Open Access Study Pre-Protocol

Effect of Myofascial Release Technique Verses Conventional Therapy in Tension Neck Syndrome: A Research Protocol

Aditi N. Nagore, Deepali S. Patil, Om C. Wadhokar

Journal of Pharmaceutical Research International, Page 409-413
DOI: 10.9734/jpri/2021/v33i46A32883

Background: A pain in the neck and shoulder region is referred to as tension neck syndrome. Symptoms include neck and shoulder muscular discomfort, pain, tiredness, and stiffness, as well as headaches. Palpable stiffening patches, sensitive sots, and spasms on the trapezius or sternocleidomastoid muscles may be identified during the physical examination, which are commonly coupled with neck pain on the opposing side, as well as a decreased range of flexion, extension, or rotation. Tension neck syndrome is a prevalent occurrence among computer                 users.

Methods: The participants (n=30) will be recruited in the study suffering from tension neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated by myofascial release technique whereas group B will be treated by conventional therapy. The protocol will cover 2 weeks of treatment. Regular assessment will be carried out. In the rehabilitation period, we will evaluate activity of daily living. Our outcome measures will be Neck Disability Index (NDI) and Visual Analogue Scale (VAS).

Discussion: Tension neck syndrome is more common in women than in men, and it is linked to computer users including office professionals, students, and others. Efficacy of the myofascial release technique verses conventional therapy will be evaluated by using Neck Disability Index (NDI) and Visual Analogue Scale (VAS). The result of the study will significantly provide affirmation on using myofascial release technique verses conventional therapy in tension neck syndrome patients.

Open Access Case Report

Amniotic Band Sequence Syndrome – A Rare Disorder

Priyanka Singh, Neema Acharya, Rishabh Gupta, Rajesh Kumar Vasam

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i46A32833

Amniotic bands sequence is a inherited diseases distinguished by craniofacial, body wall, and limb oddities that may be in relation with foetal-placental fibrous bands. Its pervasiveness has been delineated to range from 0.19 to 8.1 per 10 000 births [1]. It is a customary state prospectively alike with a variety of different confinements’ disability. The deformities arise in the wake of the pompous bodily part have formed usually in early evolution. The required cause of amniotic disruption complex is undisclosed .The three most usual decorative design are constriction ring syndrome signalized by one or more limbs being high-flown; the limb-body- wall complex; and amniotic band syndrome characterized by abnormalities of the head and face (craniofacial abnormalities), inadequacies of the brain and genuine deformation of the appendages [2].

The condition in few cases might be considered prior to nativity (antepartum), unlikely to change upon the sequels of explicit detailed imaging practices, like fetal USG, which may give away the feature inadequacies [3].

Here we present a case of pregnant woman admitted in our Obstetrics and gynecological department with her ultrasonography report indicative of amniotic band and further discussed about antenatal diagnosis, diagnostic and therapeutic approach, prognosis and genetic counselling of amniotic disruption complex.

Open Access Case Report

Meditation and Preventive Cardiac Health

Sidhharrth S. Kumaar

Journal of Pharmaceutical Research International, Page 264-268
DOI: 10.9734/jpri/2021/v33i46A32865

Thanks to advancements in medical and technical therapy, heart failure (HF) patients are now better predicted. A longer lifespan is linked to an increase in the number of risky lifestyle factors and behaviours that put a person at risk for heart failure (HF) early on in life. Doctors dealing with this challenging illness place emphasis only on medicinal products or medical equipment, although changes in lifestyles may assist to prevent and cure heart failure and are often neglected. The effects of weight reduction and exercise on cardiovascular disease (HF), as well as the impact of nutritional supplements and mindfulness on the illness's causes, physiopathology, and therapy, were studied by researchers.

Open Access Systematic Review Article

Cedarwood Oil as a Substitute for Xylene in Histopathological Laboratories – A Systematic Review

R. Deepa Viswasini, Pratibha Ramani, Abhilasha Ramasubramanian

Journal of Pharmaceutical Research International, Page 519-525
DOI: 10.9734/jpri/2021/v33i46A32895

Background: Xylene is an aromatic hydrocarbon that's extensively used as a deparaffinizing agent, and it's far extraordinarily biohazardous. It is proven to be the best chemical to be used in histopathological laboratories in spite of its carcinogenic potential.

Aim: The aim of this study is to do a systematic review on the efficacy of cedarwood oil as clearing agent and deparaffinizing agent alternative to xylene in histopathological laboratories.

Materials and Methods: The articles for this review were searched from PubMed, Google Scholar, Google search and manual search using the keywords cedarwood oil, natural substitute, natural alternative and xylene. The final of 3 articles were included in the review which compared the efficacy of cedarwood oil as a natural alternative with the gold standard xylene. Once the articles to be reviewed were finalized, data was collected, tabulated and was verified and interpreted.

Results: Three articles included in this review showed considerable and acceptable results with cedarwood oil as clearing and deparaffinizing agent.

Conclusion: Merits and demerits are equally found in both the reagents but compromising the time and cost in terms of cedarwood oil for health benefits hold good for the pathologists but bad for the patients. In case of xylene, compromising the health benefits of workers which results in quicker diagnosis hold good for the patients but not for the pathologists. Finally storage and disposal of these two reagents still remains questionable.

Open Access Case Study

Study on RCA and HFMEA in Patient Safety with Measurable Outcomes: A Case Scenario

M. R. Roopashree

Journal of Pharmaceutical Research International, Page 100-110
DOI: 10.9734/jpri/2021/v33i46A32845

Introduction: Safety concerns of outborn neonatal infant babies during transportation to the NICU had been a concern. Better team coordination and improvement in the technical competency of the care providers helped implement the ambulance policy.

Methods: With the background of the Donabedian model and Juran's Trilogy concepts, process improvisation was performed. The RCA (Root Cause Analysis) and HFMEA (Healthcare Failure Mode and Effects Analysis) as tools were used for better deliverables.

Results: The measurable outcomes in terms of time taken for departure before and after were compared, which showed considerable significance. By measuring the baby temperatures, a significant difference was seen in clinical aspects.

Discussion: Lack of infrastructure, equipment for neonatal transportation was a challenge that required prioritization of budget allocation. The procurement policy of equipment had to be relooked for user-friendly strategies. Lack of trained staff and doctors, which were major issues, required an intense training and development module. The challenges of hypothermia, ventilation issues during transportation of neonates were of major concern, were tackled using quality tools.

Application: To minimize the mortality and morbidity of neonates, infants by Specialized Pediatric Critical Care Transport (SPCCT) ambulance policy was implemented. The value addition was to minimize the risks and prevention of hazards.

Conclusion: Improvement in the Technical competency of nurses and caregivers was observed. Nurses were well exposed to handling transporting sick babies. Logistics, equipment handling was performed properly.  With better team coordination, the babies were safe. The trust and confidence among the members of the community at large improved. The patient footfall increased in numbers.

Open Access Case Study

Undescended Testicle Operated with Orchiopexy Surgery: A Case Report

Mayur Wanjari, Pratibha Wankhede, Deeplata Mendhe, Sagar Alwadkar, Hina Rodge

Journal of Pharmaceutical Research International, Page 116-119
DOI: 10.9734/jpri/2021/v33i46A32847

The testicles develop in the abdomen while a male baby is still in the uterus. Before birth, the testicles typically drop from inside the abdomen down into the scrotum. The scrotum is the sack of skin hanging behind the penis where the testicles are housed.

Undescended testicles fail to drop into the scrotum before birth or in the first few months of life. The condition is also called cryptorchidism.

Here we discussed, A 15 Years old male child was brought to Acharya Vinobha Bhave Rural Hospital with a complaint of undescended testis and is brought for surgical management. The history of previous illness as narrated by the father the child was born with an undescended testis on the right side.

Open Access Case Study

A Rare Case Report on Hirschsprung’s Disease

Pratibha Wankhede, Achal Gulghane, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 132-136
DOI: 10.9734/jpri/2021/v33i46A32849

Introduction: Hirschsprung’s disease is a condition that affects the large intestine and causes problems passing stool. It was first identified by “Ruysch” in 1961 and popularized by Hirschsprung’s in 1886. A missing nerve cell in the baby's colon muscles causes the condition, which is present at birth.

Clinical Findings: Difficulty in passing stool, Abdominal pain, fever, (Temperature 100-degree f) Vomiting, Failure to thrive, poor feeding.

Diagnostic Evaluation: CBC Infestation, Blood test, Hb -10.4 gm%, Total RBC Count -4.37 million /cu mm, RDW-13.3%, HCT-30.5%, Total WBC Cont-4000 /cu mm, Monocytes- 13%, Granulocytes-65%, Lymphocytes-30%, AST (SGOT)-28 U/L.

Therapeutic Intervention: Blood Transfusion, Inj. Aminoven 200 mg BD, Cefotaxime 400 mg BD IV, Inj. Amikacin 130 mg OD, Inj. Metrogyl 90 mg BD, Inj. Pantocid 10 mg OD.

Outcome: After Treatment the child show improvement in his passing stool frequently and relived Vomiting, fever, and increases feeding pattern.

Conclusion: My patient was admitted to pediatric ward no 22 at AVBRH with a known case of Hirschsprung's Disease, and he had complained of difficulty in passing stool, at birth after getting appropriate treatment and surgery his condition was improving.

Open Access Case Study

Positive Outcomes of Comprehensive Exercise Program on Restoration of Functional Level and Quality of Life in a Patient with Rheumatic Heart Disease Undergone Mitral Valve Replacement: A Case Report

Leksha Atul Patel, Vaishnavi Dilip Yadav, Moli Jai Jain, Om C. Wadhokar

Journal of Pharmaceutical Research International, Page 379-384
DOI: 10.9734/jpri/2021/v33i46A32879

Heart disease due to valvular anomaly has increased prevalence along with increasing age. Rheumatic heart disease is a condition in which the heart valves have been permanently damaged post rheumatic fever. The operative management including reparation or substitution with prosthetic valve is the main therapy. Still becoming question mark either rehabilitation program is beneficence for the patient undergoing valvular surgery. We report a patient with severe mitral valve regurgitation, moderate mitral stenosis, moderate tricuspid regurgitation, and severe pulmonary artery hypertension secondary to Rheumatic Heart Disease. He underwent Mitral valve replacement surgery and advised post-operative physiotherapy which comprises 2 weeks of phase I cardiac rehabilitation, a home exercise program after discharge, and follow-up after 2 weeks. During follow up patient has a high level of independence, improvement in quality of life, and early return to work.

Open Access Case Study

A Rare and Challenging Patient of Infantile Haemangioma: Case Report

Ashish Ramesh Varma, Anuj Ramesh Varma, Waqar M. Naqvi, Tanvi Shashank Banait, Shreyashee Sunil Shinde, Om Chandrakant Wadhokar

Journal of Pharmaceutical Research International, Page 394-399
DOI: 10.9734/jpri/2021/v33i46A32881

Infantile haemangioma is a condition seen in premature babies, it develops as a birth mark that grows in size commonly seen on back, chest, scalp, the swelling is characterised by bleeding or oozing. In such patients primary concern is any ill effects due to medical condition and secondary concern is cosmetic. A 9 month old baby brought to the hospital with complaints of swelling on the back with oozing. The patient was given IV propranolol for 1 year. And wound care was taught along with ergonomic education for ADLS. The study suggests that the use of IV propranolol shows significant reduction in the swelling and oozing from the swelling. 

