of disease as erythema, itching, burning sensation, cracked skin, skin rashes which worsen by exercise, skin discoloration and important symptom like rashes does not clears but increases due to antifungal creams. The management of the condition can be done in Ayurvedic perspective. According to Ayurveda all the classified disease of skin are considered as in Kushta Roga (skin disease), where the conditions of fungal infections are correlated with the Dadru Kshudra Kushta (Tinea). Due the clinical features of itch, redness, circular patches. The disease having exaggerated state of Pitta and Kapha Dosha, moreover Kapha. The treatment principle in such conditions is Shodhan Purificaton therapy along with Shaman (Pacificatory) therapy, as both therapies are considered best in Kushta Roga according to Acharyas. This case report is of the female patient suffered from itching over left thigh region along with redness, pimples, and round patches since 3 months, the patient finds the relief after following the Ayurvedic treatment as Shodhan Karma and Shaman Karma with lifestyle changes. The symptoms were diminished by Vaman Karma (emesis). She got 80-90% relief after Shodhan Karma as if one can consider the best treatment for tinea cruris.

Open Access Original Research Article

Study of the Association between Serum Ferritin Levels and HbA1c in Patient with Type 2 Diabetes Mellitus in Jordanian Population Sample

Saad AL-Fawaeir, Haytham M. Daradka, Ali Ahmad Abu Siyam

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i33B31791

Background/ aim: The most common endocrine disorder in the world is type 2 DM, affecting 85-90% of all people with diabetes. Several studies have found an association between serum ferritin levels and HbA1c, so the current study was undertaken to examine the association between serum ferritin levels and HbA1c in Jordanian patient’s sample with type 2 DM.

Method:  120 patients with type 2 DM were enrolled into the current study, and control group consist of 20 healthy individuals, blood samples were collected after 14 h of fasting, 5 ml of fasting sample for FBS and ferritin, 4 ml whole blood taken in EDTA tube for Hb and HbA1c, sample centrifuged and biochemical tests were done in the same day.

Results: The mean of serum ferittin was significantly higher in patients group (213.87±114.23 ng/ml) than control group (98.34±18.45 ng/ml, P < 0.05). There was a positive association between serum ferritin and HbA1c (P < 0.05). Also there was a significant correlation between serum ferritin and FBS P < 0.05. Among the two groups there was no significant difference regarding demographic features (sex, age and BMI).

Conclusion: collected data showed that there is a significantly association between ferittin and type 2 DM, it was higher in comparison with healthy group, so it can give an indication of glycemic  control in diabetic patients.

Open Access Original Research Article

Antiplatelet Agents Utilization Pattern and Assessment of Patient Specific Drug use Problems among Cardiac Patient

Rajesh Hadia, Priyanshi Shah, Johncy Mariam John, Rutvi Patel, Kushal kumar Gohel, Cinosh Mathew, Trupal Rathod, Dhaval Joshi, Rajesh Maheshwari

Journal of Pharmaceutical Research International, Page 6-12
DOI: 10.9734/jpri/2021/v33i33B31792

Background: Antiplatelet agents reduce the occurrence of the cardiovascular issue in people with established cardiovascular disease.

Objective: To understand the pattern of Antiplatelet drug utilization among cardiovascular disease patients. To evaluate the prevalence of polypharmacy and responsible factors like age, gender, co-morbid condition, and patient-related drug use problems.

Methodology: A cross-sectional observational study. Patients with cardiovascular disease above 18 years of age were prescribed antiplatelet agents from the department of cardiology and ICCU were enrolled in the study.

Result: A total of 150 patients were enrolled of which male 79% (N=119) and female 21% (N=31). Most patients belong to 51-60 years of age groups. The patients diagnosed with IWMI (inferior wall myocardial infarction) 43.3% (N=65) have highly prescribed antiplatelet agents. Smoking 54.7% (N=82) followed by Alcohol 26.7% (N=40) found to be the most dominant risk factors.60.7% (N=91) patients had no comorbidity followed by 31.3% (N=47) had a comorbid cardiac condition. Most prescribed antiplatelet agents were monotherapy of Aspirin 28.8% (N=43), Clopidogrel 16.7% (N=25), and combination therapy of both 51.2% (N=82).

