Open Access Case Report

Chocolate Endometrial Cyst: A Case Report

Yugandhara Hingankar, Vaishali Taksande, Manjusha Mahakarkar

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2021/v33i40B32254

Introduction: Chocolate cysts are noncancerous, fluid-filled cysts that typically form deep within the ovaries. They get their name from their brown, tar-like appearance, looking something like melted chocolate. They're also called ovarian endometriomas [1].

Case Presentation: The authors report an unusual case of chocolate endometrial cyst.  During history collection it found that patient develop a severe pain at midnight, after all the investigation the ultrasonography they diagnosed probe tenderness in RIF. Significant free fluid in abdominal cavity. Well circumscribed mix echoic mass lesion seen in hypogastric region more in right paraumbilical region with eccentrically placed small tubular structure visualized. Mass lesion of size 110mm×110mm. USG guided tapping done, the ascitic fluid smears shows fresh RBC’s and other blood cells entrapped in fibrin clot. Background is haemorrhagic and malignant cells are absent. Abdominal surgery was done and chocolate cyst was removed and sent to histopathology for further investigations.

Conclusion: In this study, author mainly focus on expert surgical management and excellent nursing care which leads to fast recovery of patient. After conversation with patient her response was positive and after nursing management and treatment she was discharged without any postoperative complications and satisfaction of recovery.

Open Access Case Report

A Brief Study on Primary Melanoma over Breast Region

K. M. Hiwale, Avadh Kishor Tyagi

Journal of Pharmaceutical Research International, Page 86-90
DOI: 10.9734/jpri/2021/v33i40B32267

Background: Malignant melanoma is mostly found in mucous membranes and skin. So it’s occurrence on the breast skin is very rare.

Case Presentation: In our study, 50-year-old female came to OPD with complaint of skin lesions on the breast since 2 months. On diagnosis, skin lesion was found to be malignant melanoma and the disease had metastasized in right axillary lymph node with discoloration over breast.

Conclusion: The prognosis for patients with this disease is very poor. Important procedures which may increase the survival rate include, Early diagnosis and surgical resection with adjuvant therapy.

Open Access Systematic Review Article

Pain Medicine in Oral and Maxillofacial Surgery

Chandrashekhar Pandey, Trupti Devadiga, Ashutosh Jaysing Thorat, Prashant Ashok Punde

Journal of Pharmaceutical Research International, Page 221-235
DOI: 10.9734/jpri/2021/v33i40B32281

A significant amount of empirical progress has been made in the management of pain over the last century,largely as a result of the introduction of a more effective pharmacological agent and the developmentof a better understanding of the principle of molecular development that governsits use. Much remains to be learned from the mechanisms and treatment of pain by researchers and practitioners. This review article will discuss regarding the important aspects of pain control in oral and maxillofacial facial surgery.

Open Access Case Study

How Under-Nutrition (Karshya) is Responded to Ayurvedic Treatment: A Case Study

Lakshmi Devi Chauhan, Sudhir Kumar Pani

Journal of Pharmaceutical Research International, Page 7-12
DOI: 10.9734/jpri/2021/v33i40B32256

Despite numerous global sensible corrective attempts to provide nutrition, undernutrition (Kaarshya) remains one of the most pressing issues. The bulk of the population in underdeveloped nations is undernourished. It is one of the main causes of death and morbidity in both children                  and adults. One of the eight components of primary health care in the worldwide campaign                           for health for all is the promotion of appropriate diet. A person who is malnourished is prone                                     to a slew of problems. It is a condition in which the body's fat and muscles are depleted. This is why it is critical to treat it to restore the body's normalcy. With its unique approach to lifestyle management and medication therapy, Ayurveda, with its holistic perspective, can aid with this disease. Swasthavritta (Community Medicine) has a part in Kaarshya management. Ashwagandhadi avaleha acts as an excellent nutritional treatment to alleviate the symptoms                      of Kaarshya in youngsters. As a result, Ayurvedic therapy for Kaarshya was arranged. After                                 one month of treatment, the patient gained 1.5 kg of weight, and the next month, i.e., the                               follow-up period, the patient exhibited substantial improvement in weight growth. Other anthropometric measures improved as a result of the therapy. The assessment was carried out over two months.

Aim: To study the effect of Ashwagandhadi avaleha on BMI and weight in karshya.

Materials and Methods: This is a single case study on underweight female. Ashwagandhadi avaleha was given for two months. Anthropometric parameters such as weight, body mass index (BMI), hip circumference (HC) and mid-arm circumference (MAC) and subjective parameters were assessed before and after 2 months.

Result: Significantly increased in weight i.e. 2Kg was observed after two months.

Conclusion: Regular intake of Ashwagandhadi avaleha significantly increases weight and body mass index in Karshya.

Open Access Case Study

Role of Haridradi Avaleha in the Management of Tamaka Shwasa (Childhood Bronchial Asthma) – A Single Case Study

Rimpi Majumder, Aboli Patil, C. R. Swapnil

Journal of Pharmaceutical Research International, Page 255-260
DOI: 10.9734/jpri/2021/v33i40B32284

The word Shwasa is derived from the root ‘Shwasa Prinane’– which actually means  difficulty in the entry of prana in the pranavaha srotas. Shwasa word  indicates  both  physiological  and  pathological state of  respiration. Tamaka Shwasa is one of the five types of disease shwasa. It is a disease of mainly pranavaha srotas. The sign and Symptoms and etiopathogenesis of Tamaka Shwasa explained in Ayurvedic  literature  have lot of similarities with the disease entity Bronchial Asthma. The goal of this study is to determine the efficacy of the formulation, Haridradi Avaleha in reducing the sign and symptoms of Childhood asthma. A 13 years old boy male Hindu patient from Limda village, Vadodara presented in the OPD of Kaumarbhritya department, Parul Ayurved Hospital, Parul University who presented clinical features of Tamaka Shwasa  was treated by internal Ayurvedic formulation, Haridradi Avaleha showed marked improvement in  the subjective parameters like breathlessness, cough, corzya, awakening in night etc and in objective parameters like ACT(Asthma Control Test), PEFR(Peak Expiratory Flow Rate) some hematological parameters viz. AEC (Absolute Eosinophil Count), ESR (Erythrocyte Sedimentation Rate), WBC Lymphocyte, Neutrophil, discussed here. All subjective and objective parameters were examined during 60 days of follow up-visits, and no instances of the above complaints were reported.

Open Access Study Protocol

Study of Efficacy of Diode Laser in Unwanted Facial Hair: Dynamic Versus Static Mode

Adarsh Lata Singh, Meenakshi Chandak, Anugandha Ghatge, Sejal Chandak

Journal of Pharmaceutical Research International, Page 267-272
DOI: 10.9734/jpri/2021/v33i40B32286

Background: Hair forms an important appendage of the body playing a significant role in an individual’s psychosocial personality. Hirsutism is the presence of terminal hair at androgen-dependent sites in a female. Hypertrichosis is excessive hair growth all over the body in a non-androgen dependent manner. Increased terminal facial hair growth leads to cosmetic embarrassment, psychological distress and a low self-esteem in women. Currently, the most effective and advanced procedure for unwanted hair removal is laser epilation. Diode laser (800-855nm) are the most frequently used for this purpose and can be used in two different modes FDP (Fast delivery pulse) and DP (delivery pulse). With this study we aim to compare the efficacy of these two modes of diode laser for facial hair reduction.

Objectives: 1.To study the clinical presentation of unwanted facial hair in patients visiting the department. 2. To study the trichoscopic features of facial hair in patients. 3.To study the correlation between the endocrinal abnormalities and clinical presentation in patients with increased facial hair. 4. To study the effectiveness of two different modes of diode laser on facial hair.

Methods: It is a prospective randomized control study with a total of 20 female patients in the age group of 18-50 years with complaints of unwanted facial hair. VIKINI Diode laser of wavelength 808nm will be used for treatment. Post randomization the participants will be divided into two groups, one of them will be treated with FDP (Fast delivery pulse) mode and the other with DP (delivery pulse) mode. A total of six sittings will be performed at an interval of 4 weeks. Baseline trichoscopy findings as well as trichoscopy at follow up visits at one, three and six months will be recorded. Post procedure patient satisfaction and pain assessment will be also be recorded.

