Open Access Case Report

A Case Report on Scleroderma: A Diagnostic Dilema

Ch. K. V. L. S. N. Anjana Male, Hari Chandana Varikallu, Tirumalasetty Sai Swapna, N. Dileep, S. Hemanth Durga Prasad, Sarath Nalla

Journal of Pharmaceutical Research International, Page 251-255
DOI: 10.9734/jpri/2021/v33i40A32241

Scleroderma is a rare heterogenous group of autoimmune fibrosing disorder that mainly exists in two forms; localized scleroderma (LS) and systemic sclerosis (SSc). It involves thickening of the skin at fingers region extending from proximal to metacarpophalangeal joints. The diagnostic criteria of scleroderma include past history of patient, symptoms of patient, serology, and skin biopsy. The morbidity and mortality are much worse for SSc with the patients are at risk for life threatening lung, heart and other visceral organ fibrosis and vasculopathy. There is no drug that can cure or stop scleroderma over fibrosis, but certain drugs regulate the symptoms associated with it and boost the patient's quality of life, particularly steroidal creams that help alleviate swelling, joint pain, loosen tight skin; blood pressure drugs that dilate blood vessels; immunosuppressive agents. If the disease is severe amputation is necessary.

Open Access Systematic Review Article

Dental Considerations in Pregnancy – A Systematic Review

Sana Bashir, Ipseeta Menon, Ritu Gupta, Anubhav Sharma, Vikram Arora, Shivangi Varshney

Journal of Pharmaceutical Research International, Page 82-100
DOI: 10.9734/jpri/2021/v33i40A32224

Background: Good oral health during pregnancy can not only improve the health of the pregnant mother, but also potentially the health of her child. There is inconclusive and contrasting nature of evidence regarding the effect of pregnancy on oral health. So the purpose of this study was to systematically review the dental considerations during Pregnancy for further investigation.

Methods: For the identification of the studies included in this review, we devised the search strategy for each database. The search strategy used a union of controlled vocabulary and free text terms. The main electronic database used to access the studies were PubMed, PubMed Central, Cochrane Review, Embase and Google Scholar.

Results: A total of 28 articles fulfilled the criteria and were selected for the review. Some prenatal oral health conditions have adverse effects on the child. Periodontitis is associated with preterm birth, low birth weight infants and high level of cariogenic bacteria in pregnant mother can lead to increased risk of dental caries in the infant. Oral lesions such as gingivitis and pregnancy tumours are benign in nature and require only reassurance and monitoring.

Conclusion: It has been suggested that some oral conditions may have adverse consequences on their children awareness related to oral health during pregnancy. Oral health care services should be routinely integrated with prenatal care services for all the pregnant women and specific preventive oral health care program should be made an integral part of antenatal care.

Open Access Study Protocol

Evaluating the Effect of Complete Dentures on Signs and Symptoms of Temporomandibular Disorders Analyzed by Craniomandibular Index in Completely Edentulous Patients- A Study Protocol

Sharayu Nimonkar, Surekha Godbole, Vikram Belkhode, Pranali Nimonkar

Journal of Pharmaceutical Research International, Page 242-250
DOI: 10.9734/jpri/2021/v33i40A32240

Background: A Temporo-mandibular disorder (TMD) itself is a cumulative terminology used to indicate the situations which entails the pain alone or in association with dysfunction of the Temporomandibular joint (TMJ) with or without involving the associated structures. One of the main cause of developing TMD is the loss of tooth. The completely edentulous patients also have reported high prevalence of TMD as in dentulous patients. 

Methods: It is a prospective interventional study that will be carried out in three years. The sample size will be those completely edentulous subjects, who has not used dentures for a duration of  six  months to five years  of tooth extraction. Such subjects will then be subjected to anamnestic component of Helkimos Index for screening purpose.110 subjects exhibiting mild to severe signs and symptoms of Temporomandibular disorders will be considered as the study participants for the study. Study participants will be categorized as Group A (study participants having mild symptoms of TMD, n=55) and the second will be Group B (study participaants having severe symptoms of TMD, n=55). The Craniomandibular Index will be used to score the severity of the TMD before denture insertion. The initial recorded score will be then correlated with the score obtained after 3 months of delivery of denture. Descriptive as well as analytical statistics will be performed. The statistical relevance among the Group A and Group B before intervention and after 3months of intervention will be assessed at p<0.05. 

Discussion: Through the study results we anticipate a fall in CMI score i.e improvement by lowering the intensity of TMD due to intervention by complete dentures in completely edentulous subjects. In case the above Hypothesis is not proved, then prevalence of TMD among patients who are completely edentulous needs to be anticipated with the factors such as anatomical or pathological diversities in TMJ and not to be associated with changes in vertical dimensions because of teeth loss.

Open Access Short Research Article

Anthropometric Analysis of Digital Models of the Dentition Using 3D Technologies in Orthodontics

Jamaleil Bagaudinovich Maisigov, Galina Viktorovna Kuznetsova, Akhmedkhan Magomedramazanovich Magomedov, Fatima Zurabovna Adzhigova, Asiyat Shamilovna Magomedova, Sofia Alekseevna Burdukova, Artem Evgenevich Mishvelov, Sergey Nikolaevich Povetkin

Journal of Pharmaceutical Research International, Page 101-105
DOI: 10.9734/jpri/2021/v33i40A32225

The development of modern computer technologies has made it possible to introduce into orthodontic practice the latest methods of diagnosis and treatment of dentoalveolar anomalies. Domestic orthodontics, which has an extensive scientific base, has received the opportunity for technological development since the beginning of the 90s. The Department of Orthodontics Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of the Ministry of Health of Russia (Moscow, Russia), throughout its scientific experience, under the guidance of Corresponding Member of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Professor L.S. Persina, uses modern diagnostic methods in her diagnostic arsenal to analyze the morphological state of the dentition.

Open Access Opinion Article

A Case Report on Treatment Outcomes of 50 Years Old Hypertensive Female with Intracranial Haemorrhage

Seema Yelne, Roshan Umate

Journal of Pharmaceutical Research International, Page 61-65
DOI: 10.9734/jpri/2021/v33i40A32221

Introduction: The burden of stroke is strongly affected by ageing. Intracerebral haemorrhage (ICH) has catastrophic effects, and treatment options are limited.  ICH has long been considered to be the stroke specific type with the worst diagnosis. Hypertensive Intracranial Haemorrhage is a form of stroke that occurs when an artery in the brain bursts and the blood spreads to surrounding areas. Due to this bleeding, permanent damage occurs to brain cells.  Swelling of brain tissues occurs from annoyance due to trauma. This condition is known as cerebral oedema. The collection of blood is called a hematoma.  Due to hematoma, the pressure on nearby tissues increases and decreases crucial blood flow and persistently destroys brain cells.

Case Presentation: This is a case of 50 year old hypertensive female with intracranial Haemorrhage.  Her diagnostic CT Brain (plain) was done. Complete blood investigations were done. She had history of Hypertension since 24 years and vomiting for 2-3 times.

Therapeutic Intervention and Outcomes: In the present case received Inj. Cefrizone 1 gm IV, bd, Inj. Pan 40mg iv od, Inj. Emset 4mg iv tds, Inj. Limsol 100 ml tds and tab Telmakind 40 mg BD and all other investigation done.  No challenges were reported in therapeutic intervention. Patients blood pressure was managed and controlled and further progression of hematoma was prevented.

Conclusion: Reduction of hypertension can be done through awareness, screening and early management of chronic diseases.

Open Access Minireview Article

Anti-Hepatotoxic Effect of Vananimbuka (Glycosmis pentaphylla Retz.)