Conclusion: The study concluded that increases in the number of co-morbidities can significantly increase the Utilization of drugs which can further lead to drug use problems. The clinical pharmacist can help to alleviate the problems of polypharmacy and its consequence.

Open Access Original Research Article

Assessment of Gene Polymorphism in GABAA1 Receptor among Sudanese Patients with Juvenile Myoclonic Epilepsy (JME)

Sami F. Abdalla, Hanan B. Eltahir, Salah M. El-Magzoub

Journal of Pharmaceutical Research International, Page 13-19
DOI: 10.9734/jpri/2021/v33i33B31793

Introduction: Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epilepsy syndrome (IGE) with a strong genetic contribution. The main characters of JME are generalized convulsive or an absences seizures proceeded by myoclonic jerks. Gene variant of gamma-aminobutyric acid type A inhibitory receptor speculated to underlay JME etiology.

Objective: This study aimed to screen for JME based on the International League against Epilepsy Commission on Classification and Terminology diagnostic criteria and to assess the link of polymorphism in the GABAA receptor gene, GABRA1 to the development of JME in Sudanese patients.

Methods: Our epidemiological study enrolled 44 JME patients, only 23 participated in the genetic part and 35 matched healthy controls were also included. Blood genomic DNA was isolated and PCR based- restriction fragment length polymorphism (RFLP) analysis was done. The data obtained were analyzed using computer software SPSS 21rt edition.

Results: The frequency of the mutant G allele was found to be 41.5% in patients and 45.5% in the controls. The genotype distribution of A and G alleles among patients were found to be (AA= 39%), (AG=39%) and (GG= 22%) and that of the controls were (AA=40%), (AG=30%) and (GG= 30%).

Conclusion: The mutant G allele of the GABAA1 receptor does not affect the development of JME in Sudanese patients but the AG genotype may be a risk factor.

Open Access Original Research Article

The Correlation between Gene Expression and DNA Methylation Levels of RAS p21 Protein Activator 3 (RASA3) Gene in Saudi Autistic Children

Aisha Alrofaidi, Rawan Saeed Alghamdi, Mona Alharbi, Khloud Algothmi, Reem Farsi, Najla Alburae, Magdah Ganash, Fatemah Basingab, Sheren Azhari, Heba Alkhatabi, Aisha Elaimi, Manal Shaabad, Ashraf Dallol, Amany Alqosaibi, Mohammed Jan, Hesham Aldhalaan, Safiah Alhazmi

Journal of Pharmaceutical Research International, Page 20-26
DOI: 10.9734/jpri/2021/v33i33B31794

The potential role of DNA methylation pattern in autism has been provided by revealing the differences in methylation level of multiple genes which are significantly associated with their expression and implicated in ASD pathogenesis. RASA3 is a member of GTPase-activating proteins, RASA3 is highly expressed in brain tissues and can be deregulated by different epigenetic mechanisms. Many studies reported that differentially expressed RASA3 is correlated with its aberrant methylation. Accordingly, this has been suggested that deferentially expression of RASA3 may be correlated with its methylation levels which could play a role in ASD which brought our attention to identify differentially-expressed genes that could be associated with their methylation level of ASD in Saudi population, by performing comparative gene expression of RASA3 then investigate its relation to methylation level.

This study was conducted on 18 Saudi autistic children as well as their healthy-control siblings. Relative expression of a candidate gene (RASA3) was measured using RT-qPCR. Furthermore, MethyLight assay was performed to estimate methylation level and evaluate its impact on RASA3 expression. Interestingly, RASA3 expression has found to be dysregulated in ASD cases. In contrast, MethyLight assay result showed no differences in the methylation patterns among ASD cases in the candidate region. However, it remains an open question whether these dysregulations of RASA3 expression could be a biomarker for early screening/detection of some cases which may also suggest a role for RasGAPs in autistic brain function.

