Open Access Case Report

A Case Report on Reversible Toxic Optic Neuropathy on Long Term Treatment of Linezolid in Extensively Drug-Resistant Tuberculosis Patient

Sunil Kardani, Rajesh Hadia, Ashish Shah, Ghanshyam Parmar, Rajesh Maheshwari, Avinash Seth, Trupal Rathod, Dhaval Joshi

Journal of Pharmaceutical Research International, Page 7-11
DOI: 10.9734/jpri/2021/v33i37A31972

We describe a case of Linezolid-induced severe toxic optic neuropathy in a patient with drug-resistant tuberculosis. Linezolid produced severe toxic optic neuropathy in some who used it for a long time. To the best of our knowledge, the optic neuropathy was completely reversed after omitting Linezolid which is one of the effective drug regimens in his prescription, with significant improvements in eye vision.

Open Access Case Report

Masked Pituitary Macroadenoma Presenting as Pituitary Apoplexy Triggered by Sepsis in Postpartum Period-A Rare Case Report

Nicole Dound, Sandhya Pajai, Neema Acharya, Sourya Acharya, Chitra Dound

Journal of Pharmaceutical Research International, Page 12-16
DOI: 10.9734/jpri/2021/v33i37A31973

Apoplexy of the Pituitary gland is rarely seen critical disorder marked by acute throbbing of head / altered mental status / visual disturbances /decreased consciousness, due to sudden haemorrhagic changes of the pituitary or infarction of the same. There are numerous factors which precipitate apoplexy of the pituitary, sepsis being one of the least common cause, as is elaborated in this case study.  Inspite of having a distinctive presentation, pituitary apoplexy eludes diagnosis and proper management as it is complicated by related co-morbidities.  Its occurrence in a postpartum lady is an even rarer incident.  This article shows a rare occurrence of apoplexy of macroadenoma in a postpartum woman which was managed conservatively.

Open Access Case Report

Primary Gastric Lymphoma (Diffuse Large B Cell Type)

Milind Pandey, Sunita Vagha, Raunak Kotecha, Anchal Manchanda

Journal of Pharmaceutical Research International, Page 54-57
DOI: 10.9734/jpri/2021/v33i37A31979

The most frequent extra-nodal site of lymphoma is gastric lymphoma. The bulk of such lesions are extra nodal marginal zone B mucosal cell lymphoma correlated with lymphoid tissue (MALT) type or diffuse lymphoma of large B cells. We are reporting a case of diffuse major B-Cellular gastric lymphoma, which at first showed indigestion, abdominal heaviness, nausea and widespread weakness with 3-4 months of weight loss. In the antropyloric region and distal portion of lesser curvature of stomach suggestive of aetiology of cancer, the CT abdomen shows circumferential wall thickening. DLBCL has been confirmed by HPE and IHC. The neoplasm entered serosa and was found to have adherence to the pancreatic capsule in stage IIE of gastric lymphoma. Following the staging, treatment with an R-CHOP regimen (rituximab, cyclophosphamide, oncovin (vincristine), hydroxydaunorubicin, and prednisone) was done.

Open Access Case Report

Advanced Physical Rehabilitation in Hairline Coccyx Fracture: A Case Report

Shrushti Jachak, Snehal Samal

Journal of Pharmaceutical Research International, Page 221-227
DOI: 10.9734/jpri/2021/v33i37A32002

Background: The fracturing of Coccyx is an injury normally caused by trauma. A fall on the buttocks can cause a coccyx fracture that may go radiographically unnoticed. There is substantial discomfort in the patient that can persist for months. Coccygectomy is suggested in cases that, after more than 2 months of conservative treatment, demonstrate coccydynia. There is little evidence available on the feasibility of this technique, though, and it is considered to have a high complication rate. As such, it requires other treatment techniques.Here, in order to effectively minimize coccydynia in a coccyx fracture patient, we report our experience using another conservative treatment option. The care consists largely of resting, physiotherapy and analgesics.

Presenting Symptoms and Diagnosis: : A 21-year-old girl had increased pain i.e. coccydynia after a traffic accident( RTA) induced by coccyx fracture. She visited physiotherapy department with complaints of pain in coccyx area, tenderness, difficulty in mobility (pain while standing from sitting position) and difficulty in performing activities of daily living (ADL). Patient gives history of road traffic accident 2 months ago, a autorickshaw dashed the patient from behind. She went to orthopedic department where X-ray was performed and she diagnosed with hairline coccyx fracture. On inspection, patient was in pain, her NPRS score was 8. Her pain was aggravated by movements and relieved at rest. Patient came with slight stooping posture. On palpation we did found that the swelling and tenderness was present with tightness. Whereas on musculoskeletal assessment, we found that there was decreased range of motion, hypomobile joints, increased tone and muscle spasm.

Therapeutic Intervention and Outcomes: Patient was on medical treatment and bed-rest, treated with the analgesic and use of ring cushion was advised. She was also advised to reduce the weight bearing on buttocks. Cross-strapping of buttocks was done. After the completion of bed-rest, her condition was improved but she was having pain and could not perform squatting activities and other activities of daily living. Physiotherapy treatment was planned for the same.

Conclusion: Timely physiotherapy treatment is quite helpful to perform her everyday activities independently. This case study reveals the patient with hairline coccyx fracture experience full recovery after conservation management.

Open Access Case Report

Bridging the Gap between Locking Compressive Plate, Skin Grafting and Rehabilitation for Tibia Fracture: A Case Report

Simran Narang, Pratik Phansopkar, Laukik Vaidya, Neha Chitale, Dushyant Bawiskar

Journal of Pharmaceutical Research International, Page 284-291
DOI: 10.9734/jpri/2021/v33i37A32010

Introduction: Road traffic accidents (RTA) have remained an ongoing endemic problem over the years and a serious economic and medical-social burden for many countries around the world. Among the most complex and frequent fractures inside the joint is tibial plateau fractures. Such fractures are linked to adverse results, because of reasons such as the damage of cartilage but also soft tissue envelopes, complications like compartment syndrome, postoperative infection, knee dysfunction or rigidity, or even post-traumatic osteoarthritis.

Case Description: An 18-year-old young girl complaining of pain and inability to perform activities of daily living was referred to physiotherapy after being operated with external fixator (LCP) and skin grafting. Locking compressive plate was placed at lateral side of leg with 2 nails near head of fibula and 2 nails near lateral malleolus. Grafted skin was seen at anterior aspect of knee and anterior to medial aspect to leg. Patient was mostly suffering from pain in right leg and knee with intensity 7/10 at rest and 9/10 slight movement and swelling over right lower limb and patient complained of limited mobility and unable to walk.

Discussion: The significance of early mobilisation and range of knee joint motion exercises has been apparent in literature in the past 40 years. From low-intensity activities to progressive strengthening and partial to complete weight with walkers, recovery objectives were devised. Good grafting rates can be achieved with fast ambulation leading low extremity skin grafting operations, which runs counter to conventional lessons in post-operative skin grafting after lower extremity

Open Access Case Report

Impact of Physical Therapy in Patients Undergoing Modified Radical Mastectomy: A Case Report

Shivani Lalwani, Shruti Deshpande, Tasneem Burhani

Journal of Pharmaceutical Research International, Page 302-310
DOI: 10.9734/jpri/2021/v33i37A32012

Introduction: Breast Cancer is responsible for 2.09 million cases and 6,27,000 deaths worldwide, as per WHO. In India, women have one of the most common cancer, accounting for 14 per cent of all women's cancers.  Numerous risk factors are present, such as ethnicity, aging, hormones,  family medical history, genetic abnormalities, and unhygienic lifestyles. Side effects of cancer treatment may be alleviated by exercise interventions. Physical- therapy has been shown  to be effective in post-operative situations. It improves the functioning of the patient and the quality of life.

Presenting Symptoms and Diagnosis: Main symptoms from the patient were pain in the upper extremity, lack of control, power and range of motion. The main clinical results in this case have been a severe decrease in the range of shoulder joint motion. Reduced strength in the  upper extremity muscles and swelling (lymphoedema) in the upper extremity. Diagnosis of the case was Infiltrative Ductal Carcinoma that was confirmed by Ultrasonography and Fine Needle Aspiration Cytology. In such cases, behavioural approaches have been shown to be effective.

