Open Access Systematic Review Article

Malnutrition and Some Related Factors in Primary School Children in Saudi Arabia: Systemic Review

Hassan Tag Elkhatim Mohamed, Fahad Salamah Obaid Alanazi, Salah Farhan T. Alanazi, Mohammed Naif H. Aljuraysi, Omar Ayed B. Alanazi

Journal of Pharmaceutical Research International, Page 118-125
DOI: 10.9734/jpri/2021/v33i41A32310

Background: Malnutrition is an underlying factor in many diseases in both children and adults, and it contributes greatly to the disability-adjusted life years worldwide. It is a major public health concern in developing countries among children since it places a heavy burden on already disadvantaged communities.

Methods: This is systematic review was carried out, including PubMed, Google Scholar, and EBSCO using the following terms in different combinations: Malnutrition, overweight, underweight, systemic review, primary school children, Saudi Arabia.

Results: The review included 9 studies from different countries that assess the level of malnutrition and associated factors among school children. Many of studies reported high prevalence of malnutrition among school children which included overweight, stunting, wasting and underweight. The studies reported that age, gender, regularity of father’s employment, and dietary factors were associated with malnutrition. Also, the type of school attended was found to be associated with malnutrition.

Conclusion: This review concluded that there was high malnutrition prevalence among school children in different parts and its affected by many factors like age and gender.

Open Access Case Study

Dapsone Induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome - A Case Report

Safi Eldin E. Ali, Osama M. Ibrahim, Sami F. Abdalla

Journal of Pharmaceutical Research International, Page 112-117
DOI: 10.9734/jpri/2021/v33i41A32309

A 50-year-old male Sudanese patient presented with a three-week history of jaundice, high-grade fever, and mucocutaneous eruption. For last months he was on compound therapy for leprosy, which had been confirmed recently. The patient’s face was prominent, along with the erythematous dusky morbilliform rash covering all the body. On examination, we detected hepatosplenomegaly and generalized lymphadenopathy. Laboratory investigations revealed hepatorenal impairment, and hematological analysis revealed leukocytosis mainly due to eosinophilia. The clinical and laboratory findings interpretation ranked DRESS or Drug-Induced Hypersensitivity Syndrome (DIHS) on top of possible causes before Dapsone Hypersensitivity Syndrome (DHS) and lepra reactions. We promptly discontinued MDT, admitted him to the dermatological ward. Two skin biopsies were sent to two different histopathologists, MF was suggested by one and Sezary syndrome by the other one. Besides the general conservative measures and vital functions monitoring, he received systemic and topical steroids. However, unfortunately, within the next three weeks, his condition deteriorated, and passed away from multi-systems failure.

Open Access Case Study

Japanese Encephalitis with Global Aphasia- A Case Report

Hina Y. Rodge, Archana Maurya

Journal of Pharmaceutical Research International, Page 367-372
DOI: 10.9734/jpri/2021/v33i41A32337

Introduction: Japanese Encephalitis (JE) is a brain infection caused by the Japanese Virus of Encephalitis (JEV).JE is also known as Mosquito-Borne Encephalitis, Summer Encephalitis and Brain Fever etc. Global aphasia is caused by a number of factors, one of which is JE.

Presentation of Case: A 15 years old male child was brought to Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India on date 22/08/2019 with complaints of fever since 7 days with 2 episodes of seizures with loss of consciousness for approximately 20 hours and the patient was unable to speak after becoming conscious. On examination, the patient had a fever, was lethargic and appeared depressed, unable to speak, and experienced pain when moving his hands. The patient had a complete blood count, which revealed that his haemoglobin percent, total red blood count, were all low, while his RDW and granulocytes were high. RBCs are predominantly normocytic Normochromic RBCs with mild anisopoikilocytosis, with a few microcytic RBCs, pencil cells, and tear drop cells visible on a peripheral smear as well as platelets were adequate, and no Hemiparasite was found. CSF analysis, CT scan of the brain, an MRI of the brain, and a blood test for P. Falciparum were all performed for diagnostic purposes. The patient was diagnosed as Japanese Encephalitis with Global Aphasia after comprehensive examinations. He was treated Tab. Cefexime, Tab. Levetiracetam, Tab. Phenytoin, Tab. Paracetamol, and Tab. Emset, as well as nursing care was provided based on his needs.

Conclusion: Patient showed spontaneous recovery.

Open Access Original Research Article

Development and Evaluation of Nanoemulsions for Phenytoin Drug Loading

Neha Joshi, Vijay Juyal, Himanshu Joshi, Shweta Dang

Journal of Pharmaceutical Research International, Page 1-13
DOI: 10.9734/jpri/2021/v33i41A32297

Aims: To understand about the nanoemulsion types and the process formation of spontaneous emulsification method by phase inversion. Then to test the different combinations of Oil, Surfactants and Co-surfactants for formation of suitable nanoemulsions for phenytoin drug loading.

Study Design: Spontaneous emulsification method by phase inversion used to form the nanoemulsions.

Place and Duration of Study: Department of Pharmaceutical Sciences, Kumaun University, Nainital, Uttarakhand, India.

Methodology: Phenytoin is a widely used drug in anticonvulsants class for epilepsy which comes under BCS Class II of drug category. Phenytoin has high permeability property but it also shows low solubility property which makes it difficult to absorb from GI tract hence make a poor penetration into the brain to target disease in the CNS. To overcome the situation of poor delivery of phenytoin, the requirement of nanoparticulate drug delivery as an innovative and effective drug delivery system from nose to brain raised. The objective of our study was to find the best combination of oil and Smix (surfactant and co-surfactant mixture) to form o/w (Oil in Water) nanoemulsions suitable for loading phenytoin drug using spontaneous emulsification method for brain targeting.

Results: Based on different compositions of oil (sunflower), surfactants (Tween-20), and co-surfactants (Transcutol P), forty-five test mixtures were made, water titration technique was employed for preparing the pseudo-ternary-phase diagrams. On the basis of these phase diagrams twenty-five phenytoin loaded nanoemulsions were formulated and further examined. After physicochemical characterization of these formulations the viscosity, pH, RI and % transmittance was found (6.149 ± 0.084 to 9.114 ± 0.027), (6.546 ± 0.018 to 6.656 ± 0.017), (1.395 ± 0.003 to 1.41 ± 0.005) and (94.53 ± 1.4% to 95.58 ± 1.2%) respectively. The release rate of phenytoin was found very satisfactory i.e., 98.51 ± 0.25 % to 99.82 ± 0.28 % after 24 hrs. The four formulations showed best release rate had further taken for particle size analysis. The particle size analysis showed that all the properties were in the desired range i.e., droplet size (18.9 to 21.9), zeta potential (-12.4 to -28.8), PDI (0.334 to 0.363). The study shows that the phenytoin loaded nanoemulsion is possible to make by water titration method and shall have a good drug release rate.

Conclusion: The nanoemulsion formulations passed through stress testing had also showed good release rate of phenytoin. Also, the other parameters like viscosity, pH, RI and percentage transmittance were in a quit satisfactory range to proceed further with these formulations. The particle size analysis confirms the formation of nanoemultions which had very good drug release rates.

Open Access Original Research Article

COVID-19 Pandemic: Public Knowledge, Attitude, and Practice towards Social Distancing and its Impact on the Population and the Healthcare System in Saudi Arabia

Abdulaziz Aljuhni, Khalid Almahmoud, Sattam Alzahrani, Naif Al-Thakfan, Khalid Alswayed, Abdulhameed Kashkary, Mahmoud Mahmoud

Journal of Pharmaceutical Research International, Page 14-25
DOI: 10.9734/jpri/2021/v33i41A32298

Aims: To determine the knowledge, attitude, and practice of Saudi population towards social distancing and COVID-19.

Study Design:  Cross-sectional.

Place and Duration of Study: This cross-sectional study was conducted in Riyadh city, the capital of the Kingdom of Saudi Arabia, during the national lockdown, between July 2020 and December 2020.

Methodology: This cross-sectional study was conducted in Riyadh, Saudi Arabia. A questionnaire composed of a total of 40 questions, which include socio-demographic, knowledge, attitude, and practice questions. According to the responses, a scale has been established in order to categorize the level of knowledge, attitude, and practice towards social distancing and COVID-19 into three categories; good, fair, and poor. One-way analysis of variance (ANOVA) and Independent t-test were used to determine the differences between categories. Multivariable linear regression analysis and Pearson’s correlation were performed in order to identify factors related to KAP.