Shyny Thankachan, Vishnu Damodar, Bhagavan G. Kulkarni

Journal of Pharmaceutical Research International, Page 309-312
DOI: 10.9734/jpri/2021/v33i40A32249

Liver, one of the largest of organs and a chief site for intense metabolism and excretion. It has a surprising role in the maintenance, performance and regulating homeostasis of the body. The major functions of liver are carbohydrate, protein, and fat metabolism, detoxification, secretion of bile and storage of vitamin. Maintaining a healthy liver is a crucial factor for overall health and well-being. But it is continuously and frequently exposed to environmental toxins, abused by poor food habits and alcohol. Prescribed and over-the-counter drugs can eventually lead to various liver ailments like hepatitis and liver cirrhosis. Thus liver diseases are some of the fatal health issues in the world today. According to Ayurveda, Yakrut is considered as one of the 15 koshtangas. It is also considered as sthana of ranjaka pitta and plays an important role in maintenance of agni. Hepatic disorders can be compared to yakrut vikaras and yakrutpleeha vikaras. In ayurveda Vananimbuka discribtion is available for yakrut vikara.

Open Access Original Research Article

Preparation and Characterization of Nano Structured Lipid Carriers for Ocular Bacterial Infection

Shubhangi Aher, Ravindra Pal Singh, Manish Kumar

Journal of Pharmaceutical Research International, Page 8-23
DOI: 10.9734/jpri/2021/v33i40A32215

The problem of bacterial conjunctivitis has dramatically increased in recent years due increased pollution and modern lifestyle. The present study was focused to fabricate Sparfloxacin loaded nanostructured lipid carriers (Spar-NLCs) for ophthalmic application to improve ocular penetration of drug and give sustained release of drug to reduce dosing frequency and toxic effect of drug associated with ocular membrane. A regular two-level factorial design was used to optimize the formulation parameters that are significantly affecting the formulation attributes. Spar-NLCs with particle size 171.1 ± 11 nm, zeta potential -49 ± 6.47 mV, entrapment efficiency 89.5 ± 5% and spherical in shape was obtained. Besides this, FTIR spectroscopy, differential scanning calorimetry, and transmission electron microscopy results suggest that the drug is successfully incorporated in NLC and has excellent compatibility with the excipients. In vitro release study follows Korsmeyer peppas model and suggests that 81.35 ± 6.2% release of drug from Spar-NLCs in 12 hours. The result of ex-vivo permeation study demonstrated 349.75 ± 7.3 µg/cm2 of permeation of drug, 44.482 µg cm-2 hr -1 of flux, and 0.1482 cm hr-1 of permeability coefficient which is 1.7 folds higher than pure drug suspension. The antimicrobial activity of Spar-NLCs was better than the pure drug suspension and equivalent to the marketed formulation. Spar-NLC formulation did not showed any ocular damage, swelling, and redness in in -vivo Draize test. The ocular tolerance test (HET-CAM test) also suggests that the Spar-NLC formulation and its excipients were nonirritant to the ocular tissues. The formulation was found to be stable over the three month of stability study. Therefore, this work strongly suggest that Spar-NLCs has higher penetration and extended release of drug which can be effectively used in prevention of bacterial conjunctivitis.

Open Access Original Research Article

Antioxidant Activities and Hepatoprotective Potential of Ethanol Leaf Extract of Justicia quinqueangularis against Selected Hepatotoxins Induced Hepatotoxicity in Albino Wistar Rats

K. Suresh, Hindustan Abdul Ahad, S. V. Satyanarayana

Journal of Pharmaceutical Research International, Page 24-34
DOI: 10.9734/jpri/2021/v33i40A32216

Background: The objective of this research was to see whether the ethanolic extract of Justicia quinqueangularis leaves had antioxidant and hepatoprotective properties against paracetamol (PCT), ethanol (ETN), and isoniazid and rifampicin (IR)-induced hepatotoxicity in Albino Wistar rats.

Methods: The leaves of Justicia quinqueangularis were dried in the shade at room temperature, pulverised, and extracted by soxhlet using ethanol. Quantitative phytochemical experiments were carried out as a first step. The ethanol extract's hepatoprotective activity was evaluated in Albino Wistar rats. PCT (3 g/kg), ETN (5 g/kg), and IR (100 mg/kg) reduced the levels of serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alkaline phosphatase (ALP) and bilirubin, which are all biochemical indicators of liver injury. Both hepatotoxin-treated and untreated group of animals determined for their antioxidant levels. SGOT, SGPT, ALP, bilirubin, antioxidant function of DPPH (2,2-diphenyl-1-picrylhydrazyl), hydrogen peroxide (H2O2), lipid peroxidation methods, hydroxyl radicals, and nitric oxide scavenging activities were among the biochemical and histopathological tests performed.

Results: The altered levels of biochemical markers were restored to near normal levels in a dose-dependent fashion after treatment with J. quinqueangularis ethanol leaf extract (100 mg / kg, 200 mg / kg, and 400 mg / kg body weight).

Conclusion: The findings of the current research indicated that the ethanol leaf extract of J. quinqueangularis had potent antioxidant and hepatoprotective properties against standard drug.

Open Access Original Research Article

Evaluation of Antiepileptic Effect of Cleome viscosa Linn. Leaves Extract in Experimental Animals

Manish Kumar Shakya, Arif Naseer, Ranjit Singh

Journal of Pharmaceutical Research International, Page 35-43
DOI: 10.9734/jpri/2021/v33i40A32217

Aim: The purpose of this study was to assess the antiepileptic effect of Cleome viscosa Linn. leaves extract in experimental animals.

Study Design: The extraction process, acute toxicity study was determined using OECD guidelines, Priliminary phytochemical screening, Antiepileptic pharmacological screening methods and statistical analysis.

Place and Duration of Study: The research work was conducted during 10 Jan. 2020 to 10 July 2020 at Dept. of Pharmacology, Rajiv academy for Pharmacy, Mathura (U.P), 281001, India.

Methodology: The fresh leaves were shade dried and reduced in size to powder and extracted by soxhlet apparatus. The MECV, CECV and AECV were prepared and subjected to comparative phytochemical profiling for in-vitro analysis. Further the in-vivo screening models like maximal electroshock induced seizures (MES), picrotoxin (PTX) and pentylenetetrazole (PTZ) induced models are used to assess the anti-epileptic effects of the methanol, chloroform and aqueous extracts of Cleome viscosa.

Results: The extracts were subjected to phytochemical tests and the carbohydrate, tannins, alkaloids, saponins, flavonoids, steroids and glycosides were found to be present. In the MES induced seizures, MECV (200 mg/kg) showed high significant inhibition on tonic hind limb extension (THLE) (9.33±0.33***), decrease in duration of stupor period (145.2 ± 2.59***) and decreased mortality significantly. In PTX induced model, MECV (200 mg/kg) showed high significant delay on the onset of convulsions (18.00±0.63***), decreased duration of convulsion (3.50 ± 0.18***) and decreased mortality significantly. In PTZ induced model, MECV and AECV (200mg/kg) showed high significant delay on the onset of convulsions (2.55 ± 0.10***), (2.50 ± 0.18***), decreased duration of convulsion (3.67 ± 0.11***), (4.33 ± 0.17**) and decreased mortality significantly.

Conclusion: It is clear from the preceding that Cleome viscosa has antiepileptic properties.

Open Access Original Research Article

Study on Thyroid Dysfunction in Patients of Dysfunctional Uterine Bleeding

Koduru Mounika

Journal of Pharmaceutical Research International, Page 44-49
DOI: 10.9734/jpri/2021/v33i40A32218

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding

Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases).

The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %.

Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made.

Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.