Open Access Original Research Article

Study to Determine the Efficacy of Illizarov Fixator for the Treatment of Complex Tibial Plateau Fractures

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

Journal of Pharmaceutical Research International, Page 27-32
DOI: 10.9734/jpri/2021/v33i33B31795

Aim: To evaluate the results of illizarov external fixation using ligamentotaxis technique in high-energy plateau fractures of the tibia.

Methodology: The external fixation of illizarov external fixation using ligamentotaxis was performed in 32 patients aged 18-50 years due to high-energy plateau fractures of the tibia. 18 on the right knee and 14 on the left knee. 28had closed wound and four had open wound fractures. According to the classification of Schatzker’s; classification was carried out for fractures. After two years (range 12 to 24 months) of follow-up, each affected knee was assessed using the Knee Society Score (KSS).

Results: There were 24Schatzker type VI and eight type V fractures of the tibia. Complications included deep infection in two cases, one patient had pin tract infection, deep vein thrombosis in two patients and one had fusional defect. The knee motionmean range was 120 degrees of flexion and six degrees of deficiency in extension. According to the KSS criteria, the outcomes were excellent in 22 patients (68.75%), 4 patients (12.5%)have good results, moderate in 5 patients (15.65%) and weak in 1 patient (3.12%).

Conclusion: Ilizarov External fixation gives good anatomicalreduction of joint surface, earlypainfreewt bear, stable fixation and maintain soft tissue envelope without major complications.

Open Access Original Research Article

Comparative Study between Saffron (Crocus sativus L.) and / or Turmeric (Curcuma longa L.) Extracts on D-galactose Deleterious Brain Effects in Rats

Fatma Hussien Ahmed, Kout Elkoloub Baker, Alyae M. S. Gabal

Journal of Pharmaceutical Research International, Page 33-57
DOI: 10.9734/jpri/2021/v33i33B31796

Aims: This study was designed to investigate the active chemical constituents and antioxidant capacities of saffron stigmas and turmeric rhizomes ethanolic extracts (ESE and ETE) respectively. D- galactose deleterious brain effects as well as the role of ESE and ETE supplementation against D-galactose intoxication were evaluated on male rat’s brain.

Place of study: Biochemistry and Nutrition Department, Faculty of Women for Arts, Science and Education, Ain Shams University.

Methodology: Fifty adult male Sprague-Dawley rats were divided into 5 groups; 10 rats each. Group (1): Healthy control; group (2): D-galactose control; rats were intoxicated with D-galactose (250mg/kg body weight /day/subcutaneously); group (3-5): D-galactose intoxicated rats and supplemented with (30mg /kg body weight /daily orally) of ESE, ETE and (15mg /kg body weight /daily orally) from each extract respectively for six weeks.

Results: Research results revealed that saffron and turmeric ethanolic extracts contain active chemical constituents including polyphenols and flavonoids that possess high antioxidant activity. Biochemical analysis of brain tissues documented that injection with D-galactose caused significant increase (p≤0.05) in oxidative stress parameters including [advanced glycation end products (AGEs), protein carbonyl group (PCG), malondialdehyde (MDA) and nitric oxide (NO) Levels], pro-inflammatory markers like [tumor necrosis factor alpha (TNF-α) and interleukin -6 (IL-6) levels] , epigenetic marker [p16INK4a content] as well as neural cell markers [metallothoenins (MTs) and serotonin (5-HT) levels].On the other hand D-galactose intoxication caused significant decrease (p≤0.05) in brain antioxidants as [total antioxidant capacity (TAC), reduced glutathione (GSH) level and catalase (CAT) activity] as well as brain acetylcholinesterase (AChE) activity. All these results were proved by the microscopic examination and apoptotic markers immunohistochemical analysis of brain tissues that revealed degenerative changes in cerebral cortex and hippocampus. Oral administration of saffron and turmeric ethanolic extracts alone or in combination decreased brain oxidants, pro-inflammatory markers, epigenetic marker and neural cell markers levels while increased the levels and activities of antioxidants as well as AChE activity associated with an improvement of brain microscopic examination and immunohistochemical analysis. The most significant improvements (p≤0.05) were recorded in the group that supplemented with both extracts.