Therapeutic Intervention and Outcomes: Physical therapy intervention involves a variety of range of motion exercises, strengthening exercises, resistance conditioning, breathing exercises, lymphoedema treatment and scar management.

Conclusion: This intensive outpatient program is a successful way to enhance the mobility of the shoulder and ROM during the initial 6-week treatment cycle after surgery.

Open Access Systematic Review Article

The Effectiveness of Different Clinical Methods of Application for In-office Bleaching Materials with Hydrogen Peroxide: A Systematic Review

Khaled Alghulikah, Ahmed Abdulrahman Alahmed, Arwa Zaid Bin Muattish, Aseel Ahmad Almazyad, Meshal Abdullah Almalki, Ohood Ayoob Almaliki

Journal of Pharmaceutical Research International, Page 311-317
DOI: 10.9734/jpri/2021/v33i37A32013

Background: In the past few years, there has been an increase in demand for esthetic dental treatment. Vital tooth-bleaching is one of the most popular cosmetic procedures requested by patients in daily dental practice. There are various materials and protocols for treating discolored teeth since the introduction of vital tooth-bleaching to dental practice. In-office bleaching can be performed clinically using hydrogen peroxide alone or it can be combined with carbamide peroxide as a home bleaching technique. Hence the aim of this systematic review was to evaluate the effectiveness of different application protocols.

Methodology: A comprehensive search was performed using online databases (PubMed and ADA Center for Evidence-Based Dentistry) to obtain clinical trials relevant to the research question. The readers validated the studies that met the inclusion criteria. The included studies were evaluated using the risk of bias assessment instrument. In addition, the strength of recommendation of clinical trials was evaluated using Ex-GRADE.

Results: After reviewing 89 studies, duplicates were removed and inclusion and exclusion criteria were applied. Finally 10 clinical studies were accepted in this review.  Acceptable sampling was performed to obtain the clinical trials with strong evidence.

Conclusion: A qualitative assessment for the included studies proved the hypothesis of the research in that the best clinical outcomes of in-office bleaching is achieved with a single application of hydrogen peroxide.

Open Access Study Protocol

Assessment of Services at Tertiary Care Hospital Located in Central India, using ‘Kayakalp Initiative Tool’

Neelam Vinod Motwani, Abhishek Joshi, Sonali G. Choudhari, Abhay M. Gaidhane

Journal of Pharmaceutical Research International, Page 138-144
DOI: 10.9734/jpri/2021/v33i37A31989

Background: Kayakalp is an innovative initiatory started by the Health and Family Welfare Ministry through Swachh Bharat Abhiyan campaign on 15th May 2015. These instructions concentrate on advancement of desirable schemes for housekeeping facilities, pest control procedure, water sanitation, appointment & tutoring of manpower, advancement and accomplishment of appropriate cleansing procedure in terms of protocols / Standard Operating Procedures (SOPs), powerful management and inspection by the employees and inherent Machinery in the treaties linked with an organizational framework which places a bonus on excellent cleaning services and sanitary facilities. This study aims to describe the experiences and knowledge based on assessment of Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District using this tool.

Objectives: To assess and document hospital upkeep, Sanitation, Hygiene Practices, Hygiene Promotion and to study Handling of Biomedical Waste, Infection Control and Hospital Support Services.

Methodology: This cross sectional hospital based study that will be conducted at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District.

Apart from observation of various practices and Processes, the participants to be interviewed will be Nursing staff in-charge in different wards along with Biomedical engineers, Administrative officers and beneficiary patients. For Quantitative data collection, a kayakalp checklist will be used. Data will be collected through observation, staff interview, record keeping, and patient interview forms as per Kayakalp Initiative Tool.

Results: This study would help to understand current hospital sanitation procedures, hospital hygiene, infection prevention, general maintenance, waste management, and support services, etc. and will help to improve services based on findings of the study so as to improve satisfaction of population catered by hospital and provide an ideal working environment for all stakeholders.

Conclusion: This work will assist in improving hospital/facility management and will aid in improvement of sanitation and hygiene practices, it will also improve overall satisfaction of all stakeholders after due implementation of changes suggested at the end of study.

Open Access Study Protocol

To Assess the Effectiveness of Selected Mass Media Intervention (Poster, Leaflet, and Booklet) for Improving Mental Health Literacy among Rural Women

Dharti Meshram, Tessy Sebastian

Journal of Pharmaceutical Research International, Page 154-160
DOI: 10.9734/jpri/2021/v33i37A31991

Background: Mental Health Literacy states to the awareness or attitudes of a person regarding psychiatric illnesses that help their identification, prevention, or management. Psychiatric health awareness contains the capacity to identify particular conditions, information on how to look for knowledge on mental health, understanding danger factors or sources, treatment of self, or manageable medical support or behaviors that facilitate proof of identity or finding effective help.

Aim: study aims to assess the effectiveness of selected mass media intervention (poster, leaflet, and booklet) for improving mental health literacy among rural women.

Objective: 1. To assess the existing mental health literacy among rural women. 2. To evaluate the effectiveness of selected mass media intervention (poster, leaflet, and booklet) for improving mental health literacy among rural women. 3. To associate post-test scores of mental health literacy among rural women with their selected demographic variables of an experimental and control group.

Methodology: It is an experimental research design and the sample will be selected as per inclusion criteria. The convenience sampling technique will be selected. Data will be collected by using a self-structure questionary and modified mental health literacy scale and rating scale used for comparison of a poster, leaflet, and booklet, and the time limit will be allotted 30 minutes to each participant for fill-up the tools. the literature review was identified through Pub MED, Medline, Cochran, computerized, books, library.

Results: A critical review of the investigator has reviewed 522 published articles and the recorded of duplicate articles 218/11 original articles that included.

Conclusion: The conclusion will be drawn from the statistical analysis.

Open Access Study Protocol

A Study on C-Reactive Protein Levels in Pancreatic Diseases and Its Prognostic Significance

Shubham Durge, Harshal Ramteke, Meenakshi Yeola (Pate)

Journal of Pharmaceutical Research International, Page 246-251
DOI: 10.9734/jpri/2021/v33i37A32006

Background: Pancreatic diseases are one of the most prevalent challenges faced by surgeons throughout their work. Unless and until surgery is noted for its complications, the most traditional management line has always been conservative. As a diagnostic tool for it, amylase and lipase have been used to date, but some prognostic methods such as CRP are being used in this research, assessing its importance as a prognostic tool

Objectives: 

  1. To measure levels of CRP in patients of pancreatic diseases and evaluating if CRP concentrations expect the magnitude of the disease.
  2. To assess the accuracy levels of CRP in diagnosing pancreatic diseases by assessing with CT diagnosing.
  3. To find out correlation between levels of C-reactive protein and CT findings in pancreatic diseases.

Methodology: It is a prospective observational study completed on the patients of pancreatic diseases. It will be conducted at Surgery Department, JNMC and AVBRH, Sawangi (Meghe), DMIMS Wardha (DU).

Results: The result would be undertaken in SPSS software

Conclusion: Conclusion will be based on findings for study of protocol

Open Access Study Protocol

Assessment of Risk Factors in the Causation & Outcomes of Diabetic Foot

Chava Aravind Kumar, Chandrashekhar Mahakalkar, Meenakshi Yeola (Pate)

Journal of Pharmaceutical Research International, Page 264-270
DOI: 10.9734/jpri/2021/v33i37A32008

Background: Diabetic foot identifies   a Diabetic patient foot that has a potential risk of pathological risk effects that includes inflammation, ulceration and deep tissue destruction consistent with neurological   disorders, differing degrees of Peripheral arterial disease , and lower limb with  metabolic complications. An ulcer is a breach of the continuity of skin, epithelium of mucous membrane in the body which is caused by removal of necrotic tissue . Foot ulcers may be caused by numerous medical conditions. The key to treatment is daily sterile dressing till the formation of healthy granulation tissue, infection control by appropriate use of antibiotics, surgical interventions such as debridement or amputation if needed.

Methods: It will be a observational study, done on the patients with Diabetic foot . It will be conducted at Dept. of General Surgery, J.N.M.C. and AVBRH, Sawangi (Meghe), Wardha of DMIMS (DU). The study will be conducted on patients of foot ulcers.