Results: This study included 407 participants; more than half of them (54%) were females, while (46%) were males. All participants were 18 years and above. The participants showed a fair level of knowledge, a positive attitude, and good practices toward COVID-19.

Conclusion: The findings of this study suggest that Riyadh residents, especially females, have a fair level of knowledge, a positive attitude, and good practices toward COVID-19 and social distancing. More emphasis should be targeted on less educated population and men. This study may help policymakers to identify the target less knowledgeable groups for COVID-19 prevention and health education.

Open Access Original Research Article

Comparison of Dentist Preference towards Software Based Versus Handwritten Prescriptions in Pediatric Dental Patients- A Mixed Methods Study

Shamika Kamath, Ashwin Jawdekar, Amar Katre

Journal of Pharmaceutical Research International, Page 41-49
DOI: 10.9734/jpri/2021/v33i41A32300

Introduction: Prescriptions for children must be with accurate drug dosages and clear instructions. A digital tool to write, save and send prescriptions can potentially overcome the limitations of hand-written prescriptions. A preliminary mixed methods study comparing a novel ‘app-based’ and handwritten prescriptions in pediatric dental settings is reported.

Methodology: Eighteen post-graduate students from departments of pediatric dentistry of two dental schools participated in this mix-methods crossover study. An android app prototype PREASY was indigenously developed to make digital prescriptions. The handwritten and app-based prescriptions were compared in terms of time taken (seconds), precision (accuracy, legibility and clarity) and satisfaction (Likert rating). The mean time taken was compared using t-test, accuracy was compared using ANOVA and satisfaction using a Chi squared test. Qualitative feedback was obtained regarding the PREASY app.

Results: The mean time taken for handwritten prescriptions {154.28(+ 54.06)seconds} was almost three times higher than that for the app based prescriptions (54.22 (+ 25.66)seconds} [Student ‘t’ test P < .00001]. The mean differences for accuracy, legibility and clarity were 1.36 + 0.66, 1.39 + 0.44 1.11 + 0.50, respectively and were statistically non-significant (P=.247). A majority of participants were very satisfied or satisfied (94.45%); and the remaining (5.55%), were neutral, dissatisfied or very dissatisfied, [Chi square test, P <.00001]. Qualitative analysis identified important themes that could be segregated in four domains from feedback obtained through open-ended questions and semi-structured group discussion.

Conclusion: App-based prescriptions were quicker and more accurate than the handwritten ones with the majority of participants satisfied. Valuable comments pertaining to limitations of the tool and improvement were identified.

Open Access Original Research Article

Implementation of QbD Principles for Simultaneous Quantitative Expression of Olmesartan Medoxomil, Telmisartan and Hydrochlorothiazide by RP-HPLC

Binny Mehta, Hirak Joshi, Ujash Shah, Pinak Patel

Journal of Pharmaceutical Research International, Page 50-61
DOI: 10.9734/jpri/2021/v33i41A32301

Aim and Study Design: Aims: The current research paper describes the RP-HPLC Method for estimation of Olmesartan Medoxomil, Telmisartan, and Hydrochlorothiazide and implements the role of QbD for Data Analysis

Study design: Mentioned study is simple, rapid, economical, accurate, and robust RP-HPLC Method for Olmesartan Medoxomil, Telmisartan, and Hydrochlorothiazide and implementing QbD Approach for Data Analysis.

Place and Duration of Study: The present study was carried out at Smt. S. M. Shah Pharmacy College, Mahemdabad, Gujarat, India from October 2019 to February 2020.

Methodology: The separation was done on Hypersil ODS C18 column with dimensions (250mm x 4.6ID, Particle size: 5 microns) and Methanol: 0.02M potassium dihydrogen phosphate buffer (60:40%v/v) pH 3 used as mobile phase. The flow rate was 1.2ml/min; detection at 254nm. QbD approach was applied for data analysis. The method was validated according to ICH guidelines.

Results: The RP-HPLC method was developed and validated for Linearity and Range through the QbD approach. Factorial Design was developed through Design Expert Software for estimation of Telmisartan, Olmesartan Medoxomil, and Hydrochlorothiazide. 27 experiments were constructed and its effect was seen on Resolution, Tailing factor, and Retention Time.

Conclusion: It was clear that the proposed method was suitable for the QbD approach and identification and validation approaches. This process helps in the proper understanding of the parameters and less amount of time for the development cycle of the analytical method.

Open Access Original Research Article

Functional Outcome of Open Tibial Fracture Using Illizarov Apparatus

Abhishek Choukse

Journal of Pharmaceutical Research International, Page 62-65
DOI: 10.9734/jpri/2021/v33i41A32302

The better treatment for tibial fractures are very vague and difficult. Since the tibia is covered by soft tissue coverage fixing of plate becomes very difficult as it creates wound complications, mainly in case of severe fractures.In this study of 20 cases of open communited fractures of tibia with the Ilizarov ring fixator hybrid technique was used, it was found that this technique has a major advantages in treatment and management of the tibial fracture.

Open Access Original Research Article

Surgical Site Infection Incidence Following Hip Surgery: A Cross-Sectional Study

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

Journal of Pharmaceutical Research International, Page 66-74
DOI: 10.9734/jpri/2021/v33i41A32303

Objective: To determine the incidence of surgical site infection among patients with hip fracture and undergo a surgical procedure for management. And to spotlight on the risk factors which may lead to surgical site infection among them. Also, to look for other complications following the surgery.

Methods: This is a descriptive, correlational cross-sectional study design. The study was conducted at Orthopedic Department, Mohammad Medical College and Hospital Mirpurkhas, Pakistan for one-year duration from March 2019 to March 2020. All patients had hip fracture and received management at the department of orthopedic. All patients were adults and older than 20 years of age. Data was analyzed using SPSS program.

Results: The study included 103 patients who had hip fractures. The most frequent age group was 40-50 years. Patients had a mix of modifiable and non-modifiable risk factors for developing surgical site infection. The incidence rate of surgical site infection in this study was 3.2%. It was correlated to having hypertension and diabetes as complications.

Conclusion: This study aimed to spotlight on the SSI following hip surgeries and to look for complications and risk factors. We noticed that the SSI rate among the study populations is almost similar as the worldwide range. This is due to the agreed protocol for managing patients. However, there is a need for log-term follow up for our patient to discover the cases of delayed SSI.

Open Access Original Research Article

Analgesic and Anti-inflammatory Activity of Withania somnifera Root Extract

Subasini Uthirapathy

Journal of Pharmaceutical Research International, Page 75-84
DOI: 10.9734/jpri/2021/v33i41A32304

The anti-inflammatory and analgesic properties of the 85 % methanolic extract of Withania somnifera (WS) root was investigated and the anti-inflammatory effect was compared with the standard drug indomethacin. Analgesic activity was carried out by hot plate and tail flick method. Anti-inflammatory activity was carried out by carraggenan induced paw edema and Freund’s adjuvant induced arthritis. The results are related with evaluation of the analgesic activity in hot plate and tail flick method, they reveal that methanolic extract has exhibited significant activity (P<0.05) at 150 mg/kg b.wt, itself, whereas, the percentage inhibition exhibited by WS (350 mg/kg b.wt,) in carrageenan induced paw edema is found to be nearer to that of standard drug (10 mg/kg b.wt.). In Freund’s adjuvant induced arthritis, WS is seen to decrease the paw volume significantly (P<0.05). Significant (P<0.05) protection is also observed by elevating antioxidant enzymes. WS does not exhibit toxic effect which is observed in standard drug treatment. The 85 % crude methanolic extract does not present toxic effect as observed in indomethacin treatment. However, the extract has exhibited analgesic, anti-inflammatory and antioxidant activities.

Open Access Original Research Article

Study to Determine the Complications and Treatment of Diabetic Foot Ulcer

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

Journal of Pharmaceutical Research International, Page 85-90
DOI: 10.9734/jpri/2021/v33i41A32305

Background: Diabetic foot ulcer is a solitary most costly and severe complication of diabetes mellitus. Foot ulcers are the after-effect of a combination of various causes, counting peripheral arterial disease and peripheral neuropathy. Patients with diabetic foot ulcers for the most part require lower limb amputation.