Open Access Original Research Article

Respiratory Myopathy in Non-Insulin Dependent Diabetes Mellitus

S. Syed Safina

Journal of Pharmaceutical Research International, Page 50-53
DOI: 10.9734/jpri/2021/v33i40A32219

The pulmonary function tests FVC, FEVl, FEVl/FVC, PEF, FEF25-75, and MVV were performed in 45 non-insulin dependent diabetics and 47 controls with RMS HELIOS 401 computerised spirometer. The FBS, PPBS, and HbAlC were estimated. The effect of levels of FBS,PPBS and HbAlC on the pulmonary function variables were analysed. The Spirometric variables values were all decreasing with increasing FBS, PPBS and HbA1c levels. This result underlines that respiratory system including the respiratory muscles are also one of the target organs of non-insulin dependent diabetes mellitus. This study supports and adds on to the literatures suggesting respiratory myopathy in non-insulin dependent diabetes mellitus.

Open Access Original Research Article

A Drug Use Evaluation Study on Antidepressants in Psychiatric Patients at a Tertiary Care Teaching Hospital

Rajesh Hadia, Bhumin Sanghani, Sushin Sajan, Tiji Mathew, Trupal Rathod, Dhaval Joshi, Rajesh Maheshwari, Sunil Baile, Sunil Kardani, Hemraj Singh Rajput

Journal of Pharmaceutical Research International, Page 66-75
DOI: 10.9734/jpri/2021/v33i40A32222

Background: The pattern of prescribing Antidepressants to patients has been varying worldwide.

Objective: We aim to observe the prescribing pattern of antidepressants as well as assess its various outcomes in patients, the rationality of the prescriptions, and the prevalence of antidepressant usage.

Methodology: A prospective observational study of a total of 56 subjects receiving antidepressants was performed at the Psychiatry. They were screened for their various outcomes on using antidepressants. The written form of the medical record sheet was used to preserve the patient's Data. Prescription pattern, treatment chart, abnormal vitals were noted. Morisky's adherence scale was used to assess the adherence of patients to prescribed drugs. Hamilton depression rating scale was used to measure the patient's depressive stage. They were screened for possible ADRs. The causality and severity assessment of the observed ADRs was done by the WHO-UMC scale and Hartwig-Seigel scale respectively. Statistical analysis was done for all relevant data.

Results: In our study, the age of patients varies from 18 years to 85 years. The maximum number of patients were from the age group of 31-40 years [28.57% (N=16)]. The 50% (N=28) of patients were diagnosed with Depressive mood disorder. A total of 169 drugs were prescribed out of which 52.07% (N=88) were Antidepressant drugs. Out of 88 Antidepressant drugs, 20% (N=18) patients received Venlafaxine, followed by 17% (N=15) Escitalopram. Out of 56, 26.78% (N=15) showed low adherence, 41.07% (N=23) showed medium adherence and 32.14% (N=18) showed High adherence.41.07% (N=23) patients were identified with drug use problems. Adverse drug reactions were suspected in 25% (N=14) patients. The most common type of Adverse reaction due to the drug was Weight gain (N=6 patients). Paroxetine drug was found with the highest number of ADRs 28.57% (N=4).

Conclusion: Most common antidepressant prescribed was Venlafaxine. Most Patients in the community included suffered from Depressive mood disorder with a maximum number of patients appeared from the age group of the thirties to forties. Patients due to their unstable mental status were adhering to therapy at medium levels. Drug use problem was identified commonly with patients on sedatives resulting them to either forget taking the pills or missing the dose. Patients generally had a common Adverse drug reaction of weight gain. Proper lifestyle modifications and patient counselling is required to benefit patient from treatment.

Open Access Original Research Article

Self Awareness as a Predictor of Adolescent Behavior among Nursing Students: A School Based Study

Vaishali D. Tendolkar, Shaini Suraj, Pravin Pande, Komal Meshram, Parikshit Muley

Journal of Pharmaceutical Research International, Page 76-81
DOI: 10.9734/jpri/2021/v33i40A32223

Adolescence is “a period of great strain and stress, storm and strife’. Every individual wants to live a healthy and peaceful life. Each one must be aware of one’s strength, weakness, feelings, perceptions, thoughts, behaviours, initiation, motivations and actions particularly at specific life events. Self-awareness directs to perform any work in effective manner. Adolescents are expected to have highest level of self-awareness as it is the most important turning point in one’s life Objectives: 1) To assess the level of self-awareness among the adolescents. 2) To evaluate the social behaviour of the adolescents. 3) To find out the relationship between self-awareness on the social behaviour of the adolescents.

Research Design: Correlation study.

Population: Adolescents in the age group of 13-17 years both males and females Sample Size: 909.

MaterialS: Modified self-awareness Scale and Researcher developed Adolescent social behavior scale.

Results: Self-awareness has positive non-significant (r=0.004, p=0.91) relationship with the social behavior among adolescents.

Conclusion: The study findings reveal that as the self awareness improves there are chances of improving the social behavior of adolescents. There are many factors contributing to social behavior such as education, socio-economic status, parental education and their occupation, friends and facilities provided for growth, motivation of adolescents and the surrounding environment and most importantly the provisions for facilitating the interactions between these factors.

Open Access Original Research Article

An Epidemiological Study of Vitiligoin an Urban City Hospital

K. P. R. Chinthaamani

Journal of Pharmaceutical Research International, Page 120-124
DOI: 10.9734/jpri/2021/v33i40A32227

Vitiligo commonly begins in childhood or young adulthood with peak onset between 10 to 30 years. From this study results it was found that females 83(55.3%)were more commonly affected with vitiligo than males 67(44.7%) and the most common affected age group is 31-50 (35.33%) and the most common site of onset of vitiligo was equal in upper limb and face seen in 71(47.33%) patients each, followed by lower limb sseenin50(33.33%) patients. The most common site involved in males was upper limb 32(47. 76%)and females was face 42(50.6%)were observed. The common type was common clinical type of vitiligo documented was vitiligo vulgaris, seen in 69(46%) patients. This was followed by mucosal vitiligo 36(24%), acrofacial22 (14.67%), segmental17 (11.33%) and vitiligo are ata6 (4%) and reported to be more common in B positive patients.

Open Access Original Research Article

Assessment of Risk Factors Leading to Amputation in Diabetic Neuropathic Ulceration of Foot

G. S. Arun Narindar

Journal of Pharmaceutical Research International, Page 131-134
DOI: 10.9734/jpri/2021/v33i40A32229

More than 65% of the patients were found to have neuropathy and associated deformity 90% of patients had history of trauma predisposing to diabetic ulcer, of which trivial trauma accounts for 60% of injuries .About 35% of these patients presented with abscess and 20% with gangrene. Majority of blood sugar values ranged from 200-350 mgs% with insulin requirements of about 20-40 units per day. 50% of cases were subjected to decompressions which resulted m salvaging of the legs.

Open Access Original Research Article

Okra-derived dietary Carotenoid lutein against Breast Cancer, with an Approach towards Developing a Nutraceutical Product: A Meta-analysis Study

Abd Elmoneim O. Elkhalifa, Eyad Al-Shammari, Mohammad Jahoor Alam, Jerold C. Alcantara, Mushtaq Ahmad Khan, Nagat Elzein Eltoum, Syed Amir Ashraf

Journal of Pharmaceutical Research International, Page 135-142
DOI: 10.9734/jpri/2021/v33i40A32230

Objective: Cancer chemoprevention with phytochemicals such as “lutein” derived from the vegetable okra could prove beneficial. Therefore, the objective of this study was to perform a meta-analysis of “lutein” against the breast cancer cell lines (MCF-7) and to establish the possible development of lutein based nutraceuticals.

Methodology: A literature survey was performed using online data bases such as PubMed, Google scholar, and EMBASE, from 2000 to 2020 by using keywords such as “Lutein”, “Anticancer activity”, “Breast cancer cell lines”, and “MCF-7”. Studies reported lutein anticancer potentials against MCF-7 were included in the study.