Conclusion: Study results proved that saffron and turmeric ethanolic extracts active components were able to correct deleterious brain effects induced by D-galactose and using their mixture was more efficient in ameliorating brain toxicity than using each extract alone evidenced by biochemical analysis, microscopic examination as well as immunohistochemical determination of apoptotic markers in bmrain tissues. It is advised to add saffron and turmeric to human foods and to prepare their ethanolic extracts to be available for human beings due to their ability to preserve brain functions and structure as well as their potential to inhibit and retard brain aging and neuro-degeneration.

Open Access Original Research Article

Antinociceptive and Anti-Inflammatory Activities of Ethanolic Stem Bark Extract of Smilax zeylanica Linn. in Wistar Rats

Rasheed Ahemad Shaik, Fazil Ahmad, Mohammed Abdul Aleem

Journal of Pharmaceutical Research International, Page 103-113
DOI: 10.9734/jpri/2021/v33i33B31801

Background: Smilax zeylanica Linn (Smilaceae) is a woody climbing shrub native to Asia's tropical and subtropical highlands. Traditionally, this plant has been widely used to cure a variety of ailments. Smilax zeylanica stem bark was extracted with ethanol to test its antinociceptive and anti-inflammatory properties.

Objective: To study the antinociceptive and anti-inflammatory activities of ethanolic stem bark extract of Smilax zeylanica Linn. in Wistar rats.

Methods: The antinociceptive activity has been assessed in mice by formalin-induced paw licking, Eddy’s hot-plate, and acetic-acid induced abdominal stretching models. Carrageenan-induced paw oedema in rats has been conducted to explore the anti-inflammatory activity. Tween 80 (10ml/kg, p.o) was given to the control group, test drug group received ethanol extract of Smilax zeylanica (EESZ) orally at doses of 200 and 400 mg/kg, and standard drugs morphine (5 mg/kg, s.c), diclofenac sodium (10 mg/kg, i.p) were injected to the standard drug group.

Results: Oral administration of ethanolic extract of Smilax zeylanica (EESZ) at test doses (200 and 400 mg/kg), produced a significant decrease of the paw licking time for 2 phases (neurogenic and inflammatory) in the formalin test, upsurge of the reaction time in Eddy’s hot plate test, and significantly decreased the abdominal stretching in the acetic acid-induced  writhes test. Ethanol extract of Smilax zeylanica significantly decreased the carrageenan-induced paw oedema.

Conclusion: The ethanol extract of Smilax zeylanica possesses antinociceptive, anti-inflammatory activity, probably involving central and peripheral pathways

Open Access Original Research Article

Antiparkinsonian Activity of Aqueous Extract of Agaricus Blazei Murill in Rotenone-induced Parkinson’s Disease

Muhammad Aslam, Hammad Ahmed, Tayyaba Mumtaz, Gahzal Hakani

Journal of Pharmaceutical Research International, Page 121-131
DOI: 10.9734/jpri/2021/v33i33B31803

Background: Parkinsons disease is a chronic neurological disorder which may be due to reduction in the dopaminergic neurons in the brain. However, Agaricus blazei is a rich source of natural antioxidants.

Aim: In this study, antiparkinsonian activity of Agaricus blazei Murill was evaluated using different animal models.

Method: Antiparkinsonian activity was evaluated using two different doses (273 mg/kg and 819 mg/kg) of Agaricus blazei Murill. Rotenone and sunflower oil were used as positive and negative control, respectively. Catalepsy test, rotarod test, exploratory behavior test (rearing) and locomotor activity test were conducted to observe antiparkinsonian activity of the drug in rats.

Result: The results of the animal models were confirmed by determining the levels of reduced glutathione, total protein, thiobarbituric acid reactive substances (TBARS) and nitric oxide in the animal brain. Pretreatment with Agaricus blazei Murill, showed marked reduction in rotenone-induced catalepsy and a significant increase in exploratory behavior, muscular activity, and locomotor activity in rats. Agaricus blazei Murill has also shown extremely significant effect in decreasing the oxidative stress in the animal brain by increasing the brain levels of reduced GSH and total proteins and decreasing the levels of nitrite and TBARS.