Open Access Study Protocol

A Research Protocol: Comparison of Ultrasound Therapy with Zingiber Cassumunar Roxb based Phonophoresis and Conventional Gel in Patients with Knee Osteoarthritis-Randomized Control Trial

Medhavi V. Joshi, Pratik A. Phansopkar

Journal of Pharmaceutical Research International, Page 15-21
DOI: 10.9734/jpri/2021/v33i46A32835

Background: Knee Osteoarthritis is considered as the leading cause of the disability in almost all over the world after age of 40. Almost about 54 percent people will end up in knee osteoarthritis in old age. Awareness of non-pharmacological treatment for knee osteoarthritis is more in practice in European as well as in Asian countries. Physical therapy, Ultrasound therapy, Otago exercises etc. are the treatments that are available for conservative management as well as preventive measure of knee Osteoarthritis.

Methodology: Subjects with knee osteoarthritis with grade II to III on Kallgren and Lawrence classification will be included in the study N = 52. Two groups each of 26 will be allocated randomly as group A who will receive ultrasound treatment with Otago exercises control group and group B who will receive ultrasound treatment with zingiber Cassumunar based gel and Otago exercises as experimental group. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), VAS, star excursion balance test will be performed before and after the treatment after 2 weeks with single blind procedure.

Objective: This research will examine the effect of treatment with Zingiber Cassumunar based gel applied by means of phonophoresis with ultrasound therapy in knee osteoarthritis patients with Randomized control trial.

Open Access Study Protocol

Effectiveness on Simulation Teaching Regarding Cardio Pulmonary Resuscitation among Workers of State Transport Depot

Sagar Alwadkar, Deeplata Mendhe

Journal of Pharmaceutical Research International, Page 111-115
DOI: 10.9734/jpri/2021/v33i46A32846

Introduction: Cardiopulmonary resuscitation is the technique of life-saving procedure in that artificial ventilation uses external chest compressions to maintain circulation flow of the heart and oxygenation during cardiac arrest. Many peoples in the developed and developing countries have taken known education of Cardiopulmonary resuscitation training which was launched jointly by Universal Medical Assistance International Center.

Objectives: 1. To evaluate the previous knowledge and skill regarding CPR among workers of ST Depot. 2. To evaluate effectiveness and correlation the post-test knowledge and skill score regarding CPR among workers of ST Depot. 3. To identify the association with the post-test skill score regarding CPR among workers of ST Depot.

Methodology: In this study, will the effectiveness of simulation teaching regarding cardiopulmonary resuscitation the sample will be the 100 ST depot workers. The workers will select according to inclusion and exclusion criteria as well as the Purposive sampling technique. One group pre-test and post-test design. It will be conducted at State Transport Depot. Wardha Maharashtra, India respectively. The data will be collected by using questionnaires and an observational checklist for simulation teaching on cardiopulmonary resuscitation.

Conclusion:  It is concluded that the effectiveness of simulation teaching on CPR was found to be effective in improving the knowledge and skill of workers of ST depot.

Open Access Study Protocol

Determine the Effectiveness of Anacardic Acid and Stannous Fluoride as an Anti-erosive Agent

Sampada Dahake, Priyanka Paul Madhu, Amit Reche, Kumar Gaurav Chhabra, Simran Kriplani, Rutuja Ubhale, Barkha Adwani

Journal of Pharmaceutical Research International, Page 495-499
DOI: 10.9734/jpri/2021/v33i46A32892

Background: The key goal of the study is to find out the effectiveness of anacardic acid and the stannous fluoride as an anti erosive agent.

Objectives: To evaluate the erosive effect of Bio vinegar and antierosive effect of Anacardic acid and Stannous Fluoride.   

Methodology: The extracted teeth were collected for in vitro study. Three solutions were selected Bio vinegar, Anacardic acid, Fluoride to treat the extracted teeth to study and compare the anti-erosive effect. The sets of extracted teeth of ten each were grouped to be treated with different solutions. The set was immersed in Bio vinegar for 8 hours for erosive action. The second set of ten extracted teeth were immersed in anacardic acid for four days. The same set of teeth were treated with vinegar for 8 hours. The cross sectional view of stained teeth was viewed under Scanning Electron Microscope. The third set of teeth was immersed in stannous fluoride for four days and then treated with Bio vinegar for 8 hours. The cross sectional view of stained teeth was viewed under Scanning Electron Microscope. A comparison of anti-erosive effect of anacardic acid and stannous fluoride were studied under Scanning Electron Microscope.

Expected Results: Determining a better effectiveness of Anacardic acid antierosive agent than stannous fluoride.

Conclusion: Reduction in the level of erosion by the application of anacardic acid and stannous fluoride on extracted teeth exposed to carbonated drinks and assessment of erosive effect of carbonated drink on tooth.

Open Access Short Research Article

Quick Response Code Based Online Appointment Scheduling System: An Approach towards Health Management

Kyati Varshney, Agnivesh Gupta

Journal of Pharmaceutical Research International, Page 183-191
DOI: 10.9734/jpri/2021/v33i46A32856

For day to day functioning of healthcare services in healthcare sector there is requirement of managing, tracking and keeping patient appointment and medication related information in a effective and efficient way. If a person is suffering from any disease and needs to visit a doctor in a hospital for checkup the patient required to fill hospital registration form in hospital and waits in a long queue while getting an appointment. In some hospitals online appointments can be done by web or smart phone application. Some of these existing applications do not provide information regarding doctor availability, and do not provide patients medical records, etc. This paper proposes a web based application to overcome drawbacks related to existing appointment systems.  In this paper the web application will provide a unique QR code to each patient, at the time the patient takes an online appointment for the doctor. The study provides an efficient way of managing health care accessibility in future.

Open Access Short Research Article

Emergency Gynecological Care during the Spread of Coronavirus Infection

Zhanetta Shamuyevna Aslakhanova, Pyatimat Timurovna Dakhkilgova, Natalia Valeryevna Arkhipova, Sergey Vladimirovich Rybakov, Maria Radislavovna Checheneshkina, Sergey Vyacheslavovich Bezuglov

Journal of Pharmaceutical Research International, Page 363-369
DOI: 10.9734/jpri/2021/v33i46A32878

The article examines the features of providing emergency gynecological care during the spread of coronavirus infection. The author comes to the conclusion that the majority of urgent gynecological cases are complex, and a significant part of them requires urgent surgical care. Also, an important role in this process is played by the organization of environmental safety and disinfection, competent management of medical waste. All of the above will optimize the process of diagnosis and treatment of emergency gynecological patients and reduce the risk of exposure to infectious pathogens on medical personnel as part of the application of planned measures for the prevention and control of COVID-19.

Open Access Minireview Article

Aconitum heterophyllum-An Overview

Vishal M. Balaramnavar, Manjeet Kaur, Anil Ahuja

Journal of Pharmaceutical Research International, Page 242-247
DOI: 10.9734/jpri/2021/v33i46A32862

Aconitum heterophyllum also known as aruna, family Ranunculaceae is used in ayurvedic formulations for the treatment of diarrhoea, hepatic issues etc. The phytochemicals in this plant consists of alkaloids, proteins, carbohydrates, saponins, amino acids, quinones, flavonoids, glycosides, terpenoids, etc. In the present paper, not only are the various therapeutic properties of this plant has been discussed but the profiling of its toxicological studies done on rats have also been elaborated upon. Unlike other species of Aconitum, Aconitum heterophyllum has shown beneficial activity on a rat model of toxicity. Firstly, the ethanolic extract of the plant was evaluated for its oral toxicity but it came out be safe. The ethanolic extract of the plant reversed the activity of castor oil. Moreover, this plant has shown good anti-bacterial activity. After summing up of all the pharmaceutical features of this plant, it could turn out to be valuable source of knowledge for the academia, practioners of traditional medicines & for the pharma industry.

Open Access Minireview Article

Treatment Modalities for Rehabilitation of Mutilated Primary Anterior Teeth

Rashi Srivastava, Nilima Thosar

Journal of Pharmaceutical Research International, Page 566-574
DOI: 10.9734/jpri/2021/v33i46A32900

Early childhood caries commonly affects the primary maxillary anterior teeth, in which extensive post- endodontic rehabilitation has always been a challenge. This is due to the small size of the crown, relatively large pulp chambers, and the age of the child. The remaining inadequate sound tooth structure renders restorations more prone to fractures. Among the available treatment modalities which include extraction of the grossly destructed tooth structure, use of semipermanent crowns and intracanal posts, the posts can be used effectively, to restore the lost function and anatomy. They also enhance the quality of the final coronal restoration by providing additional support for retention. The available methods for intracanal reinforcement for anterior teeth include the metal posts fabricated using orthodontic wires, short composite posts fabricated directed in the primary root canal, prefabricated glass fiber posts and posts utilising polyethylene fibers (Ribbond). Recently certain advanced techniques such as the biologic dentin and zirconia have also come into use. The various advantages and disadvantages for these have been summarised in this review along with the standardised clinical protocol for their placement in the primary root canals. Various in-vivo and in-vitro studies have concluded that the glass-fiber short intracanal posts provide the most suitable esthetics, strength, elastic modulus, and resilience. However, further qualitative research is required to certify it as a standard treatment modality.

Open Access Original Research Article

Quantification of Tofacitinib in Human Plasma Samples Using Radio-Labeled Internal Standard

Anilvikas Yamana, Kothapalli Bannoth Chandrasekhar

Journal of Pharmaceutical Research International, Page 22-29
DOI: 10.9734/jpri/2021/v33i46A32836

A simple, sensitive and accurate liquid chromatography tandem mass spectrometric method has been developed and validated for determination of Tofacitinib in human plasma. The method was developed on Agilent Zorbax SB-C8 150×4.6 mm, 5 µm column using 10mM ammonium formate: acetonitrile (40:60 v/v) mobile phase for Chromatographic separation of Tofacitinib. The Tofacitinib and Tofacitinib- C3 were monitored by electrospray ionization in positive ion multiple reactions monitoring mode to detect the Tofacitinib at mass/charge 313.200/149.200 and Tofacitinib-13C3 (Internal Standard) at 316.500/149.200. Liquid-liquid extraction was employed in the extraction of analytes from human plasma. Both drug and internal standards were stable in plasma samples. The proposed method was validated as per international council of harmonization guidelines over a linear concentration range of 0.2ng/mL to 100.0ng/mL with a correlation coefficient (r) of ≥ 0.9983. Bioavailability and Bioequivalence studies of tofacitinib in biological samples can be achieved by analyzing them using the validated developed method. This study plays a key role in determining routine therapeutic drug monitoring of tofacitinib drug.

Open Access Original Research Article

Analytical Study of Self-directed and Problem-Oriented Learning Sessions in Cardio-Respiratory Physiology

Suchitra Palve, Sachin Palve

Journal of Pharmaceutical Research International, Page 30-37
DOI: 10.9734/jpri/2021/v33i46A32837

Background: Learner-centred methods for teaching knowledge in the undergraduate medical curriculum utilizing an integrated approach include active learning approaches such as Problem-oriented learning and self-directed learning are two types of education.

Aim and objectives: The study aimed to see if self-directed learning and a problem-solving approach to physiology may benefit first-year medical students.

Material and methods: 250 students enrolled in Phase I MBBS for two physiology modules: CVS and RS, were involved in this cross-sectional study. Group A (n=125) received self-directed learning sessions for similar topics, whereas Group B (n=125) received problem-oriented learning sessions. An objective evaluation of all subjects covered was done after each SDL and POL session, and the results were analyzed using an unpaired t-test.