Results: Out of 28 studies, 7 research articles fulfilled the inclusion criteria. Meta-analysis data indicated that, a lutein concentration at ≥1 µM was able to reduce the MCF-7 cell viability of 59.837 with a 95% confidence interval (CI): 48.331 to 71.343. Additionally, a forest plot of the cumulative studies also indicated that impact of lutein concentration to reduce the MCF-7 cell viability was around 60%. Moreover, the I2 value of lutein was 74%, which is a considerable heterogeneity.

Conclusion: Therefore, based upon the meta-analysis data, the conclusion is that dietary lutein supplementation and fortification of food with clinical data could be an approach to develop a nutraceutical product for preventive, as well as for adjunct therapeutic purposes in various breast cancer subtypes. 

Open Access Original Research Article

Evaluation of Metformin Hydrochloride Floating Drug Delivery System: In vitro Study and In vivo Prediction

Rajesh Pawar, Swati Jagdale

Journal of Pharmaceutical Research International, Page 143-155
DOI: 10.9734/jpri/2021/v33i40A32231

Aim: This research work was aimed to evaluate Metformin hydrochloride (MH) floating dosage form by In vitro evaluation/In vivo prediction and to evaluate it’s predictability through it’s application during the R&D using Insilico technique in WINONLIN Software. MH was examined as a model drug, which is a biguanide and is an hypoglycemic agent administered orally. The study was aimed to determine the the systemic concentrations of MH using In-vivo prediction.

Study Design: Fabrication and assessment of Metformin hydrochloride floating drug delivery system: In Vitro evaluation /In Vivo prediction. Biorelevant media was selected for dissolution profile of 12 units of dosage form. Software assisted program used for data feeding and results output.

Methodology: The absorption window for MH is the upper portion of the small gut in which the GI absorption is complete after 6 h. Hence gastroretentive formulation was developed and validity of dissolution study was extended by In vivo pharmacokinetic prediction using WinNonlin Software. A mechanistic oral absorption model was built in Phoenix WinNonlin® software.

In the presented work, significant yet crucial, gastrointestinal (GI) variables are considered for biopredictive dissolution testing to account for a valuable input for physiologically-based pharmacokinetic (PBPK) platform programs. While simulations are performed and mechanistic insights are gained from such simulations from the WinNonlin program.

Results: These floating tablets were observed for In vitro release and studied for In vivo pharmacokinetic prediction. From the obtained values, a meaningful In vivo prediction was done. interestingly from the results attained floating tablets showed sustained drug release and extended drug absorbed in 24h. Fascinatingly, from the data it was proved that drug formulation resides for desired time. The absorption of MH from the developed CR tablet was 1.4 fold higher than its marketed tablet and it had higher AUC0–t values than the marketed product which indicates superior bioavailability of test product compared to marketed tablet with similar dose in Invivo pharmacokinetic prediction. The mean value of biological half-life (t1/2) and Tmax of MH from test formulation is two times more, Test product has shown higher MRT, showing that the drug is maintained longer in the body in comparison to marketed product indicates controlled absorption.

Conclusion: Here we concluded that, a comparative prediction pharmacokinetic evaluation of the fabricated controlled release tablets and the marketed formulation indicates that the fabricated controlled release tablets are well absorbed and the degree of absorption is greater than that of the marketed ER formulation with larger gastric residence time.

Open Access Original Research Article

Design and Identification of Lead Compounds Targeting Nipah G Attachment Glycoprotein by In Silico Approaches

Jainey P. James, . Apoorva, Shreya Renita Monteiro, K. B. Sukesh, A. Varun

Journal of Pharmaceutical Research International, Page 156-169
DOI: 10.9734/jpri/2021/v33i40A32232

Nipah virus (NiV) caused several outbreaks in Asian countries, including the latest one from the Kerala state of India. There is no drug available against NiV till now, despite its urgent requirement. There are reports about the anti-influenza viral drug Favipiravir, which has positively affected the Nipah virus in vitro models. In the current work, we have provided a computational screening for NiV inhibitors. Twenty-two designed compounds from favipiravir and Nipah glycoprotein, 3D11, were chosen and performed molecular docking to analyse the various conformations and interactions with the amino acids; further, their physicochemical and ADMET properties were also computed. The compound 5_Favipiravir have an excellent docking score (-6.16 kcal/mol), followed by compound 4_Favipiravir and 19_Favipiravir with docking score of -5.50 and -5.38 kcal/mol respectively. The three compounds had the respective heterocyclic moieties such as pyrazole, imidazole and pyrazinone. All the twenty-two designed compounds obey the Lipinski rule of five, which infer that they will not have problems with oral bioavailability.  Thus, it is concluded that the incorporated heterocyclic groups in favipiravir can add to the anti-Nipah activity; hence it can act as future leads for the treatment for the disease caused by Nipah virus.

Open Access Original Research Article

Trends of COVID-19 in the Central Africa Sub-region: Effective Health Care, Effect of Endogenous Parameters or a Matter of Time?

Mbarga M. J. Arsene, Hippolyte T. Mouafo, I. V. Podoprigora, L. A. Smolyakova, N. V. Yashina, A. V. Ermolaev, K. M. Mefyod, A. V. Zhygunova

Journal of Pharmaceutical Research International, Page 170-186
DOI: 10.9734/jpri/2021/v33i40A32233

Background: After the worldwide spread of the coronavirus pandemic, several experts predicted a health catastrophe in Africa. However, the expected earthquake ultimately did not occur and the statistics of the number COVID-19 cases and deaths for other continents (Europe, America, Asia) were far higher than those of Africa. This study focused on Central Africa tried to explain this low incidence of COVID-19.

Methodology: A cross-sectional time series method was adopted and the data of COVID-19 cases and deaths for Angola, Cameroon, Chad, Central African Republic, Congo Brazzaville, Democratic Republic of Congo, Gabon, Equatorial Guinea and Sao Tome and Principe between March and November 2020 were extracted from the World Health Organization COVID-19 database. The evolution of COVID-19 cases and deaths for each country were plotted and the accuracy measures such as Mean Absolute Percentage Error, Median Absolute Deviation and Mean Squared Displacement were calculated. Association between the countries and the prevalence of cases, deaths and recovered was visualized through principal component analysis.

Results: The results showed that the highest number of cases was observed in Cameroon (21,793) while Sao Tome and Principe scored the smallest one (962). However, based on the total population, the prevalence of COVID-19 cases was high in Sao Tome and Principe (0.436%) and Gabon (0.400%). The highest death percentages (≥2%) were observed in Chad (6.742%), RDC (2.708%) and Angola (2.592%) while the highest recovered percentages were in Gabon (99.10%), Equatorial Guinea (97.62%) and Cameroon (97.02%). Development of traditional medicines and modification of food behavior including consumption of plant extracts appear as the reasons for the highest recovered rates. The accuracy measurements showed that the trend curves were not correlated with the actual evolution of the pandemic, but the Spearman correlation test revealed that except Equatorial Guinea (r=0.042, p=0.817), the evolution of COVID-19 cases and deaths were strongly correlated.

Conclusion: The overall prevalence and incidence of COVID-19 is low in the countries of the Central Africa sub-region despite the problems facing the health systems of these countries.

Open Access Original Research Article

An Observational Study on Drug Utilization Pattern in Asthma and Chronic Obstructive Pulmonary Disease in Tertiary Care Teaching Hospital

Rajesh Hadia, Priyesha Bhatt, Anadisharan Panchal, Anjali Gandhi, Trupal Rathod, Dhaval Joshi, Sunil Baile, Rajesh Maheshwari, Stani Ajay, Hemraj Singh Rajput

Journal of Pharmaceutical Research International, Page 187-198
DOI: 10.9734/jpri/2021/v33i40A32234

Background: Obstructive airway diseases such as asthma and COPD are defined as a decreased capacity to get air through the conducting airways and out of the lungs.