Objective: The purpose of this examination is to survey the outcomes and complications of diabetic foot ulcers in diabetic patients and to explore the impacts of certain hazard factors on ulcer healing.

Place and Duration: In the Orthopedic unit, Dow University Of Medical and Health Sciences, SMBBIT Karachi, for nearly a two-year duration from March 2018 to April 2020.

Methods: This study was conducted on 120 patients. All patients with diabetes and DFU 18 to 90 of age were selected. 120 grown-up patients with DFUs were selected for the analysis. The diabetes duration and demographic data were recorded. Clinical proof of infection has been accounted for, as indicated by the American Association for Infectious Diseases. At that point debridement and careful treatment were begun to evacuate all the dead tissue. Follow-up was done week by week for two-year. SPSS 22 was utilized for data collection and statistical analysis. Data are introduced as a percentage and p < 0.05 was considered as the significance level. The Fisher’s test and χ2 test were utilized to test the variables relationship. Multivariate logistic regression analysis was utilized to change different variables when testing the impact of each risk factor on the outcome of DFU.

Results: A sum of 120 patients with diabetic foot ulcers were selected. 60% of patients had relieved ulcers, 8% still not resolved; In 27% of patients, minimum amputation, 7% more protuberant amputation, 2% repetitive ulcer and mortality rate was 1%. The investigation indicated that there is a measurably noteworthy connection between the foot ulcers healing with diabetes and the accompanying factors: HbA1c level, patients’ age, diabetes duration, diabetes complications (ulcer size and peripheral neuropathy).

Conclusion: The outcomes and complications of diabetic foot ulceration can be anticipated by a few factors, some of which can be changed. Changing compatible factors, for example, better diabetes control, peripheral neuropathy treatment and early treatment of ulcers can reduce complications and encourage healing of ulcers.

Open Access Original Research Article

Intra Venous Butorphanol versus Intravenous Nalbuphine for (Intra Operative) Balanced Anaesthesia and Post Operative Analgesic Effect in Patients Undergoing Laparoscopic Surgery

B. Irshad

Journal of Pharmaceutical Research International, Page 91-95
DOI: 10.9734/jpri/2021/v33i41A32306

Laparoscopic surgery has replaced many of the open surgeries because of its advantages. Both the groups of drugs have hemodynamic stability, analgesia, sedation and decrease the requirement of other anesthetic drugs. So we have chosen Butorphanol and Nalbuphine to study the analgesia and hemodynamic changes in both groups. In our study mean heart rate was lower in Butorphanol group compare to Nalbuphine group. Similarly fifty patients of ASA I&II scheduled for elective laparoscopic surgery, were randomized in to butorphanol group and nalbuphine group. It was observed that there was significant rise in systolic blood pressure & Diastolic Blood pressure after intubation in fentanyl group compare to Butorphanol. This study finds that suppression of sympathetic response to laryngoscopy and intubation was better with Butorphanol than Fentanyl. This study analysis indicates that both Butorphanol and Nalbuphine help in maintaining a steady haemodynamic state all  throughout  the procedure.

Open Access Original Research Article

Prevalence and Expression of Genes of Type II Antitoxin Toxin Systems in Clinical Isolates of Methicillin-Resistant Staphylococcus aureus

M. Rahimkhani, A. Mordadi, P. Karami, O. Zarei

Journal of Pharmaceutical Research International, Page 96-105
DOI: 10.9734/jpri/2021/v33i41A32307

Objectives: Antibiotic resistance of bacteria has been increasing in recent years and reports indicate that some bacterial strains are even resistant to the last treatment line. The survey of MazEF antitoxin-toxin genes in 84 strain of MRSA and and the antimicrobial effect of supernatants on the logarithmic growth stage of the bacteria.

Methods: In this study, 84 strains of MRSA were collected. The patients included 48 males and 36 females with a mean age of 39 years.  The primers for Staphylococcus aureus type II antitoxin genes were designed. In the first step, using the mecA primer and PCR, the strains were genetically examined to confirm methicillin-resistant Staphylococcus aureus. In the next step, the frequency of MazEF antitoxin-toxin genes was examined.

Results: All strains of methicillin-resistant Staphylococcus aureus had the F maz gene except one. The highest antibiotic resistance was related to the strains isolated from the wound and the lowest resistance was related to the strains isolated from the urine. the effect of the supernatant obtained in the death phase of Staphylococcus aureus was assessed and the antimicrobial effect of these supernatants on the logarithmic growth stage of the bacteria was measured.

Conclusion: since previous studies showed the antimicrobial effect of this supernatant on many other bacteria, a type II system was suspected that was confirmed by the results.

Open Access Original Research Article

A Cross Sectional Study to Assess the Status of Hemoglobin and Other Blood Indices among Pregnant Women Attending Tertiary Care Hospital of Vadodara

Vruti Patel, J. D. Lakhani

Journal of Pharmaceutical Research International, Page 106-111
DOI: 10.9734/jpri/2021/v33i41A32308

Introduction: A number of adaptations happen in the anatomy, physiology and metabolic processes within the mother which aids in successful progression of the pregnancy. The different blood indices such as haemoglobin concentration, packed cell volume (PCV), red blood cell count; total WBC count etc. can be measured to evaluate haematological status in a pregnant woman. The hematological profile of the pregnant women has an impact on both pregnancy and its outcome. Anaemia in pregnancy can be leads to morbidity and mortality in mother and fetus. The current study was designed to determine the variation in status of hemoglobin and other blood indices in anemic and non-anemic pregnant women.

Aims ans Objectives: 1. To study the hematological and other blood indices among pregnant women, 2. To assess the degree of anemia in pregnant women, 3. To compare the Various hematological parameters between anemic and non -anemic pregnant women.

Materials and Methods: A Cross-sectional comparative descriptive survey design and quantitative approach was adopted to achieve the goal of the study. The study was conducted at the tertiary care hospital of Vadodara, Gujarat. Total 300 pregnant women were recruited and socio demographic information was collected. Hemoglobin concentration (Hb), total leucocyte count (TLC), differential leucocyte count (DLC), and platelet count, blood indices of the recruited samples were studied.Mean and SD of Haematological parameters were calculated and unpaired t-test was used to compare the pregnant anaemic women data with non-anaemic pregnant women.

Results: Out of 300, 204 pregnant women were found anemic and most of the pregnant women 84% belonged to rural area. In accordance with severity of anemia, Moderate degree of anemia was found to be highest (41%) in anemic pregnant women. Comparison of non - anaemic pregnant women with anaemic pregnant women shows significant changes in haematological parameters (p <0.05).

Conclusion: It can be concluded that there is significant changes in hematological parameters in each trimesters of pregnancy as well compare to non-anemic to anemic pregnant women. Most of the hematological changes occur in order to physiological adaptation of pregnancy but abnormal status of Haemoglobin and other blood indices cause adverse outcome of the pregnancy.

Open Access Original Research Article

Capsaicin Encapsulated Chitosan Nanoparticles Augments Anticarcinogenic and Antiproliferative Competency Against 7,12 Dimethylbenz(a)anthracene Induced Experimental Rat Mammary Carcinogenesis

Kalaiyarasi Dhamodharan, Manobharathi Vengaimaran, Mirunalini Sankaran

Journal of Pharmaceutical Research International, Page 126-144
DOI: 10.9734/jpri/2021/v33i41A32311

Background: Capsaicin is a powerful phytochemical spotted in chilies, starkly tied up with a bunch of health benefits but its clinical applications in cancer therapy are limited due to its poor solubility, and low bioavailability. Nanotechnology offers a strategy to discover new formulations for hydrophobic agent.

Aim: The main intent of the current research was to investigate the effect of Capsaicin encapsulated chitosan nanoparticles (CAP@CS-NP) on 7,12-Dimethylbenz(a)anthracene (DMBA) induced mammary carcinogenesis in rats.

Methodology: Mammary tumor was induced in female rats by injecting DMBA (25mg/kg b.wt) at the first week of the experiment. After 7 weeks, CAP@CS-NP (4mg/kg b.wt) was administered orally to DMBA induced tumor bearing rats for 21 days (thrice per week). The experiment was terminated at the end of the 14th week and their plasma and tissue sections were analyzed.