Results: Cardiovascular physiology self-directed learning sessions, 25.6 % (32/125) of students received maximum scores (group A), whereas 21.6 % (27/125) received moderate grades. 31.2 % (39/125) of problem-oriented sessions received maximum points, whereas 47.2 % (59/125) of pulmonary system module (group A) sig. SDL sessions received intermediate points. The p values (n=0.008) (n=0.009) for both modules indicated a significant difference between 32.8 % (41/125) of those who earned maximum scores and 48 % (60/125) of those who received intermediate grades. With p values of 0.0192, 0.0190, and 0.01179, respectively, pupils achieving 80–89 %, and 70–79 % in both SDL and PBL, had significant variations in their total scores in their internal evaluation when SDL and POL were compared to their overall scores.

Conclusion: Self-directed learning sessions are less successful than problem-oriented learning sessions at communicating concepts. It takes time to raise learner’s awareness and prepare them for active; Techniques for learning that are centered.

Open Access Original Research Article

Assessment of Vitamin B12 Deficiency Caused by Metformin in Type II Diabetic Patients

R. Arun

Journal of Pharmaceutical Research International, Page 38-41
DOI: 10.9734/jpri/2021/v33i46A32838

Metformin use over time reduces vitamin B12 levels, according to several studies, and its clinical manifestation can be mistaken as diabetic peripheral neuropathy. In order to investigate vitamin-B12 deficiency in type II diabetic patients with long-term metformin treatment, a link between vitamin B12 and peripheral neuropathy, and to evaluate the quality of life in (T2DM) patients, the current study was done. At Sree Balaji Medical College and Hospital's outpatient and inpatient departments, a prospective observational case-control research was done. The study included 35 healthy volunteers (controls) and 35 Type 2 diabetes patients who had been on metformin for more than six months (cases). Patients' venous blood samples were collected in K2 EDTA vacutainers and centrifuged at 1500 rpm for 10 minutes, settled plasma was transferred into cryo-vials, and parameters such as Vitamin-B12, HbA1c, and CBP were estimated and this is used to conduct the statistical analysis. The prevalence of blood vitamin B12 deficiency and borderline deficiency in T2DM patients is 20.5 percent, while the mean HbA1C values in our study T2DM subjects are 9.07 percent, indicating either poor diabetes control or poor metformin drug compliance. Vitamin B12 insufficiency was found in 83 percent of T2DM patients who had been using metformin for 1 to 10 years. The reliability test was used to assess their quality of life, and the results revealed that the study participants' quality of life was poor.

Open Access Original Research Article

Nutritional Status of Adolescent Girls in Corporation Schools in India: Still the Goal is Far Ahead

Priya Kulkarni, Archana Jadhav, Jitendra Bhawalkar

Journal of Pharmaceutical Research International, Page 42-49
DOI: 10.9734/jpri/2021/v33i46A32839

Adolescence is a vulnerable period for the incidence of malnutrition, as rapid growth takes place in this phase of life. Malnutrition, especially among adolescent girls, adversely affects future generations and indirectly impedes national productivity. Maternal malnutrition also contributes significantly to maternal mortality. It is required to be reduced to 70 per lac live births in 2030 from 167 per lac live births in 2013 to achieve sustainable development goals. The other crucial sustainable development goal is improvement in nutritional status in all phases of life. In the present study, we assessed the healthy situation by Body mass index and Haemoglobin estimation of adolescent girls incorporation school located at Pimpri, Pune, India. Most of the girls belonged to lower-middle to middle socioeconomic status. 67.9% of AGs under study were malnourished, while 8.6% were overweight. Only 3.5% of them had Haemoglobin in the normal range, 1% had severe, 65% of adolescent girls understudy had moderate anemia, and the rest had mild anemia. Results of the study show that India is still far away from attaining Sustainable development goals regarding the nutrition of adolescent girls and will have to take great efforts by existing program evaluation, modification, and strict implementation.

Open Access Original Research Article

Quality Compliance in a Remotely Located PHC in India

M. R. Roopashree

Journal of Pharmaceutical Research International, Page 72-80
DOI: 10.9734/jpri/2021/v33i46A32841

Background: As the rural Indian health care sector is providing patient care to the community at large, evaluating the quality of services gives an insight into the level of care provided. The primary health care chose the audit evaluation voluntarily.

Objectives: The aim of the study was to assess the service quality provided in the primary health care Centre. The study was to help understand the skill set requirements in improving the quality of care and to identify the service quality gaps and to provide the best possible solutions for the gap closures by nominating the responsible personnel.

Methods: The quality of care was evaluated in three ways: staff interview, record review, and observations conducted. Six departments were chosen for evaluation: the out-patient department, in-patient department, labor room, laboratory, National health programs, and general administration. By a prepared specific checklist comprised of standards and measurable elements, an evaluation was performed. The scoring was provided as 0, 1and 2, which implied noncompliance, partial compliance, and full compliance.

Results: As per evaluation, national health program areas scored the least, whereas the inpatient departments scored the highest.  There were multiple gaps in the service provision areas and manpower allocation. The average mean score was 77.48.

Conclusion: Keeping the national standards and guidelines, an audit evaluation was performed. Quality has to be imbibed with the optimization of resource allocation and with the mindset to provide the best possible care in the interest of the individual's wellbeing.

Open Access Original Research Article

Exploring Correlations of COVID-19 Mortality Rates with Development Variables: The Case of Northeast India

Bidyutt Bikash Hazarika, Debajyoti Dutta Saikia, Bidyut Bikash Boruah, Amrit Kumar Nath

Journal of Pharmaceutical Research International, Page 93-99
DOI: 10.9734/jpri/2021/v33i46A32844

Aim: This paper explores the correlation of the Covid-19 mortality rate with some other developmental variables. This study also attempts to highlight the state-wise variability in mortality rate in the Northeastern region of India.

Study Design: The study focuses on eight Northeastern states, correlating the Covid-19 mortality rate and other development (or socio-economic) variables. This study focuses on the region of North East India because there have been few investigations on Covid-19 in the region. This study follows a cross-sectional study design.

Duration of the Study: The study was conducted and completed around three months.

Methodology: The nature of the correlation between the mortality rate of Covid-19 and the other variables is determined by using the Karl Pearson correlation approach. We began by performing a correlation study and calculating the correlation coefficients.

Results: The results demonstrate that all independent variables adversely correlate with the Covid-19 mortality rate. Except for the number of doctors in district hospitals and health spending per capita, which have a moderate negative correlation with the predicted variable, all explanatory factors have a weak negative connection with the death rate. Surprisingly, both the NSDP per Capita and the case positivity rate have negative findings. Another major issue in the findings is that none of the factors statistically link with mortality.

Conclusion: This research shows that the more a state's socio-economic infrastructures, notably its health infrastructures, are developed, the lower the mortality rate in a pandemic will be.

Open Access Original Research Article

Stability Indicating Method Development and Validation of Cenobamate in Bulk and Dosage form by Liquid Chromatography

K. Athulya Damodharan, . Nuaman, M. Archana, Mariya Palathingal, P. Ashisha, Akash Marathakam

Journal of Pharmaceutical Research International, Page 120-131
DOI: 10.9734/jpri/2021/v33i46A32848

A simple, Precise, Accurate method was developed for the estimation of Cenobamate   by RP-HPLC technique. Chromatographic conditions used are stationary phase symmetry C18 (150 mm* 4.6 mm 5 µm), mobile phase Acetonitrile: 0.01NKH2PO4in the ratio of 55:45 and flow rate was maintained at 1.0ml/min, detection wave length was 272.0 nm; column temperature was set to 30oC. Retention time was found to be 2.908 min. System suitability parameters were studied by injecting the standard six times and results were well under the acceptance criteria. Linearity study was carried out between 25% to150 % levels, R2 value was found to be as 0.999.Precision was found to be 0.5 for repeatability and 0.8 for intermediate precision. LOD and LOQ are 0.01µg/ml and 0.03µg/ml respectively. By using above method assay of marketed formulation was carried out 100.32% was present. Degradation studies of Cenobamate were done, in all conditions purity threshold was more than purity angle and within the acceptable range.

Open Access Original Research Article

Application of Response Surface Methodology in Development and Optimization of Stability Indicating RP-HPLC Method for Determination of Tolvaptan in Bulk and Formulation

A. S. Sutar, C. S. Magdum

Journal of Pharmaceutical Research International, Page 137-148
DOI: 10.9734/jpri/2021/v33i46A32850

Design of Experiment assisted stability indicating RP-HPLC was developed and optimized using response surface methodology for determination of Tolvaptan.  Mobile phase was developed and optimized using Design of Experiment with response surface methodology. Acetonitrile and phosphate buffer with pH 5.5 (70:30% V/V) was optimized as mobile phase. The flow rate was maintained at 1ml/min. Stress studies were performed as per guidelines. Method was validated in accordance with regulatory requirements and results were within specified limits of regulatory guidelines. Tolvaptan was eluted at 3.24 min. It shows linearity from 2.5-15 µg/ml. Coefficient of correlation was 0.999, LOD and LOQ values were 1.0871 (µg/ml) and 3.2942 (µg/ml). Precision was determined with % RSD of 0.8669 and 0.9709%, mean percentage Recovery value was found to be 99.88 ±1.2. All stress degradation products are very well resolved from drug peak which indicate suitability indicating nature of the developed method. Design of Experiment technique can help in fast and economical optimization of mobile phase which inturn will save time for method development. The developed method is simple, accurate, sensitive which can be utilised as stability indicating method for identification of degradation products in routine analysis of the drug.

Open Access Original Research Article

To Assess the Effectiveness of Self-Instructional Module on Knowledge Regarding Selection of Play Articles for Children and Its Importance among Parents of 6-12 Years Children

Pritam Meshram, Deeplata Mendhe

Journal of Pharmaceutical Research International, Page 161-168
DOI: 10.9734/jpri/2021/v33i46A32853

Introduction: Kids are humanity's hope. The children of today are the masters of the world of the future. The saying goes, "Health is richness." Therefore, if children are happy, they will be healthier for the future generation, a healthy nation's result. Play articles are more than just playing things, but while they should be enjoyable, they should also be children's age-appropriate physical and emotional growth. It is necessary to consider playing items or playing articles as a cognitive learning tool for children.

Objective: Assess the knowledge and effectiveness of the self-instructional module regarding the selection of play articles for children and its importance among parents of 6-12 years of children. Associate the post-test knowledge score with selected demographic variables among parents of 6-12 years of children.

Methods: Study research design is a pre-experimental one-group pre-test post-test. Population in this study parent of 6-12 years children selected area of Wardha city with 80 parents to use close-ended structured questionnaires have been used in this study for assessing knowledge.

Results: The finding of the study shows that the post-test, the sample was had a poor level of knowledge score, none of them had a poor level of knowledge score, none of them had an average level of knowledge, none of them had a good level of knowledge score, 52 (78.75%) had an excellent level of knowledge score and 28 (21.25%) have a very good level of knowledge, The minimum score was 13 and the maximum score was 19, the mean score was 16.79 ± 1.290 with a mean percentage score of 55.96%.

Conclusion: The conclusion of this study shows that 28 (21.25%) having a very good level of knowledge and 52(78.75%) having an excellent level of knowledge.