Expected Results: The result would be undertaken in SPSS software. This study will help in understanding which technique is superior for laser hair reduction for facial hair.

Conclusion: The conclusion will be based on findings for study protocol.

Open Access Opinion Article

Comparative Study of Children's' Blood Sugar in Fluid Therapy with Dextrose Saline, Ringer and Normal Saline 0.9% Serums and its Relationship with Depth of Anesthesia in Elective Surgery

Farhad Nanaei, Morteza Habibi Moghadam, Zahra Eslamifar, Hadi Bahrami, Mohammad Hasan Bigdeli, Zohreh Sekhavatpour

Journal of Pharmaceutical Research International, Page 91-102
DOI: 10.9734/jpri/2021/v33i40B32268

Background: This study was aimed to determine the children's' blood sugar level in fluid therapy with DSS (dextrose saline serum), RS (ringer serum) and NS 0.9% serums (normal saline 0.9%) and its relationship with the depth of anesthesia in elective surgery.

Method: This double-blind experimental study was performed with 90 children referred to the surgical ward, including: group A (receiving DSS), group B (receiving NS 0.9%) and group C (receiving RS) that the blood sugar of each group in 5 steps was measured: half an hour before induction of anesthesia, during induction of anesthesia, half and one hour after induction of anesthesia and after complete awakening in recovery. In addition, the monitoring the vital signs, measuring depth of anesthesia, pulse oximetry and electrocardiogram were performed for all groups.

Results: The results showed that the mean blood sugar in the 5 steps measured had a significant difference in three groups under study (P <0.05). The mean blood sugar in the group receiving DSS was significantly higher than the two groups receiving RS and NS 0.9%. Also the mean depth of anesthesia in three groups did not show a significant difference.

Conclusion: Finally, according to this study, the use of DSS from the beginning of anesthesia, RS half an hour after the start of anesthesia and NS 0.9% one hour after the start of anesthesia can increase blood sugar in children. Therefore, the use of DSS is not recommended due to the stressful nature of anesthesia and operating room and the possibility of hyperglycemia.

Open Access Original Research Article

Is It Necessary to Perform Pre Operative Upper Gastrointestinal Endoscopy in Elective Symptomatic Cholelithasis?

Ubedullah Shaikh, Zahid Ali Memon, Masroor Mubeen Phulpoto, Munawar Hussain Mangi, Nawaz Ali Dal, Mujeeb Rehman Abbasi

Journal of Pharmaceutical Research International, Page 13-17
DOI: 10.9734/jpri/2021/v33i40B32258

Objective:  Is it necessary to perform pre operative upper gastrointestinal endoscopy in elective symptomatic cholelithasis?

Study Design: Prospective observational study.

Place and Duration of Study: This study was conducted at surgical departments of  Services Hospital,  Ruth PFAHU, Civil Hospital Karachi, Shaheed Benazir Bhutto Medical College, Lyari Karachi and Liaquat University Of Medical and Health Sciences, Jamshoro from July 2018 to December 2019.

Methodology: Study consisted of 382 patients. All patients were subjected to Upper Gastrointestinal Endoscopy 24 to 48 hours before cholecystectomy followed by biopsy were obtained for histopathology if required. Those patients not willing for surgery, General anesthesia problem, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructive jaundice were excluded.

Results: Out of the 382 patients, 66(17.27%) males and 316(82.72%) females with mean age of study population was 46.10 ± 6.31 years (22 to 65 years). Patients were present typical pain in 146(38.21%) cases and atypical pain in 236(61.78%) cases. Pre operative upper gastrointestinal endoscopy findings revealed Esophagitis in 22(5.75%) cases, GERD in 26(6.80%) cases, gastritis in 88(23.03%), gastric ulcer 49(12.82%), duodenal ulcer in 39(10.20%), polps 21(5.49%) and carcinoma of stomach 9(2.35%). Out of 236(61.78%) cases with atypical pain had persistence of symptoms in 141 (59.74%) cases upto four months.

Conclusion: We conclude that upper gastrointestinal endoscopy preoperatively for gallstone disease should be performed. So that preoperatively atypical symptoms are evaluate and taken care of, and patients is fully informed and also treated for associated conditions.

Open Access Original Research Article

Evaluation of Anti-Ulcer Activity of Garcinia cambogia in Experimentally Induced Ulcer in Rats

G. P. Sharook, Prasanna Shama Khandige, K. C. Bharath Raj

Journal of Pharmaceutical Research International, Page 18-25
DOI: 10.9734/jpri/2021/v33i40B32259

Peptic ulcer is the most common gastrointestinal disorder that world faces at present. Garcinia cambogia is one of the folk plants used by the people to treat various ailments to attain health benefits.  Every part of the plant has various activities which can eradicate maximum health issues. The present study is aimed to investigate the gastro-protective and anti-ulcerogenic activity of ethanolic extract of Garcinia cambogia. The ethanolic extract was tested orally in doses of 200 mg/kg and 400mg/kg which was obtained from the acute oral toxicity studies on gastric ulcerations experimentally induced by pylorus ligation and ethanol in rats. Comparison of the drug effect is done with the effect of standard drugs, omeprazole (30 mg/kg) and sucralfate (100 mg/kg). The parameters like gastric pH, gastric acid volume, total acidity, free acidity and ulcer index are assessed.The ethanolic extract showed an activity in a dose of 200 mg/kg and 400 mg/kg with a reduction in the gastric volume, total acidity, free acidity, ulcer index and raise in the gastric pH when compared to that of ulcer control group. A gastro-protective and anti-ulcerogenic activity is shown by the extract of Garcinia cambogia both in ethanol induced ulcer model and pylorus ligated ulcer model.At the concluding point, extract of Garcinia cambogia was found to possess a very good gastroprotective and anti-ulcerogenic property. The results of the study revealed the further uses of the leaves of this plant in the treatment of ulcers in the stomach.

Open Access Original Research Article

Formulation and Evaluation of Clarithromycin Loaded Nanostructured Lipid Carriers for the Treatment of Acne

Pooja Shettigar, Marina Koland, S. M. Sindhoor, Ananth Prabhu

Journal of Pharmaceutical Research International, Page 26-38
DOI: 10.9734/jpri/2021/v33i40B32260

Background: Clarithromycin is a macrolide antibiotic used in acne treatment, but it has poor solubility, which decreases its permeability through lipid barriers such as skin. Nanostructured lipid carriers can enhance the permeability of clarithromycin through the skin, thus improving its potential for controlling acne.

Aim: To formulate and evaluate Nanostructured lipid carriers of clarithromycin for topical delivery in acne treatment

Methods: Nanostructured lipid carriers were prepared by emulsification and ultrasonication methods using lipids such as glycerol monostearate and oleic with poloxamer 188 as stabilizer. These nano-carriers were optimized with the help of the Quality by Design (QbD) approach employing Design-Expert® software. The nanoparticles were characterized for particle size analysis, zeta potential, drug-excipient compatibility, entrapment efficiency, and surface morphology by Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). The nano-carriers were also investigated for in vitro drug release and ex vivo permeation through excised goat skin. The optimized formulation was incorporated into topical carbopol gel base, formulated and examined for pH, viscosity, spreadability, in vitro drug release, ex vivo permeation, and stability under accelerated conditions.

Results: The average particle size of the optimized nanoparticles was 164.8 nm, and zeta potential was -39.2 mV. FTIR studies showed that drug and lipids are compatible with each other. The morphology study by SEM and TEM showed spherical shaped particles. The entrapment efficiency of the optimized formulation was found to be 88.16%. In vitro drug release studies indicated sustained release from the formulation due to diffusion through the lipid matrix of the particles. The ex vivo permeation study using goat skin produced greater permeation from the NLC gel (89.5%) than marketed gel (65%) due to the lipid solubility of the nanoparticles in the skin. The formulation was stable under accelerated conditions.

Conclusion: The optimized formulation can be considered as promising nano-carriers suitable for the sustained release of clarithromycin into the skin for effective control of acne.