Results: We found that significantly elevated levels of lipid peroxidation and diminished levels of antioxidant status in plasma, liver and mammary tissues. Increased levels of detoxification phase I enzymes and dropped levels of phase II enzymes in liver and mammary tissues in DMBA induced tumor bearing rats. As a result, oral administration of CAP@CS-NP suppressed the tumor growth, significantly raised body weight and restored abnormal enzymatic levels to near normal ranges. Additionally, histopathological and immunohistochemical analysis were also confirmed that CAP@CS-NP protects DMBA mediated cellular disruption and also inhibits abnormal cell proliferation.

Conclusion: These findings suggest that nano encapsulation of CAP@CS-NP could be useful in targeted drug delivery and act as a promising chemotherapeutic agent to treat mammary carcinogenesis.

Open Access Original Research Article

Effects of Spider Cage Therapy in Combination with Conventional Speech Therapy on Speech and Language Function in Children with Cerebral Palsy of Age between 05 and 15 Years

Fahad Masood, Muhammad Sikander Ghayas Khan, Farjad Afzal, Amna Rashid, Saba Mubarak

Journal of Pharmaceutical Research International, Page 145-149
DOI: 10.9734/jpri/2021/v33i41A32312

Objective: The objective of study was to determine the effects of spider cage therapy in combination with conventional speech therapy on speech and language function in children with cerebral palsy of age between 05 And 15 Years.

Materials and Methods: A total of 20 children from a special institute with cerebral palsy who were provided with spider cage therapy in combination with conventional speech therapy were evaluated from January 2017 to June 2017. Effect of spider cage therapy in combination with conventional speech therapy was determined by applying dysarthric profile revised before and after the treatment.

Results: Baseline score on dysarthric profile was 34.76±2.67 and post intervention score was 69.93±8.14. Result indicated that out of 20 children with cerebral palsy, there was a statistically significant difference in total score.

Conclusion: The findings suggested that the Mean score of spider cage therapy in combination with conventional speech therapy post treatment in children with cerebral palsy was improved. On the basis of this study it is concluded that speech therapy in combination with conventional speech therapy is more effective in children with cerebral palsy.

Open Access Original Research Article

In-vitro Cytoprotective Activity of Eichhornia crassipes Flowers Against Hydrogen Peroxideinduced Oxidative Stress in BRL 3A Rat Liver Cells

S. Rajarajan, S. Sivakrishnan, V. Ganesan

Journal of Pharmaceutical Research International, Page 150-166
DOI: 10.9734/jpri/2021/v33i41A32313

The aim of this study was to investigate the cytoprotective effect of ethanol extract of Eichhornia crassipes flowersand its fractions against hydrogen peroxide induced oxidative stress in BRL 3A liver cells. Powdered flowers of Eichhornia crassipeswere subjected to hot continuous extraction in soxhlet extractor using ethanol as solvent material. Initially, the solvent extracts were subjected to qualitative, quantitative analysis and assessed for in-vitro free radical scavenging activity and anti-oxidant activity. The ethanol extract was fractionated using benzene, chloroform and n-butanol. The crude ethanol extract and its fractions were evaluated for its potential cytoprotective effect against hydrogen peroxide (H2O2) induced oxidative stress in BRL 3A cell lines.Biochemical assays were carried out to determine the cytoprotective activity, including cell viability, lipid peroxidation by determining the formation of malondialdehyde, lactate dehydrogenase leakage into culture medium, the catalase activity and the content of reduced glutathione (GSH) in the cells. Exposure of BRL 3A to 2mM H2O2 reduced the cell viability, increased the malondialdehyde (MDA) level, increased the leakage of lactate dehydrogenase (LDH) and caused reduction in antioxidant activities. Pretreatment of cultured cells with crude ethanol extract of Eichhornia crassipes flowers and different solvent fractions at concentrations 0.01, 0.1, 1, 10, 100 μg/ml for 30 minutes before H2O2 exposure attenuated the oxidative injury in dose-dependent manner. It was observed that crude ethanol extract of Eichhornia crassipes flowers exhibited a strong cytoprotective by increasing cell viability, decreasing lipid peroxidation and LDH leakage. Further increase in catalase and reduced glutathione activity was noted in the cells pre-treated with ethanol extract of Eichhornia crassipes flowers. These findings suggest that ethanol extract of Eichhornia crassipes flowers has a strong cytoprotective activity against oxidative injury caused by reactive oxygen species.

Open Access Original Research Article

Phytochemical Screening and Antioxidant Activity of Salvia hispanica

Hanane Dib, Meryem Seladji, Fatima Zohra Bencheikh, Meriem Faradji, Chahid Benammar, Meriem Belarbi

Journal of Pharmaceutical Research International, Page 167-174
DOI: 10.9734/jpri/2021/v33i41A32314

Background: There is a growing interest worldwide to identify novel functional foods able to exert important biochemical activities with low or without toxic effect. Accordingly, the use of Salvia hispanica L. (chia) a Mexican herb, has tremendously grown as an agriculture crop owing to the nutritional and medicinal values. The objective of this study was to evaluate phytochemical composition of chia seeds and prove their claim for functional properties.

Materials and Methods: The determination of total phenolic, flavonoid and condensed tannin contents of chia seeds were carried out by the Folin-Ciocalteu, the aluminum trichloride and the vanilline acid spectrometric methods. Antioxidant activities of chia seeds extracts were assessed using free radical scavenging assay DPPH, Ferric Reducing Antioxidant Potential FRAP and β-Carotene bleaching assay.

Results: Chia seeds contain high levels of total phenolic and flavonoid contents 19.06±0.14 mg GAE/ g DW and 12.3±0.04 mg CE/g DW, respectively. The content of condensed tannins was estimated at 8.32±0.01 mg CE/g DW. The flavonoid extract showed a higher antioxidant potential against DPPH, FRAP and the bleaching of β-Carotene (0.27±0.00, 0.06±0.03 and 0.39±0.01 mg/mL, respectively).

Conclusion: Following the obtained results, we should explore the use of this seeds in food products due its nutritional and chemical composition, possible human health benefits and role as a functional food.

Open Access Original Research Article

Analysis between Cigarette and Shisha Smokers for Early Atherogenesis: A Cardiovascular Disease

Danish Iqbal, Izhar Wasif Burhan, Ranjay Kumar Choudhary, Mohammed Alaidarous, Bader Mohammed Alshehri, Saeed Banawas, Shabir Ahmad Mir

Journal of Pharmaceutical Research International, Page 175-186
DOI: 10.9734/jpri/2021/v33i41A32316

Aims: Tobacco smoking is a major health issue in Saudi Arabia, particularly among the student population. Smoking is one of the major risk factors in the genesis of coronary atherosclerosis and the development of coronary heart disease. This study aimed to evaluate the effect of cigarette and shisha smoking on atherogenic indexes, lipid profile and hematological parameters of undergraduate smokers at Majmaah University.

Methodology: This cross-sectional study was conducted between November 2019 and March 2020, at the Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, enrolling 100 undergraduate students (35 cigarette smokers, 30 shisha smokers, 35 non-smokers). The subjects were asked to fast overnight and early morning blood samples were collected and analyzed to measure lipid parameters, complete blood cell count and LDH. Lipid parameters were used to calculate lipid indexes and atherogenic indexes.

Results: Compared with non-smokers, cigarette and shisha smokers had significantly higher levels of TC, TG, LDL-C and VLDL-C, but significantly lower levels of HDL-C. The values of comprehensive lipid indexes, including non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, atherogenic index (AI), lipoprotein combine index (LCI), and atherogenic index of plasma (AIP) were all significantly higher in cigarette and shisha smokers. Hematological parameters were found to be within normal reference range, however when compared with non-smokers, cigarette and shisha smokers has significantly higher values of complete blood cell count, except for lymphocytes and mean corpuscular hemoglobin concentration (MCHC) which were significantly lower. LDH was also found to be elevated in cigarette and shisha smokers.

Conclusion: The findings of this study shows that, both cigarette and shisha smokers have abnormal lipid profile suggesting dyslipidemia. Prediction of early atherosclerosis through the atherogenic indexes was observed to be significantly higher in shisha smokers than in cigarette smokers. Therefore, shisha smoking has more adverse effects on the health status of adult smokers. This study adds to the accumulating evidence on the harmful effects of shisha smoking, which is a growing epidemic among young smokers, and calls for the awareness of the possible consequences of developing early atherogenesis.