Open Access Original Research Article

Neural Networks Oblige Diagnosis of the Ischemic CVA’s by MRI

Pallavi Srivastava, Kirti Mishra, Chitrangada Chaubey

Journal of Pharmaceutical Research International, Page 175-182
DOI: 10.9734/jpri/2021/v33i46A32855

In present time the technological & computing evolution are promoted for new opportunities that will help to improve the standard of life between the new medical accomplishments, in particular and the standard of diagnostic evaluations. MRI is one of the imaging equipment for the diagnosis which has become more beneficial for technological development, because of this and due to the standard of a diagnosis manufacturer, that is one of the most engaging apparatus in the clinical application. The attentiveness in that pathology & in the general the encephalon picture analysis as the preventive diagnosis. The present research paper suggests the evaluation of the ability of ANN for the automatic identification of an ICVA by tissue images density obtained by MRI. In this examination the diagnosis and their medical reports were used to train the ANN classifier which extracted features from the given images. In this stage the ANN significantly contributes to the ICVA of MRI diagnosis aid, so since the test occurrence automatic identification of ischemic lesions that has been performed with the accuracy results that will be false positive and false negative.

Open Access Original Research Article

Development and Validation of a Diethyl Phosphite Content in Foscarnet Sodium USP by GC MS Technique

Mohan Bhatale, Neelakandan Kaliyaperumal, Gopalakrishnan Mannathusamy, Gurunathan Ramalingam

Journal of Pharmaceutical Research International, Page 192-201
DOI: 10.9734/jpri/2021/v33i46A32857

A simple, rapid, selective, and reproducible Gas chromatographic mass spectrometry (GC-MS) method has been developed and validated for the estimation of Diethyl Phosphite content in Foscarnet Sodium USP Drug substance. The drugs were estimated using HP-5, Length-30 M, Internal diameter 0.32 mm; Film thickness 1 μ at a total flow rate of 11.9 ml/min, and column flow of 1.49 ml/min was used for the separation. Flow control mode was pressure. Column oven temperature 70°C and injector temperature 220°C. Oven program modified for proper elution of peak. The linearity range used was 0.025-0.120µg/ml and (Rt) was 6.7 min. The correlation coefficient values were found to be 0.997. Precession studies showed % RSD values less than 15.0% for all the selected concentrations. The percentage recovery of Diethyl phosphite from LOQ to 150% was found in range of 100.7 -116.7%. The content results of Phophite content were within the limits of less than 0.12 ppm. The method was validated as per the International Conference on Harmonization (ICH) guidelines. The developed method was successfully used for the quantitative analysis of commercially available dosage forms.

Open Access Original Research Article

Heart Disease Diagnosis by Neural Networks

Khyati Varshney, Mrinal Paliwal

Journal of Pharmaceutical Research International, Page 202-208
DOI: 10.9734/jpri/2021/v33i46A32858

In the present time the Mortality rate will be increased all around the world on their daily basis. So the cause for this might possibly be largely ascribe to the developing in the numbers of the patients with the cardiovascular patient’s diseases. To aggravate the cases, many physicians that have been known for the misdiagnosis of the patients announce heart related ailments. In this research paper, the intelligent systems have been designed in which they will help in the successful diagnosis of the forbearing to avoiding misdiagnosis. In the dataset of a UCI stat log of heart disease that will be using in this investigation. The dataset contains 14 attributes which are essential in the diagnosis of the heart diseases. A system is sculpted on the multilayer neural networks trained with convolutional & simulated convolutional neural networks. The identification of 89% was acquired from the testing of the networks.

Open Access Original Research Article

Anti-inflammatory Activity of Sclerotium stipitatum Berk. et. Curr. an Ethnomedicinal Fungus, in Chronic and Acute Animal Models of Inflammation

Alina K. Sebastian, P. V. Anto

Journal of Pharmaceutical Research International, Page 209-218
DOI: 10.9734/jpri/2021/v33i46A32859

Sclerotium stipitatum Berk. et. Curr., locally known as ‘nilamanga’ is a rare macro fungus, traditionally used to treat numerous diseases like arthritis, earache, jaundice etc. The present study aims to evaluate the anti-inflammatory activity of ethanol extract of S. stipitatum and identify the bioactive compounds present in them. Phytochemical screening of extracts obtained using different solvents like petroleum ether, chloroform, ethanol and water were done. The best extract was chosen for the acute carrageenan-induced and chronic formalin-induced anti-inflammatory studies. Diclofenac was used as the standard drug. Ethanol extract showed significant inhibition of inflammation induced by carrageenan and formalin-induced paw edema models compared to the control. GC-MS analysis shows certain bioactive compounds. The significant inhibitory effect on paw edema proves that S. stipitatum possesses remarkable anti-inflammatory activity, and isolation and identification of bioactive compounds can be used for new drug formulations.

Open Access Original Research Article

An Analytical Study on Acute Liver Injury in Patients Caused by Classic Heat stroke

Kirti Mishra, Pallavi Srivatava

Journal of Pharmaceutical Research International, Page 219-223
DOI: 10.9734/jpri/2021/v33i46A32860

Heat Stroke is a kind of medical emergency that can cause severe dehydration and neurological changes as a result multi-organ injuries or failure could be possible. Heat strokes occur when the body temperature exceeds 40 0C due to external heat and humidity. The liver is widely affected by heatstroke that’s why taking care of patients suffering from heatstroke is very important. Various studies have been reported in the literature regarding acute liver failure but none of the studies discussed acute liver failure during the hospital stay. Patients during their hospital stay will have a higher risk of mortality due to heatstroke. In this paper, an analytical study has been done on admitted patients to a government hospital in India. These patients are suffered from heatstroke from April 2007 to September 2011 and a second time period from July 2018 to September 2019. The sample includes 60 patients with 58 (97%) males having a totaled number of 12 fatalities. The observed International Normalized ratio (INR) parameter is greater than 1.6 and no increased mortality has been noticed, aspartate aminotransferase (AST), as well as alanine aminotransferase (ALT) levels, were not associated with an increased mortality rate.

Open Access Original Research Article

Fabrication of Chitosan Based Antibacterial Implant for Multibacterial Bone Infection

Ashish Y. Pawar, Sejal R. Jadhav, Deelip V. Derle

Journal of Pharmaceutical Research International, Page 224-241
DOI: 10.9734/jpri/2021/v33i46A32861

Despite advancements in medicines and novel surgical methods, osteomyelitis is still a complex and difficult to treat multi-bacterial bone infection. It generates in tissue necrosis along with rupturing of bone in chronic cases leading towards limited vascularity at infection site, local treatment might not show accountable level of antibiotic at infection site. The present research aims towards development and evaluation of bio-degradable implant of Ciprofloxacin hydrochloride to treat local osteomyelitis. Chitosan is widely investigated biodegradable polymer with hydroxyl moiety which is active and can be altered chemically to develop biomedical and therapeutic dosage forms. Here this active group was modified using epichlorohydrin & crosslinked Chitosan matrices were used as carrier to formulate different Ciprofloxacin implant. In vivo parameters and in vitro study was conducted for optimized batch. The formulation having 40% drug loading (EC4) was found to be optimum when all evaluation parameters were tested. The concentration of Ciprofloxacin Hydrochloride (HCl) in bone and surrounding tissues is much higher than minimum inhibitory concentration (MIC) even after a month. After observing the water uptake and extended release of drug from all formulations the drug loading was found to be higher. The present work concluded that, the highly branched chitosan remarkably reduce the percent (%) drug release up to a month which could be useful in the treatment of osteomyelitis.

Open Access Original Research Article

Protective Effect of Terminalia arjuna Against DBTC Induced Pancreatic Cancer in Male Wistar Rats

Kadiyala Harshitha, Uma Sankar Gorla

Journal of Pharmaceutical Research International, Page 248-256
DOI: 10.9734/jpri/2021/v33i46A32863

Aims: To study the protective effect of hydroalcoholic bark extract of Terminalia arjuna against DBTC induced pancreatic cancer in male wistar rats.

Study design: Healthy male Wistar Albino rats weighing 150-200 g were segregated into four groups (n=6). Group I was considered as normal control, received normal saline (0.9%w/v, 1 ml/kg body weight, orally). Group II rats were treated with DBTC (6 mg/kg body weight, i.p.) which served as negative control. Group III and IV received Terminalia arjuna Linn bark hydroalcoholic extract at doses of 250 mg/kg body weight, per oral and 500 mg/kg body weight, per oral respectively.

Place and Duration of Study: University College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, Andhra Pradesh, India, between May 2020 and July 2020.

Methodology: The experimental animals were segregated into four groups of six rats each. According to acute toxicity data, 250 mg/kg as low dose and 500 mg/kg as high dose of the test compound have been chosen for administration. All the drugs were given for 28 consecutive days to all the respective groups with standard pellet diet and water ad libitum. The assessment of serum parameters such as α-Amylase, Lipase and blood glucose levels were carried out on 1st day, 14th day and 28th day to the respective groups.

Results: Pretreated groups of Terminalia arjuna Linn bark hydroalcoholic extract (250 mg/kg and 500 mg/kg body weight, orally) showed significant (#’p<0.001) decrease in the levels of α-Amylase, Lipase and glucose in the blood when compared to DBTC (6 mg/kg body weight, i.p.) induced group which served as negative control.

Conclusion: This study suggests that Terminalia arjuna may have a protective role against DBTC induced pancreatic cancer in male wistar rats and further investigation may be required to confirm its therapeutic potentials clinically.

Open Access Original Research Article

Antioxidant, Cytotoxic and larvicidal Potential in Oxalis latifolia Kunth. Methanolic Leaf Extract

R. Gopi Krishnan, S. Murugesh

Journal of Pharmaceutical Research International, Page 269-275
DOI: 10.9734/jpri/2021/v33i46A32866

Aims: The current work was analyzed in antioxidants, cytotoxicity and larvicidal potential were examined for O. latifolia methanolic leaf extract.

Methodology: Antioxidant assasy for Hydroxyl radical (H2O2). Cytotoxicity potential was studied against colon (HT-29). Culex quinquefasciatus  (IVth instar) larvae was used for larvicidal test.

Results: Antioxidant and cytotoxicity exhibits significant activities with IC50 value of 442.94 µg/mL and also the cytotoxicity activity IC50 values of 50.00μg/mL for HT-29. Larval mortality against the larvae of Cx. quinquefasciatus showed best activity with LC50 09.50mg/L and LC90 28.72 mg/L.

Conclusion: Thus, this study proved that methanolic leaf extracts of O. latifolia have significant biological activities. Hence, it can be used for pharmacetutical applications.

Open Access Original Research Article

Comparative Evaluation of Antipyretic Activity of an Ayurvedic Herbo-mineral Formulation Dhatryadi Churna and Its Modified Dosage form in Albino Wistar Rats

Bharat Rathi, Sanket Shelke, Renu Rathi, Devyani Awari

Journal of Pharmaceutical Research International, Page 289-300
DOI: 10.9734/jpri/2021/v33i46A32868

Introduction: Experimental studies are essential and expected part of a new drug development. The studies are conducted to know about the toxic effects (if any), produced by the drug & to access safety of the drug. Studies also help to ascertain the efficacy of the drug & measures to be taken so as to curtail the toxic effects.

Aim & Objective: Study was aimed to do comparative evaluation of antipyretic activity of an Ayurvedic herbo-mineral formulation Dhatryadi Churna and its modified dosage form in experimental albino rats.