Conclusion: The results of rotenone-induced catalepsy, exploratory behavior, rotarod test and locomotor activity showed that Agaricus blazei Murill exerts a significant ameliorative effect on Parkinson’s disease in rats.

Open Access Original Research Article

Comparative Study of Native or Nano Quercetin on Epigenetic Modification and Nephropathy Biomarkers Post Challenges in Diabetic Hamsters

Soha Shebel Nassar, Mona Ahmed Sadek, Huda Mohamed Ismail, Gehan Salah El-Din Moram

Journal of Pharmaceutical Research International, Page 140-153
DOI: 10.9734/jpri/2021/v33i33B31805

Aims: The aim of this study is to examine the regulatory effects of quercetin nanoparticles (QNPs) compared with native quercetin either with or without metformin against the abnormal molecular and biochemical pathways that eventually culminate in the pathologic condition clinically known as diabetic nephropathy (DN) in hamsters

Methodology: After synthesis and characterization of the QNPs, seventy male adult hamsters are divided as following; G1:healthy control, G2:untreated DN hamsters, G3:DN+metformin G4:DN+native quercetin, G5:DN+QNPs, G6:DN+native quercetin+ metformin and G7: DN + QNPs + metformin.

Results: Our results illustrated that the effect of QNPs + metformin is the most effective in IRS-1 and GLUT-4 gene expression that correlated with inhibition of HDACs which in turn improved diabetic and nephropathy biomarkers, this effectiveness followed by G6 then   G3 and finally G4 after G5. These results were confirmed by immunohistochemical  examinations. Levels of antioxidant and inflammatory biomarkers also reflected the protective effect of our treatments.

Conclusion: All tested treatments significantly exhibit renal improvement.

Open Access Original Research Article

Analysis of Predictors of 30-Day Mortality for Patients Undergoing Surgical Repair of Post-Myocardial Infarction Ventricular Septal Defect

Yelizaveta Lebedieva, Chacón-Lozsán Francisco, Ramil Aliyev, Mykhailo Grusha

Journal of Pharmaceutical Research International, Page 161-169
DOI: 10.9734/jpri/2021/v33i33B31807

Aims: Despite the existence of numerous studies devoted to predictors of 30-day mortality in patients with post-myocardial infarction (MI) ventricular septum defect (VSD), the choice of surgical treatment tactics for post-MI VSD remains an item of discussion. The purpose of the research was to determine the most significant risk factors of 30-day mortality in patients with post-MI VSD in order to optimize the tactics of such patients’ surgical repair.

Study design: The retrospective analysis of the results of a comprehensive examination and surgical treatment of 88 in-patients with post-MI VSD for the period of 2002-2019 was carried out.

Results: As follows of the research findings, independent predictors of 30-day mortality in patients with post-MI VSD were determined. The predictors identified were combined into a Scoring system to stratify the risk of surgical failure in patients with post-MI VSD. Modelling the surgery outcomes makes it possible to optimize the tactics of surgical treatment of patients with post-MI VSD.

Conclusion: we have identified the most significant predictors of 30-day mortality in patients with post-MI VSD. The Score designed for mortality risk assessment is easy in use compared to other existing tools used in clinical practices when planning the surgical intervention in post-MI VSD patients. This Score may allow the stratification of post-MI VSD patients.

Open Access Original Research Article

A Cross-Sectional Questionnaire-Based Study to Find Out the Knowledge and Awareness of Community Pharmacist and Physician about Drug Information Center (DIC) and Its Services

Rajesh Hadia, Rushabh Shah, Jahnvi Parikh, Jisa Johnson, Anchu Marry Thomas, Niraj Pandit, Trupal Rathod, Dhaval Joshi, Sunil Baile, Kushalkumar Gohel

Journal of Pharmaceutical Research International, Page 177-184
DOI: 10.9734/jpri/2021/v33i33B31809

Background: Drug information centre (DIC) is a facility specially developed to provide relevant, accurate and unbiased drug information (DI) to consumer and health care professionals regarding the proper use of the drugs, drug safety and all the critical problems regarding the drug information of their usage and side effects.

