Open Access Case Report

Spectrum of Magnetic Resonance Imaging Findings in Sturge Weber Syndrome: A Rare Neurocutaneous Syndrome

Varun Singh, Bhushita Lakhkar, Rajasbala P. Dhande, Shreya Tapadia, Bhavik Unadkat

Journal of Pharmaceutical Research International, Page 20-26
DOI: 10.9734/jpri/2021/v33i34A31818

Sturge Weber syndrome is a type of neurocutaneous disorder also known as meningofacial angiomatosis. It is generally seen in paediatric age group and more  commonly effects the  males which present with delayed milestones, seizure disorder, loss of vision and other neurological deficits. Clinical suspicion of Sturge weber syndrome should be made on the  presence of port wine stain(facial nevus) in a young children. MRI (magnetic resonance imaging) plays a key role in detecting the various spectrum of cortical and vascular defects associated with the syndrome. Clinicians can come to a final diagnosis of Sturge weber syndrome, when the clinical history is supplemented with MRI findings. We in our case report will be discussing the various spectrum of MR findings in this rare neurocutaneous syndrome.

Open Access Case Report

Physiotherapeutic Approach in Stress Urinary Incontinence with Prolapsed Uterus: A Case Report

Sakshi Palkrit, Waqar M. Naqvi, Tasneem Burhani

Journal of Pharmaceutical Research International, Page 54-59
DOI: 10.9734/jpri/2021/v33i34A31822

The International Continence Society (ICS) describes incontinence as an objectively demonstrable loss of urine which is not voluntary and that is a social and/or sanitary issue. The complaint of leakage of urine, which is not voluntary on an effort made, on exertion, on sneezing or while coughing is described as Stress urinary incontinence (SUI). The intra-abdominal increases as the effort or exertion increases, and the urethral sphincter is not capable to sustain a pressure greater than the pressure applied on the urinary bladder. Eventually, leakage of urine occurs during the daily activities like lifting, laughing, jumping, while sneezing or coughing. In women, stress urinary incontinence is most common category of incontinence of urine. Even though it isn’t a lethal illness. SUI has a number of negative effects on women's quality of life, including restricting social interaction and relationship and the personal relationships but also physical activity. Cystocele is the weakness of pubocervical fascia, which makes the urinary bladder to descend downwards and backwards against the anterior wall of the vagina. If this is a not taut then it will protrude. In more extreme cases a pouch of bladder sets up which holds on to the residual urine. The conservative treatment, a nonsurgical therapy, includes ameliorating the living standards, urinary bladder training, pelvic floor muscle exercises and strengthening. Kegel exercises are the most effective form of strengthening muscles of pelvic floor in addition are a noninvasive therapy and the use of vaginal weights or cones are not included. The rehabilitation and strengthening muscles of pelvic floor is facilitated and promote urine storage. The combination of Kegel’s exercise along with other interventions for a span of six weeks has shown a significant improvement in the symptoms.

Open Access Case Report

Case Report on Left Ovarian Torsion: A Rare Complication in an Adolescent PCOS

. Priyanjali, Shazia Mohammed, Neema Acharya, Mehul Salve, Priyanka Singh

Journal of Pharmaceutical Research International, Page 67-72
DOI: 10.9734/jpri/2021/v33i34A31824

Introduction:  Ovarian torsion is an acute emergency and women in any age group having cysts may have this complication. With increase in number of women having PCOS mainly adolescent girls are also at risk of this complication. Here we report a case of young PCOS girl who presented with acute abdomen who was found to have left ovarian torsion. The emergency was managed by emergency laparoscopic derotation and oophoropexy.

Main symptoms and clinical findings:  A 14 year old girl with PCOS presented with severe pain over right lower abdomen and was associated with 2 episodes of non-bilious vomiting. On examination she was anxious with tachycardia of 104 bpm. Right iliac fossa was tender without any distension, guarding or rigidity.

Main diagnoses, therapeutic interventions, and outcomes:  Her lab investigation revealed leukocytosis with hormonal profile consistent with PCOS. On USG there was bulky left ovary of 7.9 x 5.5 x 4 cms and volume of 87cc with lack of arterial blood flow. She was promptly taken up for emergency laparoscopy where left ovary was rotated 360 degree clockwise with gangrenous looking cyst wall which improved on detorsion. Left ovary was then fixed to lateral pelvic wall in anatomical position.

Conclusion:  All adolescent girls with ovarian torsion but no apparent ovarian pathology should be tested for PCOS using ultrasound and biochemical tests. Also girls with known PCOS  in this age group presenting with acute abdomen, ovarian torsion should be considered and promptly investigated.