Materials and Methods: Present study was carried out at Animal house attached with the Institute. 24 healthy Albino wistar rats of either sex weighing 180-200 gm were randomly selected and divided into 4 groups. Pyrexia was induced in rat by subcutaneous injection of 10 mL/kg b.w. of a 20% aqueous suspension of brewer's yeast.  The trial drug Dhatryadi Churna and Dhatryadi Vati administered orally in the form of suspension to the albino rats.

Observation and Results: The present result shows that the Dhatryadi Churna (DC) and Dhatryadi Vati (DV) have a significant antipyretic effect in yeast induced pyrexia in rats. Hematological parameters were found to be within the normal biological and laboratory limits on comparison with the values of the control group.

Conclusion: Dhatryadi churna and Dhatryadi Vati does not show significant adverse effects on the blood, blood cells, and target organs at the doses used and can be safely used in human being.

Open Access Original Research Article

A Study to Assess Prevalence of Nocturnal Enuresis and Its Associated Factor among School Going Children in Selected Rural Areas of Vadodara

Nirali Soni, Rupal Patel, Jenisha Patel, Hetavi Patel, Hemali Patel, Harsh Patel

Journal of Pharmaceutical Research International, Page 301-306
DOI: 10.9734/jpri/2021/v33i46A32869

Background: Nocturnal enuresis, also called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Little is known about toilet training in pre-modern societies, but attitudes toward training in recent history have fluctuated substantially, and may vary across cultures and according to demographics. Treatments range from behavioral therapy, such as bedwetting alarms, to medication, such as hormone replacement, and even surgery such as urethral dilatation. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control. Bedwetting is the most common childhood complaint. Children may face certain risks associated with training, such as slips or falling toilet seats, and toilet training may act in some circumstances as a trigger for abuse.

Aims: The aim of this study is to assess the prevalence of nocturnal enuresis and its associated factors among school going children in selected rural areas of Vadodara.

Methods: A descriptive research design was carried out for this study. The sample size of the study is 500. Participants were selected using stratified sampling technique. The tool is consists of two parts. First part consist of demographic data of the sample and second part consist of assertiveness self-assessment questionnaire.

Results: While assessing the associated factors of nocturnal enuresis in school going children, 15% children are having mild nocturnal enursesis,77%children are having moderate nocturnal enuresis and 8% children are having severe nocturnal enuresis. While assessing the association, there are three demographic variables age, sex and education of father has no significant association. So H0 has been rejected and H1 is accepted.

Conclusion: The present study concluded that majority of the children’s is having moderate level of nocturnal enuresis (77%) and minority of the children’s is having severe level of nocturnal enuresis (8%).

Open Access Original Research Article

Clinicopathological Study of Benign Neoplastic Lesions of the Oral Cavity

Ashwini Handal, Ganesh Kulkarni

Journal of Pharmaceutical Research International, Page 307-311
DOI: 10.9734/jpri/2021/v33i46A32870

Oral benign tumors are common in the Indian subcontinent. These benign neoplastic lesions may mimic other tumors like lesions or malignant tumors of the oral cavity. Aim: The current study's goal is to investigate the demographical distribution of benign tumors of the oral cavity and to study their histopathological and site-wise distribution. Materials and method: It's a retrograde observational study of 30 patients. In the Indian subcontinent, benign tumors and tumor-like lesions are prevalent. Data is collected from the otorhinolaryngology department of a referral center and medical college in the Maharashtra state of India. Data was collected from previous histopathological reports of excision biopsies done in the Otorhinolaryngology Department. Result: papilloma is the most common benign tumor found in the present study is a retrospective observational study. This research was carried out at tertiary care referring facility and health college in the Indian state of Maharashtra. Data were collected from 30 patients from the department of otorhinolaryngology and histopathology reports of benign neoplastic lesions.

Open Access Original Research Article

Assessment of Different Oxidative, Endocrinological and Biochemical Parameters using Catharanthus Roseus on Rats

Eshwa Dar, Abdul Rashid Shaikh, Muhammad Shahbaz Yousaf, Muhammad Adnan, Samar Akhtar, Kashif Iqbal

Journal of Pharmaceutical Research International, Page 312-317
DOI: 10.9734/jpri/2021/v33i46A32871

The current study was planned to assess the different oxidative, Endocrinological and biochemical parameters using extract of Catharanthus roseus (C. roseus) on diabetic rats. Three groups of Diabetic rats were assigned viz. Group A have Negative Control which was fed basal diet; Group B have Positive Control and was non-supplemented; and Group C supplemented with C. roseus extract. The results showed that blood glucose level, ALT, TGs and urea concentration was elevated non-significantly (P>0.05), of Group C which was supplemented by C. roseus when compared with non-supplemented Group B animals. In Group C which was supplemented by C. roseus, AST, and Cholesterol results were decreased as showed by statistics analysis (non-significantly). When level of Blood cortisol was compared between Group C and B, there was increased in Group C, as per non-significant statistics measurements (P>0.05). It was observed that level of T4 and T3 hormones was decreased in Group C (supplemented by herbal extract) when compared with Group B. When catalase enzyme results were checked in animals comprised of Group A, B and C, it showed that rate of catalase increased, respectively. In conclusion, Catharanthus roseus restore the levels of thyroid hormones, and cholesterol; and elevate catalase enzyme activity in animals which produce stress relieving effect.

Open Access Original Research Article

Application of Elements of Quality by Design to Development and Optimization of HPLC Method for Fingolimod

Siddique Akber Ansari, Mrinmayee Deshpande, Jaiprakash N. Sangshetti, Sarfaraz Ahmed, Irfan Aamer Ansari

Journal of Pharmaceutical Research International, Page 318-328
DOI: 10.9734/jpri/2021/v33i46A32872

Purpose: A HPLC method for Fingolimod was developed using a Quality by Design concept. QbD has gained importance in recent times due to regulatory requirements. Actual study was started after determination of target profile and qualification of instrument.

Methods: Separation was carried on a Grace C-8 column (4.6 x 250 mm, 5-μm particle size).The composition of mobile phase was methanol and 20 mM ammonium formate buffer of pH5.8 in gradient mode HPLC method development is affected by critical factors like pH, flow rate and mobile phase composition.

Results: To study the effects of these three factors on USP tailing, Box Behnken optimization model was applied. Desirability of the model was set at Tailing less than 1.2.Analysis of results was done using surface diagrams. Verification of Software generated results was done by taking six replicates of the run. Thus developed and optimised method was Finally validated as per ICH guideline.

Conclusion: A Quality by Design approach has been successfully utilised in method development of the Fingolimod in bulk. All key aspect of QbD were tried to be implemented in said study.

Systematic approach was utilized for method development which includes beginning with determination of target profile characteristics, instrument qualification, risk assessment, design of experiment and validation.

Three factors i.e. Ph, flow rate and methanol concentration were analysed for their effect on USP tailing as a responce. Interaction and quadratic effect of the factors were studied with least possible runs by using Box Behnken model. Response surface diagrams and contour plots were studied for coming to conclusion which factors are affecting response and their limits were recorded. Optimum run condition was obtained; Replicates of run having optimized condition were taken to confirm the predicted response with actual response.

Open Access Original Research Article

Formulation, Optimization and Pharmacodynamic Studies of Pioglitazone HCl Solid Lipid Nanoparticles

Y. Indira Muzib, E. Ramya, Y. R. Ambedkar

Journal of Pharmaceutical Research International, Page 329-341
DOI: 10.9734/jpri/2021/v33i46A32873

Pioglitazone HCl is an oral anti-diabetic agent used for the treatment of diabetes mellitus type II. The aim of the present work is to evaluate the pharmacodynamic activity of solid lipid nanoparticles of pioglitazone HCL prepared by using solvent injection technique and to compare with the control and test group. Among all the formulations, F5 was found to possess highest in-vitro drug release within 24 hrs i.e., 95.02±1.26%. The in vivo studies were performed using male albino rats of wistar strain (150-200g). Rats were divided in to five groups (n=6), group-I normal, group-II diabetes control, group-III   placebo control, group-IV reference, group-V test group. Diabetes was induced by streptazocin (60 mg/kg) by intraperitonial route. The reference group was treated with marketed tablet of pioglitazone HCL, test groups were treated with SLNs suspended in 0.1% Tween 80 and given to animals through oral gavages. Blood samples were collected by retro-orbital puncture before treatment, and after treatment at time intervals 0, 2, 4, 6, 8, 10, 12 and 24h in anti-coagulated vials. Parameters like glucose, tri glycerides (TG), total cholesterol (TC) and HDL-C were estimated by calorimetric method.  Diabetes induced rats showed elevated levels of glucose, TG, TC and reduced HDL. The oral administration of drug loaded SLNs in 0.1% Tween 80 solution showed reduced levels of glucose, TG and elevated levels of HDL-C and slightly reduced levels of TG in 24 h where as the marketed tablet showed reduced levels of glucose, TG and TC up-to 12 h and in 24thh  the glucose levels get elevated. Thus the optimized SLNs showed prolonged activity.

Open Access Original Research Article

Effectiveness of Reminiscence Therapy on Self-health Perception and Self-esteem among Elderly Residing at Selected Old Age Homes

N. M. Reshma Rajan, Syed Imran

Journal of Pharmaceutical Research International, Page 348-355
DOI: 10.9734/jpri/2021/v33i46A32875

Purpose: To assess the level of self-health perception and self-esteem among elderly residing at old age homes and to determine the effect of reminiscence therapy on the level of self-health perception and self-esteem.

Methods: Quasi-experimental pre-test post-test control group design was carried out on 80 elderly residing at old age homes selected by non-probability convenient sampling technique to test effectiveness of reminiscence therapy. The data was collected by using self-health perception scale consist 32 items and Rosenberg self-esteem scale consist 10 items.

Results: The result showed thatthere was a significant difference in self-esteem in the intervention group after the intervention (p=0.03<0.05) and there was no significant difference in self-esteem of the control group (p=0.83>0.05), whereas in self-health perception there was no significant difference in both intervention and control group (p=0.18 & 0.95>0.05). Between the groups there was no significant difference (p>0.05) found in the protest score of self-esteem and self-health perception between intervention and control group, while there is a significant difference found in post-test of self-esteem (p=0.002) and self-health perception score (p=0.004) between the groups. The obtained p values of chi-square and likelihood ratio test were >0.05. Only a few associations were found between both self-health perception and self-esteem with demographic variables that are sex and previous occupation/job in the control group.

Conclusion: Reminiscence therapy proved to be effective in improving self-esteem among elderly residing in selected old age homes at Mangaluru, whereas not shown effectiveness in improving self-health perception.

Open Access Original Research Article

Comparison of Effects of Mouthwash Containing Chlorhexidine and Chlorine Dioxide on Salivary Bacteria-A Randomized Control Study

Chiranjeevi Vedula, Santhi Priya Potharaju, Hanusha Bathula, Chandrika Chinta, Manasa Akula, Gayathri Paleti

Journal of Pharmaceutical Research International, Page 356-362
DOI: 10.9734/jpri/2021/v33i46A32876

Aims: The present study aimed to compare the effectiveness of Chlorhexidine (CHX) and Chlorine dioxide (ClO2) mouthwashes in reducing the microbial load in saliva.

Place and Duration of Study: Department of Periodontics, Government Dental College and Hospital, Afzalgunj, Hyderabad, between January and March 2020.