Open Access Original Research Article

Distribution of Microbial Plaque on Intaglio Surfaces of Maxillary Removable Complete Denture: A Cross Sectional Study

Usman Bashir Shaikh, Aamir Mehmood Butt, Beenish Chachar, Kashif Ali Channar, . Aqsa, Nadeem Hussain Jatoi

Journal of Pharmaceutical Research International, Page 39-45
DOI: 10.9734/jpri/2021/v33i40B32261

Aim: To assess the dispersion of prosthetic microbial plaque on intaglio planes of removable completely edentulous denture.

Study Design:  Descriptive Cross Sectional

Place and Duration of Study: Department of Prosthodontics, Liaquat Medical University Hospital from December 2107 to November 2018.

Methodology: The maxillary removable complete dentures were collected from the 62 patients. The inner sides of the maxillary prosthesis remained revealed with 1% neutral red solution. These internal sides stayed at that point captured with an advanced camera. Natural plaque scattering on the inner layer of the denture was inspected by calculating plaque layering the subsequent definite zones of the denture inner layers: The fitting layer of the maxillary prosthesis was divided into 14 zones. Biofilm was enumerated in all of the 14 assessed zones by a visual analogue scale. The data was analyzed by SPSS version-16. Independent t test and Anova test were applied for statistical difference of plaque score.

Results: Males and females were 48% and 52% respectively. The mean age was 56.48 ± 7.176. The mean plaque score on intaglio surface was 1.912 ± 0.468. The Vestibular inclination of the right labial flange (areas 4) had the highest biofilm growth 19% tailed by palatal inclination, frontal portion of the right buccal flange (area 8) 18%, vestibular inclination of the left labial flange (area 3) 14% and palatal inclination, front portion of the left buccal flange (area 11) 11%. There was no statistical difference between gender and plaque score.

Conclusion: The Vestibular slope area of the right labial flange had the greater growth of plaque shadowed by Palatal slope space, frontal zone of the right buccal extension area, Vestibular slope area of the left labial extension and slope of palate area, front zone of the left buccal extension.

Open Access Original Research Article

Evaluation of Levofloxacin Prescription Pattern and Appropriateness Rate in the Outpatient Setting; A Cross-Sectional Study from Iran (2018-2019)

Bayan Azizi Pharm. D., Sholeh Ebrahimpour Pharm. D., Mohammadreza Salehi M. D., Zahra Jahangard-Rafsanjani Pharm. D.

Journal of Pharmaceutical Research International, Page 46-56
DOI: 10.9734/jpri/2021/v33i40B32262

Background: Levofloxacin is prescribed widely as a first-line or alternative treatment option for different infectious diseases. The inappropriate use of this agent has increased the risk of antibiotic resistance, which has convinced researchers to address this issue by designing antibiotic prescription pattern studies.

Aim: This study aimed to evaluate levofloxacin's prescription pattern and appropriateness in the outpatient setting in Iran.

Methodology: This cross-sectional study included all admitted prescriptions containing levofloxacin from October 2018 to June 2019. Data regarding the demographics, clinical and laboratory presentations, preexisting comorbidities, dose and duration of levofloxacin, and the prescribers medical specialty were collected by reviewing the patient's prescriptions or history taking. The pattern and appropriateness of prescriptions were evaluated according to the assessment tool based on accepted international guidelines.

Results: A total of 300 eligible patients (median age: 56.5 years; 56.7% male) were included in the study. Respiratory tract infections were the most common indication for levofloxacin prescription (55.6%); more than half of them were related to community-acquired pneumonia (29.6%). The inappropriateness rate for levofloxacin prescription was 55.3 %, of which 12.6% were related to community-acquired pneumonia, 9.6% skin infections, 8.4% rhinosinusitis, and 6.6% Urinary tract infection. Only 54 (18.0%) patients received levofloxacin with an appropriate indication, dose, and duration, indicating its rational use.

Conclusion: This study found that more than half of all levofloxacin prescriptions in the outpatient setting are inappropriate, contributed mainly to respiratory tract diseases. Interventions that target these health care providers are essential to improve prescribing of this valuable antibiotic.

Open Access Original Research Article

Communication Strategies to Combat COVID-19 Vaccines Hesitancy

Destaw Bayable Yemer, Minwuyelet Andualem Desta, Melaku Bayu Workie

Journal of Pharmaceutical Research International, Page 72-85
DOI: 10.9734/jpri/2021/v33i40B32266

COVID-19 infectious disease resulted in a pandemic that has threatened millions of people in the world. It is caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), and it has created a global health crisis. Hence, the present study aimed at assessing communication strategies used by Ethiopian Public Health Institute and Ministry of Health to address COVID-19 vaccine hesitancy, make analysis of vaccination messages, and hybrid media messages to label best practices of communication techniques to address vaccine hesitancy. To attain this objective, a qualitative research method was employed to analyze messages that were disseminated with the hybrid national and regional media and social media platforms. MOH and EPHI disseminated messages; ministers, prominent people, opinion leaders and activists’ speeches used as subjects of the study. COVID-19 vaccination messages were selected through purposive sampling method. The contents of messages regarding health communication were analyzed. The finding showed that building COVID-19 vaccine acceptance through effective communication is important to stop the spread of the virus. The participatory and presumptive style communications are the possible method to promote COVID-19 vaccination before it reaches on refusal stage. Moreover, the results revealed that communication strategies contributed to vaccine advocacy and vaccination campaign to improve vaccine acceptance. MOH and EPHI used the hybrid media to mold the unscientific information and the misinformation of the vaccine. In sum, using effective communication strategies is very important to create awareness about COVID-19 vaccines, and avoid vaccine hesitation to strength the public vaccines acceptability.

Open Access Original Research Article

Renoprotective Influence of Pomegranate Juice on Nephrotoxicity Induced by Methotrexate

Afnan H. Saaty

Journal of Pharmaceutical Research International, Page 103-113
DOI: 10.9734/jpri/2021/v33i40B32269

Methotrexate (Metho) is cytotoxic drug widely used to treat malignant (lymphoma, leukemia, breast cancer) and non-malignant (rheumatic arthritis) diseases. It mediates nephrotoxicity via cellular oxidative stress. Pomegranate juice (POJ) has a potent antioxidant property. This research aimed to assess the potential protective effect of POJ against Metho-induced renal damage in rats. Renal toxicity was induced through intraperitoneal (ip) injection with a single dose of Metho (20 mg/kg). Forty male rats were randomly segregated into 4 groups; each group contained 10 rats. Control (Cont); Metho: rats on the 23rd day injected ip with Metho; POJ (2 ml/kg) +Metho: rats given POJ (2 ml/kg) orally once a day, and on the 23th day injected with Metho ip; and POJ (4 ml/kg) + Metho: rats given POJ (4 ml/kg) orally once a day, and on the 23th day rats were injected with Metho ip. After 5 days of Metho ip. injection, blood samples and renal tissue were obtained. Serum renal functions, ionic electrolytes (sodium and potassium), and pro-inflammatory cytokines were analyzed. Renal oxidative stress and antioxidant enzymes were also measured. Renal tissue were examined microscopically. Metho caused a significant increase in serum renal functions and disturbance in ionic electrolytes. As well as, there was a significant increase in pro-inflammatory cytokines and oxidative stress parameters, with detectable degenerative alteration in glomerulus and renal tissue changes compared with the Cont group. Pretreatment with POJ resulted in preventing biochemical and histopathological alterations induced by Metho. The high dose of POJ (4 ml/kg) was significantly more effective than low dose (2 ml/kg). In conclusion, POJ exerted a potent nephroprotective action and prevent Metho-induced nephrotoxicity. Therefore, POJ may has a beneficial effect in patients receiving Metho therapy.

Open Access Original Research Article

To Assess the Physical Morbidity Profile among the Welders

Mayur Bhaskarrao Wanjari, Pratibha Wankhede

Journal of Pharmaceutical Research International, Page 114-119
DOI: 10.9734/jpri/2021/v33i40B32270

Introduction: The welding profession poses many health hazards that the welders are exposed to everyday during working time. This leads to a large number of health consequences and diseases. Worldwide 10 million employees are exposed to iron fumes. Most are exposed by inhaling welding fumes that have iron as their main component. Exposure to iron fumes in steel mills and iron/steel foundries is also significant.