Objective: The present study was about to access the knowledge of the primary care physicians and community pharmacists about the DIC and its facilities and to spread awareness regarding the same.

Methodology: A cross-sectional, questionnaire-based study was conducted among the 88 participants of Vadodara city, Halol-Kalol town for 6 months of period. 68 pharmacist and 20 physicians took part in the study from these cities. The data was further Analysed by comparing the available data and resource to find out the awareness regarding the DIC.

Result: During the study duration, a total of 88 participants took part in the study from various out of them 68 (77%) were community Pharmacist, and 20 (23%) were primary care physicians. In the end of the study, 48 (70.2%) pharmacist and 10 (50%) physicians know about the following data of DI, DIC, DIQ (Drug Information Query), resources and the role of pharmacist in DIC and it was clearly evaluated that the knowledge about the DIC, DI, DIQ was not thoroughly available for the pharmacist and physicians.

Conclusion: The present study concludes that the awareness about Drug Information Centre (DIC), Drug Information, and its value and importance is not as much as it should be in Vadodara city, Halol-Kalol. Several awareness programme should be carried to bring the importance and value of DIC in limelight and to make it accessible easily for all to decrease several drug related problems.

Open Access Original Research Article

Disease Diagnosis System using Machine Learning

Shailesh D. Kamble, Pawan Patel, Punit Fulzele, Yash Bangde, Hitesh Musale, Saipratik Gaddamwar

Journal of Pharmaceutical Research International, Page 185-194
DOI: 10.9734/jpri/2021/v33i33B31810

The efficient use of data mining in virtual sectors such as e-соmmerсe, and соmmerсe has led to its use in other industries. The mediсаl environment is still rich but weaker in technical analysis field. There is а lot of information that саn оссur within mediсаl systems. Using powerful analytics tооls to identify the hidden relationships with the current data trends. Disease is а term that provides а large number of соnditiоns connected to the heath care. These mediсаl соnditiоns describe unexpected health соnditiоns that directly соntrоl all the оrgаns of the body. Mediсаl data mining methods such as соrроrаte management mines, сlаssifiсаtiоn, integration is used to аnаlyze various types of соmmоn рhysiсаl problems. Seраrаtiоn is an imроrtаnt рrоblem in data mining. Many рорulаr сliрs make decision trees to рrоduсe саtegоry models. Data сlаssifiсаtiоn is based on the ID3 decision tree algorithm that leads to ассurасy, data are estimated to use entrорy verifiсаtiоn methods based on сrоss-seсtiоnаl and segmentation and results are соmраred. The database used for mасhine learning is divided into 3 parts - training, testing, and finally validation. This approach uses а training set to train а model and define its аррrорriаte раrаmeters. А test set is required to test а professional model and its standard performance. It is estimated that 70% of people in India can catch common illnesses such as viruses, flu, coughs, colds etc. every two months. Because most people do not realize that common allergies can be symptoms of something very serious, 25% of people suddenly die from ignoring the first normal symptoms. Therefore, identifying or predicting the disease early using machine learning (ML) is very important to avoid any unwanted injuries.

Open Access Original Research Article

Incidence and Management of Post Cholecystectomy Biliary Fistula at Tertiary Care Hospital

Ahtesham-Ul- Haq, Sohail Ahmed Memon, Riaz Ahmad Memon, Bilal Rasool, Shahnawz Khatti, Shahida Khatoon

Journal of Pharmaceutical Research International, Page 203-208
DOI: 10.9734/jpri/2021/v33i33B31812

Objective: To determine the incidence and management of post cholecystectomy biliary fistula at tertiary care Hospital. 

Methodology: This was a prospective study which was conducted at general surgery department of Liaquat University of Medical and health Sciences, during one year from March 2017 to February 2018. All the patients those underwent laparoscopic cholecystectomy or open cholecystectomy, age more than15 years and either of gender were included. All the patients were evaluated for developed biliary fistula after cholecystectomies. All the patients of biliary fistula were managed conservatively and surgically and their management outcome was recorded. After operation most of patients were followed up to 6 months. The data was collected via study designed proforma. Data was analyzed by using SPSS version 20.