Methods and Materials: 60 Patients with gingivitis were included in the study. Ultrasonic scaling was done and saliva samples of the participants were collected and transferred onto blood agar plates. These plates were sent for the microbial count. Later they were given the mouthwash (Chlorhexidine or Chlorine dioxide or Distilled water by random selection) which they used for four weeks. Each group of participants was instructed to rinse

  • 10 ml of 0.2% CHX for one minute twice per day. (Group A)
  • 10 ml of ClO2 (Freshclor) for one minute twice per day. (Group B)
  • 10 ml of Distilled water for one minute twice per day. (Group C)

After four weeks of usage of prescribed mouthwashes, the participants were recalled and salivary samples were again collected and sent for the microbial count.

Results: The intergroup comparison of CFU between the groups after four weeks showed significant reduction of CFU Groups A and B when compared to Group C. When compared to Group A (CHX), Group B (ClO2) witnessed statistically significant reduction of CFU in with a mean difference of 0.26±0.09 (p<0.001).

Conclusion: The present study demonstrated that ClO2 mouth rinse was effective in reducing microbial load after four weeks of usage than CHX.

Open Access Original Research Article

The Main Factors Influencing Adherence to drug Therapy in Patients with Diabetes Mellitus

Mikhail V. Vodolagin, Nikita V. Polukhin

Journal of Pharmaceutical Research International, Page 385-393
DOI: 10.9734/jpri/2021/v33i46A32880

Introduction: Diabetes mellitus is a disease that requires the patient to strictly adhere to the prescribed treatment throughout his life to prevent the development of various complications of diabetes. The need for repeated daily medication intake, learning knowledge about diabetes, gaining skills of self-monitoring of health indicators (glucose, blood pressure, level of physical activity), visits to healthcare facilities for preventive examinations and treatment is a heavy burden on the patient, reducing the quality of life and motivation to comply with the prescriptions of the attending physician.

Objectives: To analyze the level of adherence to drug therapy and its factors in patients with diabetes mellitus.

Methods: The survey was carried out over the Internet from November 2020 to February 2021. 434 respondents with diabetes mellitus, aged from 18 to 80, were included into study. Among them there were 221 women (50,92%) and 213 men (49,08%). The proportion of respondents with type 1 diabetes mellitus (T1DM) was 23,96% (n = 104, 95% CI 20,17%–28,22%), with type 2 diabetes mellitus (T2DM) – 76,04% (n = 330, 95% CI 71,78%–79,83%). The survey questionnaire consisted of 2 parts. The first part contained 54 questions related to demographic, socioeconomic, and health status of participants’ along with questions designed to identify respondents’ risk factors, diabetes course and complications, information technology usage in treatment and health management process. The second part of the survey contained 25 questions based on the “Russian universal questionnaire for quantifying adherence to treatment” (KOP-25). The Pearson chi-square test and Cramér's V test of the effect size were used to assess the collected nominal data.

Results: A low level of adherence to drug therapy prevailed among all respondents, 38,48% (n = 167). Statistically significant differences in the level of adherence to drug therapy were found among respondents with type 1 diabetes mellitus (p < 0,0001), ones visited the schools of diabetes (p <0,001), respondents with a high level of knowledge about diabetes (p <0,001), respondents who adhered to the prescribed medical regimen (p = 0,001), respondents who visit a doctor at least 1 time per year (p = 0,001), ones who used remote forms of interaction with the attending physician (p <0,001), respondents in younger age groups (p <0,001), respondents with a shorter duration of diabetes mellitus (p = 0,005).

Conclusion: The main direction for the quality of life improvement for patients with diabetes mellitus is to increase patients' awareness of possible ways to change their lifestyle while maintaining a high level of adherence to drug therapy using information and communication technologies and telemedicine.

Open Access Original Research Article

New Formulation and Characterization of Topical Films of Tioconazole and Evaluation of Their Antifungal Therapy

Siddique Akber Ansari

Journal of Pharmaceutical Research International, Page 400-408
DOI: 10.9734/jpri/2021/v33i46A32882

Purpose: New formulation of Scleroglucan (Sclg) films loaded with tioconazole, a medication typically applied for dermal treatments prepared. The feasibility of that treatment relies on                      the penetration of medications through the target layers of the skin in effective                 concentrations.

Methods: Dynamic and mechanical characterization and swelling studies of the novel delivery system were analysed. An aqueous solution of Sclg (Cp=1% w/v) and glycerol (2% w/v) was prepared and kept at room temperature under magnetic stirring for 72 hrs. Tioconazole previously solubilised in Labrasol, was added to the polymer/glycerol solution.  4 ml of solution was poured in a plastic plate. The films were dried at 40°C for 1 hr and then allowed to dry at room temperature (about 25°C) for a week. Translucent films were obtained.

The fungal strain used to test the film are CO23 sensitive to drugs, CO23 RFLC resistant to fluconazole, CO23 RFK resistant to  micafungin, ATCC  standard strain.

Results: The water uptake of the films significantly increased up to 24 hrs. The optical microscope films images show that the presence of the drug did not significantly influence the appearance of the samples. The in vitro studies demonstrated the perceptible fungal activity of the new formulation against Candida albicans infections.

Conclusion: The patches showed antimicrobial activity against all tested strains. An evident inhibition zone diameter, about 40 mm, for the strains sensitive to azoles (CO23 RFK and CO23) in comparison to strain resistant to fluconazole (CO23 RFLC) was observed. After 48 hours the inhibition zone diameters were reduced of about 6-7 mm in comparison to those observed after 24 hours of incubation.

Open Access Original Research Article

Assessment of Prescription Pattern Prescribed to Patients Affected by Rheumatoid Arthritis: A Cross Sectional Health Survey Conducted in Different Hospitals of Bangladesh

Zannatul Marzia, Shahin Sarkar, Md. Emran Hossain, Sadia Jahan, Md. Arafat Hussain

Journal of Pharmaceutical Research International, Page 414-420
DOI: 10.9734/jpri/2021/v33i46A32884

Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects the joints with variable degrees of severity depending on the patient. As it is a chronic disease and patients have to go through medication for a long period of time, choosing the proper drug is very crucial to avoid irrational use of drug. The present study was designed to evaluate the usual prescription pattern that are prescribed by the physicians, and unveiling the scenario of patient care treating for arthritis.

Materials and Methods: The current survey-based research study was conducted in seven divisional areas of Bangladesh. Data was collected for Five months periods from September 2020 to January 2021. This cross-sectional study was carried out at a variety of private and governmental hospitals. The study included 300 individuals who had been on antirheumatic medicines for at least six months. Patient demographic details, prescribed drugs, adverse drug reactions, and use of complementary and substitute medicine were used to analyze the pattern of drug use.

Results and Discussions: The results of the study found that most of the patients are from 40 to 60 years of age. The number of drug prescribed ranges from 3 to 8, with an average of 6.1 medicines per prescription. The most used Disease-modifying antirheumatic drugs (DMARDs) were tofacitinib, glucocorticosteroids were prednisolone and NSAIDs were Aceclofenac group. None of these drugs were prescribed as generic names, rather proprietary names were used.

Conclusion: Most of the patients are treated with more than one drug to fight against arthritis. So the incidence of drug interaction should be observed carefully. Moreover, both the prescriber and patient should be aware of ensuring rationale use of drug.

Open Access Original Research Article

An Improved Commercially Feasible Process for Flecainide Acetate

Nilesh Takale, Neelakandan Kaliyaperumal, Gopalakrishnan Mannathusamy, Rajarajan Govindasamy

Journal of Pharmaceutical Research International, Page 421-430
DOI: 10.9734/jpri/2021/v33i46A32885

Commercially viable manufacturing process for Flecainide Acetate (I) conforming to regulatory specification and cost effective process is reported. Specifically, an improved process for the preparation of Flecainide Acetate allows isolation of anhydrous hydrochloride salt of Compound III, which facilitates the reduction of the pyridine ring with the only catalytic amount of platinum on carbon within 2 hours Therefore, simplifies the synthesis and isolation of Flecainide acetate on a commercial scale to a considerable extent.

Open Access Original Research Article

Anti-Cancer Activity of Gabapentin and Chiral Amino Acids-Based Hybrid-Peptides against MCF-7 Breast Cancer Cell-Line

Vraj B. Pansuriya, Khushal M. Kapadiya, Suryajitsinji L. Rathod, Usha B. Prajapati, Bhavin M. Vavaiya, Jasmin B. Padariya, Foram U. Vaidya, Chandramani Pathak, Hitesh M. Parekh

Journal of Pharmaceutical Research International, Page 431-446
DOI: 10.9734/jpri/2021/v33i46A32886

Aims: Herein, we report the cytotoxicity of gabapentin-based peptides (11a-11j) using L-alanine and L-phenyl alanine chiral amino acids for peptide bond formation in ten efficient and straightforward steps. The in vitro MTT assays of derived molecules on the MCF-7 cell line (a human breast adenocarcinoma cell line) exhibited enhanced antitumor activity compared to the control (100% cell proliferation).

Methods: The ten steps synthetic methods were adapted for the synthesis of the Gabapentin-based peptide derivatives through BOC- deBOC methods and using EDC-HCl, DMAP and commercially available solvents. All the synthesized peptides were unambiguously characterized with the help of spectroscopic (IR, 1H NMR, 13C-NMR, mass spectra, and elemental) data analysis.

Results: The Compounds 11a, 11b, 11h,11i, and 11j showed a remarkable antiproliferative (cell death) activity, with % cell proliferation values ranging from 25-38 %.

Conclusion: The study showed that the compounds with some specific functionalities like, benzylic and trifluoromethyl functionality enhanced the potency with comparable %cell proliferation and cell death. Based on the findings in this work and their easily accessible molecular structures, compounds 11a and 11j are worthy of further biological investigations.

Open Access Original Research Article

Evaluate the Effectiveness of Reminiscence Therapy

A. R. Bharathi

Journal of Pharmaceutical Research International, Page 447-452
DOI: 10.9734/jpri/2021/v33i46A32887

Background: The aging begun with the birth and observed as a continuous change in different phases of life due to weakening of the body function with respect to the time and quantity. Aging also causes a continuous stress on the adaptive response and indirectly enhance the disease conditions. The adaptive childhood degree is more important to the man for his well- being and happiness. But, due to stress increasing, a strong decreased adoptability led to the increase of the inner withdrawal,bitterness, weariness of life and depression are the results of failure to adapt.

Methodology: The geriatrics eventually lead to depressed state and lack a prominentsupport. The current study aimed to analyze efficiency of the Reminiscence based therapy in aged and depressed people. The present work was based on quasi experimental nonequivalent control group designin selected senior citizen home, Chennai.Of 64 samples, experimental group (31)and control group (33) using Non-probability, purposive- sampling technique and measured based on Yesavage geriatric depression scale.

Results: Continuously, twenty-one days, two session per day (morning and evening) the experimental group were demonstrated with Reminiscence therapy. Reminiscence therapy characteristically having non-pharmacological psychosocial intervention for depression remedy. The results showed the significant difference in degree of depression between the two groups.

Conclusion: As conclusion, the study showed that reminiscence therapy had tremendously decreases the depression and elevated the well-being feeling in elder people.