Open Access Original Research Article

Tenofovir Alafenamide Fumarate Microspheres, Process Parameters for Enhanced Permeability and Liver Targeting

K. Sudhamani, B. Jeevan Jyothi

Journal of Pharmaceutical Research International, Page 187-196
DOI: 10.9734/jpri/2021/v33i41A32317

Aims: Chronic hepatitis B (CHB) infection is a serious global health problem and one of the main causes of chronic liver disease, cirrhosis. Tenofovir Alafenamide Fumarate (TAF) is a prodrug of Tenofovir, a nucleotide analogue with limited oral bioavailability. TAF is considered to be a BCS Class III substance (high solubility, low permeability). The aim of the study was to develop the Tenofovir Alafenamide Fumarate (TAF) microspheres to improve permeability.

Study design: Preparation and Evaluation of Microspheres.

Place and Duration of Study: Department of pharmaceutics, Mallareddy Institute of Pharmaceutical Sciences, Affiliated to JNTUH, Hyderabad, Telangana, India, between January 2018 and June 2019.

Methodology: TAF loaded chitosan microspheres were prepared by emulsion cross linking method using glutaraldehyde as cross-linking agent. The prepared microspheres were characterized by morphology, size distribution, encapsulation efficiency. The permeability study was evaluated by Ex-vivo permeation studies. The optimized formulation was subjected to FTIR studies to examine the Drug Excipient Compatibility.

Results: Scanning Electron Microscopy (SEM) studies indicated that the microspheres are spherical in shape. The optimized formulation has average particle size of 11.00 ± 0.05 µm, the encapsulation efficiency 68

± 0.04% and the percentage (%) yield of 94%. FTIR studies indicated that the drug and polymer are compatable with each other. In Ex-vivo permeation studies of optimized formulation 80% of drug was permeated with in 60 min.

Conclusion: TAF microspheres could improve the absorption by increasing the permeability.

Open Access Original Research Article

The Content, Antioxidant Activity, and Structural Characteristics of Sodium Alginate Extracting from Sargassum polycystum Grew in Vietnam: Effect of Various Extraction Conditions

Nguyen Dinh Thuat, Vu Ngoc Boi, Nguyen Xuan Hoan, Dang Thi Thanh Tuyen, Do Thuy Kieu, Nguyen Kim Nguyen, Nguyen Ngoc Bao Huy, Pham the Trinh, Pham Thanh Thuan, Dang Xuan Cuong

Journal of Pharmaceutical Research International, Page 197-206
DOI: 10.9734/jpri/2021/v33i41A32318

Introduction: Alginate is a biopolymer commonly in brown algae, high content, diversity in structure and bioactivity. They are applied to other fields such as food, functional food, pharmaceuticals, and heavy industry and extracted from Sargassum, Laminarin, Tubinaria and Sargassum polycystum species commonly grow in the world than another genus. The content, the antioxidant activity, and the physical chemistry properties of alginate extracting from the species did not exhibit in the previous studies.

Methods: The study focused on the impact of various extraction conditions (temperature (40 to 90,oC), time (01 to 06, hours), the solvent-to-material ratio (10/1 to 40/1, v/w), solvent pH (8, 9, 10), and numbers of extraction (1, 2, and 3 times) on alginate content and its antioxidant activity, also evaluated sugar compositions, average molecular, viscosity, and 13C-NMR spectrum characteristics of alginate.

Results: The results showed that the suitable condition for the extraction of alginate was for 4 hours at 60oC with the ratio of Na2CO3 (pH 9)-to-material (40/1, v/w) and one number of extraction. The highest alginate content was 176.22 mg uronic acid equivalent/g DW, corresponding to antioxidant activity (188.54 mg ascorbic acid equivalent/g DW). Alginate possessed the intrinsic viscosity (271.86, ƞ) and the average molecular weight (78.6, kD). Different sugar compositions of antioxidant alginate were fructose, fucose, mannose, galactose, rhamnose, mannose, and glucose. The 13C-NMR spectrum of antioxidant alginate exhibited chemical shifts of C sites of D-mannuronic (M) and L-guluronic (G), corresponded to C1, C2, C6, and C2, C3, C4, C5, C6, respectively.

Conclusion: Alginate is non-toxic, therefore, antioxidant alginate extracting from brown algae Sargassum polycystum grown in Vietnam is a potential in functional food and pharmaceuticals.

Open Access Original Research Article

Prevalence of Sub-Clinical Hypothyroidism in Diagnosed Cases of Gallstone Disease

C. Kamalakkhannan

Journal of Pharmaceutical Research International, Page 207-212
DOI: 10.9734/jpri/2021/v33i41A32319

Thyroid issues have long been debated as a possible cause of gall stone disease. The link between hypothyroidism and gallstone disease could be explained in a variety of ways. The main objective of this study is to determine the prevalence of hypothyroidism in gallstone patients and to rule out hypothyroidism as a probable cause of gallstone formation. A prospective study was conducted in surgical wards of Department of surgery sree balaji medical college from 2016 to 2017. All patients were evaluated using a comprehensive clinical history and examination, as well as suitable investigations such as abdominal USG, thyroid function tests, and lipid profiles. Out of 22 patients 19 patients (86.4%) had normal TSH, 2 patients (9.1%) had increased TSH, 1 patient (4.5%) had decreased TSH. Raised TSH was more in the AGE Group of 61- 75 years, which is comparable to other studies. Out of 22 patients, (100%) had normal T3 levels. 19 patients (86.4%) had normal T4 levels and Ultrasound examination of neck, 2 patients (9.1%) had decreased T4 level and 1 patient (4.5%) had increased T4 levels and 3 patients (13.6%) had abnormal Ultrasound Neck findings. Hence In this Study Cholelithiasis is most commonly seen in Females of age group of 41-60 years and prevalence of raised TSH level in cholelithiasis patient was 9% and most were found in the age group of 61-80 years.

Open Access Original Research Article

The Effect of Ethanol Extract of Carica papaya Seed towards Lipid Profile on Rats Induced Rifampicin and Isoniazid

. Liana, I. Nyoman Ehrich Lister, Edy Fachrial, . Adrian

Journal of Pharmaceutical Research International, Page 213-219
DOI: 10.9734/jpri/2021/v33i41A32320

Aims: Rifampicin one of the most commonly used front-line drugs in antituberculosis therapy, has been known to be hepatotoxic. The oxidative stress that is formed in the mitochondria due to rifampicin and isoniazid causes an imbalance in lipid metabolism. This study aims to determine the effect of lowering total cholesterol, triglyceride, and LDL levels and increasing HDL levels of papaya seed ethanol extract in rats induced by rifampin and isoniazid.

Study design: This study is experimental study.

Methodology: This study was divided into 9 groups including normal group, negative group 1, 2, 3, positive 1, 2, treatment group I (EECP 100 mg/kgbw), treatment group II (EECP 300 mg/kgbw), and treatment group III (EECP 500 mg/kgbw). Rifampicin (50 mg/kgbw), isoniazid (50 mg/kgbw), and EECP were given 28 days, on day 29 rats were dissected and blood was taken and the total cholesterol, triglyceride, LDL and HDL levels were measured.

Results: The results showed that the ethanol extract of papaya seeds at a dose of 100 mg / kgbb, 300 mg / kgbb, and 500 mg / kgbw could reduce levels of total cholesterol, triglycerides, LDL and increase HDL levels. The dose of 500 mg / kgbw was not statistically significant (P> 0.05) with the normal group.

Conclusion: Ethanol extract of Carica papaya has a potential effect of preventing the destruction of lipid metabolism effect by reducing the LDL, Trygliseride, Cholesterol Total, and increasing the level of HDL.

Open Access Original Research Article

Overview of the Pharmacological Management of Osteoporosis in Postmenopausal Women

N. Sherly Shulamite, B. Pragna Malavika, P. Aravinda Swami

Journal of Pharmaceutical Research International, Page 220-229
DOI: 10.9734/jpri/2021/v33i41A32321

Aim: The aim of the study is to assess the Pharmacological management of osteoporosis in postmenopausal women.

Objective: The purpose of this study is to evaluate the treatment of osteoporosis in postmenopausal women.

Methodology: This is an observational prospective study, carried out in a tertiary care hospital.