Objectives:

  • To evaluate the microbiological and clinical characteristics of diabetic foot infection
  • To analyze the outcomes of a patient with diabetic foot with underlying risk factors HBA1c, Hypertension, Smoking, Diabetic Neuropathy, Recurrence, Obesity, Peripheral arterial diseases.
  • To analyze the association of Risk factors in the causation of Diabetic foot.
  • To predict outcome parameters based on Risk factors and its treatment modalities.

Results: The results will be analyzed after data collection in SPSS software.

Conclusion: Conclusion will be drawn on findings of study.

Open Access Minireview Article

Pharmaceutical, Therapeutically and Nutraceutical Potential of Aloe Vera: A Mini-review

Md. Mizanur Rahman, Ruhul Amin, Tahmina Afroz, Jayita Das

Journal of Pharmaceutical Research International, Page 109-118
DOI: 10.9734/jpri/2021/v33i37A31986

Aloe vera belongs to the family of Asphodelaceae, the oldest medicinal herb ever found and the world's most common medicinal plant. It is known as Ghritkumari, is used in medicine sources of homeopathy, ayurvedic, and allopathy. The species is a good source of repository of chemical ingredients that shows a precise range of biological activities such as wound healing, burn treatment, mitigating frost bite damage, defense against, lung cancer, intestinal problems, x-ray damage to the body, raising and decreasing high density and low lipoprotein content, reduction of diabetic blood sugar, battle against acquired immune deficiency syndrome (AIDS), and strengthening of the immune system. Aloe vera leaves are used to create drinks, perfume, skin lotion, cosmetics, or ointments. The plant's key ingredients are different kinds of vitamins, proteins, carbohydrates, minerals, saponins, amino acids, and salicylic acids. The plant is a good source of antioxidants. It also contains folic acid and vitamin A, C, E and B12. Aloe vera gel includes important ingredients, including the essential amino acids required by the human body. The plant can be used in the pharmaceutical and cosmetics industry. This research article is an effort towards Aloe Vera's industrial and ethnobotanical characteristics.

Open Access Minireview Article

Surgical Treatment of Adult Moyamoya Disease In Saudi Arabia: A Review Article

Bedour Eid H. Alatawi, Faisal Saeed A. Al-Ghamdi, Muath Sulaiman G. Alhamdi, Raghad Dhafer E. ALamri, Lena Defallah G. Alzahrani, Norah Majed Albalawi, Sultan Suliman Q. Al-Ruwaili, Khaled Abdullah S. Alasmari, Marwan Saleh D. Albalawi, Ghadeer Abdullah Albalawi

Journal of Pharmaceutical Research International, Page 145-153
DOI: 10.9734/jpri/2021/v33i37A31990

Moyamoya disease (MMD) is an isolated chronic, usually bilateral, vasculopathy disease of undetermined etiology. The clinical presentations of MMD include TIA, ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. Intra- and extra-cranial revascularization for the prevention of recurrence of bleeding in patients with hemorrhagic MMD is controversial. Surgical revascularization of MMD includes 3 types: Direct revascularization, indirect revascularization and combined revascularization. The surgical goal of cerebral revascularization is to prevent progression of symptomology, alleviate intracranial hemodynamic stress, and reduce the incidence of subsequent ischemic or hemorrhagic stroke. However, surgical treatments pose various complications due to the sudden increase in cerebral blood flow or hemodynamic changes caused by perioperative risk factors and anesthesia, such as HS, cerebral hemorrhage and cerebral infarction, bypass occlusion caused by distal vascular resistance, bypass occlusion caused by compression of the temporalis, and anastomotic aneurysm.

Open Access Minireview Article

Ultrasonography: The Third Eye of Anaesthesiologist

Kirti Gujarkar Mahatme, Pratibha Deshmukh, Parag Sable, Vivek Chakole

Journal of Pharmaceutical Research International, Page 235-238
DOI: 10.9734/jpri/2021/v33i37A32004

Anesthesiology is an evolving branch. Most of the procedures done by anesthesiologists, are blind except for endotracheal intubation. Ultrasonography (USG) helps anesthesiologists to see the actual anatomy in real time and thus helps them to give safe anesthesia minimizing the complications in every aspect of the field like difficult airway, vascular access, regional anesthesia, chronic pain management and critical care.

Open Access Original Research Article

Study the Effect of Ipomea carnea Jacq. Patra swarasa (Leaves Juice) in Treatment of Indralupta (Alopecia Areata): A Pilot Study

Prashant R. Umate, Pramod D. Khobragade, Saurabh Deshmukh, Sonali Wairagade, Minal Kalambe, Sonal Muley

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2021/v33i37A31971

Introduction: Hair and skin disease create negative impact on individuals. Although such diseases doesn’t have any life threatening effects like systemic diseases still have much more importance as the cosmetic issue concern. Indralupta is a rare entity found in both male, and female at any age which can be correlated with Alopecia areata. There are many treatment modalities are available for the Indralupta (Alopecia areata) but application of leaf juice of Ipomoea carnia is simple and cost effective treatment.

Aim &Objective: Study the effect of Ipomea carnea Jacq. patra swarasa (leaves juice) in management of Indralupta (Alopecia Areata). To study the adverse effects of Ipomea carnia leaf juice local application if noted during study.

Methodology: Fresh leaf juice will be extracted from clean leaf of Ipomea carnia and apply over the spot where hairs are lost for 15 days at morning before bath. 10 objects will be selected from kaychikitsa OPD randomly and consider for study after their willingness and consent. Outcomes will be assessed with the help of different criteria according to hair texture, Hair fall and scalp area examination.

Result: Result will be observed according to criteria and Wilcoxon signed rank test will be a applied.

Conclusion: Ipomea carnea will be effective in Indralupta(Alopecia areata).

Open Access Original Research Article

A Novel Severity Scoring Derived from Chest Radiographic Findings in COVID 19 Patients Admitted to a COVID Care University Hospital in India

Abhijit Mahavir Patil, Meenakshi Bhakare, Sundeep Salvi

Journal of Pharmaceutical Research International, Page 17-25
DOI: 10.9734/jpri/2021/v33i37A31974

Coronavirus (COVID 19) disease predominantly affects the Respiratory system and cause by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2). It enters into the host cells via angiotensin-converting enzyme-2 (ACE-2), a part of the renin-angiotensin system (RAS) found in the epithelium of the nasal, lungs.

Aim: Chest Radiographic findings in COVID-19 patients detected for COVID care. Applying the novel chest radiographic scoring in disease-spread patients is admitted to the COVID care center and its correlation with blood oxygen saturation (SpO2) and clinical severity.

Objective: 1) To apply the novel chest radiographic scoring in patients of COVID 19 infection are admitted to our Covid Care Centre and

2) To apply its correlation with blood oxygen saturation (SpO2) and clinical severity.

Results: 1) We found a moderate negative correlation between the chest radiographic score and SpO2. 2) Weak positive correlation between Clinical grading and CxR score.

Conclusion: Chest radiographic score taking into account the nature of opacities and extent is useful in classifying the patients into mild-moderate, severe, and critical grades. Take-home Message: A chest radiograph can be used as a baseline radiological investigation in COVID 19 patients as it can help to triage them according to the severity and treat them accordingly.

Open Access Original Research Article

Glutathione-S-Transferase Pi and Malondialdehyde in Alcoholic Patients Attending Smhrc and Avbrh Hospital

Ranjit S. Ambad, Suryakant Nagtilak, Gangaram Bhadarge, Meghali Kaple

Journal of Pharmaceutical Research International, Page 26-30
DOI: 10.9734/jpri/2021/v33i37A31975

Introduction: Alcohol abuse is a global health problem. The liver maintains high muscle damage by over drinking because it is a major source of ethanol metabolism. Among substance abusers, about 35 % develop advanced liver disease because the number of viral mutations increases, slows down, or inhibits the progression of liver disease. Glutathione-S-transferase is a family of Phase II enzyme-releasing toxins that cause the synthesis of glutathione in a variety of chronic and external electrophilic types. GSTs are divided into two very different family members: family members bound by microsomal membrane and cytosolic.

Aim: To study the Glutathione S Transferase π and Malondialdehyde in Alcoholic Patients.