Open Access Case Study

Report on Steroid- Responsive Encephalopathy in a Case of Hashimoto’s Thyroiditis

Mayuri A. Dehane, Darshana Shingode, Manoj Patil

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2021/v33i34A31816

Introduction: Thyroiditis caused by Hashimoto's common, Thyroid gland enlargement that is painless and diffuse that affects mostly women in their forties and fifties. While most patients are euthyroid, hypothyroidism may grow. In addition, several patients have thyroid antigen-specific cell-mediated immunity, which can be demonstrated using a variety of strategies. The annual number of cases per 10,000 people prevalence of at least 2% among women. Thyroiditis causes the thyroid gland to become extinct capacity to keep iodine in a safe place, generate together with secrete circulating iodoproteins in the blood, and produce inefficient hormone. As a result, the thyroid gland is overstimulated, and the patient has a high rate of Iodine in the thyroid turnover.

Clinical Finding: enlargement of thyroid gland. Difficulty in swallowingand breathing, unexplained weight gain,constipation, slow heart beat, fatigue, swelling in extremities, dryness.

Medical History: In 2010 she was suffering from same problems. Hashimoto thyroiditis cured for medical intervention in Nagpur medical college, after that treatment of Hashimoto thyroiditis she took the treatment in A.V.B. R. Hospitalfor management of Hashimoto thyroiditis. Now she is admitted in peadiatrics ward for further management of Hashimoto thyroiditis.

The Diagnosis and Therapeutic Intervention: After physical examination and investigation, this case was diagnosed as Hashimoto thyroiditis. Thyroid hormone replacement therapy was used to treat the condition. This normally entails taking levothyroxine.

Leoxyl Check: After six to eight weeks of treatment, the TSH level should be normal with dose 12.5-25 mcg. Absorption of levothyroxin may be affected by some drugs, supplements, and diets taken 4 hours. Triiodothyronine 5 to 10 mcg received in twice in day.

Nursing Perspectives: Assessement of anterior or posterior location of the thyroid IV Fluid was provided. Check blood pressure and vital signs per hourly. Monitor the Pulse oximetry, ABG, and respiratory rate, and pattern are all factors to consider.

Conclusion: Comprehensive systemic review of autoimmune disease, our best estimate of incidence rates for hypothyroidism in female and male treatment and management improves the outcomes of Hashimoto thyroiditis.

Open Access Study Protocol

Effectiveness of Mental Health First Aid Kit for Depression and Psychological Well-being in Adolescents

S. Mukherjee, T. Sebastian, J. Gawai

Journal of Pharmaceutical Research International, Page 122-128
DOI: 10.9734/jpri/2021/v33i34A31831

Background: Psychological state for youth not just impacts physical wellness at the moment, but also in potential lives. One of the major setbacks with adolescents developing depression in India is that most of them are unaware of the situation and majorly receive therapeutic help after the situation turns chronic in nature. Mental Health First Aid explains how symptoms of mental disease should be recognized and managed.

Objectives: To develop, evaluate and validate the Mental Health First Aid Kit for depression among adolescents and their psychological well-being.

Materials and Methods: For this community approach study, the teachers from the selected schools at Wardha city will be trained as potential volunteers to conduct this experimental trial with the scholar. The efficacy of Mental Health First Aid Kitwill be assessed by using various scale. The pre and post values obtained will be subjected to statistical analysis.

Expected Results: The development of the proposed indigenous Mental Health First Aid Kit would facilitate positive outcomes in primary assistance to adolescents with mental health concerns.

Conclusion: The results of the proposed study will be helpful to encourage the adolescent individual to identify and seek primary care until a more definitive medical diagnosis and treatment is availed.

Open Access Study Protocol

Effect of using Blended Learning Method on Final Year Students of BAMS to Learn Shalyatantra

Pooja Shrivastav, Babaji Ghewade, Shweta Parwe, Devyani Dasar

Journal of Pharmaceutical Research International, Page 129-134
DOI: 10.9734/jpri/2021/v33i34A31832

Background: E – learning has been considered as one the most up-to-date learning techniques, which come with a slew of benefits like it allows worker to be trained, educated etc and negative aspect like dependence on technology, a lack of motivation, and a lack of human touch. Blended learning, on the other hand, is a mix of online and face-to-face learning. The aim of this study is to compare the efficacy of blended learning to traditional learning.

Aim and Objectives: To study the effect of Blended learning method on Final year BAMS students in comparison with conventional teaching method to learn Shalyatantra.

Methodology: The Final year BAMS students of MGAC.H & RC will be selected for the study and equally divided in two equal groups i.e A and B. ‘Kshar Karma’ will be taken as study topic. In Group A, topic will be taught by Conventional method while in Group B it will be taught by Blended learning method. Senior and experienced Shalyatantra faculty will be chosen. Sensitization of teacher and final year BAMS student regarding Blended learning method will be done. Total 70 students will be equally divided into two groups. Pretest (before commencing study) and posttest (after sessions) form consisting of 20 MCQ will be distributed and filled up by the participants.  

Results: Result will be drawn on the basis of the observations.

Conclusion: Conclusion of the study will be drawn on the basis of statistical data calculated.