Objective: To study the drug utilization pattern in asthma and chronic obstructive pulmonary disease, determine irrationally (does not comply with prescription) drug usage, and whether they were prescribed following the standard treatment guidelines.

Methodology: A total of 150 patients of either sex aged 18 years and above having asthma and/or COPD were included in the study. The medical records of patients were checked and information was recorded. The prescriptions were analyzed for drug utilization patterns. The newly diagnosed patients were followed up and medication adherence was determined after 1 month.

Results: Out of all 150 patients there were 103 male and 47 female patients. 54 patients were having asthma, 89 patients COPD, and 7 patients asthma COPD overlap. The majority of the patient were prescribed 1 to 3 drugs per prescription. Inhaled corticosteroids were the highest prescribed drug class. The most commonly prescribed drug combination was budesonide + formoterol. The majority of the patients have poorly adhered to the treatment.

Conclusion: Study data highlights that very few drug interactions were identified between prescribed medications. The drugs and their combinations were prescribed according to the standard guidelines GOLD (Global Initiative for Chronic Obstructive Lung Disease) and GINA (Global Initiative for Asthma).

Open Access Original Research Article

A Comparative Study of Premenstrual Syndrome among Married and Unmarried Women

M. Smitha

Journal of Pharmaceutical Research International, Page 199-205
DOI: 10.9734/jpri/2021/v33i40A32235

Premenstrual syndrome is characterized by a wide range of psychological, physical, and physiological symptoms. The study's goal was to evaluate and contrast premenstrual symptoms in married and unmarried women. The sample size was 300 women, including 150 unmarried and 150 married women selected by age group at SreeBalaji Medical College and Hospital's Obstetrics and Gynecology Out Patient Department. Data was collected from unmarried and married women using a premenstrual symptoms checklist. At the 0.05 level of significance, the value was confirmed to be statistically significant. There was a considerable difference in premenstrual symptoms between unmarried and married women, it can be deduced.

Open Access Original Research Article

A Clinical Trial on the Glycemic Index of Nutritional Product for Diabetes Mellitus

Nguyen Trong Hung, Le Thi Hang, Tran Thi Tra Phuong, Nguyen Thi Diep Anh, Vu Thi Thu Hien, Bui Thi Thuy, Ngo Thi Thu Huyen, Dinh Tran Ngoc Huy, Le Thi Tuyet Nhung, Nguyen Van Thoan, Truong Tuyet Mai, Nguyen Hong Truong, Le Danh Tuyen

Journal of Pharmaceutical Research International, Page 222-230
DOI: 10.9734/jpri/2021/v33i40A32238

In the world as well as in Vietnam, diabetes have shown bad effects and there is increasing number of deaths over years because of diabetes as one of three leading causes of deaths. Penalver et al (2016) stated to achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary.

The type of food tested was Nutritional product (Vietnam). Nutritional product solution with 83.3g diluted in 390 ml water. The food-to-water ratio followed the processing instruction from the manufacturer.

In this study we discover a low GI of nutritional product, as of (48.2 ± 5.3). And also, we found out there is decrease (slow) of responses of mean blood glucose (Nutritional product) after 90 minutes (4.7 mmol/L) till 120 minutes (4.3 mmol/L). As we conduct this paper with younger subjects, comparing to older people, they can regulate blood sugar better.

Finally, we also compare to other previous studies for literature review.

Open Access Original Research Article

Topical Delivery of Fenugreek Seed Extract Loaded Solid Lipid Nanoparticles Based Hydrogels for Alopecia

P. Ananth, Marina Koland

Journal of Pharmaceutical Research International, Page 231-241
DOI: 10.9734/jpri/2021/v33i40A32239

Background: Alopecia, a chronic dermatological inflammatory condition affecting the hair follicles. Conventional treatments are associated with the risk of serious side effects. The stratum corneum limits the percutaneous absorption of drugs. Hence, the development of novel herbal formulations for topical delivery has been the target, with the enhancement of their therapeutic efficacy and safety of use.

Aims: To formulate and characterize Fenugreek seed extract loaded solid lipid nanoparticles carrier for the management of Alopecia to reduce the systemic side effects.

Methodology: Fenugreek seed extract loaded solid lipid nanoparticles (SLN) were prepared by melt emulsification accompanied by probe sonication. The formulation was prepared using GMS, Tween 80, and Soya lecithin as Lipid, Surfactant, and Co-Surfactant. The SLN was incorporated into carbapol 934 dispersion to convert it into a gel. The SLN formulation was evaluated for size, Polydispersity Index, Zeta Potential, Entrapment efficiency, Transmission Electron Microscopy. After that, the SLN gel was examined for Spreadability, Extrudabilty, Viscosity, In vitro drug release, Ex vivo permeation, and Skin deposition studies.

Results: The formulated Fenugreek seed extract loaded showed a particle size of 223.36 nm with a narrow PDI of 0.313. Entrapment efficiency revealed that 74.56±0.12% of the drug was entrapped. Transmission electron microscopy images confirmed the spherical nature of the SLN. The extended-release pattern of the formulated SLN for 24h was observed in the in vitro release studies and followed Higuchi model(R2=0.9964). Ex vivo permeability showed a 72.05±0.15% deposition of Fenugreek seed extract loaded SLN. The formulation was stable for three months without significant changes.

Conclusion: Fenugreek seed extract loaded NLC demonstrated enhanced permeation, improved skin retention, and extended release compared to conventional gel. The developed formulation would be further used for in vivo studies and by seeing above results it can be an alternative for Alopecia in the future.

Open Access Original Research Article

Application of 3D Technologies in Surgery on the Example of Liver Echinococcosis

Arslan Ayavovich Tatamov, Tatiana Temirbolatovna Boraeva, Asya Bekovna Revazova, Aminat Shamilovna Alibegova, Khedi Mairbekovna Dzhanaralieva, Aida Rasulovna Tetueva, Luiza Askhabovna Yakubova, Marina Vitalevna Tsoma, Artem Evgenevich Mishvelov, Sergey Nikolaevich Povetkin

Journal of Pharmaceutical Research International, Page 256-261
DOI: 10.9734/jpri/2021/v33i40A32242

Preoperative assessment of an echinococcal liver cyst with surrounding tissue structures is extremely important for planning the course of surgical intervention. The paper presents the first experience of treating a patient with a parasitic cyst using three-dimensional reconstruction of the liver affected by echinococcus at the preoperative stage. The use of this approach made it possible to avoid the development of intraoperative complications and get a good treatment result.

Open Access Original Research Article

Wound Healing Potential of Rhodomyrtus tomentosa and its Bioactive Compounds- Rhodomyrtone

Evana Kamarudin, Hasseri Halim, Tengku Shahrul Anuar, Roslinah Hussain

Journal of Pharmaceutical Research International, Page 262-273
DOI: 10.9734/jpri/2021/v33i40A32243

Aims: The present work was aimed to study the phytochemical composition of a crude ethanolic extract of Rhodomyrtus tomentosa [SERT], and the presence of rhodomyrtone and SERT's in vitro wound healing activity.

Introduction: Rhodomyrtus tomentosa is native plant to southern and southeastern Asia, India, east to southern China, Taiwan, Philippines, and south to Malaysia. In the traditional Vietnamese, Chinese and Malaysia, all its part, including leaves, roots, buds, and fruits have been used. A need for a new source of wound healing agent is the call for the investigation of the potential of R. tomentosa as the source of health-promoting agent, specifically as a natural wound healing agent.