Open Access Original Research Article

Possible Protective Effect of Silver Nanoparticles against Cisplatin Induced Pulmonary Inflammation in Rat Model

Hanan Y. Alharbi, Nawal W. Helmi, Neveen A. Salem

Journal of Pharmaceutical Research International, Page 453-463
DOI: 10.9734/jpri/2021/v33i46A32888

Silver nanoparticles (AgNPs) are gaining interest in medical applications for their prominent antibacterial and antimicrobial potentials. AgNPs possess remarkable anti-inflammatory and antioxidant activities and enhances wound healing. The main objective of the current study was to investigate the therapeutic effect of administration of AgNPs on cisplatin (CP) induced pulmonary inflammation in rats. Sixty male albino rats were used in this study. Rats were divided into 6 groups (n=10). Group I control group. Group II and III control groups received AgNPs at doses (5 and 10 ppm). Group IV CP group received CP (2.5 mg/kg). Group V and VI CP group received AgNPs (5, and 10 ppm). All doses were administered intraperitoneally once a day for 4 weeks. Oxidative stress and antioxidant status, inflammatory mediators, fibrogenic as well as apoptotic markers were determined in lung tissues. The results revealed that rats treated with CP showed remarkable elevation in lung tissues MDA, TNF-α, IFN-γ, IL-6, CRP, Fibrinogen and P53 levels associated with depression in SOD, GSH and CAT activities. However, administration of AgNPs (5 or 10 ppm) to CP group resulted in significant amelioration of the aforementioned parameters in a dose dependent manner. Histopathological investigation of lung tissues of CP group demonstrated disruption of normal lung architecture and lung injury. However, treatment with AgNPs revealed significant improvement in lung tissue against CP- induced inflammatory changes and lung tissue damage. It could be concluded that AgNPs exert potent cytoprotective effects via combating oxidative stress, inflammation, fibrogenic and apoptotic markers and repairing histopathological changes in lung tissues.

Open Access Original Research Article

To Evaluate the Effect of an Educational Programme on Breast Care Attentiveness among Young Mothers after Childbirth

A. R. Bharathi

Journal of Pharmaceutical Research International, Page 464-469
DOI: 10.9734/jpri/2021/v33i46A32889

The postpartum period, also known as the puerperium and the "fourth trimester," refers to the time after delivery when maternal physiologic changes related to pregnancy return to the non-pregnant state. From the day of delivery to six-eight weeks after delivery is termed as the fourth trimester. A few days after birth, the mother’s breast will swell with milk and become tender swollen, firm, and painful breasts. If the breasts are severely engorged, they are very swollen, hard, shiny, warm, and slightly lumpy to the touch. This is called engorgement. Breast care is necessary postnatally since this will avoid complications such as mastitis – infection caused due to trapped milk. Post natal education on breast care is much needed for all mothers. Mastitis, for example, is an infection that causes inflammation of the breast tissue. It’s most commonly caused by milk trapped in the breast. Untreated mastitis can lead to complications such as a collection of pus in the clogged milk ducts. Often, even well educated women seem to know very less about breast care post childbirth. Hence the present study was framed to assess on how much knowledge the new mothers possess about breast care (sample size: 60). From the results obtained we conclude that all the new mothers post the awareness rendered about breast care acquired good or adequate knowledge regarding the same when compared to pre-test. This emphasizes the need for public health interventions and awareness programs to educate as well as minimize the related complications.

Open Access Original Research Article

Design of Novel Selective Estrogen Receptor Inhibitors using Molecular Docking and Protein-Ligand Interaction Fingerprint Studies

Galla Rajitha, Murthi Vidya Rani, Umakanth Naik Vankadoth, Amineni Umamaheswari

Journal of Pharmaceutical Research International, Page 470-483
DOI: 10.9734/jpri/2021/v33i46A32890

Aims: The genomic and non-genomic actions of human estrogen receptor α (hERα) play a crucial role in breast epithelial cell proliferation and survival, as well as mammary tumorigenesis. hERα has been proved as a potential target for breast cancer therapy over the last 3 decades. Hence designing novel inhibitors targeting hERα can be a valuable approach in breast cancer therapy.

Study Design:  In the present study, the goal is to identify novel hERα inhibitors through molecular docking, AI based virtual screening and interaction fingerprint analysis.

Place and Duration of Study: Department of Bioinformatics, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India in between July 2021-sep 2021.

Methodology: Molecular docking studies were performed using the human estrogen receptor alpha ligand-binding domain in complex with 4-hydroxytamoxifen (PDB: 3ERT) against existing compounds from literature. The best docked existing compound and co-crystal ligand were subjected to shape screening against 28 million compounds and resulted compounds constituted the hERα inhibitor dataset which was subjected to rigid receptor docking. Further, interaction fingerprint analysis was applied as complimentary method to docking for comparing the similarity of predicted binding poses of proposed leads with that of reference binding pose.

Results: Co-crystal ligand (4-OHT) and E99 exhibited better binding affinity among existing ligand set. Rigid receptor docking studies resulted in four lead compounds possessing better docking scores than 4-OHT and E99. Moreover, leads showed favorable absorption, distribution, metabolism, excretion and toxicity properties within the range of 95% FDA approved drugs. Proposed leads showed interactions with binding site residues of hERα similar to that of 4-OHT with better binding affinity. The ability of obtained leads to retrieve actives was validated using receiver operative characteristic (ROC) curve.

Conclusion: From above results, it has been observed that the proposed leads have potential to act as novel hERα inhibitors.

Open Access Original Research Article

Comparison of Single Antibiotic Paste Nitrofurantoin and Calcium Hydroxide Paste as Intracanal Medicaments in Alleviating Post-Operative Pain in Patients with Symptomatic Irreversible Pulpitis -A Randomized Controlled Trial

Hira Abbasi, Abhishek Lal, Ammara Shamim Jaffrani

Journal of Pharmaceutical Research International, Page 484-494
DOI: 10.9734/jpri/2021/v33i46A32891

Aims: This study aims to compare the efficacy in alleviating pain between intracanal medicaments, namely Nitrofurantoin and Calcium Hydroxide Paste.

Study Design:  Randomized Controlled Trial.

Place and Duration of Study: Sample: Department of Operative Dentistry, Sir Syed College of Medical Sciences, Pakistan, between January 2021 and May 2021.

Methodology: 60 patients were randomly divided into 3 groups, each group having 20 patients as following: Group 1: Nitrofurantoin, Group 2: Calcium Hydroxide and Group 3: Control. Preoperative pain was recorded using a numerical pain scale. After access preparation, chemomechanical preparation was performed with subsequent placement of intracanal medicaments. Pre-operative pain score was initially recorded, followed by post-operative pain at 12, 24, 48, and 72 hours, respectively. Root canal treatment was performed in single rooted teeth with patients suffering from symptomatic irreversible pulpitis

Results: Majority of the patients in all 3 groups were initially presented with moderate to severe pre-operative pain. After 72 hours post-operatively, 50% patients in Group 1 reported no pain, while 5% patients in both Group 2 and 3 had no pain. Pain significantly subsided in Group 1 as compared to Group 2 and 3. Regarding age and gender, both had no significant relationship with the pain scores in all of the 3 groups

Conclusion: Nitrofurantoin has been proven to be an effective intracanal medicament in alleviating immediate post-operative pain in patients with symptomatic irreversible pulpitis as compared to calcium hydroxide. While the control group with no intracanal medicament showed little reduction in pain scores. So, nitrofurantoin can be used as a substitute to currently available standard intracanal medicaments.

Open Access Original Research Article

Antibacterial Effect and Factors Influencing the Relationship between Coffee, Tea Consumption and Dental Caries

Samar Hatem Abuzinadah, Hawraa Alsunni, Rabab Al Jumian, Sarah Al Salman, Reham Al Faraj, Fatimah Al Matrook, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Page 500-505
DOI: 10.9734/jpri/2021/v33i46A32893

Aims: To assess the association between the frequency and quantity of coffee and tea consumption and dental caries severity among adolescents (middle and high schools) in the Eastern Province, Saudi Arabia.

Study Design: This is an observational cross-sectional study.

Place and Duration of Study: Conducted in the Eastern Province (Dammam and Al-Khobar), Saudi Arabia, from January to February 2019.

Methodology: A cross-sectional observational survey study that was carried out in Eastern Province, Saudi Arabia. Validated interview-based questionnaires were used to ask about the background information and the frequency and quantity of coffee and tea consumption with two sections of the survey: The first section was about the demographic data and the second section assessed the frequency and quantity of coffee and tea consumption and examination was done during daylight using disposable dental mirror and blunt probe.

Results: A total of 2265 middle school children with a response rate of 77.8%. Out of them, Females accounted for 1288 (56%) and the mean age (±SD) was 14 (±1.322). Regarding parents’ education, 1916 (84.6%) of participants’ fathers and 1836 (81.1%) of their mothers had a high school certificate or higher. There was a significant association between the frequency of coffee and tea consumption and caries (p=0.013).

Conclusion: There was a significant association between the frequency of coffee and tea consumption and caries (p=0.013). The frequency of coffee and tea consumption, the higher the caries. However, there was no association between the quantity of coffee and tea consumption and D nor with the overall DMF score.

Open Access Original Research Article

Lexical-semantic Properties in Parkinson's Disease with and without Dementia

Alkhanani Lamis, Alandas Nourah, Alzahrani Hamad

Journal of Pharmaceutical Research International, Page 506-518
DOI: 10.9734/jpri/2021/v33i46A32894

Dementia has important clinical consequences for patients with PD and their caregivers, which may negatively, affected their daily living activities and quality of life. Previous studies, have investigated the properties and characteristics of the words generated in semantic fluency task by patients with Alzheimer's disease, but this has not been investigated in PD patients yet. This study aimed to investigate if there are possible distinctive features that might differentiate between cognitive decline direct consequence of Idiopathic PD and that of Alzheimer’s type dementia associated with PD. There were six PD patients with dementia, six matched PD patients without dementia and six matched controls participated in this study. The present findings showed that although patients with dementia performed worse than those without dementia on all neuropsychological tests, significant differences were found only on the semantic fluency test and Frontal assessment battery. Furthermore, the present findings showed that patients with dementia produced fewer words in the semantic fluency task than healthy controls did. The words generated by demented patients were longer, less familiar, less typical and acquired later in life than the words produced by healthy controls. These findings might use for clinical application to distinct between PD patients with and without dementia.

Open Access Original Research Article

FEM Based Elasto-Electric Analysis of Elastomers for Pharmaceutical Applications

Rumesa Nazeer, Mehwish Afridi, . Marvi, Muhammad Umair Alam, Badar Ali, Sana Afzal Alvi, Kashif Iqbal

Journal of Pharmaceutical Research International, Page 538-549
DOI: 10.9734/jpri/2021/v33i46A32897

Elastomer materials are very important due to weak intermolecular forces and very low Young's modulus and have high failure strain. Due to these properties, they are used in a large number of applications especially in pharmaceutical industry and medical / surgical equipment etc. Electrostatic discharge on such material is a potential hazard for the operator who is dealing with elastomers.  In the research presented here, a detailed analysis on the elasto-electric analysis of 03x elastomers is analyzed in detail by using Finite Element Method (FEM). A CAD model is generated in accordance with an early research on elasto-electric study of Silicon material. Subsequently FEM based analysis is carried out to study vital electrostatics properties like Surface deformation and surface potential distribution developed on the application of external forces on 03x types of elastomers i.e. Silicon Rubber, Nitrile (NBR) and Poly Vinyl Chloride (PVC). The whole study is carried out in COMSOL multi-physics software. Analysis showed that the electric field developed on the surface of the elastomer is dependent on the deformation on non-linear nature and depends upon the material properties. FEM based results show that Silicon Rubber develops maximum deformation and electric potential of three chosen materials up to 50mm and 3150V respectively. Based on the conducted analysis, Silicon Rubber is widely recommended for its utilization in Pharmaceutical applications requiring electrostatics.