Open Access Original Research Article

Features of the Organization of Dental Care for Underage Patients in Tense Epidemiological Conditions

Sulaymonov Hamroqul Komildzhonovich, Abdullaev Dzhavid Galib Ogli, Alexei Valerievich Yumashev, Andrey Olegovich Galustyan, Tatyana Timokhina, Tatiana Andreevna Makarova

Journal of Pharmaceutical Research International, Page 60-66
DOI: 10.9734/jpri/2021/v33i34A31823

In modern conditions, dental care for children who need it from an early age is associated with a number of difficulties. The fear of catching a new coronavirus infection has led to a number of restrictions that negatively affect the practice of providing medical care to underage patients. For this reason, it is important to provide dental care to young patients, since the loss of teeth at an early age causes significant problems at an older age. The purpose of the work is to consider the features of the organization of dental care for underage patients in the tense epidemiological conditions associated with the spread of coronavirus infection on a global scale. In the conclusions of the study, it was noted that taking into account the complex epidemiological conditions, approaches to providing dental care will change. Traditional approaches used to address oral health problems in children before the COVID-19 pandemic will need to be adapted to the new era. Minimal intervention methods that minimize or eliminate aerosol formation should be practiced, as well as comprehensive oral health prevention measures to ensure the safety of dental offices at this unprecedented time, to control disease and maintain oral health in the population.

Open Access Original Research Article

Altered Thyroid Function amongst the Infertile Insulin Resistant Women with Polycystic Ovarian Syndrome

Urooj Zafar, Aliya Irshad Sani, Hira Ahmed Malik, Aisha Faraz, Rabeea Rizwan, Mariam Muneer

Journal of Pharmaceutical Research International, Page 73-80
DOI: 10.9734/jpri/2021/v33i34A31825

Background: Polycystic ovarian syndrome (PCOS) is a hormonal disorder common among women of the child-bearing age. Likewise, women with PCOS are more likely to be obese or overweight, which may be due to their higher Insulin resistance and TSH levels.

Aim: The study's objectives were to assess the prevalence of subclinical hypothyroidism in infertile PCOS, distribution of insulin resistant in PCOS women with subclinical hypothyroidism, and the efficacy of Metformin treatment in these women.

Methods: It was a single-center study which included all infertile patients who visited the Department of Obstetrics and Gynecology at a Karachi hospital between January 2019 and September 2019. The infertile PCOS patients were then divided into two groups: Group A (Insulin Resistant with Subclinical Hypothyroidism) and Group B. (Non-Insulin Resistant with Subclinical Hypothyroidism). Following the written consent, both the treatment groups received Metformin 500mg T.D. for three months.

Results: The infertile PCOS patients showed a higher prevalence of subclinical hypothyroidism. Insulin resistance was found to be 63.3% among subclinical hypothyroid PCOS women. Finally, three months of Metformin treatment resulted in a significant reduction in TSH levels in Insulin resistant PCOS women.

Conclusion: We identified a positive link between TSH levels and insulin resistance in PCOS women, both in terms of incidence and treatment.

Open Access Original Research Article

Pharmaceutical Preparation of Arka Lavan and Assessment for Its Analytical Study

S. Sheikh, A. Wanjari, S. Kamble, S. Wankhede, D. Wanjari, N. Chouragade

Journal of Pharmaceutical Research International, Page 81-85
DOI: 10.9734/jpri/2021/v33i34A31826

Background: Arka is commonly found plant in India. It is mostly used for religious purpose in India. In Ayurved, it has in used for various medical preparation. One of such preparation is Arka Lavan.

Aim: Pharmaceutico-analytical study of Arka lavan& evaluation for Antimicrobial study

Materials: The raw materials Arka patra will be collected from the medicinal plant garden, of Mahatma Gandhi Ayurved College , Hospital & research centre, Salod ( H), wardha. The arka patra will  be authenticated by Dravyaguna department. The another raw material is Saindhava Lavan will be procured from Dattatraya Ayurved Rasashala and will be authenticated by Rasashastra & Bhaishajya kalpana Department Arka lavan will be prepared as per the reference.The prepared Arka lavan will be analyzed.

Observation and Results: The Arka patra lavan will be assessed for organoleptic, physicochemical and TLC parameters 

Conclusion: The pharmaceutical & analytical study of Arka lava will provide the standard parameters.

Open Access Original Research Article

Clinical Study of Scleral Fixated Intraocular Lens Implantation in Blunt Ocular Trauma

Girish Gadre, Neha Maheshwari, V. H. Karambelkar

Journal of Pharmaceutical Research International, Page 86-91
DOI: 10.9734/jpri/2021/v33i34A31827

Aim: to assess visual outcome and complications associated with SFIOL implantation in traumatic lens subluxation/ dislocation cases.

Methods: This is a retrospective study of 45 patients who were managed for traumatic dislocation/subluxation of clear or cataractous lenses from June 2019 to July 2020 in a Krishna hospital, Karad, Satara. All cases underwent anterior vitrectomy/3 port pars plana vitrectomy + removal of lens and ab externo 2 point scleral fixation with rigid or foldable sfiol. In posteriorly dislocated/subluxated lens, vitrectomy was done and the lens was removed using pick forceps and retrieved by hand shake technique. In anteriorly dislocated cataractous lens, the lens was removed through the tunnel incision.