Methodology: SERT was screen for its phytochemicals and the detection of rhodomyrtone using liquid chromatography–mass spectrometry, /Quadrupole time-of-flight [LC-MS/QTOF] analysis. Cell viability, cell proliferation, and migration assay were performed to examine the SERT effect's in vitro wound healing activity on human fibroblast cells [CRL-2522].

Results: The phytochemical study showed the presence of saponins, flavonoids, tannins and steroid in the crude ethanolic extract. The LC-MS analysis of crude ethanolic extract of SERT showed presents of rhodomyrtone which is one of the major compounds in the extract. SERT exhibit proliferative and migratory rate in human fibroblast cells [CRL 2522] in dose-dependent manner, which supports wound healing process. Its bioactive compounds presented wound healing activities at 0.325 up to 2.5 µg/mL.

Conclusion: Both SERT and rhodomyrtone portrayed in vitro wound healing activities. Further studies to elucidate the mechanism of action of SERT and rhodomyrtone is recommended.

Open Access Original Research Article

Correlation of Hamstring Flexibility with Sitting Hours and Physical Activity among Physiotherapy Students

Maitri Shukla, Purvi Patel

Journal of Pharmaceutical Research International, Page 282-287
DOI: 10.9734/jpri/2021/v33i40A32245

Background: The hamstring group is an example of muscles which is commonly found to be shortened. Hamstring tightness is caused by extended or prolonged sitting at work places and educational institutions, inadequate physical activity, genetic predisposition, previous injury to hamstring.

Objectives: To assess the hamstring flexibility in college students along with their sitting hours and physical activity.

Material & Methods: 150 students of college of physiotherapy were included via convenient sampling in the study. Popliteal angle was measured using active knee extension test (AKE). All students’ sitting hours and physical activity were noted.

Results: In this study, mean values of popliteal Angle was higher than 20 degree. There was a significant difference correlation between popliteal angle and sitting hours as well as physical activity (p value <0.05).

Conclusion: This study showed tightness of hamstring in college students. There is a significant increase in tightness with more sitting and less physical activity.

Open Access Original Research Article

Comparison of Complications between Direct Trocar Insertion Versus Veress Needle for Creation of Pneumoperitoneum in Patients Undergoing laparoscopic Cholecystectomy: A Randomized Control Trial

Kamran Hamid, Shabbir Ahmad, Bahzad Akram Khan, Muhammad Faheem Answer, Amer Latif, Syed Mazhar Ali Naqvi, Muhammad Afzal Bhatti, Muhammad Asim Rana, Muhammad Mansoor Hafeez

Journal of Pharmaceutical Research International, Page 294-299
DOI: 10.9734/jpri/2021/v33i40A32247

Aim: To compare the outcomes in term of complication of Veress Needle Insertion (VNI) to Direct Trocar Insertion (DTI) for creation of pneumoperitoneum in laparoscopic cholecystectomy.

Design: Randomized controlled trial

Place and Duration of Study: The current analysis was conducted at Khawaja Muhammad Safdar Medical College Surgical Department, Allama Iqbal Memorial Hospital and Govt. Sardar Begum Teaching Hospital, Sialkot from September 27, 2017, to September 26, 2020.

Methodology: A total of six hundred and eight (n=608) patients, having age 30 to 75 years planned for laparoscopic cholecystectomy were included in this study. Patients were randomly divided into two groups, Group A (Direct Trocar Insertion), Group B (Veress Needle Insertion). Both groups had age and sex matched males and female. All trocars and veress needle used were disposable, with a safety shield. The primary outcome of our study was to compare the complications to assess the safety levels, while total time taken by the procedure and mean time for laparoscopic entry were the secondary end points. The collected data was analyzed by using software SPSS version 22. Chi-square test was used to check the significance of variance. P-value less than 0.05 remained the statistically significant.

Results: The complication rate in VNI group were significantly greater than the DTI group (p < 0.01), the duration of surgery between the two groups was not significantly different (p > 0.05), but we found statistically significant difference in mean laparoscope insertion time (DTI 3.4+ 1.4 versus VNI 4.8+ 0.7 minutes, p < 0.001).

Conclusion: From the results of our study, it can be concluded that the direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy as it is associated with fewer complications.

Open Access Original Research Article

Health Research Conducting Quality Perceptions of Medical Postgraduate Trainees

Shanti Chouhan, Khalida Naz Memon

Journal of Pharmaceutical Research International, Page 313-319
DOI: 10.9734/jpri/2021/v33i40A32250

Background: Health researchers in medical universities are surrounded by existing hurdles to the health research during the process of conduction which may affect the quality of conduction of health research undertaken by the medical trainees. The current study is conducted to determine
the effects of barriers on the quality of conduction of health research.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Research conducting postgraduate trainees in various disciplines in Liaqaut University of Medical & Health Sciences, Jamshoro from 1st September 2018 to 31st December 2018.

Methodology: Two hundred & sixteen health research trainees were recruited for study                    through stratified sampling technique; the subjects included 79 males &137 females of age bracket of 24-50 years. After taking the consent, data was collected on a preformed questionnaire and analyzed in SPSS version 23.0 by computing proportions, mean ± standard deviation and using Chi-square test as statistical test of significance with the p-value of 0.05 taken as level of significance.

Results: Overall, two hundred and fifty subjects were approached to obtain the complete response of the required sample of two hundred and sixteen. The response rate was 86.4%. The 72 (33.3%) trainees in medicine and allied sciences, 66 (92%) trainees experienced various barriers in quality of conducting of health research. From 42 (19.4%) trainees in surgery and allied sciences, 22 (51.2%) perceived effects of barriers on their health research conducting (HRC) quality. Amongst 33 (15.3%) trainees in basic sciences, 15 (45%) faced various hurdles while going through their research; surprisingly all the trainees conducting research in field of pharmacology faced various barriers during research process. Out of 67 (31.0%) postgraduate trainees in dentistry, 60 (90%) reported various barriers (p= 0.03).

Conclusion: Quality conduction of health research affected by barriers is experienced by majority of medical researchers and trainees during their postgraduate training.  The majority of the postgraduate trainees conducting research from clinical fields face more effects on their research conducting quality as compared to the basic sciences researchers.

Recommendation: Quality assessment protocol should be incorporated during research conducting process. Actions should be taken for reducing the barriers related to HRC quality. Collaborative health research amongst clinical and basic sciences fields can be done to improve the quality.

Open Access Original Research Article

Study on Haemodynamic Response to Laryngoscopy and Intubation using McCOY and Macintosh Laryngoscopes: A Comparative Approach

M. Barish

Journal of Pharmaceutical Research International, Page 320-324
DOI: 10.9734/jpri/2021/v33i40A32251

Introduction: Laryngoscopy and endotracheal intubation are known to cause increase in arterial blood pressure, heart rate and may be associated with various dysarythmias. This study is done to compare the hemodynamic changes with McCOY laryngoscope and Macintosh laryngoscope in 120 patients who were divided into 2 groups.

Methods: A positive correlation has been demonstrated between force exerted at laryngoscopy and patient's height, weight, body mass index (BMI) and presence of maxillary incisors but it was seen that effect of these factors on force exerted with the McCOY blade is not as important as with Macintosh blade. So this study was done to compare the hemodynamic response to laryngoscopy and intubation using McCOY and Macintosh laryngoscope in stress attenuation.

Results: Maximum increase in heart rate from the baseline after laryngoscopy in group 2 and a least rise in heart rate from base line in group 1.Group 1 has 9 % increase in heart rate from basal value. Group 2 has 22 % increases in heart rate from basal value. Group 1 has 6 % increase in  Systolic BP from basal value Group 2 has 27 % increase in Systolic BP from basal value. Rise in Plasma adrenaline after laryngoscopy was not observed in Laryngoscopy with McCOY blade.