Materials and Methods: Present study comprises 100 Subjects were included in the study and distributed in two groups. Patients from group one was alcoholic patients, enrolled from medicine ward and 50 non-alcoholic healthy individuals from group two were from non-alcoholic population as well as medicine ward.

Results: Rise of GGT, AST and ALT in Alcoholic patients (54.54 ± 3.72, 19.21 ± 0.68 and 24.32 ± 1.27 respectively) as compare to healthy individuals (24.40 ± 3.16, 10.36±0.35 and 17.06±0.84 respectively). The level of GST-π was decreased in alcoholic patients (62.44±26.30) as compare to control group (83.26±32.71). Similarly, the level of MDA was raised in alcoholic patients (5.36 ± 0.51) as compare to healthy individuals (4.73 ± 0.21).

Conclusion: Present study suggests that it would be vital to contain SGOT, SGPT, GGT, MDA and GST-π calculation in the prognostic assessment of alcoholic patients.

Open Access Original Research Article

Case Study on Post-Discharge Persistence or Reappearance of Respiratory Symptoms in COVID-19 Hypoxia Patients

Jayshree Kharche, Deepak S. Khismatrao, Reshma Patil, Rajkumar Nikalje

Journal of Pharmaceutical Research International, Page 31-39
DOI: 10.9734/jpri/2021/v33i37A31976

Introduction: News published about persistence or reappearance of symptoms in Covid 19 is worrisome. However, only one study from Italy is observed in this reference.

Aim: the current study is conducted to study persistence or reappearance of especially respiratory symptoms amongst COVID 19 hypoxia patients.

Study Design: Post-discharge follow-up, observational study with the telephonic interview of Covid 19 hypoxia patients from a dedicated Covid 19 hospital in India.

Methods: Sixty-two patients were interviewed 1 – 3 months post-discharge to elicit history on persistence or reappearance of respiratory symptoms.

Results: out of the results many patients doesnot show any symptoms compared to female, male are more prone to respiratory problems. Thus, the oxygen therapy showed proof that males are more prone to illness and depict the symptoms compared to females.

Conclusion: A large multi-centric year-long study is recommended to further conclude on the natural history of the disease.

Open Access Original Research Article

Study on Serum Zinc Levels and Vitamin a Levels in Tuberculosis Patients

Gangaram Bhadarge, Nandkishor Bankar, Sudhir Singh

Journal of Pharmaceutical Research International, Page 40-44
DOI: 10.9734/jpri/2021/v33i37A31977

Introduction: Tuberculosis, an infectious disease caused by the bacteria Mycobacterium tuberculosis (MTB), is also a major cause of death in humans around the world. According to a World Health Organization (WHO) survey, MTB infects one-third of the world's population, with 9.6 million new tuberculosis (TB) infections and 1.5 million deaths confirmed this in 2021

Aim: study of serum zinc levels and vitamin a levels in tuberculosis patients.

Materials and Methods: This study included 40 newly diagnosed PTB patients of both sex with the age group of 18-60.Time period of this study was from September 2020 to Арril 2021 а nоn-rаndоmised соntrоlled trial was involved.

Result: There was a strong correlation between serum zinc and vitamin A levels P < 0.01) Hb, P < 0.01) and serum albumin levels P < 0.01) were also strongly correlated with the vitamin A levels; however, WBC P < 0.01) and ESR P < 0.01) were negatively correlated with the vitamin A levels.

Conclusion: In view of the above, the patient's nutritional status may be the most important determinant of infection tolerance. Zinc deficiency can have an indirect impact on Vitamin A metabolism by reducing the levels of circulating protein. Because of this, the addition of zinc in combination with vitamin A may be helpful in achieving the disease status.

Open Access Original Research Article

Quality of Life in Recent Stroke Patients and Burden on Caregivers in Gujarat state of Western India

Palani Kumar, Preksha Nagar, Lata Parmar

Journal of Pharmaceutical Research International, Page 45-53
DOI: 10.9734/jpri/2021/v33i37A31978

Background: Stroke is a global health problem. Patients with stroke may be damaged in many aspects of life, which affects the physical, psychological and social dimensions of quality of life. These factors lead to burden on the caregivers. This burden on the caregivers negatively affects the rehabilitation of the stroke patients.

Objective: To study the quality of life of stroke patients and burden on caregivers.

Methods: Stroke patients fulfilling the inclusion criteria were assessed for the quality of life by the Stroke Specific Quality Of Life Scale and the burden on caregivers was measured using the Zarit Burden Interview on one to one interview basis. The data were analysed using the SPSS software.

Results: The quality of life and burden scores were weakly correlated (r= -0.558 and p= 0.001). The quality of life and burden scores were also weakly correlated to the MMSE scores.

Conclusion: There is a negative correlation of the burden on caregivers with the quality of life of the stroke patients. There is also a positive correlation of MMSE score with the quality of life. Whereas, there is no correlation of the quality of life and burden scores with the patient’s age and sex, type of stroke, duration post stroke and whether any treatment has been taken.

Open Access Original Research Article

Antibiotic Prescribing Practices in Primary Care Settings Using 2019 WHO AWaRe Framework

Haritha Pasupulati, Vishal Avadhanula, Amit Mamilla, Mahadev Bamini, Satyanarayana S. V. Padi

Journal of Pharmaceutical Research International, Page 58-68
DOI: 10.9734/jpri/2021/v33i37A31980

Background: Bacteria have ability to rapidly evolve, develop strategies to resist antibiotics, and reduce the effectiveness of antibiotics. The emergence and spread of antimicrobial resistance is an important global public health challenge to tackle. Studying antibiotic prescribing practices would allow rational use and preserve effectiveness of antibiotics.

Objective: To study prescribing practices of antibiotics in out-patients in primary care settings using the WHO AWaRe framework.

Methodology: A prospective cross-sectional study was conducted to evaluate prescribing practices of antibiotics in the primary care facility of three private hospitals using the WHO ‘core prescribing indicators’ and Access, Watch, and Reserve (AWaRe) classification. A systematic sampling technique was employed to collect the prescriptions at each hospital for three months. Descriptive statistics were applied to the collected data.

Results: A total of 2685 prescriptions were systematically evaluated. 1280 encounters had at least one antibiotic (47.7%), of which 1041 consist of only one antibiotic (81.5%). Among 1280 antibiotic encounters, the average number of antibiotics per encounter was 1.2 and 14.6% were prescribed with a parenteral antibiotic. 26.6% and 78.6% antibiotics were prescribed using generic names and from the WHO Essential Medicines List, respectively. Amoxicillin/clavulanic acid, ceftriaxone, azithromycin, cefoperazone, and amoxicillin were the five most commonly prescribed antibiotics. According to the WHO AWaRe classification, a total of 27 specific antibiotics (Access 11, Watch 14, and Reserve 2) were prescribed. 38.4%, 53.7%, 0.3%, and 10.5% of antibiotics prescribed were from the ‘Access’, ‘Watch’, ‘Reserve’, and ‘Not Recommended’ categories, respectively. Third generation cephalosporins (24.0%) were prescribed in high rate among ‘Watch’ category. The most commonly prescribed ‘Access’ and ‘Watch’ antibiotics were amoxicillin/clavulanic acid (12.5%) and ceftriaxone (10.6%), respectively. Amoxicillin index was 19.5% and ‘Access-to-Watch’ index was 0.76, which were below the priority values.

Conclusion: Except few indicators, still better prescribing practices of antibiotics are needed to fully meet the WHO recommendations. Antibiotic prescribing guidelines as per the WHO AWaRe framework, changes in prescription patterns and preference of “Access” over ‘Watch’ antibiotics are crucial to preserve effectiveness and promote rational use of antibiotics.

Open Access Original Research Article

Applicability of State Responsibility for Health Emergencies and the Unique Situation of China amid SARS-COV-2

Sujata Arya, Srijoy Deb, Virendra Singh Thakur

Journal of Pharmaceutical Research International, Page 77-84
DOI: 10.9734/jpri/2021/v33i37A31982

This article aims to understand the limitations in enforcing state responsibility on a state of Origin for Trans boundary harm caused by a health emergency by analyzing the factors of force majeure, multiparty involvement, and inability to provide reparations, and the unclear source of the virus as the chief hindrances in prosecuting such states. The authors further explore the various conditions that triggered other PHEICs in history and the consequences and actions taken due to the trans-boundary harm caused. Furthermore, the article also studies the conditions that gave rise to the wet markets and traces the shortcomings in law that hurt the Origin of the virus. After that, the article studies how countries have failed to invoke the state responsibility of trans-boundary harm caused by a PHEIC.  Lastly, the article further delves into how Chinese authorities blame both pre and post-outbreak and examine how the global community can negotiate with China for adequate compensation.