Results: Majority of the patients were between 55-65 years of age with male pre-ponderance (73.3%).Out of 45 cases, 21 cases (46.6%) were traumatic dislocated lens and 24 cases (53.3%) were traumatic subluxated lens. The mean preoperative BCVA was 0.13 ± 0.24 logMAR, which improved 0.39 ± 0.366 logMAR postoperatively (P <0.0001 ).Preoperatively BCVA in logMAR in 39 cases (86.6%) was 0.3 or better, 6 cases (13.3%) was 0.3 to 1.0 . Postoperatively BCVA in logMAR in 21 cases (46.67%) was 0.3 or better, 24 cases (53.3%) was 0.3 to 1. P-value is 0.00057 which is significant. Early postoperative complications noted were raised intraocular pressure in 12 cases (26.6%), corneal edema in 9 cases (20%), vitreous hemorrhage in 8 cases (17.7%)  and hypotony in 3 cases (6.67%).Late postoperative complications were persistent elevation of intraocular pressure in 10 cases (22.2%), cystoid macular edema in 3 cases (6.67%), epiretinal membrane in 3 cases (6.67%).

Conclusion: In every horrendous case, long haul follow-up is needed to distinguish confusions and start treatment at the most punctual.

Open Access Original Research Article

A Critical Review on Formulations Used in the Management of Malavstambha (Constipation)

Shweta Parwe, Swati Tikale, Puja Shrivastav, Milind Nisargandha

Journal of Pharmaceutical Research International, Page 92-100
DOI: 10.9734/jpri/2021/v33i34A31828

Background: Malavstambha is not mentioned as a disease in any text of Ayurveda, but it is symptoms of many diseases. Many types of diseases caused by ‘Malavstambha’ (sarveshamev kupita malaha). Multiple reasons contribute to this phenomenon, such as the effects of ageing on gut physiology, certain illnesses, medications, reduced mobility, inadequate caloric intake, and anorectal sensory changes. It is a very common problem which is increase day by day. For readily available market preparation is used for malavstambha. There is many formulations are mentioned in Ayurvedic Text but it is not in practice or didn’t researches conduct.

Aim: To find out the various formulations for malavstambha

Result and Observations: In Bhaishajya Ratnawali, Yogratnakar, Charak Samhita, Ashtanga Hriday and Sushruta Samhita,we found many formulations. 

Conclusion: There are many formulations mentioned in our Samhitas. Some of them are used in practice, but we have to conduct researches on mentioned formulations and create evidence based protocol for malavstambha.

Open Access Original Research Article

Equisetum arvense L. Extract Ameliorates Oxidative Stress, Inflammation and Testicular Injury Induced by Methotrexate in Male Rats

Ahlam A. Alahmadi, Eman A. Abduljawad

Journal of Pharmaceutical Research International, Page 101-114
DOI: 10.9734/jpri/2021/v33i34A31829

Methotrexate (MTX) is a cytotoxic drug used to treat a wide range of cancers and non-cancerous conditions. However, it can cause unfavorable acute toxic effects in several organs, including the testis.  Equisetum arvense L. (E. arvense) extract is effective in counteracting oxidative stress-related disorders. This study assessed the preventive effect of E. arvense extract against MTX-induced testicular toxicity. Gas chromatography-mass spectroscopy (GC-MS) was used to analyze the active constituents of E. arvense extract. Testicular toxicity was induced via MTX injection (0.5 mg/kg/ twice a week for 4 weeks). Forty male albino rats were divided into 4 groups: I- control (Cont); II: MTX; III: E. arvense (500 mg/kg/daily for 10 weeks); and IV: E. arvense + MTX. E. arvense main active constituents were squalane (15%), ascorbic acid per methyl (9.55%), phytol (8.69%), 2-pyrroline 1,2-dimethyl (8.63%), and octacosane (8.23%). Treatment of MTX injected rats with E. arvense produced a significant rise in body weight, serum testosterone and luteinizing hormone. E. arvense significantly increased the sperm counts, viability, and motility relative to the MTX injected rats. The levels of testicular oxidative stress and inflammation significantly reduced in the MTX rats treated with E. arvense. Furthermore, E. arvense markedly improved the testicular tissue and seminiferous tubules’ pathologic features in MTX-treated rats. E. arvense significantly decreased lipid peroxidation products, interleukin-1 beta, tumor necrosis factor-alpha while increasing superoxide dismutase levels.  E. arvense prevented MTX-induced testicular damage via anti-inflammatory and antioxidant activities.

Open Access Original Research Article

Diploma Nursing Final Year Students with that of Degree Nursing Final Year Students

Lina S. Fating, Tessy Sebastian

Journal of Pharmaceutical Research International, Page 115-121
DOI: 10.9734/jpri/2021/v33i34A31830

Background: Everyone is special, but we also have a couple of things in common. In psychology, one of the most interesting questions is to get to grips with human nature and what makes a personality. The type of personality that we hold is essential to our human perception. This study aimed to compare the emotional maturity of diploma nursing final year students with that of degree nursing final year students.