Conclusion: McCOY laryngoscope produces significantly less in Hemodynamic parameters when compared with Macintosh blade.So this non­pharmacological intervention of McCOY blade can be utilized as a tool for obtunding hemodynamic responses to laryngoscopy and intubation

Open Access Original Research Article

Synthesis and Research of Nanocompositions of Oxide Materials Based on Titanium Dioxide for use as Contrast Agents in Optical Coherence Tomography

Artem Nikolaevich Kupriyanov, Diana Evgen’evna Fidarova, Linda Ruslanovna Makhmudova, Magomed Rasulovich Gadzhiev, Shuainat Ruslanovna Nimatulaeva, Magomed Narimanovich Durniyazov, Alina Yuryevna Maslova, Sergey Nikolaevich Povetkin

Journal of Pharmaceutical Research International, Page 325-338
DOI: 10.9734/jpri/2021/v33i40A32252

In this paper, the contrasting properties of titanium dioxide nanoparticles in various compositions were considered. In the course of the work, methods for the synthesis of oxide materials SiO2-TiO2, SiO2-ZrO2, TiO2-ZrO2 and SiO2-TiO2-ZrO2 were developed; the microstructure of oxide materials SiO2-TiO2, SiO2-ZrO2, TiO2-ZrO2and SiO2-TiO2-ZrO2was studied; the stability of oxide materials SiO2-TiO2, SiO2-ZrO2, TiO2-ZrO2and SiO2-TiO2-ZrO2 was determined. The elemental composition of the oxide materials SiO2-TiO2, SiO2-ZrO2, TiO2-ZrO2and SiO2-TiO2-ZrO2 has also been studied using SEM and XRD methods. It was found that SiO2-TiO2-ZrO2 nanocomposites with content of titanium dioxide from 8 to 9.5 % and zirconium dioxide from 0.5 to 2 % are completely insoluble in a highly alkaline medium. Thus, this composition is the most optimal for use as a contrast agent in optical coherence tomography.

Open Access Original Research Article

Comparison of Midazolam with Bupivacaine and Fentanyl with Bupivacaine in Caudal Epidural Analgesia for Efficacy and Duration of Post­ Operative Analgesia in Children Undergoing Infra Umblical Surgeries

B. Sangeetha

Journal of Pharmaceutical Research International, Page 339-341
DOI: 10.9734/jpri/2021/v33i40A32253

Caudal anaesthesia is a useful adjunct to general anaesthesia for infra umbilical surgeries in children as it provides post-operative analgesia and reduces pen­ operative narcotic requirements There is prolongation o. f duration of analgesia by mean duration of 318.20±24.49 minutes with addition Fentanyl to Bupivacaine. When comparing the efficacy of two differential drugs fentanyl I µg/kg and midazolam 5 0µg/kg in combination with Bupivacaine 0.2 5%, lml/kg.  Duration of analgesia was found significantly more in group using Fentanyl with mean duration of 318.20 ± 24.49 minutes compared to Midazolam with mean duration of 247.25 ±12.19 minutes.

Open Access Review Article

Quality of Patient Care in Hospital Administration: A Review

Hamed Salem S. Albalwei, Nazim Faisal Hamed Ahmed

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i40A32214

Patients in need of healthcare expect high quality personalized care, which is also the primary goal of service providers. The main objective of our study was to synthesize the current evidence on the quality of patient care in hospital management. Methods: MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA were searched from 2000 to April 2021, and reference lists of included studies were searched. The included studies describe the current evidence for the quality of patient care in hospital management. No software was used to analyze the data. The data are extracted on the basis of a specific form containing (Name of the author, year of publication, country, method and results). Results and Conclusions: Communicating a better understanding of health care quality is an important preliminary step towards health care quality research and initiatives. Without clear meaning, quality improvement can be sporadic or ineffective. Competent authorities should consider shaping the curriculum to provide training for future professionals to increase patient satisfaction. Improving the quality of health services requires strong leadership from national governments, targeted local support and action at the health facility level. At all levels, there is a need to engage and empower the communities served by the health system. Improving the quality of health services requires special attention to the creation and learning of knowledge. Lessons on the delivery of quality care should be systematically documented, documented and shared within and across countries. 

Open Access Review Article

Prevalence of Depression among Type-2 Diabetic Patients-A Review

Faisal Suliman Algaows, Sara Nasser Almisrea, Fahad Khalid Alshammari, May Yahya Barakat, Abdulrahman Abdullah Alamri, Alsharif, Aqeel Mohammed M., A. Alwagdani Shatha Mesfer, Fahad Abdullah Alahmadi, Abdulmohsin Mohammed Altuwaijri, Z. Alshammari Nada Naif, Raghad Ateegallah Alawfi, Maria Mahdi Alqadeeb, Duja Naji Zarnogi, Eman Mohammed Aldraihim

Journal of Pharmaceutical Research International, Page 54-60
DOI: 10.9734/jpri/2021/v33i40A32220

The global prevalence of DM is steadily increasing. Depression in patients with diabetes is more prevalent than in the general population. There is good evidence. The bidirectional link can be between diabetes and depression. The chronic nature of the illness and its various consequences can lead to depressive diabetes patients, while increased counter-rulatory hormones can cause the development of diabetic syndromes. Social and environmental variables which influence self-care burden patients and their families substantially. It can lead to depression. Depressed people with diabetes also may experience poor health, inadequate income, stigma and a lack of social support. The aim of the present study is to summarize previously estimated prevalence of depression in patients diagnosed with T2DM, and to identify sociodemographic, clinical and psychological factors associated with the occurrence of depression in diabetic patients in Saudi Arabia and worldwide.

Open Access Review Article

A Paradigm Shift in Ocular Drug Delivery to Posterior Segment: Review on Current Drug Delivery Approaches

Ravi Kumar Koduru, Jigeesha Kasaraneni, Ravi Kumar Reddy Juturi

Journal of Pharmaceutical Research International, Page 106-119
DOI: 10.9734/jpri/2021/v33i40A32226

Objectives: Owing to the increasing number of patients suffering from posterior eye disorders, efficient medicine delivery to the posterior segment is now in great demand in the clinical services. With unmet medical requirements, the posterior eye segment is an important therapeutic target. So, physicians should be informed of new indications and current strategies of drug delivery when new technologies enter the market.

Summary: The most common causes of vision impairment in developed nations are abnormalities of the posterior eye tissues. Poor drug distribution to lesions in patient's eyes is a key barrier to ocular disease therapy. The existence of barriers, such as the corneal barrier, aqueous barrier, and inner and outer blood-retinal barriers, severely limits medication accessibility in these locations. Because of its anatomical peculiarities, the posterior portion is particularly difficult to access for medications. The use of several new strategies for drug delivery is therefore a viable option for enhanced therapy of ocular disorders since recent advances in ocular drug delivery systems research have brought fresh insights into drug development.

Conclusion: This article provides an overview of several aspects of ocular medication administration to the posterior region, with a focus on nano carrier-based approaches, suprachoroidal drug delivery system and ophthalmic devices, including the structure of the eye, its barriers, delivery routes, and the present status of drugs/devices.