Open Access Original Research Article

A Prospective Observational Study on Prescription Pattern and Its Efficacy in the Management of Osteoarthritis at Multispecialty Teaching Care Hospital

Sarvajeet Khare, Trupal Rathod, Rajesh Hadia, Sunil Baile, Nikhil Khambhati, Sunil Kardani, Dhaval Joshi

Journal of Pharmaceutical Research International, Page 92-100
DOI: 10.9734/jpri/2021/v33i37A31984

Background: osteoarthritis is a severe clinical condition in elderly patients. Almost any bone can fracture as a result of the increased bone fragility of osteoarthritis.

Aim and Objective of study: The principle aim of drug utilization research is to facilitate the rational use of drugs in an individualized patient. To Study current prescription pattern and its efficacy to manage osteoarthritis.

Methodology: This study was a prospective observational study and conducted over a period of six month from October 2015 to March 2016. Patients diagnosed with arthritis with or without co-morbidities were enrolled in the Study considering the inclusion and exclusion criteria. The main sources of data collection were OPD file and case sheets of patients.

Results: In this study 148 patients were enrolled, 105 (70.9%) female patients and 43 (29.1%) male patients were participated. Out of 148 study participants 60 (40.54%) patients from age group 51-65 years, followed by 54 (36.48%) patients from age group 36-50 years. In the study population 94 (63.51%) patient were suffering osteoarthritis of both knee, 29 (19.59%) patients were suffering osteoarthritis of right knee and 25 (16.89%) patients were having osteoarthritis of left knee. X-ray report were representing in study population, in 44 patient reports were shows degenerative change seen in both knee, 08 patient report were shows degenerative change seen in right knee. In our study out of 148 patients, 92 (62.16%) patients prescribed NSAIDs, 25 (16.89%) patients prescribed Analgesic, 05 (03.37%) patients were prescribed Opioid analgesic, 11 (07.43%) patients were prescribed supplements and 15 (10.13%) patients received other class of drugs.  Among the study population 112 (75.67%) patients were received oral route of drugs and 36 (24.32%) Patients were prescribed topical preparation. The visual analogue scale has been categorized as follows 0-3 Mild pain, 4-7 Moderate pain and 8-10 severe pain. In visual analogue scale initially 16 patients were suffering mild pain, but after treatment it was 93 patients suffering mild pain. The facial pain scale has been categorized as follow 0 = very happy, no hurt, 2 = hurts just a little bit, 4 = hurts a little more 6 = hurts even more, 8 = hurts a whole lot, 10 = hurts as much as you can imagine.  Among 148 study participants 14 patients were having final Facial pain score 0, 67 patients were having a final Facial pain score 2 and 3 patients having Initial Facial Pain score 2, 42 patients were having a final Facial pain score 4 and 42 patients having Initial Facial pain score 4, 19 patients were having a final Facial pain score 6 and 63 patients having Initial Facial pain score 6, 06 patients were having final Facial pain score 8 and 33 patients having Initial Facial pain score 8, 07 patients having Initial Facial score 10.

Conclusion: The principal aim of drug utilization research is to facilitate the rational use of drugs in an individualized patient. For the individual’s patients, the rational use of a drug implies the prescription of the well documented drug at optimal dose, together with the correct information, at an affordable price.

Open Access Original Research Article

Formulation and Evaluation of Conventional Metronidazole Tablets using Natural Gum Extracted from Grewia species

J. A. Avbunudiogba, O. Oghenekevwe

Journal of Pharmaceutical Research International, Page 128-137
DOI: 10.9734/jpri/2021/v33i37A31988

Aims: The pharmaceutical world has been paying increasing attention to the extraction, development and use of natural gums as binders in the formulation of solid dosage forms. The use of natural gums as binders is more advantageous than the use of synthetic ones due to availability, low cost, biodegradability and biocompatibility. In this study, gum extracted from Grewia species was compared with that fromAcacia in metronidazole tablets.

Study Design: Ten batches of metronidazole tablets were formulated with varied concentration of Grewiaspp gum and Acacia gum.

Place and Duration of Study: The study was carried out in Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Delta State University, Abraka, Nigeria; between January and December 2019.

Methodology: Five batches of metronidazole tablets containing 0.5, 0.75, 1.0, 1.25 and 1.5% w/w of Grewia gum were preparedby wet granulation. Resulting granules were characterised by measuring flow and packing properties. In other experiments, five batches of tablets were formulated using same concentration of gum, with Acacia gum substituted for Grewia gum. Both sets of granules were compressed into tablets using tableting machine at a load of 27 arbitrary units. Tablets so formed were evaluated for hardness, friability, disintegration time, drug content and drug release profiles. Drug – excipient interaction was investigated with FTIR.

Results: The resulting metronidazole tablets showed hardness of 5.46 kgF to 7.87 kgF (Grewiagum) and 6.06 kgF-8.20 kgF (Acacia gum). Friability percentages of all the batches were above 1% except for A3-A5 and B5 which are less than 1%. All formulations released more than 75 % of the drug content within 60 min. The FTIR analysis revealed no interaction between the metronidazole and Grewia species gum.

Conclusion: Metronidazole granules and tablets were successfully prepared using Grewiagum and showed comparable pre-compression and post-compression properties with those formulated with Acacia.

Open Access Original Research Article

Studies of Mixed Ligand Lanthanum Complexes: Synthesis, Spectral Interpretations and Antibacterial Study

Sunil Patil, Bhushan Langi, Minakshi Gurav, Digambar Patil

Journal of Pharmaceutical Research International, Page 161-174
DOI: 10.9734/jpri/2021/v33i37A31992

The mixed ligand lanthanum complexes have been synthesized using polydentate ligands. The (2Z)-2-(N-hydroxyimino)-1,2-diphenylethan-1-ol (cupron) was used as a primary ligand and L-isolucine, L-threonine, L-lysine and L-glycine were used as secondary ligands for the synthesis. Conductometry, elemental analysis, magnetic susceptibility measurements, complexometric estimation, UV-Visible spectroscopy, FTIR spectroscopy, thermal analysis and XRD methods were used for structural interpretation of all synthesized complexes. All complexes were solid and white and slight yellow in colour. They are non-electrolytic and diamagnetic in nature, as confirmed by conductometric and magnetic susceptibility methods respectively. All the complexes were synthesized by combination of lanthanum metal ion, primary ligand and secondary ligands in 1:2:1 ratio which was confirmed by elemental analysis. During reaction between lanthanum ion, primary ligand and secondary ligands there was transition of electrons which was confirmed by UV-Visible spectroscopy. Identification of functional group in the complexes was carried out and confirmed by FTIR spectroscopy. The decomposition temperature and thermal behaviour of the complexes have been concluded by thermal and XRD techniques. Tube dilution and agar cup methods have been employed to study antibacterial activities of all synthesized lanthanum complexes. The inhibition potential was seen to some extent.  

Open Access Original Research Article

A Comparative Analytical Study of Fresh Honey Collected from Honey Comb of Apis Mellifera and Market Samples of Honey

Bharat Rathi, Renu Rathi, Dhirajsingh Rajput, Anita Wanjari, Mujahid Khan

Journal of Pharmaceutical Research International, Page 175-181
DOI: 10.9734/jpri/2021/v33i37A31993

Honey is a natural product which was known to ancient seers of Ayurveda since Veda period. The nutritional and therapeutic benefits of honey were well known and also documented in authentic texts of Ayurveda. However the abundant availability of honey has gone decreasing since industrialization and deforestation. It has resulted in artificial culture and marketing of honey. The quality of such honey is matter of concern as it is easy to adulterate honey but is very hard to find out the difference between natural and adulterated honey. Considering this issue, present work has been planned to compare freshly collected natural honey and marketed samples of honey. For the comparative analytical study four different samples were collected. Three samples of three different pharmacies were procured from market (honey of branded Ayurvedic companies) and compared with collected honey sample from honeycomb of Apis mellifera. The collected four samples of honey have almost similar organoleptic characters i.e. colour, odour, taste and touch. Considerable differences are detected in physico-chemical analysis, nutritional value and HMF value. The observations are within normal range however the differences are suggestive of need of establishing quality control parameters based on source of honey, collection season, temperature and storage condition and also providing these details while labelling the samples. Finding of present study revealed that freshly collected natural honey have best desired attributes compared all three marketed samples.