Background: For welders it is most important to take safety measures during working time. Welders are exposed to various types of hazardous substances that can affect their health. Worldwide welder’s morbidity is in a large number of welders affected. We conducted a study to find the physical morbidity pattern of welders in the Wardha region.

Objective- To assess the physical morbidity profile among the welders, and associate the physical morbidity profile with selected demographical variables in Wardha, India.

Methods: A purposive sample was conducted among 100 welders to identify the physical morbidity among welders. Welding workshop in separated space outside and inside the city of way ANOVA and t-test used to estimate the degree of association between the physical morbidity profile and the selected demographic variables.

Results: All welders were having some type of physical morbidity. The most frequent issues with the welding workers are injury to the eyes and skin. Age of welding worker, educational qualification, experience of welding work, hours worked per day are in association with the physical morbidity among welders.

Conclusion: In this study, the physical morbidity pattern of welders is identified. 87% welders were identified with mild physical morbidity and 13% of welders with moderate physical morbidity. Need some training program for welders to do right and safety welding and certificated course for welders.

Open Access Original Research Article

Enrichment of Therapeutically Significant Flavonolignans of Silybum Marianum in Vegetative Parts by Applying Fungal Elicitors, Methyl Jasmonate and Silver Nanoparticles as Elicitor in Hydroponic Culture

Bismillah Mubeen, Qurban Ali, Ammarah Hasnain, Arif Malik

Journal of Pharmaceutical Research International, Page 126-138
DOI: 10.9734/jpri/2021/v33i40B32272

Introduction: Medicinal plants are being used to treat several diseases for many decades and this is an ancient method to treat the patients. Herbal plant Silybum marianum found most effective one to cure liver disorders. This plant produces silymarin which is a secondary metabolite and have hepatoprotective properties. Silymarin is a mixture of flavonolignans (silybin A, silybin B, isosilybin A isosilybin B, silychristin, silydianin apigenin 7-D glucose and taxifolin) that has antiviral, antibacterial, antifungal and antiallergenic properties. Therefore, the excessive production of silymarin is necessary to cure different types liver disorders, so the present study executed to boost up production of Silymarin flavonolignans in vegetative parts of the Silybum marianum plant by using different elicitors.

Materials and Methods: In the present study, elicitation technique in hydroponics system was used to enhance the production of pharmacologically active flavonolignans in Silybum marianum. Fungal elicitors prepared from lyophilized Aspergillus niger biomass, methyl jasmonate, silver nanoparticles and combination of silver nanoparticles and methyl jasmonate were added (0.2g/l), (100µM/l), (1 ppm) and (100µM/lppm) in hydroponics with Hoagland’s solution in hydroponics to enhance the production of flavonolignans of Silybum marianum. Controls were also set for each treatment. Plants were harvested after 72 hours of introduction of elicitors. High performance liquid chromatography technique was used for analytical purpose. Four solvents (methanol, acetonitrile, chloroform and 2% Trifloro acetic acid) were used in HPLC. Column was C18 and run time of sample was 1 hour. Silybum marianum’s seed extract was used as a standard. Extract of control and treated plants were run on the same polarity in HPLC.

Results: Results showed that after elicitation significant increase was observed in production of silymarin’s flavonolignans (silybin A, silybin B, isosilybin A, isosilybin B and apigenin 7-D glucose) in vegetative part of the plant but rate of production was different for each elicitor, fungal elicitors prepared from lyophilized Aspergillus niger biomass proved best among all treatments.

Open Access Original Research Article

A Retrospective Drug Utilization Study on Psychiatric Illness in a Tertiary Care Teaching Hospital

I. Jerlin Michelle, E. Dhanushri, V. Nidhish RAJ, Muhammad Aslam Syed, A. Priyadharshini, S. P. Ahalya

Journal of Pharmaceutical Research International, Page 148-153
DOI: 10.9734/jpri/2021/v33i40B32274

Psychiatric disorders are now widely recognized as a major contributor to the global burden of disease. It has been described that there is an increased risk of adverse effects when more than one psychotropic drug is prescribed. Knowledge of the pattern of utilization of drugs in the general population can be achieved through the conduct of drug utilization studies. The present study has therefore been conducted to observe the pattern of drug use in psychiatry patients in a tertiary care hospital.

Aim and Objective:

To assess the epidemiology of various psychiatric illnesses among the study population

To assess the Prescribing Pattern of drugs in Psychiatric Illness.

To assess the drug-drug interactions in the prescription using MICROMEDEX.

Methodology: A retrospective descriptive observational study was performed in a tertiary care hospital. A total of 100 prescriptions were collected from MRD. 

Results: The study reported that 66% of patients were males and 34% were females. The average number of drugs and psychotropic drugs per prescription is six and four respectively. Around 61.98% of drugs in the prescription are psychotropic drugs, among that 40.17% of benzodiazepines are majorly used, followed by 34.27% of antipsychotics. Almost 95 prescriptions had a minimum of one drug-drug interaction. 

The average number of psychotropics per prescription was higher than in studies. The average number of drugs per prescription was 5.84, which lead to polypharmacy.

Conclusion: Using WHO indicators prescription analysis was done and it showed some deviation from the standard value which can be improved. Polypharmacy was noted in this study. Most of the drug is prescribed in the brand name which should be avoided.

Open Access Original Research Article

Knowledge and Awareness about Diabetes of Recently Retired Athletes

Abida Naseer, Saeed Javed, Faryal Gul, Sumera Sattar, Fehmida Ayub, Abdul Haseeb Hayat, Ali Sher, Adnan Asghar

Journal of Pharmaceutical Research International, Page 154-160
DOI: 10.9734/jpri/2021/v33i40B32275

Objective: The present research aimed to provide knowledge and awareness to the retired athletes about their diabetes.

Methodology: The research hascross-sectional research design. The glucose level of 300 recently retired male athletes was observed through Glucometer before data collection. Total 163 out of 300 athletes were found diabetic. The data was collected from these 163 diabetic retired athletes through the questionnaire. The researchers took three months to complete the process of glucose testing process retired athletes through Glucometer. Afterward, the collected data was edited into SPSS (v-26) for further analyses. The collected data were analyzed through descriptive statistics using frequencies and percentages on the written observations of retired athletes.

Results: The findings have shown that athletes were become diabetic due to give up their sports practices and exercises after their retirement. Before retirement, they were taken rich carbohydrates in their meals and utilized them in their routine sports practices and competitions. Afterward, the eating habits of athletes were still in progress but their sports habits were changed which cause their diabetes.

Conclusion: It was concluded that the retired athletes of Pakistan belonging to any sports should observe their blood glucose regularly. Furthermore, they should continue their exercises and sports involvements to maintain their fitness levels as well as to control the glucose levels in their blood. This enhances not only their healthy lifestyle but also they may spend their healthy lives.

Open Access Original Research Article

Stability Indicating RP-HPLC Method for the Analysis of Dacomitinib and its Related Impurities in Bulk and Oral Solid Dosage Formulations

Venu Kamani, M. Sujatha, G. S. N. Koteswara Rao, N. Vinod Kumar

Journal of Pharmaceutical Research International, Page 187-199
DOI: 10.9734/jpri/2021/v33i40B32278

Dacomitinib is an epidermal growth factor receptor inhibitor prescribed for the treatment of metastatic non small-cell lung carcinoma. There are no reported significant official of HPLC methods that resolve the impurities and degradation products generated during stability studies. Therefore, an isocratic RP-HPLC-UV method was developed for the determination of Dacomitinib in the presence of its related impurities and degradation products. The separation of Dacomitinib, impurity 1 and 2 was achieved on Agilent ZORBAX Eclipse (250×4.6 mm; 5 µ id) column as stationary phase, 0.1M sodium perchlorate at pH 5.6, acetonitrile as mobile phase in the ratio of 20:80 (V/V) at a flow rate of 1.0 mL/min in isocratic condition as mobile phase and UV detection was carried at 253 nm. In the optimised conditions, well resolved and retained peaks were observed at a retention time of 5.8 min, 4.0 min and 7.7 min for Dacomitinib, impurity 1 and 2 respectively. In the developed method, a very sensitive detection limit of 0.06 and 0.025 µg/mL was observed for impunity 1 and 2 respectively. The calibration was observed to be within the concentration range of 20 – 200 µg/mL for Dacomitinib and 0.2 – 2 µg/mL for impurity 1 and 2. The proposed method was used to investigate the effective separation of impurities along with degradation compounds formed under different degradative conditions and confirms that the method is stability indicating. Hence it can be concluded that the method was found to be simple, sensitive, specific, accurate, linear, precise, rugged, robust, and useful for estimation and characterizing the stability of Dacomitinib, impurity 1 and 2.