Results: A total of 300 postmenopausal women were enrolled in the study. The mean ± standard deviation, of the age of postmenopausal women included in this study was 55.5 ± 5.0 years. 68.1% were prescribed with the combinational therapy of Teriparatide+Bisphosphonates. 39.2% of subjects were using acetaminophen for pain.

Conclusion: Antiresorptive drugs (hormonal therapy, bisphosphonates, and denosumab) and, the anabolic agents (teriparatide) are commonly prescribed, in this study it is obvious that Sequential Therapy is highly prevailing in the clinical practice, with 68.1%.

Open Access Original Research Article

Irinotecan Engineered Proniosomes: In vitro and In vivo Characterization

Prakash Goudanavar, B. Ramesh, Santosh Fattepur, Nagaraja Sreeharsha

Journal of Pharmaceutical Research International, Page 230-238
DOI: 10.9734/jpri/2021/v33i41A32322

Objective: The focus of this research has been to improve efficacy, decrease tolerance and increase the irinotecan pharmacokinetic profile.

Methods: Proniosomesformulated with various surfactants, cholesterol and dicetyl phosphate using the slurry method. A slurry process was used to prepare proniosomes with maltodextrin as the carrier by using surfactants span 20, span 60, tween 20 and tween 80.

Results: The preparations were characterized in terms of shape and specific surface area, entrapment efficacy, in vitro release studies, in vivo tissue diffusion and stability testing. The proniosome surface was found to be smoother in nature showing thin and compact layer with skim milk powder. For formulation 2 (73.94±2.8%), the maximum entrapment efficacy was found.

Conclusion: The formulation 3 obtained the desired maximum release profile within 24 hours (98.06%). The in vivo tissue distribution studies for the proniosomes reveal that the drug was preferentially targeted to liver followed by the alveolus and lymphatic system.Stability studies have indicated that the most acceptable condition for storage of the formulation 2 was 4o C. Proniosomes provide an acceptable method to the carrier for targeted therapy. These can be held at specific sites and can release the drug for a prolonged period of time.

Open Access Original Research Article

Cardiac Protection Activity of Ethanol Extract of White Curcumin (Curcuma Zedoaria), Against Cyclophosphamid Induced Cardiovascular Complications in Male Rat

Addin Amrullah, . Florenly, Edy Fachrial

Journal of Pharmaceutical Research International, Page 248-256
DOI: 10.9734/jpri/2021/v33i41A32324

Objective: The common side effects associated with cyclophosphamide administration are bone marrow suppression, exposure to infections, as well as cardiovascular complications, including sinus bradycardia, pericarditis, myocarditis, and type 1 heart problems. The present study was sought to investigate the effect of curcumin on modulating side effectt of cyclophosphamide and the mechanisms involved. 

Methods: This experimental study was carried out in the Department of Pharmacology, North Sumatra University during 2020.  Thirty Wistar albino male rats, weighing 100 to 150 g (initial body weight); aged 85 to 100 days were selected for the study. After acclimatization for 14 days.  Rats (n = 30) were pretreated with catechin (200 mg/kg, p.o.) alone, normal sample and different dose combination of curcumin (200, 400, 800 mg/kg, p.o.) in 10th day. The whole rats in each groups fed on 150 mg/KgBW of cyclophosphamide solution on days 11th to 15th of the trial The heart was remove blood was taken Serum creatine kinase-MB (CK-MB) level was estimated by IFCC method and Troponin T (cTnI) level by ELISA method. The blood samples were collected and complete blood count were measured by cell counter. The statistical analysis was done by one way ANOVA followed by Tukey post hoc test, with coefficient interval of 95% (α = 0,05).

Results: The results revealed that the CKMB and Troponin T levels decreased along with a dosage increase in thegroup with ethanol extract of white turmeric and an improvement in homeostasis and the histopathology of the liver of the rats. The  impact of white turmeric is protective against cardiac cell damage of mice.

Open Access Original Research Article

Use of Aerial Roots of Ficus benghalensis for Green Synthesis of Silver Nanoparticles with Enhanced Antibacterial Activity

Tarannum Rashid Patave, Aquil-Ur Rahim Siddiqui

Journal of Pharmaceutical Research International, Page 257-267
DOI: 10.9734/jpri/2021/v33i41A32325

Basically, nanosubstances are developed by a variety of chemical methods which are not environmentally providential.

Aim: The present research work deals with the synthesis of silver nanoparticles using the aerial root of Ficus benghalensis extract. The absolute reduction of silver ions was observed after 48 h of reaction when extact combine with aqueous solution of Silver nitrate. The visual colour changes were observed during the reduction of silver ion into the silver nanoparticles in the reaction mixture allows producing dark brown colour. The formed silver nanoparticles was purified by high speed centrifugation, collected and stored for further characterization.

Methodology: The formation of silver nanoparticles was confirmed by UV-Visible spectroscopy, and characterised by X-Ray Diffraction (XRD) pattern, FTIR, High Resolution Transmission Electron Microscopy (HRTEM), Zeta potentiometry, ICP-AES.

Results: The results showed that UV peak at 437.5 nm, the silver content estimation by ICP-AES was found to be 413.06 µg/mL and images were recorded by using High resolution TEM. Synthesized AgNPs were found to be effective against micro-organisms responsible for bacterial infections like Staphylococcus aureus, Pseudomonas aeruginosa, E. coli and Methicillin resistant Staphylococcus Aureus (MRSA). Further In-vitro cytocompatibility studies showed lack of toxicity at even higher concentration. 

Conclusion: Still, these Silver Nanoparticles are cytotoxic in nature and could serve as a good green method for synthesis of silver nanoparticle by using plant extract. 

Open Access Original Research Article

Comparative Efficacy of Four Fruit Extract Mouthrinses on Gingivitis in Orthodontic Patients : A Randomised Clinical Trial

Asmita Kharche, Swapnil Kurhade, Priyadarshini Sarkate, Mugdha khond, Ganesh Kotalwar, Akshay Gelda

Journal of Pharmaceutical Research International, Page 268-274
DOI: 10.9734/jpri/2021/v33i41A32326

Aim: To evaluate the efficacy and antimicrobial properties of four herbal mouthrinses on orthodontic patients with gingivitis

Methods and Materials: A total of 60  individuals with fixed orthodontic therapy with established gingivitis were enrolled in this study. Well Diffusion method was used to formulate mouthrinses of freshly prepared fruit extracts from Punica granatum (Pomegranate), Vaccinium macrocarpon (cranberry), Morinda Citrofilia L. (Noni) and Psidium guajava L. (Guava) and distilled water as control. The Plaque and Gingival Index scores were taken into consideration for assessing the effectiveness of mouthrinses against gingivitis.

Results: ANOVA test showed significant difference between the groups for PI and GI score (p<0.05). The Post Hoc analysis shows the plaque and gingival  index scores were significantly reduced in Group A ,Group B , Group C and Group D than Group E whereas no significant difference exist in the mean PI  and GI scores of Group A,B,C and D  (p>0.005).

Conclusion: All the tested mouthrinses from fruit extract  were equally effective in reducing gingivitis in individuals with fixed orthodontic theraoy suggesting that phytotherapeutic agents may be used  in the future to inhibit oral microbial growth.

Open Access Original Research Article

Cytotoxicity of Eurycomanone and Fargesin in RAW 264.7 Murine Macrophages

Hanim Akmar Rosly, Amira Nabila Mat Roof, Salfarina Ramli, Visarut Buranasudja, Pornchai Rojsitthisak, Boonchoo Sritularak, Hasseri Halim

Journal of Pharmaceutical Research International, Page 275-284
DOI: 10.9734/jpri/2021/v33i41A32327

Bioactive natural compounds derived from plants are the source for the development of new drugs. Numerous in vitro studies have explored the anti-inflammatory effect of eurycomanone and fargesin, derived from Eurycoma longifolia and Flosmagnoliae, respectively. However, before anti-inflammatory investigation is conducted, it is important to obtain the safe doses of these compounds to ensure the validity of the anti-inflammatory results. Therefore, the present study was aimed to investigate the cytotoxicity of eurycomanone and fargesin towards macrophage RAW 264.7. cells to determine the safe doses of these compounds. Different concentrations of eurycomanone and fargesin were subjected to RAW 264.7 cells. The cytotoxicity of the compounds was evaluated by MTT assay and 50% inhibitory concentration (IC50) of these compounds was determined. Morphological changes of RAW 264.7 cells upon exposure to these compounds were also observed. Eurycomanone exhibited its cytotoxic effect by reducing RAW 264.7 cell viability dose-dependently with the IC50 of 94.17 µM. Meanwhile, fargesin had slight cytotoxicity towards RAW 264.7 cells with the IC50 of 173.5µM. Eurycomanone was more cytotoxic towards RAW 264.7 cells compared to fargesin. In conclusion, eurycomanone and fargesin at concentration up to 25 µM, was not toxic to the RAW 264.7 murine macrophages cells and the findings can be applied in the future anti-inflammatory study.