Open Access Original Research Article

Coronavirus Pandemic: An Update on the Transmission, Diagnosis, Clinical Features and Managment

Saad S. Alqahtani, Santhosh Joseph, Otilia J. F. Banji, Abdulkarim M. Meraya, Ahmed A. Albarraq, Hafiz A. Makeen, David Banji, Mamoon H. Syed, Ayesha Yasmeen, Ambreen Shoaib, Nawazish Alam, Khalid O. Alfarouk, Nabeel Kashaan A. Syed, Sarfraz Ahmed

Journal of Pharmaceutical Research International, Page 182-192
DOI: 10.9734/jpri/2021/v33i37A31994

The novel coronavirus, designated as “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS-CoV-2), is a new coronavirus that has evolved as a global pandemic recently, and it has created a widespread interest in coronaviruses causing human infections. This article compares the pathogenesis, distribution, clinical characteristics, and treatment of the three highly pathogenic coronaviruses that caused epidemics, namely, “Severe Acute Respiratory Syndrome Coronavirus” (SARS), “Middle East Respiratory Syndrome” (MERS), and SARS-CoV-2. This narrative review is prepared using the data compiled from literature search using relevant MeSH terms. The clinical manifestation of SARS-CoV-2 infection (COVID-19) is mild with relatively low fatality rate than the other two coronaviruses; however, its overall capability to cause explosive spread of the disease and reach a pandemic level is greater. Unlike SARS and MERS, COVID-19 has no accepted treatment protocols at present. Extensive studies and analyses on COVID-19 are necessary before making strong recommendations for or against any particular treatment, although some recent medications have shown great potential. COVID-19 still needs further investigation, where all of the lessons gained from previous outbreaks of SARS and MERS and the experience from the countries that managed COVID-19 seem to be the best approaches to counteract this new global hazard at present until effective preventive vaccines are available in sufficient quantity for mass vaccination programs worldwide.

Open Access Original Research Article

A Comparative Study of Functional Outcome of Olecranon Fractures Managed with Tension band Wiring Using K Wires with Tension Band Wiring Using Cancellous Screws Fixation

Ashutosh Parate, Vasant Gawande, Suvarn Gupta, Ankit Jaiwal, Ashwin Chavan, Kunal Saoji

Journal of Pharmaceutical Research International, Page 193-198
DOI: 10.9734/jpri/2021/v33i37A31996

Introduction: Olecranon fracture are some of the common injuries seen in emergency with commonest mode of trauma being fall on outstretched hand and road traffic accident.

Methods: This prospective comparative study was carried out from May 2020 to May 2021 within a study period of 1 year in Datta Meghe Medical College. 20 patients of olecranon fractures were enrolled randomly.

Results: According to the Mayo classification, the majority of the cases in our study were type II A fractures. The Mayo elbow performance score. In the K wire category, 5 patients (50%) had excellent results, 3 patients (30%) had decent results, and 2 patients (20%) had fair results. In both categories, there were no negative repercussions. In the cancellous screw category, excellent results were found in 8 patients (80%), nice in 1 patient (10%), and fair in 1 patient (10%).

Conclusions: From this study, we came to the conclusion that for displaced olecranon fractures as per Mayo’s II A classification fixed by using cancellous screw with tension band wiring gives better clinical outcome When compared to tension band wiring, K-wire fixation keeps costs down, time, and the chance of implant removal complications.

Open Access Original Research Article

An Observational Study on Immune-related Disorders and Their Treatment Response in Ayurveda- Case Series

K. Pradeep, M. Abhilash, M. A. Reshma, Bindu K. Viswambaran

Journal of Pharmaceutical Research International, Page 199-207
DOI: 10.9734/jpri/2021/v33i37A31999

Immune-related disorders are common health problems in the world. Based on the principal immunologic mechanism they are classified into four types. One of the four types includes immediate hypersensitivity which is an IgE antibody and mast cell-mediated reaction. Ayurvedic treatments have sometimes delivered good results in the treatment of these disorders. This work is a humble effort to streamline Immune-related diseases in the settings of Govt Ayurveda Medical College, Tripunithura, Kerala, India. In this case series study patients with allergic rhinitis and urticaria were selected. Their symptoms and blood parameters were assessed both before and after the Ayurvedic treatment for one month. In both allergic rhinitis and urticaria, there was a significant reduction in the symptoms. In the case of blood investigations, only IgE showed a significant change in allergic rhinitis. Even though Ayurvedic immunology has a strong potential to treat allergic disorders with its pro-nature individualized holistic approach to make significant changes in immune parameters administration of rejuvenators for more than one month is very essential.

Open Access Original Research Article

Comparative Study of Malondialdehyde, Superoxide Dismutase and Glutathione Peroxidase in Urolithiasis Patients: A Case Control Study

Rakesh Kumar Jha, Ranjit Ambad, Ajonish Kamble, Yashwant Lamture

Journal of Pharmaceutical Research International, Page 208-213
DOI: 10.9734/jpri/2021/v33i37A32000

Background: Urolithiasis i.e. stone firming disease in the urinary passages is one of the frequently encountered diseases in man. Perhaps the disease is as ancient as the man himself as has been revealed by the archaeological excavation done in different parts of the world such as in Egypt.

Aim: Comparative Study of Malondialdehyde, Superoxide Dismutase and Glutathione Peroxidase in Urolithiasis Patients: A Case Control Study

Materials and Methods: The study was carried out in the Department of Biochemistry, Datta Meghe Medical College Nagpur in collaboration with Department of Surgery, Division of Urology and Department of Pharmacology.

Results: The urolithiasis patients have shown a marked increase in plasma MDA levels. There was a significant increase in the values of superoxide dismutase in patients suffering from urolithiasis (6.26 ± 0.86 µmol/l RBC lysate) as compared to the normal control values (3.40 ± 1.09 µmol/l RBC lysate) in human volunteers (p<0.01).A significantly decreased value of glutathione peroxidase has been observed in patients suffering from urolithiasis as compared to the control group.

Conclusion: Enhanced SOD can reduce the formation of Calcium Oxalate crystals and reduce the damage of renal tubular epithelial cell.

Open Access Original Research Article

Prevalence of Pulmonary Hypertension in Sickle Cell Anemiai Patient in KSA

Eman AbdulAziz Balbaid, Manal abdulaziz Murad, Hoda Jehad Abousada, Abdurrahman Yousuf Banjar, Mashael Abdulghani Taj, Nazeha Khalid Bamohsen, Somayah Ali Alghubishi, Ahmed Jaza Mohson Alrsheedi, Nada Faiez Alshanbari, Raneem Siddiq Nasser Alsahaqi, Abdulmajeed Abdulaziz Alharbi, Rana Abualqasim Mohammed Kudam, Abdulmajeed Hadi Alanazi, Hassan Mansour Alharbi, Abdullah Matar Alsulaimi

Journal of Pharmaceutical Research International, Page 214-220
DOI: 10.9734/jpri/2021/v33i37A32001

Introduction: Pulmonary hypertension (PH) is a relatively common and severe complication of SCI and an independent risk factor for mortality. Sickle cell disease is considered one of the most common diseases in the Kingdom of Saudi Arabia. When a healthy disease related to cardiovascular health is highlighted, sickle cell anemia may be the most common and related disease in high pulmonary pressure. In this study, we aimed to determine prevalence of PHTN in SCA patient, and associated risk factors with it.  

Methodology: This is an analytical cross-sectional study conducted in kingdom of Saudi Arabia (General population, SCA patient and CVD patient), from 29/7/2020 till 15/11/2020. The study was depending on online self-reported questionnaire that included assessing the demographic factors as gender, nationality besides, disease-related information:  SCA patient , CVD patient and DM patient.