Open Access Review Article

Overview on the Prevalence, Risk Factors and Surgical Management of Temporomandibular Joint Dislocation: A Review Article

Mohammed Mahmoud Badran, Mohammed Abdullah Alqahtani

Journal of Pharmaceutical Research International, Page 125-130
DOI: 10.9734/jpri/2021/v33i40A32228

Temporomandibular joint dislocations account for 3% of all recorded dislocations. Traumatic causes of mandibular dislocations may indicate some masculine taste, as facial trauma is more common among men. Frontal dislocations are the most common type of mandibular dislocations, usually secondary to non-traumatic causes. Magnetic resonance imaging is increasingly being used to investigate the condition of the articular disc to determine whether or not there is an internal defect in the temporomandibular joint. It is more cost-effective than cone-beam CT scans and is made available to many dentists. Management of  temporomandibular joint dislocation should be provided promptly. Non-surgical treatment of temporomandibular disorders remains the most effective way to manage over 90% of patients. In relation to surgical management, acute anteromedial, medial, lateral, or posterior dislocations can be manually reduced under analgesic control, with local or general anesthesia, sedation or not, but other methods Used in the literature.

Open Access Review Article

Epidemiology and Evaluation of Congenital Cyanotic Heart Disease in Children- A Review

Ahmed Abdelsamie Fadl, Yaslam Mabruk S. Alsaiari, Khadijah Nasr Aldeen M. Dhafer, Marwan Saleh S. Alharbi, Rakan Hamdan M. Alelyani, Rana Ali A. Hakami, Rawiah Yahya A. Mushari, Amani Yahya Hassan Jawhari, Rawan Ibrahim Alshawikhat, Khalid Mohammed S. Alqahtani, Lafi Saleh L. Alanazi

Journal of Pharmaceutical Research International, Page 206-214
DOI: 10.9734/jpri/2021/v33i40A32236

Structure abnormalities of the heart or intrathoracic great vessels that arise during fetal development are known as congenital heart disease (CHD). It is the most frequent type of birth defect. Despite great success in surgical and medicinal care of CHD. many operations are palliative rather than curative. and some survivors still have significant residual hemodynamic and electrical conduction abnormalities. as well as long-term cardiovascular problems. The field of congenital heart defect treatment has come a long way in its infancy. With heart problems that were an automatic death sentence 60 years ago, to contemporary surgical survival rates of more than 96 percent for all defects evaluated together. No other branch of research or medicine has done so much in such a short time. In this paper, we overview epidemiology, evaluation and management of congenital cyanotic heart diseases in children.

Open Access Review Article

Role of Anti-VEGF (Bevacizumab) in Management of Neovascular Glaucoma: A Review

Abdulrahman Arshed N. Alharfy, Marwan Saleh D. Albalawi, Abdulmajeed Mousa Alzahrani, Ruby Naif M. Alsubaie, Amani Ahmad S. Albalawi, Waad Ali Alkaabneh, Abdullah Ibrahim Altidlawi, Amal Nafea J. Alharbi, Afnan Mohammed H. Almutairi, Rola Ali S. Alotabi

Journal of Pharmaceutical Research International, Page 215-221
DOI: 10.9734/jpri/2021/v33i40A32237

Neovascular glaucoma (NVG) is an aggressive type of glaucoma, which often results in poor visual outcomes. Antivascular endothelial growth factor is frequently used for various conditions in which VEGF release is induced in response to retinal ischemia. Bevacizumab is a humanized anti-VEGF monoclonal IgG1 antibody. The potential of antivascular endothelial growth factor (anti-VEGF) agents to modify the disease course of neovascular glaucoma (NVG) was recognized shortly after their use in the treatment of age-related macular degeneration was reported. These medications were noted to induce rapid regression of the anterior segment neovascularization that characterizes NVG. Several studies as well as extensive clinical experience have demonstrated a rapid regression of anterior segment neovascularization following the injection of anti-VEGF agents. This review aims to summarize current evidences regarding effectiveness of Bevacizumab in management of neovascular glaucoma.

Open Access Review Article

Intravascular Shunt in Management of Limb Trauma- A Review

Hashem Bark Awadh Abood, Abdulaziz Munahi Alanazi, Falah Bader Alhajraf, Wejdan Nawaf Mesfer Alotaibi, Bushra Saad Alghamdi, Shahd Ali H Alramadhan, Daliah Abdulrahman Alharbi, Asia Abdullah Alamri, Salman Abdulrahman Alhumud, Mohammad Nabil Khojah, Shda Fahad Khalil

Journal of Pharmaceutical Research International, Page 274-281
DOI: 10.9734/jpri/2021/v33i40A32244

Vascular injuries to the upper or lower limb in the context of significant soft tissue loss, fractures, or other life-threatening injuries are associated with a high amputation rate. Complex extremity vascular injuries in which acute arterial insufficiency combined with severe or prolonged shocks are unacceptable because warm, warm, skeletal muscle time is often exceeded before adequate revascularization, and are associated with extended ischemia periods or fractures or soft tissue wounds. Revascularizing the limb is essential for the success of the limb rescue. Selective intravascular temporary shunting hence allows better overall care of the patient and can therefore be predicted to increase both limb rescue and patient survival rates. The aim of this article was to review and summarize results of previous literature regarding effectiveness on intravascular shunting as management of limb trauma as well as reviewing its potential complications.

Open Access Review Article

Overview on Causes and Management of Upper Extremity Ischemia- A Review

Hashem Bark Awadh Abood, Mohammad Saleh Almarri, Faisal Mohammed Khoshaim, Barak Abdullah Alsubaie, Al Abbad, Mohammed Ahmed A., Sultan Abdulaziz Alzhrani, Raghad Mohammed Alsafri, Hayat Mohammed Alharbi, Hamzah Hussain Owaydhah, Rayan Hussain S. Alobaidi, Alanoud Awaji Hakami

Journal of Pharmaceutical Research International, Page 288-293
DOI: 10.9734/jpri/2021/v33i40A32246

Acute upper limb ischemia (AULI) occurs less often than acute lower limb ischemia, contributing for even less than 5% of all limb ischemia instances. It is known to be rare vascular emergency with serious long-term effects if not treated promptly. Timely detection and localization of the arterial occlusion are critical for effective revascularization and limb salvage. Surgical procedure, most commonly embolectomy, has become the standard of care for embolic or thrombotic AULI. Vascular repair is synonymous with morbidity and death, which can be avoided in some circumstances. Nonsurgical options such as endovascular procedures, thrombolytic agents, and anticoagulation therapy continue to advance, but their function in upper extremity ischemia remains unclear. In this Review, we discuss causes and management of acute upper extremity ischemia.  The paper concluded that longer symptoms mean greater likelihood of functional sequelae. Surgical management is the most commonly used and best treatment. It is also possible that conservative management is being underreported. The prognosis of upper extremity ischemia is related to prompt and appropriate treatment and is predictable based on initial serum LDH levels.

Open Access Review Article

Overview on Ocular Manifestations of Albinism- A Review

Abdulrahman M. Albahlool, Fatema Adel Almajed, Maryam Essa Alwabari, Rana Mohammed Hilmi, Reem Mohammed Saad Abahussain, Sarah Mohammed Alasgah, Rima Salman M. Bnfadliah, Khalid Alwalid Alekrish, Zinab M. Abuammah Alharbi, Mohammad Maitham Almomen

Journal of Pharmaceutical Research International, Page 300-308
DOI: 10.9734/jpri/2021/v33i40A32248

Albinism is a set of heritable disorders in ectoderm-derived tissue linked with reduced or missing melanin. Reduce melanin synthesis might include the skin, hair follicles and the eye, causing eyelid or locating the eye in the main, leading to eye albinism. Common eye symptoms include foveal hypoplasia, fundal hypopigmentation, iris transillumination, nystagma, visual acuity reduction, stereopsis decreased or absent, squint, and abnormalities in refractive functionality. Fixing the refractive defect, sun glasses or specific photo aversion filter lenses and prismatism for an irregular head posture may be needed. Operation with strabismus is typically unneeded but may be done to enhance the peripheral fields of visual fusion. In this review, we summarize ocular manifestations of albinism.