Results: Out of 318 patients, 280 patients underwent laparoscopic cholecystectomies, 38 patients underwent open cholecystectomies. Mean age of the patients was 41.34+8.23 years. Females were in majority 233(73.3%) and males were 95(29.7%). Out of all post-cholecystectomy biliary fistula was seen in 10(3.14%) patients. Incidence of post-cholecystectomy biliary fistula was insignificantly associated with types of cholecystectomies (p=0.425), while it was highly prevalent in females (p=0.001).

Conclusion: In the conclusion of this study the post cholecystectomy biliary fistula was observed to be 3.14% and mostly patients were manged via conservative treatment.

Open Access Original Research Article

Comparative Study of Arjun Twak Lepa and Arjun Twak Kukkutand Pottali in Management of Vyanga with Special Reference to Melasma

Priyanka Shelotkar, Shweta Parwe, Swapnil Borage

Journal of Pharmaceutical Research International, Page 209-217
DOI: 10.9734/jpri/2021/v33i33B31813

Background: A person's beauty and self-confidence are both enhanced by healthy and glowing facial skin.A darkening of the skin caused by an excess of the pigment melanin in the skin is known as hyperpigmentation.Vyanga is a Kshrudraroga with appearance of Niruja (painless) and Shavavarna Mandalas (bluish-brownish) on the face. Melasma, one of the hyper pigmented disorders, can be compared to it.based on clinical features. Whole raw egg/egg yolk alone/with herbs have shown very good results in tightening of skin, complexion and healing in skin disorders, when it is locally applied. So, in present study egg is used with Arjun Twak Churna in the form of Pottali in experimental group for better result in management of Vyanga.

Aim and Objectives: To study the effect of Arjun Twak Kukkutand Pottali on MSI (Melasma Severity Index) and to compare the effect of ArjunTwak Kukkutand Pottali and Arjun Twak Lepa on MSI.

Methodology: Total no. of 44 patients will be enrolled (22 in each group). In control group for a period of 21 days, Arjun Twak Lepa will be available for local use. While in experimental group, ArjunTwak Kukkutand Pottali will be given for local application for 21 days. The assessment will be done on 0 & 21st day.

Results: Changes will be observed as per subjective & objective parameters.

Conclusion: ArjunTwak Kukkutand Pottali will be more effective on MSI (Melasma Severity Index).

Open Access Original Research Article

Evaluation of the Skin Infections and Conditions among Students of Gomal Medical College Pakistan

Shumaila Parveen, Yaser M. Alahmadi, Faryal Adnan, Eshawa Darr, Ali Alalawi, Syed Shafqat Ali Shah Rizvi, Sadaqat Hussain Awan, Awais Ahmed, Muhammad Asif Shahzad, Tahseen Ahmed, Abdul Rashid Shaikh, Altaf Ali Mangi

Journal of Pharmaceutical Research International, Page 218-222
DOI: 10.9734/jpri/2021/v33i33B31814

Objective: The objective of the current study is to determine the pattern of dermatological disorders and to find out their connection with different socioeconomically factors among students of the Medical College.

Methodology: The Cross sectional observational study was carried out for the period of three months .The research instrument used was the well developed questionnaire.

Results: The questionnaire was administered among total 350 students and the most participant age group was the > 22 and that was about 47.4% of the total sample size the more skin complication seen was the acne that was about 59.7%, in addition to this dandruff contributed very heavily to the hair complexities which makes about 35.7% of the sample.

Conclusion: Skin infections especially the cosmetic are very common among the Medical students.