Results: we received 794 responses to our questionnaire where 93.5% of them were Saudi Arabian.  The prevalence of sickle cell anemia is 8.8%. Male represented 29.8% of patients while female represented 52.2% of patients. In SCA patients, the prevalence of PHTN was 31.8%. Moreover, it was found that having cardiac disease is considered a risk factor for developing PHTN where 37.7% of patients having cardiac disease had PHTN compared with 6.2% of health patients (OD: 9.16, 95% CI: 5.5479 to 15.13, P=0.000) while diabetes mellitus increase risk for developing PHTN by more than seven fold (OD: 7.6, 95% CI; 4.7175 to 12.4, P=0.000) and disorder of nervous system by 12 folds (OD: 12.7; 95% CI: 7.6658 to 21.09, P=0.000).

Conclusion: we had found that the prevalence if SCA among Saudi Arabia is 8.8% with a higher prevalence in female than male. Moreover, the prevalence of PHTN in SCA patients was high about 31.8% which is much higher than its prevalence in normal individuals. Moreover, it was found that having cardiac disease is considered a risk factor for developing PHTN besides, having diabetic condition and disorder of nervous system which increased risk for developing PHTN in SCA by nine, seven and 12-fold respectively.

Open Access Original Research Article

Awareness, Practice, Knowledge and Attitude toward the COVID-19 among Antenatal Patients at Tertiary Care Hospital

Fahmida Parveen, Samia Aijaz, Sakeena Ahmed Memon, Hina Akmal

Journal of Pharmaceutical Research International, Page 228-234
DOI: 10.9734/jpri/2021/v33i37A32003

Objective: To determine the awareness, practice, knowledge and attitude toward the Covid 19 among antenatal patients at tertiary care Hospital.

Methodology: This was a cross sectional survey which was conducted at Gynae and obstetrics department at Liaquat University Hospital Hyderabad. Study duration was six months from March 2020 to August 2020. All the pregnant women visited antenatal clinic age 18 to 40 years and either of parity were included. All the pregnant females were interviewed by using a questioner regarding awareness, attitude and practice toward the Covid19 after taking informed consent. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20.

Results: Total 173 pregnant women were interview regarding COVID-19, their mean age was 29.34+13.12 years. Most of the women were presented with age between 18 to 37 years. 70.5% were multigravida and majority of women were uneducated. Mostly women 75.1% had heard regarding. 72.8% women said, they should stay at home and 25.4% said should wear the face mask, while 38.7% said the women should inform the health care provider in advance before visit to Hospital if developed any symptom. Most of the women had good knowledge and attitude, while preventive practice was found to be unsatisfactory.

Conclusion: knowledge and awareness were found to adequate; while preventive practice has been observed unsatisfactory among pregnant women during antenatal clinic. Clinicians should provide appropriate counseling to reassure and elucidate doubts of pregnancy females regarding COVID-19 during antenatal visits.

Open Access Original Research Article

In vitro Comparative Quality Evaluation of Formulated and Marketed Losartan Potassium 25 Mg Tablets

Md. Emran Hossain, Sukria Hossain, Md. Shahin Sarker, Mst. Mahfuza Rahman, Mir Imam Ibne Wahed

Journal of Pharmaceutical Research International, Page 239-245
DOI: 10.9734/jpri/2021/v33i37A32005

Background: The outcome of the drug therapy depends largely on the quality of the drug product. The lower quality of the drug product can be the reason for therapeutic failure. The present study was designed to evaluate the quality standard of Losartan Potassium tablet brands available in Bangladesh market to get an idea of quality standard of drug product people consuming in this country.

Materials and methods: Three brands of losartan potassium were chosen randomly. Tablets of each brand were collected from individual retail outlets to gauge the qualitative evaluation and compare them by in-vitro drug release study. They were subjected to various quality control tests to measure the hardness, thickness, weight variation, friability, disintegration time, potency, stability, and dissolution profile. All these tests were performed according to the U.S. Pharmacopeia (USP) specification. Researchers further formulated a batch of tablet of Losartan Potassium and compared them with the existing brands. The formulation was prepared by optimizing the existing one available in the USP. Test results of the existing brands were taken into consideration during the optimization of the formulation.

Results and discussion: Two brands passed the weight variation test, while one brand exceeded the range (±5%). The potency was determined instantly and 15 days after keeping the tablets in a stability chamber at 75% humidity and 60oC temperature. The potency of two brands degraded below the lower limit specified by the USP, while that of the remaining one was within the limits. Results of other tests were within the specified limits. Tablets prepared in the lab using an optimized formulation showed a better dissolution rate than the existing brands.

Conclusion: Some of the brands failed to meet the desired quality, so the quality control system of that companies should be upgraded and a proper monitoring system should be developed by the drug administration.

Open Access Original Research Article

Formulation, Evaluation and Comparison of the Poly Herbal Anti-Diabetic Tablet with the Commercial Tablets

N. Chauhan Nidhi, Mistry Rujuta, Mandale Drasti, Ugharatdar Siddik Ismail, Dadubhai Ezaj, C. Patel Vaishnavi

Journal of Pharmaceutical Research International, Page 252-263
DOI: 10.9734/jpri/2021/v33i37A32007

Objective: To formulate a poly herbal anti-diabetic tablet and to evaluate and compare its physicochemical properties with the marketed herbal tablets.

Materials and Methods: The poly herbal anti-diabetic tablet was formulated by adding the powder of extract of  Enicostemma littorale in powder of  roots of Aconitum heterophyllum rhizomes of Picrorhiza kurroa and fruits of Piper longum in different proportions to an  aqueous 5 % Starch solution and  Several tests such as visual inspection, ash values, moisture content, Water soluble extractive value and Alcohol soluble extractive value, disintegration time, Uniformity of weight of tablets, Determination of hardness of tablets, Determination of friability of tablets etc and Preliminary phytochemical screening and qualitative chemical examination were performed and compare Laboratory formulated tablets with  commercial tablets.

Results: The study showed that Laboratory formulated poly herbal anti-diabetic tablet has good flow property and compressibility. The moisture content of laboratory formulations was found to be 4.8%. Water extractive value was found to be 28.14% W/V result shows that laboratory formulation consisted of higher amount of water soluble substances like carbohydrates. Alcohol extractive value was found to be 20.08% W/V denotes the amount of alcohol soluble constituents present in the formulation. Disintegration of tablet was found to be 3 mins results shows laboratory formulation was within the limit as it was prepared with starch paste (5%w/v) as a binding and disintegrating agent. Disintegration of tablet is not more than 30 minutes.  The laboratory formulation was found to have 3 (Kg/Cm2) hardness, 0.38 % Friability and weight variation within pharmaceutical limits. However, further research and development is required to improve its quality and safety.

Conclusion: The aim of this study was to formulate a completely poly herbal antidiabetic tablet. Our Laboratory formulated tablets showed comparable good results as compare to that of marketed tablets but further research and development is required to improve its overall quality.

Open Access Original Research Article

Implementation of WHO Surgical Safety Checklist and Pre-operative Anxiety Levels to Study the Effect on Post-operative Recovery among Surgery Patients

Rajesh Hadia, Juliet Joy Joseph, Jilce Mathew, Shivani Patel, Trupal Rathod, Dhaval Joshi, Bhavin Shah, Sunil Baile, Kushalkumar Gohel, Sunil Kardani, Rajesh Maheshwari

Journal of Pharmaceutical Research International, Page 271-283
DOI: 10.9734/jpri/2021/v33i37A32009

Background: World Health Organization Surgical Safety Checklist demonstrated a significant reduction in both morbidity and mortality.

Objectives: This study aimed to find out the feasibility of implementation of WHO Surgical safety checklist in the routine practice, to ensure the teams follow critical safety steps, consistency in patient safety, and to maintain a culture that values achieving it, to assess the pre-operative status and post-operative quality of recovery among the patients undergoing surgery.

Methodology: It is a prospective and observational study. A total of 65 patients of age group 18 and above were included in the study. The data was collected by filling the patient medical record sheet.

Result: A total of 65 patients were included in the study. 64.62% were male, 35.38% were female. Out of 65 patients 61.54% experienced pre-operative anxiety; of which 20% of patients (n=9) showed very fast to fast recovery, 27.5% of patients (n=11) showed moderate recovery) and 52.5% of patients (n=21) showed slow to very slow recovery.