Open Access Original Research Article

Testosterone Correlation with Low and High Density Lipoprotein in Male Type 2 Diabetics

Mubeena Laghari, Shazia Murtaza, Zuha Talpur, Mohsina Hamid, Faryal Adnan, Arslan Ahmed

Journal of Pharmaceutical Research International, Page 200-206
DOI: 10.9734/jpri/2021/v33i40B32279

Aim: To determine correlation of serum testosterone with low and high density lipoprotein in male type 2 Diabetics presenting at a tertiary care hospital of Sindh. 

Methodology: A cross sectional study, Department of Biochemistry and Department of Medicine, Liaquat University Hospital from January 2018 to February 2019. One hundred male type 2 diabetics (cases) and one hundred age matched male (control) were selected through non – probability purposive sampling. Male diagnosed cases of DM belonging to 4th to 6th decade of life was included. Blood samples were collected by venesection and sera were squeezed by centrifugation and stored at – 20 0C in refrigerators. Testosterone was estimated by the ELISA (competitive immuno- assay) assay method and blood lipids - cholesterol, triglycerides (TAGs), LDLc and HDLc by colorimetric method. Pearson`s correlation was generated on Statistical software SPSS 21.0 version (IBM, Incorp, USA) for correlation of serum testosterone with lipids fractions (P≤0.05).

Results: Age shows majority of male type 2 diabetics were in their 5th decade. We found low serum testosterone level (10.85±4.7 mmol/L) in cases compared to normal testosterone level (13.39±3.8 mmol/L) in control (P=0.0001). Pearson`s correlation shows inverse association with HDLc (r= -0.70) (P=0.0001) and positive association with LDLc (r= 0.670) (P=0.0001).

Conclusion: We found low serum testosterone in male type 2 diabetics that showed negative correlation with high density lipoprotein (HDLc) and positive correlation with low density lipoprotein (LDLc).

Open Access Original Research Article

Pharmacoepidemiological Safety of Drugs Used in Geriatrics: A Systematic Review in Madanapalle and Punganur Region of Andhra Pradesh

M. Akmal Ali Baig, Girendra Kumar Gautam

Journal of Pharmaceutical Research International, Page 207-220
DOI: 10.9734/jpri/2021/v33i40B32280

In this study, we were provided universal considerations for the setting up and carry out of pharmacoepidemiological studies of drug use for disorders like Osteoarthritis, Hypertension, Hyperlipidemia, Hypothyroidism, Depression, and Osteoporosis in geriatric patient. The study method was focused on monitored and categorized the prescriptions of geriatrics from 650 patient in Madapalle and Puganur region of Andhra Pradesh, Identified and prepare the list of drugs, which were inappropriately prescribed and used in geriatrics by using Revised Beers criteria and also assess the Activities of Daily Living (ADL) by using Modified Barthel Index (MBI). Identify any drug-drug interactions among the drugs used in geriatrics. We were reported the adverse drug reactions appeared in geriatrics and the various treatments that the patients are received with different co-morbidity disease with the assessment of drug exposure, and ascertainment of PIM, PPO STOPP, START criteria and MBI outcomes. Characteristic of statistics sources include evaluation of complete history of drug use in elderly patient with co-morbidity condition, allowing approximate of collective exposure. Result data from beers criteria with PIM, modified barthel index are preferable, but elderly patient treatment data from reliable sources, for example, patient or pathology registries, and medical records are also considered. We present report to showed poly-pharmacy effects of drug use on elderly patient improvement and converse the need for employing STOPP and START criteria of PIM and PPO to avoid undesirable drug reaction causation. We emphasize that a study design of beers criteria always be considered and result of Modified barthel index shows the dependency rate in elderly patient. We also underline the need for Comorbidity analyses in geriatric patient and drug usage, as drug utilization in geriatric are prone to dose and number of drugs in treatment dependent. In the main, studies of Prescription analyses like polypharmacy, PIM, PPO in prescription should explore risk Geriatric patient, the present study reveal the PIM and PPO of in prescription from six hundred and fifty geriatric patient. We conclude the pharmacoepidemiological studies of elderly patient are likely to develop significantly in the coming years, due to the rising mortality of long-term drug exposures and less awareness of poly-pharmacy result, the increasing perform of multinational studies, permiting studies of rare and common disease in elderly people, types of medication and procedural development specifically addressing geriatric treatment and long-term outcomes.

Open Access Original Research Article

A Simple LC-MS/MS Method for Determination of Vemurafenib in Rat Plasma Fed with High Fat Diet

Ayşe Özdemir, Senem Şanli, Erten Akbel

Journal of Pharmaceutical Research International, Page 261-266
DOI: 10.9734/jpri/2021/v33i40B32285

In this study, high fat diet was fed to rats and the amount of vemurafenib in rat plasma was determined by the developed liquid chromatography with tandem mass spectrometry. The calibration curve was linear between 0.01 and 0.8 µg mL−1 vemurafenib with 0.999 regression coefficient.  The limit of detection and quantification of the method are estimated from the signal to noise ratio 3:1 and 10:1, respectively. These are 1.10-4 µg mL−1 for LOD and 4. 10-4  µg mL−1 for LOQ. This method has been found to be reproducible and highly sensitive and  provides a combination of faster analysis time and improved limits of detection.

Open Access Original Research Article

Ankle Peak Systolic Flow Velocity (PSV) with Coronary Artery Disease in Diabetes Mellitus

Archana Bhat, Krishna Kiran Karanth, Pradeep Periera

Journal of Pharmaceutical Research International, Page 273-278
DOI: 10.9734/jpri/2021/v33i40B32287

Introduction: Ankle peak systolic flow velocity can measure peripheral arterial blood flow which can predict extent of peripheral arterial disease. Atherosclerosis is more common in patients with diabetes mellitus and can affect simultaneously coronary circulation and peripheral circulation.

Aims and Objectives: The primary objective of the study was to determine the occurrence of peripheral vascular disease by ankle Peak Systolic Velocity (PSV) in patients admitted for coronary artery disease with diabetes mellitus .The secondary objective was to see the association between the ankle Peak Systolic Flow Velocity (PSV) with the extent of abnormality of coronary angiogram in diabetic patients.

Materials and Methods: All patients admitted in the hospital with coronary artery disease with diabetes mellitus in whom coronary angiogram was done were included in the study over a period of one year Presence of significant vessel disease CAD was defined as at least >70 % stenosis at one or more major coronary arteries (left anterior descending, left circumflex and right coronary artery). Ankle Peak Systolic Velocity (PSV) was measured in all patients by the Duplex method. The peak systolic velocities in the distal posterior tibial artery and the distal anterior tibial artery was measured and the average peak systolic velocities within three cardiac cycles6 was recorded by the radiologist. The ankle peak systolic flow above 40cm/s was considered as good flow in the lower limb extremity [7]. The data was analysed using SPSS version 17.0 software and mean and standard deviation was used .