Objective: 1. To evaluate the level of emotional maturity of final year students in diploma nursing. 2. To evaluate emotional maturity rates of degree nursing   final year students. 3. To compare the level of emotional maturity of diploma nursing final year students with that of degree nursing final year students. 3. To associate the level of emotional maturity of diploma Students in the nursing final year with their demographic variables selected. 4. To associate the level of emotional maturity of degree nursing final year students with their selected demographic variables.

Materials and Methods: A Comparative study was conducted among diploma Nursing students from the final year and nursing students from the final year Wardha. Purposive sampling technique was used.

Result: The data obtained to describe the that 11 % of the diploma final year nursing students had extremely emotionally maturity level, 21 % of them had emotionally immature 56% moderately emotionally maturity level 12% of diploma final year nursing students had extremely emotionally immature level. Minimum emotional maturity score was 67 and maximum emotional maturity score was 207.Mean emotional maturity score was 97.28 ± 22.08. degree final year nursing students that 82% of the degree final year nursing students had extremely emotionally mature level, 05 of them had moderately emotionally mature level, 10% of them had emotionally immature level and 3% them had extremely emotionally immature. Minimum emotional maturity score was 73 and maximum emotional maturity score was 235.Mean emotional maturity score was 179.98 ± 41.25. 

Conclusion: The majority of diploma final year nursing students statistically significant difference was found in emotionally mature are degree final year students. Hence H1 is accepted. There is positive correlation between emotional maturities of diploma Nursing students and in final year and nursing students in the final year.

Open Access Original Research Article

Utilization Pattern of Indian Traditional Medicine in the Treatment of Cancer

Manju K. Mathew, K. Saravanan, Sujith Abraham

Journal of Pharmaceutical Research International, Page 135-143
DOI: 10.9734/jpri/2021/v33i34A31833

Aim: The aim of this study was to find the utilization pattern of Indian traditional medicine systems among the cancer patients.

Study Design: The present study is an observation cross-section design and conducted among the patients visiting in a hospital practicing Indian Traditional Medicine system from January2019 – December 2019.

Methodology: 379 cancer patients were participated in this study and required information were collected using a descriptive semi-structured questionnaire.

Results: The result implies that ITMS is widespread in cancer patients with 86.28% treating with selected form of ITS. A mixed group of 341 remedy was recognized and practiced. Ayurveda, Siddha, Homeopathy, Unani as well as Yoga and nutrition was the very frequently prescribed ITMS remedies. Herbal medicine use tripled from use prior to detection of cancer. Multivariate analysis showed that the usage patterns of the ITMS patients were belong to the adult populations and female. The source of information was mainly from friends/ family and the media, while directions from allopathic doctors and nurses were very negligible in giving ITMS related suggestions. 82.06% of patients used ITMS in order to improve the immunity to fight against cancer and/ or increase physical well-being. 88.92% of patients have gained from ITMS. 10.03% of patients reported minor side effects.

Conclusion: From the findings of the present, that the healthcare professionals can investigate the use of ITMS with cancer patients. The patients have shown strong attraction towards the ITM system due to less side effects and comparatively treatment cost is less though the efficacy and safety are yet to be explored many therapy regimens. The patients can be counselled regarding its potential benefits of ITMS remedies with the restricted existing effectiveness and for the improvement of patients.

Open Access Original Research Article

Effect of Triclosan and Sodium Monofluorophosphate on Plaque Reduction

Seema Soomro, Munir Ahmed Banglani, Parveen Memon, Mahwish Memon, Abdul Qadir Khan Dall, Salman Shams

Journal of Pharmaceutical Research International, Page 154-159
DOI: 10.9734/jpri/2021/v33i34A31835

Objective:  The aim of the study is to compare the clinical efficacy between two ingredient Triclosan and sodium monofluorophosphate on plaque accumulation.

Material and Methodology: This cross section study was carried out in school (Govt Girls High School Kotri). Total 100 school children were selected, between age ranges 13–16 years, which were divided in to two groups (group A & B) according to dentifrice given.

Group A: Toothpaste containing the active ingredient 0.3% Triclosan.

Group B: Toothpaste containing 0.8% sodium monofluorophosphate.                     

All patients were examined clinically for assessment using the Plaque index (PI) at follow up periods every week. Plaque was evaluated by using the silness-loe index.  Oral examination for dental plaque assessment was carried out at the start of the study and the children were follow up to 10 weeks. Data were analyzed by SPSS 16 version and one-way ANOVA test.

Result: Triclosan toothpaste users experienced significant reduction in plaque accumulation as compared to the sodium monofluorophosphate toothpaste users.

Conclusion:  At 3-weeks, Triclosan provided statistically significantly greater reductions than sodium monofluorophosphate in plaque reduction.