Conclusion: Implementation of the WHO surgical safety checklist may improve miscommunications between the OR team, avoid unexpected errors ((Improving teamwork and communication). Appointing a staff or member of the OR team with the responsibility to check the checklist may improve the feasibility to implement the WHO SSC. The level of pre-operative anxiety greatly influences postoperative recovery. Thus, the Surgical and Anaesthetic team must assess the patient's pre-operative anxiety and take the necessary step before surgery.

Open Access Original Research Article

A Cross-sectional Observational Study on Pharmacoeconomic Burden of Asthma in a Tertiary Care Teaching Hospital

Rajesh Hadia, Azrin Shaikh, Twinkle Ajay, Elizabeth Philip, Dhaval Joshi, Trupal Rathod, Arti Shah, Hemraj Singh Rajput

Journal of Pharmaceutical Research International, Page 292-301
DOI: 10.9734/jpri/2021/v33i37A32011

Background: Asthma remains one of the most common chronic respiratory diseases. Even with significant advancement in the diagnosis and management of asthma, its control remains suboptimal. As the overall health expenditures are escalating, the healthcare community has become more sensitive to the concept of Pharmacoeconomic.

Objective: We aimed to assess the healthcare cost; economic burden associated with the management of asthma.

Methodology: A Prospective Observational Study was conducted in a Hospital of Vadodara, Gujarat, India with the sample of 120 patients. Patient’s data, financial data and the healthcare cost were collected while interviewing the patient. The healthcare costs included were direct medical cost, direct non-medical cost, and indirect cost.

Result: The average costs per asthmatic patient per month with severe, moderate and mild asthma were found to be USD 65.27, USD 50.89, and USD 48.85, respectively. The average overall cost with or without co-morbidity were calculated as USD 56 and USD 38, respectively. Out of USD 53.6, the average direct medical cost was USD 29.6, the average direct non-medical cost was USD 17.4, and the average total indirect cost was USD 6.6. The mean total cost for inpatient was calculated to be USD 105.12 and for outpatient it was USD 56.09. The 43% of the population had burden of illness less than 30% and 40% of the population had burden of illness between 60-80%. Only 6.6% of population had more than 80% of Pharmacoeconomic burden of asthma.

Conclusion: In our study, it was concluded that the patients with severe asthma and/or co-morbidity have higher treatment cost. Out of the overall cost, the maximum cost borne by the patient was the direct medical cost. The hospitalization increased the total health care cost by about 47%. The 43% of the population has less than 30% of burden of asthma while only 6.67% of population had more than 80% of burden of asthma.

Open Access Review Article

Woman Mental Health - Midlife

Prakash B. Behere, Anagha Abhoy Sinha, Debolina Chowdhury, Aniruddh P Behere, Richa Yadav, Amit Nagdive, Rouchelle Fernandes

Journal of Pharmaceutical Research International, Page 69-76
DOI: 10.9734/jpri/2021/v33i37A31981

Woman’s mental health, is an important issue and easily one of the most neglected domains, especially so for a woman in her middle age full of physiological and psychological turmoil. Mental health problems occur in higher frequency in women in general. Depression is more common in women as compared to men, women are twice as likely to experience anxiety as men and about 60 % of persons suffering from an OCD or a phobia are women. The greater gender predisposition necessitates an in-depth analysis of the biological and environmental factors of women which cause them to be more predisposed to mental illnesses. A recent report on Women of Tomorrow, reported women in India to be the most stressed female population of the world. Overall, the women of the developing nations were found to be more stressed than their sisters in the developed world. This led us to think about the cultural and environmental influences on the disorders, along with attitudes and perceptions of the society in the mental make-up of a woman. The contributing factors discussed in this article need extensive research to help modulate the implicated factors and in turn amount to primordial prevention. This article emphasizes the priorities to be studied in the context of a woman’s mental health, explores deeper issues and interrelationship of multi factorial determinants.

Open Access Review Article

COVID-19 Mutation and Impact on Various Organs

Kunal Chintalwar, Swaroopa Chakole

Journal of Pharmaceutical Research International, Page 85-91
DOI: 10.9734/jpri/2021/v33i37A31983

Background: COVID-19 is the continuously evolving pandemic affecting billions of people. The viruses are notorious for mutations in them. Novel coronavirus is no exception to mutation and mutated into various strains according to geographical locations.

Summary: The recent second and third wave which is actually a resurgence in COVID-19 cases after a steep fall is attributed to the mutation that is occurring in novel coronavirus. Various strains has been isolated and is being under study to tackle their menace. But blaming completely the mutant version of the virus is unjust as there are other factors such as lax implementation of preventive measures, negligence on account of people by not wearing masks and not following physical distancing. The impact of COVID-19 on human organ system is almost negative and affects the functioning of the organ adversely. Therefore proper care must be taken to ensure the safety of oneself.

Conclusion: Mutations in viruses cannot be stopped and solution lies within us. By following preventive measures and guidelines issued by WHO and other competent authority can a key to keep oneself self. Also balance diet along with proper exercise can help in these pandemic. More study needs to be done to establish various correlation so than containment plan of COVID-19 can be modifies accordingly.

Open Access Review Article

Approach of Physiotherapist towards Patient during COVID-19 Pandemic in Rural Area

Tejaswini B. Fating, Ashish W. Bele, Pratik Phansopkar, Waqar Naqvi

Journal of Pharmaceutical Research International, Page 101-108
DOI: 10.9734/jpri/2021/v33i37A31985

COVID-19 is an acute respiratory disease associated with coronavirus, SARS-CoV-2 named coronavirus disease  (COVID-19), coronavirus is interspecies, and can also be transmitted from human to human that has triggered a global pandemic over the past one year. As no particular medication is available at present as said preventive is better than cure must pursued. Many health professional like physiotherapist play a big role in understanding of COVID-19 and its precautionary steps to stop the spread of corona virus. Because a strong immunity will protect us, but prevention and recovery is an important way to cope up with the dangerous situation of COVID -19 diseases. And in rural area there is lack of hospital facilities so the need for the awareness, precautionary measures and rehabilitation is essential measures to spread of corona virus in community. Physiotherapist plays a primary rolls in awareness about precautionary and safety measures also physiotherapeutic care during acute and post Covid situation. Physiotherapist plays internal roll in community rehabilitation through home workouts, training for physical fitness by exercise, yoga and respiratory care exercises to increase strength and reduce disability. During this pandemic physiotherapist work on digital platform through telehealth, virtual group rehabilitation methods which work on health rehabilitation with also proper ergonomic training during work from home to reduce work hazards and improve productivity.

Open Access Review Article

Labour Induction Methods: An Overview

Sanjivani Wanjari, Anil Wanjari

Journal of Pharmaceutical Research International, Page 119-127
DOI: 10.9734/jpri/2021/v33i37A31987

Overall the rate of induced labours has increased and almost 25% of women undergo labour induction worldwide. Cervical ripening and cervical preparedness is necessary before labour can be induced. The status of the cervix is traditionally assessed with help of Bishop’s score. Labour induction becomes necessary when the cervix is not favourable as noted on the cervical scoring system. Mechanical or surgical methods or a combination of both can be sued for labour induction. These include Foley’s catheter induction, sweeping of membranes, amniotomy etc. Pharmacological agents like oxytocin, prostaglandins PGE1 & PGE2 and newer agents like mifepristone can be used.  Mechanical methods like Foley’s catheter induction are associated with lesser FHR variability and decreased rates of caesarean section as compared with oxytocin infusion or prostaglandins used locally. Oxytocin is the most widely used pharmacological method used for induction of labour. Proper titration of oxytocin can result in contractions that mimic normal labour. Oxytocin is often combined with amniotomy.  Prostaglandins PGE1 & PGE2 are safe and effective options for labour induction. Prostaglandin PGE1 or misoprostol is used in the dose of 25 microgram mcg given orally or vaginally or via the sub-lingual route. Prostaglandin PGE2 or dinoprostone is used intra-cervically or vaginally in the posterior fornix. The newer drug mifepristone is being studied as cervical ripening agents because of its anti-progesterone effect.