Results: Out of the cases studied 24 patients (80%) were males and 6 patients (20%) were females. All the Coronary angiograms was classified to single 13(43.3%), double 8(26.7%) and triple 9 (30%) vessel disease by the cardiologist. Out of the 13 patients with single vessel disease 3 patients had < 40 cm/s flow in the right anterior tibial artery and 10 patients had >40 cm/s flow in the right tibial artery indicating good perfusion.Out of the 8 patients with double vessel disease 4 patients had flow <40 cm/s and 4 patients had flow >40 cm/s. In triple vessel disease category 5 patients had flow <40 cm/s and 4 patients had flow>40cm/s. The p value was 0.2 was not significant and the chi square was 2.79 Similar results were obtained while compared with left ankle peak systolic flow velocity.

Conclusion: In this study patients with single vessel disease have higher ankle peak systolic velocity though statistically not significant. Lower ankle peak systolic flow velocity corroborates with peripheral arterial disease [12] and is seen in patients with coronary artery disease [13].

Open Access Original Research Article

Outcome of Fracture Distal Femur Treated with Intramedullary Interlocking Nailing

Ajmal Khan Silro, Niaz Hussain Keerio, Mohsin Aijaz Soomro, Muhammad Faraz Jokhio, Raheel Akbar Baloch, Najeeb Ur Rehman, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 285-291
DOI: 10.9734/jpri/2021/v33i40B32289

Objective: To evaluate the functional and radiological outcome of the distal femur fracture treated with a retrograde locking nail.

Methods: This is a descriptive study conducted at the Orthopedic department Dibba Hospital Fujairah, United Arab Emirates for one-year duration from March 2019 to March 2020. All patients who met the inclusion criteria were treated with femoral retrograde nailing technique. The postoperative functional score was assessed according to Schatzker and Lambert criteria, which were rated excellent, good, and poor. Radiological union was assessed by X-rays.

Results: There were 103 patients with a mean age of 35.20 ± 10.66 (range, 20 to 50 years). There were 78 men (75.72%) and 25 women (24.27%). Most of the fractures (68.9%, n = 71) were caused by car accidents. Fracture of the right side occurred in 70 (67.96%) patients, and the left side fracture in 33 (32.03%) patients. Excellent results were obtained in 75 (72.81%) patients and good results were obtained in 28 patients (28.20%). The nonunion has been documented in one patient.

Conclusion: Excellent and good functional and radiological results were obtained in patients with distal femur treated with retrograde locking nails. For some distal femoral fractures, we recommend the use of a retrograde locking nail.

Open Access Original Research Article

Healthcare Policy for Patients with Chronic Heart Failures at Nam Dinh General Hospital in Vietnam

Pham Thi Bich Ngoc, Dinh Tran Ngoc Huya, Pham Thi Hong Nhung

Journal of Pharmaceutical Research International, Page 292-299
DOI: 10.9734/jpri/2021/v33i40B32290

The study aims to provide knowledge of healthy food to serve for better health of patients through analyzing the current status of self-care knowledge and practice of patients with chronic heart failure at the Department of Cardiology - Nam Dinh General Hospital in 2018 and evaluate the change in self-care knowledge of patients with chronic heart failure after health education interventions. We perform method of one-group intervention study with before-after comparison. Health education intervention was carried out for 90 patients with chronic heart failure inpatient treatment at Cardiology Department - Nam Dinh General Hospital.  Our results show that a good healthcare and nutrition policy for patients are needed: reduce natri, increase fibre-rich foods such as whole grain, vegetables, bean, etc. It pointed that roles of nurses are becoming important because Patients with chronic heart failure have limited knowledge and practice of self-care but have improved significantly after health education interventions. Research results show the need for regular health education to improve knowledge and practice self-care for patients with chronic heart failure. This research finding and recommended healthy foods to support for better health of patients with chronic heart failure in many developing countries.

Open Access Original Research Article

Frequency of Thyroid Dysfunction in Type 2 Diabetes Patients

K. Madhumidha

Journal of Pharmaceutical Research International, Page 300-305
DOI: 10.9734/jpri/2021/v33i40B32291

Thyroid problems are more common in people with type 2 diabetes. They have microvascular problems as a result of hypothyroidism. Patients with diabetes and hypothyroidism have a higher risk of cardiovascular disease. Diabetic individuals who are screened for thyroid dysfunction will be able to receive early therapy for hypothyroidism. The goal of this study was to determine the extent of thyroid dysfunction in people with type 2 diabetes and the relationship between thyroid dysfunction and diabetic complications. This study is to be conducted at a tertiary care hospital in Chennai for a period of 1 year 200 patients were selected 100 were diabetics and 100 were controls (non-diabetic). 24 patients out of 100 subjects were detected to have thyroid dysfunction. 17 patients were detected to have SCH, 6 had primary hypothyroidism and I had primary hyperthyroidism. No case of subclinical hyperthyroidism was detected. TSH values were significantly higher in diabetics. Thyroid dysfunction especially SCH was prevalent in diabetics. There was a poor glycemic control in diabetics with thyroid dysfunction.

Open Access Original Research Article

An Observational Study on Drug Utilization Pattern in Anaemic Pregnant Women in the Tertiary Care Teaching Hospital

Sunil Baile, Rajesh Hadia, Pankti Patel, Maitree Shah, Priyal Soni, Rita Gaikwad, Trupal Rathod, Dhaval Joshi, Ghanshyam Parmar, Hemraj Singh Rajput

Journal of Pharmaceutical Research International, Page 306-319
DOI: 10.9734/jpri/2021/v33i40B32292

Background: Anemia is a disease that is more prevalent among pregnant women in India.

Objective: To Study the Drug Utilization Pattern, compare and evaluate better drug selection in Anaemic Pregnant Women.

Methodology: A total of 300 pregnant women ranging in the age group of 17 to 38 years and having 1 month to 9 months of pregnancy was included in a study. The medical records of patients were checked and information was recorded. The prescriptions were analyzed for drug utilization patterns. Statistical analysis was done.

Result: Out of all 300 pregnant women 176 patients having iron deficiency Anemia, 99 patients having sickle cell Anemia, 20 patients having folate deficiency Anemia, and the rest of the patients having Vitamin B12 deficiency or hemolytic or beta-thalassemia. The average number of drugs prescribed per patient was 3-4 and the average monthly cost per patient was 920.68 Rs. The most commonly prescribed drug was Vitamin C it is of Category C drug which could be harmful to the fetus followed by MVBC (Multivitamin B complex).

Conclusion: Anemia was commonly seen in 2nd trimester. Sickle cell Anemia was seen in 1/3rd of the patients. Study data highlights that Vitamin C, Calcium & Multivitamin B complex were the most prescribed drugs in anemic patients. Drugs prescribed were produced risk to the fetus according to USFDA criteria.

Open Access Original Research Article

Prospective, Randomized Comparison of Proseal Laryngeal Mask Airway and Endotracheal Tube in Adults Selected for Elective Laparoscopic Abdominal Surgery

Narendran Karthigayan

Journal of Pharmaceutical Research International, Page 320-324
DOI: 10.9734/jpri/2021/v33i40B32293

Both PLMA and SLIPA were easy to insert (100% success) and ventilate with maximum sealing pressure of 30cm H2o (P = 0.4) with no muscle relaxant. No significant difference (P = 0.265) in intubation time between PLMA and ETT were observed in the study. A significant SpO2 change (P = 0.804, 0.561, 0.657, 0.248, 0.561) measured Pre op, Pre intubation, lmt, 3 mt and 5mts after intubation and there were no significant EtCO2 changes (P =0.861, 0.251, 0.44) measured after intubation was observed. Blood staining in 1/25 cases with PLMA and 2/25 cases with ETT with a P value of 0.561was seen.