Open Access Original Research Article

Comparative Evaluation of Pain Related Behavior During Administration of Local Anesthesia Using the Conventional Syringe and the Computerized Controlled Local Anesthetic Device in Children Exhibiting Different Levels of Anxiety: In vivo Study

Pooja G. Muzumdar, Vikas Bendgude, Aditi Mathur

Journal of Pharmaceutical Research International, Page 285-294
DOI: 10.9734/jpri/2021/v33i41A32328

Background: Pain experienced during dental procedures evolves into negative attitude towards dentistry, which is projected as anxiety and fear of the child. Administration of local anesthesia (L.A) although an intervention to render painless procedures, in itself causes pain by its conveyance. Wand® (Milestone Scientific, Livingston, NJ, USA) is a system introduced to decrease soreness in the course of anesthetic conveyance. Owing to the sparse information comparing conventional systems with those of Wand, the present study evaluated pain related behavior in children exhibiting pre-assessed variant levels of anxiety midst administration of local anesthesia.

Aim: To correlate pain related behavior amidst delivery of local anesthesia using conventional syringe and the Wand® STA system in children exhibiting variant anxiety levels.

Methodology: The In vivo study embodied 32 children aged between 6 to 8 years. The volunteered participants were pre-categorized into low and high anxiety using the Modified Child Dental Anxiety Scale. They were further divided using the SNOSE technique – receiving L.A the conventional syringe (group A) and those receiving L.A using the C.C.L.A.D (group B). Pain reactions and perceptions to the two delivery methods were calculated using subjective scales and objective physiological parameters.

Results: Comparing pain perception in pre-assessed anxiety categories affirmed a remarkable difference with the use of C.C.L.A.D and appeared to bestow effortless, pain-free delivery over the traditional cartridge delivery.

Conclusion: C.C.L.A.D builds a refined acclivity for dispersal of the solution, ergo an utilitarian tool in pediatric dentistry.

Open Access Original Research Article

The Perceptions about Their Profession of Kosovo`s Nursing Students

Edona Haxhija, Zamira Shabani, Fatbardha Osmanaga

Journal of Pharmaceutical Research International, Page 305-313
DOI: 10.9734/jpri/2021/v33i41A32330

Background and Aim: Nurses are key to the health of the nation. Nursing can be described as both an art and a science; a heart and a mind. The aim of this study is to evidence the students' perceptions about the profession of nursing. This is a cross-sectional study.

Study Design: The research question is: "What are the nursing students’ perceptions about the profession of nursing?" 

Methodology: The study was realized during the period of January- February 2021. The study was conducted with nursing students in first, second and third year of study, in bachelor degree of University of Pristina "AAB College" Kosovo, Faculty of Nursing, Department of Nursing, Kosovo. In this study were included n=130 students, respectively (n= 29, 22.3% in first year, n=57, 43.8% second year and n= 44, 33.8% in third year of study). The questionnaire “Cockrell-Punter Nursing Perceptions Scale” used consisted of 25 perception statements related to nursing. These scores no longer reflected simply agreement/disagreement, but as positive or negative perceptions of nursing with a scale values ranged from 1=negative perception to 5=positive perception. The survey performed in classroom was anonymous. All data collected were elaborated with SPSS version 19.

Results: In this study, 22.3% (n=29) of students were male and 77.7% (n=101) were female. Age ranged from 18 to 47 years old. The average age is 21.9 years old. The distribution of student’s age was: (8.5% were 18 years old, 18.5%, 19 years old, 27.7% 20 years old, 19.2% were 21 years old and 26.1% were over 21 years old) mean 19.8 years old, min 18 years old, maximum 47 year old, Std. Dev ± 4.19. According to the residence, 88 (67.7%) of students were from urban area and 42 (32.3%) from rural area.

Conclusion: Nursing students have good perception about the nursing profession. With age the level of perception increases, so the oldest have more positive perception.

Open Access Original Research Article

Formulation and Evaluationation of Anti-Alzheimer Drug MEM HCL Nanogel

Subhasri Mohapatra, Sourabh Jain, Karunakar Shukla

Journal of Pharmaceutical Research International, Page 323-329
DOI: 10.9734/jpri/2021/v33i41A32332

The object of present study was to formulate and evaluate MEM HCl loaded thermo sensitive in situ nanogel for 08 nasal delivery formulations. In present project a novel drug delivery system i.e. in situ polymeric gel was designed in the manner that the gel load MEM HCl in better concentration and it also incorporates penetration enhancer as a way to enhance the absorption of release drug from gel to the systemic circulation. In this research work Different Nanoparticles were (NP) prepared, using ionotropic gelation method with slight medication in which chitosan (0.4% w/v) was dissolved in aqueous acetic acid solutions (1 % v/v) (pH 6.1), while TPP (0.1% w/v) was dissolved in deionized water. Dried nanoparticles are incorporated with in situ gel. In situ gel was prepared by cold method using the solutions of Poloxamer-188 and Carbopol-934. From this study, it is concluded that, among all formulations prepared, NG8 was the best optimized formulation. Prepared gel can be used as promising nasal drug delivery system for the anti-Alzheimer drug MEM HCl, which enhance nasal residence time owing to increased viscosity and mucoadhesive characteristics; furthermore, it also exhibited a permeation enhancing effect.

Open Access Original Research Article

Therapeutic Effect of Curcumin on Scanning Electron Microscopy of Rat Adrenal Gland in Experimental Fluorosis

A. Shashi, Manisha Tikka

Journal of Pharmaceutical Research International, Page 330-344
DOI: 10.9734/jpri/2021/v33i41A32333

Aim: The present study was designed to investigate the therapeutic role of Curcumin against fluoride induced toxicity on adrenal gland of rats by using scanning electron microscopy (SEM).

Methodology: Wistar albino rats were divided randomly into six groups The group I was administered with 1 ml of deionized water/kg b.w./day orally for 40 days. The Groups II and III were given 300 and 600 mg of NaF/kg b.w./day for the same period, respectively. The group IV was given 200 mg/kg b.w. of Curcumin for 20 days. The Groups V and VI were treated with 300 and 600 mg of NaF/kg b.w./day for 40 days respectively were post-treated with 200 mg of Curcumin for next 20 days. The animals were excised and adrenal tissue was taken out and processed for SEM.

Results: The results revealed that rats exposed to 300 mg/kg b.w./day of NaF showed rough edges, numerous microvilli and damaged surface with crystal depositions. Also, numerous granules were distributed all over the surface. The rats treated with 600 mg/kg b.w./day of NaF showed decellularized adrenal tissue along with network of collagen fibres. Moreover, adrenal gland surface displayed abrasions and distorted cuboidal cells. The filopodia were prominent on the surface and wall of cavity possessed rough outline. After post-treatment with Curcumin, fluoridated adrenal gland of rats showed normal structure, reappearance of cuboidal cells on the surface as well as less number of microvilli and filopodia.

Conclusion: The post-treatment with Curcumin possess therapeutic potential against NaF induced toxicity in adrenal gland of rats.

Open Access Original Research Article

A Study of Cardiac Autonomic Neuropathy among Type-II Diabetic Patients

B.V. Surendra, N. S. Muthiah, M. V. Sailaja, K. Prabhu

Journal of Pharmaceutical Research International, Page 345-352
DOI: 10.9734/jpri/2021/v33i41A32334

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression.

AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital.

Materials & Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion & exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk                  factors with the presence of CAN was analysed by using Pearson’s chi square test.                               Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P<0.05).

Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant.

Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension & smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

Open Access Original Research Article

Hyperinsulinemia and Preeclampsia among Pregnant Women: A Quantitative Study

K. Sofia Mercy

Journal of Pharmaceutical Research International, Page 353-358
DOI: 10.9734/jpri/2021/v33i41A32335

Hypertensive disorders in pregnancy complicate 1 in 10 pregnancies, often associated with maternal and neonatal mortality and morbidity. The study was done on 100 pregnant women’s attending antenatal clinic of SreeBalaji Medical College & Hospital, Chromepet, Chennai, during the period from December 2013 - May 2015. All women who met the inclusion and exclusion criteria were taken intothe study. Fasting insulin was calculated at 18 -22weeks of gestation, and then follow up of caseswas donefor signs of development of Pregnancy-induced hypertension (PIH). In the hypertensive group, the bulk of the patients were between the ages of 25 and 30. As (P > 0.05), there is no statistical Significance in correlation between age and (PIH) in our study. Out of 100 cases studied, 64 cases (64%) had hyperinsulinemia. The remaining 36 cases (36%) had normal insulin values. The prevalence of PIH associated with hyperinsulinemia was 58% in our study. This test showed sensitivity of 87%, specificity of 82%, positive predictive value of 90%, negative predictive value 77% and diagnostic accuracy was 92%.

Open Access Original Research Article

Association of Vitamin D Receptor Gene Polymorphism with Type 2 Diabetes in the Northern Region of Saudi Arabian Population

Ahmed Alharbi, Md Jahoor Alam, Mohd Saeed

Journal of Pharmaceutical Research International, Page 359-366
DOI: 10.9734/jpri/2021/v33i41A32336

Background: Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms are associated with type 2 diabetes mellitus (T2DM), However, its association with type 2 diabetes mellitus) is controversial and has not been established in different ethnic populations. Therefore, we aimed to evaluate the possible association between VDR gene polymorphisms (Fok1, Bsm1, and Taq1and Apa1) and T2DM patients in Saudi Arabia.

Methods: 100 patients with T2DM and 100 healthy age-matched control subjects were enrolled. Fasting blood glucose, lipids profile and HbA1c were measured by autoanalyzer. The circulatory level of 25 hydroxyvitamin D [25(OH)D] was measured by immunochemiluminance. VDR gene polymorphisms detection has been done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) method.

Results: Our study has shown lower levels of 25(OH) D in patients with T2DM (in comparison with control subjects (44.65 ± 7.19), p < 0.00. There were statistically significant differences between patients with type 2 diabetes and controls regarding the distribution of FokI and Taq1 genotypes and alleles (p<0.004 and p<0.04) and nonsignificant differences regarding Bsm1genotpes and allele.

Conclusions: Vitamin D deficiency is prevalent in T2DM patients in Saudi Arabia. An association was found between VDR FokI and Taq1 gene polymorphism and susceptibility to T2DM in Saudi Arabian patients.

Open Access Review Article

Bone, it’s Architecture, Markers of Resorption and Their Role in Osteoporosis in India: A Detailed Review

Tirthal Rai, Janice DSa, Premjit Sujir

Journal of Pharmaceutical Research International, Page 26-40
DOI: 10.9734/jpri/2021/v33i41A32299

Bone is a dynamic tissue that undergoes constant remodeling throughout the life span. Bone turnover is an equilibrium between the rates of bone formation and resorption. Assay of bone turnover markers (BTMs) is very important as they provide an insight in to the dynamics of bone turnover in many metabolic bone disorders. An increase in bone turnover seen with aging and pathological states such as osteoporosis leads to deterioration of bone microarchitecture and thus contributes to an increase in the risk of fracture independent of low bone mineral density (BMD). These microarchitectural alterations affecting the bone quality can be assessed by BTMs and thus may serve as a complementary tool to BMD in the assessment of fracture risk. Osteoporosis is a major health problem in India with 230 million people getting affecting. Women get more crippled as they show an additional accelerated phase of bone loss, which occurs 10 years earlier in India. Bone health in Indian women is more appalling with deficient nutritional status as compared to their counterparts. Biochemical assays are non-invasive, not site specific, reflect the turnover of entire skeleton, can detect early changes in the bone turnover. The present review was aimed to discuss the normal architecture of bone, markers of it’s turnover and their role in osteoporosis in India.

Open Access Review Article

Updates in Diagnosis and Managements of Polymyositis: Simple Review

Laila Abdullah S. Alanazi, Abdullah Mohammed A. AL Madshush, Omniyyah Mohammed S. Alatawi, Asmaa Hamed M. Albuhairy, Jomana Khalid M. Aljohani, Asmaa Muslim Alfahimani, Jalawi Talal A. Alotaibi, Abrar Atallah O. Alatawi, Mohammed Ibrahim F. Bin Ibrahim, Saud Mohammed S. Alrofydi, Marwan Fahad H. altemani

Journal of Pharmaceutical Research International, Page 239-247
DOI: 10.9734/jpri/2021/v33i41A32323

Idiopathic inflammatory myopathies (IIMs) includes an unusual group of acute, chronic, and subacute developed diseases of skeletal muscle characterized by moderate to severe muscle weakness and inflammation.Polymyositis is generally considered to be a prototypic T cell-mediated autoimmune myopathy, while DM was traditionally associated with a humoral-driven microangiopathy, though the putative autoantibodies and their targets have yet to be identified, and there is increasing evidence implicating the type I interferon pathway in the pathogenesis of the disease.  Women between the ages of 50 and 70 are the most typically affected. Proximal muscular weakness is the most common clinical symptom. Inflammatory arthritis, Raynaud's phenomenon, myocarditis, and interstitial lung disease are all examples of extramuscular involvement. In this review, we overview updates in diagnosis and managements of polymyositis.

Open Access Review Article

Ayurveda Concept of Medoroga with Special Reference to Obesity and Related Complication and their Medical Management

Prasad Navanath Ghanawat, Prakash Mane, Pallavi Lahanu Nibe, Ravindra Mirgane

Journal of Pharmaceutical Research International, Page 295-304
DOI: 10.9734/jpri/2021/v33i41A32329

Obesity or medoroga is the only disease that is gaining more and more attention at the global level. This disease is prevalent in developing as well as in developed countries, in both sexes, across all ages and socioeconomic groups. Obesity is one of the prices we have to pay for rapid urbanization and a sedentary lifestyle. Obesity has been described in Ayurveda texts as medoroga or Sthaulya. Acharya Charaka has described eight varieties of impediments known as ashta nindita Purusha. Ati Sthaulya comprises one of them. Obesity is the risk factor for many diseases like diabetes, CVA, hypertension, etc. It is difficult to prevent and treat lifestyle diseases like obesity with the modern system of medicine alone. Ayurvedic science has great potential in preventing and treating lifestyle disorders like obesity. The presenter's view deals with aetiopathogenesis, symptomatology prevention, and management of Sthaulya as given in the Ayurveda classics.

Open Access Review Article

Etiology and Management of Hypoventilation Syndromes

Mohammed Salah Hussein, Monera Abdulrhman Mohammed Abdulhaq, Albadi Abdullah Anwar A, Morteda Jasim Alsalim, Abdulrahman Hafidh A. Alghamdi, Montadher Mahfoudh A. Alzidany, Noor Khalid Abdulrazaq Aljarba, Alqurashi, Qays Ahmad M, Rakan fahad Alsinaideh, Tariq Fayadh Alanazi, Mohammed Mehthel Alqahtani, Abdulrhman Abdulaziz Albrkheel, Salman Fahad Alkhodairy

Journal of Pharmaceutical Research International, Page 314-322
DOI: 10.9734/jpri/2021/v33i41A32331

A number of diseases affecting central ventilation, breathing mechanics or both, characterize hypoventilation syndromes. The incidence of hypoventilation syndromes varies according to the underlying reason. The hypoventilation syndrome's clinical symptoms are generally vague and are in most cases due to the underlying clinical condition. More individuals develop hypercapnia and hypoxemia as hypoventilation continues to worsen. Therefore, clinical indications of hypoxemia such as cyanosis, and evidence of hypercapnia may also be present. Regardless of the etiology, successful hypoventilation therapy focuses on the underlying illness and noninvasive ventilation. Treatment for these diseases includes integrated main disorder treatment and, increasingly, non-invasive positive pressure breathing. In this paper, we overview current evidence regarding different etiologies and management of hypoventilation syndromes. Data was collected during the period of 6 months searching Pubmed, EPISCO, Web of science, Google scholar databases to include papers with relative topics.