Open Access Original Research Article

Challenges in Implementation of Green Chemistry in Indian Pharmaceutical Sector

Arushi Kapoor, Smita Mehendale

Journal of Pharmaceutical Research International, Page 160-168
DOI: 10.9734/jpri/2021/v33i34A31836

The alarming environmental pollution caused by pharmaceutical Industries has led to the growing importance of Green Chemistry in India. It is high time that the pharmaceutical industry that is considered as a red category by the environment ministry, adopts green chemistry & green technology to address this issue. This study aims to find out the major barriers to implementing green technology in the pharmaceutical sector. Integrated Structural Modelling method & MICMAC Analysis has been adopted to identify a structure by which the pharmaceutical industries can implement green technology. An extensive literature review & discussions with industry experts led to identifying ten major challenges to the adoption of green technology in the pharmaceuticals. Economic &financial barriers & regulatory barriers have been identified as the major barriers. This study brought out a lack of consolidation of knowledge in this field as a challenge to the implementation of green practices, which has been largely ignored in previous studies and needs to be addressed.

Open Access Original Research Article

Service Quality in Rural Healthcare: An Exploration of Expectation Versus Veracity

Pallawi B. Sangode

Journal of Pharmaceutical Research International, Page 169-177
DOI: 10.9734/jpri/2021/v33i34A31837

Purpose: This paper aims to scrutinize the healthcare service quality in the rural population of a developing economy like India. It further aims at analyzing the service quality gap of the healthcare sector as perceived by its customers.

Design/ Methodology/Approach: This paper used the SERVQUAL model to examine the service quality of the health care units. For this study, only public health care units from the rural areas were considered.

Findings: The results entail that the hospitals have little or no provision of necessary infrastructural facilities inside the hospital in terms of medical equipment. The healthcare personnel do not provide personalized attention to the patients. Research

Limitations: The study was limited to rural state-owned hospitals' status; the results and interpretations may not be completely applicable or relevant to the private sector hospitals and urban hospitals.

Practical Implication: The study clearly states that the patients know their expectations in terms of service quality.

Originality/ Value: Vivid research has been done to examine the quality of services provided by the healthcare units, the least of them focusing on the rural front. This study is a genuine work by the authors to understand the healthcare providers' rural population's expectations.

Open Access Original Research Article

Black Raisins Improved Experimentally Induced Iron Deficiency Anemia. Biochemical and Histological Evidence

Fadia A. Abu Zaid, Eman A. Abduljawad, Haya M. Aljadani, Nada M. Ali, Zuhair M. Mohammedsaleh, Maha Ibrahim, Soad S. Ali, Seham K. Abunasef, Omar T. Ahmed, Hanan A. Amin, Soad K. Al Jaouni

Journal of Pharmaceutical Research International, Page 188-201
DOI: 10.9734/jpri/2021/v33i34A31839

Iron deficiency anemia is a challenging clinical problem with a profound impact on general health. Administration of iron-containing preparations were reported to be associated with many side effects. The current study aimed to evaluate black raisins’ therapeutic role against experimentally induced iron deficiency anemia in rats. Forty female rats were divided into 4 groups (n=10); control, anemia, anemia + iron, and anemia + raisins. Anemia was induced by bleeding and an iron-deficient diet for 4 weeks. Anemic rats were treated with ferric sulfate (200 mg/kg) or raisin extract (375 mg/kg) daily for 12 weeks. Complete blood count (CBC), blood films, body weight, splenic weight, and index were assessed. The spleens were processed and stained by hematoxylin and eosin (H & E) and immunohistochemically stained for CD3+ and CD68. Raisins contain a considerable amount of iron, vitamin B, phenolics, and flavonoid antioxidants. In raisins treated rats, CBC parameters displayed a significant increase compared to the anemic rats. Most of the RBCs in blood films showed normal shape, size, and central pallor. The spleen of raisins and iron-treated rats showed a marked increase in the area of white pulp. Their spleens also showed a significant increase in the CD3+ PALS area compared to anemic rats. Iron and raisins significantly decreased splenic CD68 macrophages. Consumption of black raisins could be considered an excellent natural source for flavonoids and iron to be used as an adjuvant supplement to iron for anemic patients with increased splenic T lymphocytes.

Open Access Original Research Article

Arginase, a Possible Therapeutic Target in Prostate Cancer

Subodhini Abhang, Prachi Shelgikar, Shruti Mulgund

Journal of Pharmaceutical Research International, Page 202-207
DOI: 10.9734/jpri/2021/v33i34A31841

With increasing populations, the prevalence of prostate cancer increases. In the future, a significant public health crisis can be recognized in the present incidence of prostate cancer. In order to counter this, markers should be established for the advanced diagnosis and treatment of the illness prognosis. The cells dominate our immune system and grow into a detectable tumour, causing cancer. At this stage in the body, several processes are dominated, governed and deregulated by the tumour. In most cases, immune response undertakes measures by limiting the availability of Arginine. In this context it is fascinating to examine how the levels of Arginine fluctuate with the severity of the disease and the levels of Arginase and NO. Substances and methods: In 25 beginning phases and 25 advanced stage of the prostate cancer patients and compared to 25 healthy controls, 5 ml of the blood were taken and tested for serum levels of Arginina, and nitric oxide. A substantial reduction in arginine (p<0.001) found was detected. In Arginase and levels a substantial increase (p<0.001) was detected. Conclusion: Increased Arginase levels are linked to the illness progression and the result lowers as Arginase uses most phases. Therefore, Arginase inhibition can be promising therapeutic target in prostate cancer.