Open Access Original Research Article

Development and Validation of Novel RP-HPLC Method for the Simultaneous Determination of Remogliflozin and Vildagliptin in Bulk and in synthetic Mixture

Drashti A. Mandale, Chainesh Shah, Rakesh Jatt

Journal of Pharmaceutical Research International, Page 338-349
DOI: 10.9734/jpri/2021/v33i40B32296

Vildagliptin which is DPP-4 inhibitor and Remogliflozin which is SGLT2 inhibitor in single dose regimen lower blood glucose by separate, complementary mechanisms. Both are glucose dependent, accounting for the low risk of hypoglycaemia during treatment. There is no risk factors associated with this combination and moreover it is single dose regimen. The aim of the present study was to develop and validate a simple, rapid and reproducible gradient high performance reverse phase liquid chromatography method for the estimation of Remogliflozin and Vildagliptin in bulk drug sample and in synthetic mixture using Xterra® Waters C18 column (150 mm×4.6 mm, 5 µm) at 25°C with UV detection at 210 nm and for this gradient mode was used. The compounds were eluted gradiently at a flow rate of 1.0ml/min. The average retention times for Remogliflozin and Vildagliptin were 4.881 and 6.334 min, respectively. The calibration curves were linear (r2 =0.988) over the concentration range 10-200 µg/ml for Remogliflozin and 10-200 µg/ml for Vildagliptin. No spectral or chromatographic interferences from formulation excipients were found and hence it was successfully applied for the determination of Remogliflozin and Vildagliptin in bulk and in synthetic mixture. The accuracy of the proposed method was determined by recovery studies and found to be 98-101%. The proposed method was validated and results conformed to ICH parameters.

Open Access Review Article

Soft Tissue Injuries Management in Emergency Department: A Review

Sultan Suliman Q. Al-Ruwaili, Mohammed Abdullah S. Alasmari, Reem Hammad M. Albalawi, Raghad Adnan M. Alghazzawi, Sultan Abdulrahman S. Alamrani, Ziad Saleh Albalawi, Muath Sulaiman G. Alhamdi, Marwan fahad H. altemani, Faisal Ibrahim S. AlSukairan, Sarah Mohammed A. Alzolaibani, Renad Ibrahim Aljasser, Abdullah Mohammed Alrofydi

Journal of Pharmaceutical Research International, Page 57-63
DOI: 10.9734/jpri/2021/v33i40B32263

Soft tissue injuries (STI) is the damage of muscles, ligaments and tendons and they are one of the most common injuries that also being presented to the different emergency department but often approached differently. Accident and emergency (A&E) services frequently see acute soft tissues injuries. To achieve the best potential results for patients with soft tissue injuries, the quality of emergency department (ED) care offered is crucial. The unstable situations of injured people are caused by these critical aspects, which include polytrauma in many cases, a lack of precise recovery periods, the use of definite tissue flaps, and the type of circulation. Soft tissue injuries are also sometimes complicated with another injury.

Open Access Review Article

Causes and Management of Uterine Perforation- A Review

Mazen Bishrah, Linah Saleh Abbas, Muhannad Abdullah Almalki, Rehab Ahmad Alquzi, Nada Atiah Alotaibi, Ayman Fahad Almazyad, Layan Hussain Alharbi, Safa Khalaf Almashyakhi, Bashayer Hussain Alnasser, Sarah Hassan Alsubaie, Zainab Abdullah Jadher

Journal of Pharmaceutical Research International, Page 64-71
DOI: 10.9734/jpri/2021/v33i40B32264

Uterine perforation is an intrauterine problem that can occur with any therapy. It is a rare but possibly dangerous consequence of uterine manipulation, evacuation of retained products of conception or pregnancy termination (TOP), hysteroscopic treatments, and coil implantation. Injury to blood arteries or viscera, such as the bladder or the intestine, might be related. Severe bleeding or infection may ensue if not discovered at the time of surgery; nevertheless, the most majority of uterine drilling is subclinical and safe without treatment, with no substantial long-term damage. Perforation can be caused by cervical stenosis during trans-cervical operations or by a reduction in myometrial wall strength during pregnancy or menopause. Uterine abnormalities, infection, recent pregnancy, and postmenopause are all factors that raise the chance of uterine perforation. The treatment of uterine perforation is determined by the operation and the equipment employed. Admission to the hospital, intravenous antibiotics, and close supervision are required following a uterine perforation and any accompanying injuries. In this paper, we overview common causes and updated management of uterine perforation. Data was collected during a period of 6 months searching Pubmed, EPISCO, Web of science data bases to include studies with relative topics.

Open Access Review Article

Causes and Management of Urethral Strictures in Elderly: A Review

Abdalah Emad Almhmd, Khaled Nasser Almujel, Meshal Ali Alruwaili, Ahmed Mohammed A. kaseb, Yousef Ali Alaenzi, Faris Abdullah Alhashem, Sultan Suliman Q. Al-Ruwaili, Hussain Mubarak Huraysi, Yara Abdulrahman Alali, Saad Abdullah Aldawood

Journal of Pharmaceutical Research International, Page 120-125
DOI: 10.9734/jpri/2021/v33i40B32271

Urethral stricture disease is a moderately frequent condition that comes at a high financial cost and can have long-term consequences. Understanding urethral stricture epidemiology is critical for identifying risk factors linked with illness genesis or development. This knowledge might lead to better therapies and preventive actions, which could lower disease severity, generate better health outcomes, and save costs. Based on existing published case series, we conducted a comprehensive assessment of urethral stricture disease, highlighted knowledge gaps, and recommended future research initiatives.

Open Access Review Article

Overview on Juvenile Idiopathic Arthritis: A Review

Ahlam Shary J. Hazazi, Badaya Awadh M. Alshehri, Yara Abdulrahman Alali, Rahf Mohammed I. Alqarni, Ibtisam Shary J. Hazazi, Nujud Abdulqader Albalawi, Dimah Mohammed A. Abu Murad, Atheer Mansour E Alatawi, Nouf Ali Alatawi, Maisaa Mokhtar M. Yousuf

Journal of Pharmaceutical Research International, Page 139-147
DOI: 10.9734/jpri/2021/v33i40B32273

Juvenile idiopathic arthritis (JIA) is a broad term that refers to a clinically heterogeneous group of arthritis that develops before the age of 16 and has no recognized cause. JIA treatment has evolved during the last two decades. Clinical trials research has been directed at more specific therapeutics based on what has been discovered about the biology of disease. Pediatric rheumatologists now have many more medications to offer patients, with the expectation that their disease will be managed, thanks to advances in immune system research and the introduction of biologic drugs in the twenty-first century. Continuing development in these biological agents and discoveries new drugs as long as developing current gene analysis techniques is the best method to treat JIA and provide best quality of life.

Open Access Review Article

COVID-19: Diagnosis, Management and Response

Ashwini Shalikrao Mhaske, Swaroopa Chakole

Journal of Pharmaceutical Research International, Page 161-170
DOI: 10.9734/jpri/2021/v33i40B32276

Background: COVID infection 2019 (COVID-19) is identified as a disease caused by Corona virus formally known as severe acute respiratory syndrome (SARS-CoV-2), which was first detected in Wuhan City, Hubei Province, China, amidst of an outbreak of respiratory sickness cases.

Summary: As there is no affirmed total course of treatment for the Novel Coronavirus, the best way to handle it is by playing it safe, its administration and early reaction. Segregation and disinfection go inseparably with regards to dealing with a COVID positive patient. In any case, the predetermined number of clinical office accessible is blocking the cycle of control and anticipation for a particularly number of infected patients.

Conclusion: As the pandemic is advancing, more examinations and exploration is needed to effectively deal with the spread of the novel Corona virus. Foundation improvement and arrangement of clinical office and gear is the preeminent prerequisite for early reaction and treatment.

Open Access Review Article

Hyperlipidemia Condition and Novel-Drug Therapies: A Overall Study

CH. K. V. L. S. N. Anjana Male, V. Swathi, D. Sai Kumar, . Karishma, Md. Shuaib Yunus

Journal of Pharmaceutical Research International, Page 171-186
DOI: 10.9734/jpri/2021/v33i40B32277

Hyperlipidaemia is an condition that increases the chance of coronary heart disease (CHD) and atherosclerotic disease (ASHD) in blood vessels. Hyperlipidaemia occurs in response to smoking, obesity, sedentary lifestyle, and other risk factors to extend CHD. Cardiovascular disease (CVD) is the reason for death.

Hyperlipidaemia is divided into two broad classifications: Primary (familial) and Secondary (acquired).