Open Access Review Article

Therapeutic Role of Nitric Oxide in Diabetic Wound Healing: A Systematic Review

Mayur Meghashyam Chavhan, Ranjit Vinayak Gadhave, Yogita Sachin Ozarde, Ganesh Bhaurao Choudhari

Journal of Pharmaceutical Research International, Page 68-80
DOI: 10.9734/jpri/2021/v33i33B31798

Post injury, healing of wound is essential for recovery of uprightness of the body, which is one of the complex, continuous and unanticipated chains of events in case of diabetic patients. Nitric oxide represents a potential wound therapeutic agent due to its ability to regulate inflammation and eradicate bacterial infections. Impaired wound healing is a prominent diabetic complication which may lead to amputations also. In addition to modern medicines we can use nitric oxide therapy prominently for diabetic wound healing. Prominent and proven role of nitric oxide as well as conventional materials (like metformin and hydrogen sulphide, whey proteins, acidified nitrile etc), therapies (like low level laser therapy, hyperbaric oxygen therapy etc) and techniques (like in vivo implants with biosensors) can be taken into consideration. Many plant extracts showed promising results for wound healing activity by increasing nitric oxide levels. Use of modern technologies such as implant with biosensor and technique like sonic head hog gene are available for diabetic wound healing using Nitric oxide. In this review, an attempt has been made to compile comprehensive updated information of role of nitric oxide in diabetic wound healing, which may be exploited by focusing more on development of effective strategies to treat diabetes-associated wound.

Open Access Review Article

A Comprehensive Study of Medicinal Plants with Antidiabetic Properties

Faruk Alam, Ruhul Amin, Mohidul Islam, Republica Borgohain, Moidul Islam Judder, Aswini kumar Sethi

Journal of Pharmaceutical Research International, Page 81-96
DOI: 10.9734/jpri/2021/v33i33B31799

The purpose of this research is to assess the anti-diabetic effects of several medicinal herbs. Herbal medicine has grown in popularity in both developing and developed countries over the last several years, owing to its natural origins and lack of negative effects. Even though medicinal plants have been utilized to treat diabetes mellitus from ancient times, they have been offered as abundant but untapped prospective sources for anti-diabetic medicines. It's a reality that diabetes can't be cured, and no one has ever claimed to be completely free of the disease. Diabetes mellitus is becoming a severe hazard to human health in all regions of the world due to its fast growing occurrence. Furthermore, several novel bioactive compounds derived from plants have demonstrated antidiabetic action with greater efficacy than oral hypoglycemic medicines already utilized in clinical therapy in recent years. Despite the fact that many plants are recommended, further pharmacological and chemical study is needed to fully understand the mechanism of hypoglycemic action.

Open Access Review Article

Review Article Recent Advances in Preventing Dental Erosion

Barkha Adwani, Simran Kriplani, Kumar Gaurav Chhabra, Amit Reche, Priyanka Paul Madhu, Rutuja Ubhale

Journal of Pharmaceutical Research International, Page 223-231
DOI: 10.9734/jpri/2021/v33i33B31815

Dental erosion is defined as an irreversible loss of dental hard tissue due to exposure to chelating agents or non-bacterial acids. The occurrence of this condition was noted and the incidence and prevalence of dental erosion has been increasingly documented.The Ant erosive agents such as Anacardic acid in which the key component is the cashewnut shell liquid is phenolic lipids. It is a mixture of molecules which are saturated and unsaturated. It is also considered to have an anti-microbial effect and has been studied for the treatment of cancer, oxidative damage, inflammation and obesity disorders. Other anti-erosive agent like Fluoride helps in tooth remineralization. Fluorapatite, rather than hydroxyapatite, forms during the process of remineralization when fluoride is found in oral fluids. In apatite crystal lattice formation, fluoride ions replace hydroxy ions. Fluorapatite, even under acidic conditions, is less soluble than hydroxyapatite, which helps to regenerate tooth enamel. Fluoride is therefore a stronger anti-erosive agent. Various Recent advances in anti-erosive agents are Calcium and phosphate, Casein phosphopeptide amorphous calcium phosphate (CPP-ACP), Protease inhibitors, Oils, Chitosan chitosan and Multivalent metal ions Various techniques to evaluate dental erosion are in vitro techniques and in vivo techniques. In vitro techniques are Scanning electron microscope, Surface Profilometry, Polarized Light Microscopyand Non-Contact Confocal Laser Scanning Microscopy (CLSM). And iv vivo techniques are Photographs Clinical review and indices. The most important point of treatment is identifying and removing the erosion factor, above all current materials and methods. Therefore, early identification of the lesions, evaluation and removal of the etiological variables are relevant topics.