Open Access Review Article

A Compact Analytical Profile of Aripiprazole: Analytical Methodologies

O. V. Athira, Muhamed Rishad, K. Anand Babu, K. Praseetha, . Indukala, S. Kathirvel

Journal of Pharmaceutical Research International, Page 7-19
DOI: 10.9734/jpri/2021/v33i34A31817

Aripiprazole (APZ) is an antipsychotic drug that belongs to benzisoxazole derivatives and is used to treat schizophrenia as well as acute manic or mixed effects in patients with bipolar 1 disorder. APZ is used to treat certain mental, mood disorders such as bipolar disorder, Schizophrenia, Tourette's syndrome, and irritability associated with autistic disorder. It may also be used in combination with other medication to treat depression. The present review article would be useful for prospective studies for researchers interested in APZ formulation production and quality management. Using a thorough computer assisted literature survey; this review touches upon the various reported analytical methods for the quantification of APZ both in API (Active Pharmaceutical Ingredient) and pharmaceutical dosage forms. The present write-up also encompasses the various published research articles like Spectroscopy techniques, X- Ray Diffraction (XRD), Electro Chemical Technique, Differential Scanning Calorimeter (DSC) and Capillary Electrophoresis. This is the first review article in this series with focus on the analytical profile of APZ. Although, several methods were reported in the literature, HPLC stands out first for the quantification of APZ.

Open Access Review Article

Rheumatic Heart Disease in Indian Paediatrics: A Review

Vahini B., Narenthiran C. K., Keerthana Chandrasekar

Journal of Pharmaceutical Research International, Page 27-33
DOI: 10.9734/jpri/2021/v33i34A31819

Rheumatic heart disease (RHD) is a condition in which the valves of the heart are damaged, it is mainly caused by Group A Streptococcus, it mainly affects the paediatrics and young adults. Inflammation occurs in the joints, heart and blood vessels due to group A streptococcus. The exact pathogenesis of rheumatic heart disease is unknown. It is manifested as fatigue, chest pain and shortness of breath; pulmonary hypertension, heart failure are some of the complications of the disease. Endocarditis, viral myocarditis and prolapse of the mitral valve are the differential diagnosis of rheumatic heart disease. It is diagnosed by revised Jones and World Heart Federation criteria. Benzylpenicillin is the first-line drug for rheumatic heart disease, followed by oral Penicillin V, Erythromycin can be recommended. Paediatrics who are allergic to Penicillin Azithromycin, Erythromycin can be recommended based on Indian paediatrics and World Health Organization guidelines. It is prevented by reducing the exposure to infection in high-risk regions; treat with appropriate antibiotics; prevent recurrence of infections and complications. The aim of this review is to highlight rheumatic heart disease in paediatric population.

Open Access Review Article

Steps towards Universal Health Coverage through Health and Wellness Center under Ayushman Bharat Programme Delivering Comprehensive Primary Health Care in Bhandara District

Shrikant Madhukar Ambekar, S. Z. Quazi, Abhay Gaidhane, Manoj Patil

Journal of Pharmaceutical Research International, Page 34-38
DOI: 10.9734/jpri/2021/v33i34A31820

Background: In 2018-19 as recommended by National Health Policy an Ambitious health care scheme as Ayushman Bharat programme was started by Government of India steps toward the Universal health coverage. Ayushman Bharat is also known as Healthy India having two major component. Creation of Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana (PM-JAY). Comprehensive primary health care services will be delivered up gradation of existing health facility in various 10 core area and 13 different types of health services will be delivered at HWC health facility.

Progress in Health and Wellness under Ayushman Bharat Programme: First HWC was inaugurated by GOI in state of Chhattisgarh within Bijapur district at jangla village of Bhairamgarh Taluka on On 18th April 2018. Till 06th Feb 2021 total 58961 Health and wellness cneters are operational in India and In Maharashtra total 8423 Health and wellness cneters are operational where in Bhandara district total 177 Health and wellness cneters are operational which include 143 SHC Health and wellness center, 33 PHC Health and wellness center and 1 UPHC Health and wellness center.

Achievements in Health and Wellness Center: In Bhandara district 98% of Medical Officer, 90% of Staff Nurse, 93% of MPW Female, 88% of MPW Male and 99% of ASHA trained NPCDCS Programme. Where 10,69,219 screening test for Hypertension and 10,81,901 screening test for Diabetes conducted in HWC health facility. Total 4097 Yoga sessions conducted at HWC health facility.