Primary hyperlipidemia has been generated by hereditary defects and climatic factors or by undisclosed mechanisms. Secondary hyperlipidemia concern to the metabolic disorders linked with the diabetes mellitus, liver complication, thyroid, and kidney complications. Hyperlipidemia also refers to as elevated levels of lipids within the blood. Circulating lipid are carried in lipoproteins that transport the lipids to varied tissues for energy use, lipid deposition, hormone production, and steroid formation. The lipoprotein consists of esterified and unesterified cholesterol, triglycerides, phospholipids, and protein. The general public who have hyperlipidemia experience no symptoms. Hyperlipidemia is most oftenly correlated with high-fat diets, a stationary lifestyle, obesity and diabetes mellitus. Four different classes of cholesterol-lowering drugs namely, statins, niacin, resins, and fibrates are available to treat hyperlipidemia; however, statins are now considered to be the first line therapy. The preventable causes of hyperlipidemia can include: Smoking, Being overweight, Physical inactivity, Steroid use, Alcohol consumption & Diet high in saturated fat, & cholesterol such as cheese, meat, fried & processed foods and egg yolk. The treatment of hyperlipidemia includes statins, bile acid sequestrants, fibric acids, niacin, and cholesterol absorption inhibitors.

There are some of the novel drugs which are selected for the treatment of hyperlipidemia which includes: Evolocumab, Alirocumab, Bempedoic acid, Lomitapide, Evinacumab, and Sebelipase alfa.

Open Access Review Article

Perceived Benefits and Risk of NSAIDs in Relation to Its Association with Cancer: A Comprehensive Review

Jishu Kalita, Krishnanu Dutta, Saikat Sen, Biplab Kumar Dey, Pal Gogoi

Journal of Pharmaceutical Research International, Page 236-244
DOI: 10.9734/jpri/2021/v33i40B32282

Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to treat fever and pain. Apart from its medicinal benefits, it is also well known for its numerous side effects, including myocardial infarction, gastrointestinal haemorrhage, renal failure, etc. Even beside these side effects NSAIDs are believed to play a major role in cancer. Though there are contrary of being inducing or preventive reason for cancer. Many studies shows NSAIDs are associated with the increasing risk of cancer. While as in various studies these drugs also have been investigated for their anti-cancer property as chronic inflammation has direct association with carcinogenesis. This review enlights the role of NSAIDs in cancer promotion and cancer prevention, connection between chronic inflammation and cancer, and some of the potentially lethal side effects of these drugs.

Open Access Review Article

Role of CT Scan in Diagnosis of COVID-19 Infection- A Review

Hossam A. El-Kenawy, Balto, Abdulaziz Abdulrahman A, Almutawah, Fatimah Hussain M, Mohammed Saad Alamir Alqahtani, Ghulman, Maan Bassam A, Mohammedsaleh, Maani Mahmoud A, Alsalhi Turki Abdulaziz M, Abdulrahman Mohammad A. AL Suqair, Ahmed, Moayad Khalid A, Aldhahri, Abdulrahman Mansour S, Hatim Bakheet Aloufi, AlAli, Danah Yousif M, Nurah Abdullah Alabidan

Journal of Pharmaceutical Research International, Page 245-254
DOI: 10.9734/jpri/2021/v33i40B32283

Since it was declared a worldwide pandemic, COVID-19 has ravaged almost all over the world and has overloaded several health-care systems. The pandemic also resulted in job losses as a result of lengthy shutdowns, which burdened the global economy. Even though significant clinical research progress has led to a better perceiving of the virus (SARS-CoV-2) nature and the disease (COVID-19) management, preventing the virus's spread has become a major concern as SARS-CoV-2 continues to wreak havoc around the world. Several countries suffered from the second or third wave of viral disease outbreaks, primarily caused by the mutation of SARS-CoV-2. Imaging is critical in the diagnosis and follow-up of patients with new coronavirus-infected pneumonia (NCIP). The primary imaging modality in clinically suspected cases is CT scan and it is useful for monitoring imaging changes following therapy. Therefore, CT is regarded as a useful diagnostic technique for clinically suspected cases of COVID-19. CT has the ability to detect patients who have a negative reverse transcription–polymerase chain reaction (RT-PCR) but are highly suspicious of NCIP in terms of clinical problems. In addition, the results of a CT scan may also reveal information concerning the severity of the condition. In this review article, the diagnosis of COVID-19 is discussed and CT characteristics are defined based on the newest research for the diagnosis and management of COVID-19.

Open Access Review Article

The COVID-19 - An Agent for Bioterrorism?

Varsha Gupta, Nandkishor Bankar, Manju Chandankhede

Journal of Pharmaceutical Research International, Page 279-284
DOI: 10.9734/jpri/2021/v33i40B32288

Bioterrorism is a form of terrorism where there is intentional release of biological agent (bacteria, virus, fungi or other germs) to cause harm, illness or death of people, livestock and crops. It is an unlawful use of microorganisms to inflict various forms of harm/harmful incidence or injuries in humans, whole population and environment. There are reasons why this COVID-19 global pandemic appears to represent a deliberate act of Bioterrorism. This is occurring at a critical time in the worldwide especially in times of US presidential election cycle. It appears to be worse in males which have implications for military which might be seen as a biological weapon. This has created a market whiplash the large pullback in markets. COVID-19 represents a tremendous opportunity for investment and wealth redistribution like Swine flu pandemic in 2008-2009 when fortunes were made during that recovery.

Open Access Review Article

An Overview on Contact Dermatitis: Simple Review

Shahad Abdulaziz S. Alzahrani, Bandar Mohammed A. Abu Murad, Rawan Lafi S. Alatawi, Ghadah Eid M. Alatwi, Wejdan Lafi S. Alatawi, Hezam Shalan alshahrani, Anwar Abdullah M. Alghamdi, Norah Abdo A. Hezam, Rinad Rasheed M. Alrashidi, Ahad Salamah M. Alsharif, Abeer Salamah M. Alsharif, Alaa Nemer S. Alruwaili

Journal of Pharmaceutical Research International, Page 325-332
DOI: 10.9734/jpri/2021/v33i40B32294

Contact dermatitis (CD) is usually the result of cumulative exposure to sensitive irritants and accounts for 80% of all contact dermatitis cases. ICD can coexist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with Alzheimer's disease and ACD may also have a lower infection threshold for ICD. Therefore, it must stand out from EA and CAD lesions. People with ICD have experienced uncontrolled tingling and burning sensations. Itching is typically manifested in patients with AD and ACD. Compared with AD and ACD, ICD lesions are usually well described. The prognosis of ICD is based on the exclusion method. Monitor patients to rule out type 1 and type 4 hypersensitivity reactions. A negative result indicates the prognosis of ICD. Management includes identifying and avoiding irritants through the normal use of emollients. Although ICD is older, it is not uncommon in some majors, and genetics and environment play a vital role in its development.

Open Access Review Article

The Role of SGLT-2 Inhibitors as an Adjuvant to Insulin Therapy in Type-1 Diabetes Mellitus- Literature Review

Sultan Ali Alshehri, Sultan Abdulwahab M. Asiri, Aalaa Mohammad Algarni, Manal Mohammed Alamari

Journal of Pharmaceutical Research International, Page 333-337
DOI: 10.9734/jpri/2021/v33i40B32295

Background: Type 1 diabetes mellitus is the main risk factor for cardiovascular complications. Therefore, intensified insulin therapy might be needed to achieve better glycemic control in some patients. However, insulin therapy might lead to increase body weight and induce hypoglycemia. Increase body weight is directly correlated to insulin resistance, the main factor for cardiovascular risk. 

Objective: To assess the effectiveness of adding SGLT2 inhibitors to insulin therapy in type 1 diabetes mellitus. 

Methods: We searched in the PubMed database looking for relevant articles on the topic. We used Mesh words search, including SGLT2 inhibitor, sotagliflozin, type 1 diabetes mellitus, insulin treatment. 

Conclusion: Adding oral antidiabetic agents, such as SGLT2 or dual SGLT inhibitors to insulin regimen might be beneficial in improving insulin resistance. Thus, it achieved better insulin resistance by decrease daily insulin requirements and bodyweight control, leading to better cardiovascular outcomes among Type-1 diabetes patients.