Conclusion: 13 different types of health services which are delivered at Health and Wellness Centres health facility under Ayushman Bharat is step towards the Unvarsal health coverage provision in rural area of bhandara district.

Open Access Review Article

Cardiovascular Complications in COVID-19 Pandemic and Its Management

Varish Ahmad, Sohail Akhtar, Sanjay Krishna Pandey, Aftab Ahmad, Mohammed F. Abuzinadah, Haitham Ali Alzghaibi, Ali H Alharbi, Qazi Mohammad Sajid Jamal

Journal of Pharmaceutical Research International, Page 39-53
DOI: 10.9734/jpri/2021/v33i34A31821

Pneumonia like the pandemic COVID-19 is a virus disease, first time came into light in December 2019 in the Wuhan city of China.  As of today, more than two million deaths from more than 210 countries have been confirmed. This disease has modeled a great threat to human mental health, physical health, and forcefully stuck the routine life with psychosocial consequences globally. The COVID-19 disease is caused by SARS-CoV-2 which leads to acute respiratory distress. The pathogenesis of the disease started from virus entry to the host cell where it controlled the cellular system of the patient directly or indirectly. Population having cardiovascular, immunosuppressive, AIDS, and diabetes-like complications are thought to be very risky for mortality caused by the SARS-CoV-2 virus. The correlation to Noncommunicable diseases like cardiovascular disorders and diabetes has led our attention towards the management of these diseases in the corona outbreak. Thus, this review aimed to better understand the threats modeled by the disease COVID-19 to the cardiovascular system, and the medical community should share their experiences promptly. It is concluded that both published research and real-time experiences shared on social media by world experts will act as a valuable tool and will help to learn more about this disease. Several preventive and therapeutic measures including drug therapy are suggested to manage the disease in comorbidities conditions.

Open Access Review Article

Implications of Oral Squamous Cell Carcinoma to Submandibular Gland: A Systematic Analysis

Shaikh Amjad, Rajiv M. Borle, Mahalaqua Nazli Khatib, Nitin Bhola

Journal of Pharmaceutical Research International, Page 144-153
DOI: 10.9734/jpri/2021/v33i34A31834

Objective: Submandibular Gland (SG) Located in Level ΙB Region of Neck. During neck dissection, it is routinely removed along with level ΙB lymph nodes. Less data is available to represent SMG involvement in oral squamous cell carcinoma (OSCC). Main objectives of systemic Review are to establish the rate, pattern and pathways of SMG involvement in OSCC.

Data Sources: A systematic review of related article were analyzed and articles recognized through  PubMed, Scopus, Medline and Cochrane library were studied until November 2019.

Review Methods: Explanatory features of main primary tumours, key management modalities, rate, pattern and pathway of SMG involvement, existence results. If existent were conveyed, subsequent PRISMA guidelines.

Results: The collected information were investigated and produced 259 articles, 19 out of 259 fulfil the inclusion criteria. 2699 patients in that 3235 SMG resections is selected out of 19 articles. Sixty-four glands (1.97%) had tumour participation. direct SMG infiltration by primary tumour was most common pathway (48 of 64, 1.4%). The subsequent usual method of SMG invasion was from involved peri-glandular lymph nodes (12 of 64, 0.3%). Only 3 resected SMG out of 3235 (0.1%) had metastatic parenchymal involvement from primary tumor.

Conclusion: Scarcity of SMG involvement in OSCC, SMG protection could be practicable in some patients. Decision regarding resection of submandibular glands should be done after visual examination during surgery instead of pre-planned resection. Though, extra analyses is required to assess the function of retained SMGs amongst patients who received postoperative radiotherapy.

Open Access Review Article

Roles and Rules of Some Regulatory Agencies around the World during COVID-19 Pandemic

Aseel Bin Sawad, Fatema Turkistani

Journal of Pharmaceutical Research International, Page 178-187
DOI: 10.9734/jpri/2021/v33i34A31838

Objective: Collecting and synthesizing relevant data on COVID-19 from official sources of some different regulatory agencies around the world.

Methods: The information and actions related to responding to the COVID-19 situation were collected from the websites of some regulatory agencies, including the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), Health Canada (HC), Swiss Agency for Therapeutic Products (Swissmedic), and the Australian Therapeutic Goods Administration (TGA).

Results: All the regulatory agencies help in expediting the development of COVID-19 treatments and medical devices. These agencies also developed an international regulatory collaboration to develop cure models for the pandemic. While some of the agencies conduct the COVID-19 testing, like the US FDA, the others do not. The agencies also differ in their approaches towards resolving the pandemic. FDA and EMA are more aggressive in a way that they prioritize more testing and hospitalization coverage. However, as of the 22nd of June 2021, the FDA authorized the highest number (388) of diagnostic COVID-19 test kits followed by TGA (128), and EMA (88).

Conclusions: Although the regulatory agencies differ in their approaches towards resolving pandemic COVID-19, all regulatory agencies help in expediting the development of COVID-19 treatments and medical devices.