Open Access Original Research Article

To study to Assess the Effectiveness of Planned Teaching on Knowledge and Attitude Regarding Transmission and Prevention of HIV/AIDS among Students of Junior Colleges

Hina Rodge, Usha Waghmare, Ashvini Sayare, Harshit Tirkey, Kajal Gote, Kajal Neet

Journal of Pharmaceutical Research International, Page 582-592
DOI: 10.9734/jpri/2021/v33i46A32902

Introduction: HIV/AIDS is becoming a growing global danger to mankind. Since the first cases were reported, HIV/AIDS has been spreading at an alarming rate.

Background: In India, The age group of 15-24 years accounts for 35% of all AIDS cases, indicating that the younger population is especially vulnerable to epidemics.

Methods: The study was based on an interventional evaluatory approach and one group pretest-posttest design used. 60 junior college student samples were collected using Non-probability purposive sampling technique. one way ANOVA and t-test used to estimate the  association between post-test knowledge and posttest attitude score transmission and prevention of HIV/AIDS among students of junior college the and the selected demographic variables.

Results: This study revealed that the Mean value of the pretest knowledge score was 21.51 and the post-test knowledge score was 26.46 and the standard deviation of the pre-test knowledge score was ±4.96 and the post-test standard deviation was ±5.66. The t-value is 5.09 and the p-value is 0.0001. The mean value of the pretest attitude score was 28.48 and post-test attitude score was 40.25 and the standard deviation of the pre-test attitude score was ±4.13 and the post-test attitude score was ±2.45. The t- value is 18.98 and the p-value is 0.0001. There was a significant association of post-test knowledge score with the source of information about HIV/AIDS and there was no significant association of post-test attitude score regarding transmission and prevention of HIV/AIDS.

Conclusion: The study concluded that planned teaching on knowledge and attitude regarding transmission and prevention of HIV/AIDS among students of junior college was effective as a teaching strategy.

Open Access Original Research Article

Molecular Characterization of Flt3 Mutation in Acute Leukemia

Aamir Ramzan, Kiran Aamir, Anwar Ali Jamali, Khalil Ahmed Memon, Rameez Iqbal Memon, Irfan Ahmed Bhatti, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 601-606
DOI: 10.9734/jpri/2021/v33i46A32904

Background: Fms-like Tyrosine Kinase 3 (FLT3) has an important role to perform in hematopoietic malignancy pathogenesis. Hence the focus of several studies has recently been FLT3.

Objective: To determine the molecular characterization of FLT3 mutation in patients of acute leukemia.

Methodology: This descriptive analysis was carried out from January 2018 to December 2018 upon a sample of 94 newly diagnosed cases of acute leukemia (chosen via non-probability, consecutive sampling) presenting to the Department of Pathology, Liaquat University of Medical & Health Sciences, Jamshoro. After taking informed written consent, Data were obtained from laboratory records and patient interviews were noted down with the help of structured questionnaire. SPSS v. 20.0 was used for analysis of the obtained data.

Results: The mean age of participants was 41 years (±19 SD). 59.57% of the sample comprised of males while the remaining 40.43% were females. Among the total of 94 patients studied, patients with acute lymphoblastic leukemia (ALL) were 41 in number while those with acute myeloid leukemia (AML) were 53. The polymerase chain reaction verified FLT3 mutations in 6 (11.32%) out of 53 AML cases and 2 (4.88%) among 41 ALL cases. In acute myeloid leukemia (AML) FLT3 mutation was more prevalent among the older age set (51 and above), while in acute lymphoblastic leukemia (ALL) the FLT3 mutation was more commonly seen a comparatively younger patient age set (21 to 30 years).

Conclusion: It was found out that the FLT3 mutations are not uncommon in our study setting. With a greater prevalence observed among older male patients. AML was more common than ALL, with greater incidence rate of FLT3 mutations observed in the AML patients.

Open Access Original Research Article

Butea Monosperma Shows Anti-cancer and Anti-Oxidant Activity: In-vitro and In vivo Study

Prashant Ajmire, Rakesh Patel, Nandu Kayande, Ravindra Bakal

Journal of Pharmaceutical Research International, Page 615-628
DOI: 10.9734/jpri/2021/v33i46A32906

Breast cancer is one of the predominant cancers in Indian subcontinent and the global scenario is not very different. Treatment of this type of cancer is possible by chemotherapy, surgery, and radiotherapy, which relieve the patient; however, off target activity and severe toxicity of non-cancerous cells remained the major drawbacks of these chemotherapeutics. In order to overcome these issues, modern cancer therapeutics emphasizes the implication of natural bioactive compounds. In this current piece of work, we have studied the anti-cancer potentiality of Butea monosperma flower in in vitro breast cancer cells. Various extracts of this flower were found to be non-toxic to breast epithelial cells but toxic to breast cancer cells. However, the methanol extract of this flower was most effective amongst all other extracts. Data suggest that Butea monosperma flower induce DNA damage mediated apoptosis and inhibit cell proliferation, angiogenesis and metastasis. It also inhibits the angiogenesis and metastasis in xenograft mice model system. Moreover, the anti-cancer phenomenon was found to be induction of inflammatory cytokines mediated oxidative stress in breast cancer. Collectively, Butea monosperma flower shows excellent cancer therapeutics in order to induce DNA damage, inhibit angiogenesis and metastasis simultaneously.

Open Access Original Research Article

Anti-Inflammatory Drugs and Usage of Them among Saudi Population: Knowledge and Attitude Assessment

Khalid A. Algamdi, Muteb A. Aldajam, Fadiyah D. Alanazi, Alya M. Rajab, Rasha S. Alshammari, Muhannad A. Almohaimeed, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Page 370-378
DOI: 10.9734/jpri/2021/v33i46A32877

Aims: To measure knowledge and attitude among the Saudi population about non-steroidal inflammatory drugs.

Study Design: This is an observational cross-sectional study.

Place and Duration of Study: Conducted in the north region of Saudi Arabia between June 2020 and July 2021.

Methodology: The data collection done by using an electronic questionnaire. Total sample size of 1018 participants, aged between 15-60, Female and Male, agree to participate. Each person meeting the inclusion criteria was provided informed consent, explaining the study aim, and ensuring the confidentiality of information. Data were obtained by filling out the designed Questionnaire.

Results: A total of 1018 participants completed the survey questionnaire. About 81% of the study participants stated that they have a history of analgesic use without physician prescription in the past six months. More than 30% of participants stated that the pharmacist is the frequent source of recommendation about medication. The most common indication for the participants to use analgesia was headache followed by insomnia.

Conclusion: The awareness and attitude of the participants to NSAIDs' usage and its complications was not that adequate. Paracetamol was the most usually used analgesic. It must to teach and strengthen the awareness among citizens about the proper method to use NSAIDs.

Open Access Review Article

Investigating the Impact of Machine Learning in Pharmaceutical Industry

S. Nagaprasad, D. L. Padmaja, Yaser Qureshi, Sunil L. Bangare, Manmohan Mishra, Bireshwar Dass Mazumdar

Journal of Pharmaceutical Research International, Page 6-14
DOI: 10.9734/jpri/2021/v33i46A32834

In the pharmaceutical and consumer health industries, artificial intelligence and machine learning played an important role. These technologies are critical for the identification of patients with improved intelligence applications, such as disease detection and diagnostics for clinical testing, for medicine production and predictive forecasts. In recent years, advances in numerous analysis tools and machine learning algorithms have led to novel applications for machine learning in several areas of pharmaceutical science. This paper examines the past, present, and future impacts of machine learning on several areas, including medicine design and discovery. Artificial neural networks are employed in pharmaceutical machine learning because they can reproduce nonlinear interactions typical in pharmaceutical research. AI and learning machines are examined in everyday pharmaceutical needs, industrial and regulatory insights.

Open Access Review Article

Understanding the Pathophysiology of Tourette’s Syndrome: A Review

Ritu P. Guha, Manish Dhall, Prity Lather, Kulwant Singh, Renu Kadian, Ashwani Arya

Journal of Pharmaceutical Research International, Page 50-71
DOI: 10.9734/jpri/2021/v33i46A32840

Tourette’s syndrome (TS) is a neuropsychiatric and neurodevelopment disease typified by deterioration of motor and vocal tics which leads to neuropsychiatric symptoms and impaired motor activities manifestation. Several lines of study indicate the interplay of genetic and environmental factors to be involved in this complex neuropsychiatric syndrome. Approximately 1% people are affected worldwide from this syndrome. In this review, a concise outline presented on the classification, its clinical features and neuropsychiatric co-morbidities linked with this syndrome. This paper also highlights the neurochemistry, dysfunction of (Cortioc-Striato-Thalamo-Cortical) CSTC circuits in TS and an overview on the management approach towards the prevention of TS. Regardless of the major improvements in the understanding of exact cellular and molecular basis of TS, the various evidence indicate that the various neurotransmitter such as dopamine, glutamate, gamma- aminobutyric acid (GABA), serotonin, noradrenergic, cholinergic system, serotonergic system and histaminergic pathways play a major role in pathogenesis of TS. Several research indicates that the dysfunction of CSTS circuits occurred in this complex syndrome These areas of research have contributed to the therapeutic approach towards the management of TS and also provide the basis for future progress of the therapeutic strategies. Thus, tics generated in TS, which affect the social and academic life of patients and disruptive or troubling the family of patients. Patients existing with this syndrome have to face difficulties integrating into social life and coping with day to day basis activities, as a consequence of the syndrome.

Open Access Review Article

Overview of Epidemiology and Management of Undescended Testis (Cryptorchidism)

Haider Osman Elmisbah, Fay Melfi Sayer Alenezi, Raghad Khalid R. Alruwaili, Sama Abdulfattah M. Almadani

Journal of Pharmaceutical Research International, Page 81-87
DOI: 10.9734/jpri/2021/v33i46A32842

Cryptorchidism (undescended testis, maldescendus testis) is a disorder in which one or together testes miscarry to slope into the bottommost of the scrotum. The study aimed to summarize the updated evidence regards, epidemiology, etiology, classification, diagnosis, and treatments of Cryptorchidism or undescended testis. Several causes can result in developing cryptorchidism. Disruption of any phase of testicular prolapse due to genetic hormonal, structural, ecological, or social issues can lead to cryptorchidism. The diagnosis of undescended testes is clinical. The test should be performed by an experienced person and should always be performed using a two-way technique. In some cases, imaging diagnostics for cryptorchidism may be helpful. The rationale for treating cryptorchidism is to reduce the risk of its long-term consequences. Current treatments for undescended testes include hormone therapy, orchopexy, and surgical correction.

Open Access Review Article

Promotion of Children Health with Giving Supplement of Rainbow Nutrition: A Review

Sagar Alwadkar, Pratibha Wankhede, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 88-92
DOI: 10.9734/jpri/2021/v33i46A32843

Introduction: "Eat the Rainbow" is an educational approach intended to encourage children to incorporate fruits and vegetables in their daily diet so that they can receive all the foods they need for their health. According to UNICEF, school children are the future generation of tomorrow, the age group from 6 to 12 years is considered the school-age children. They grow steadily but gradually and generally eat four to five times a day, which include snacks. Maintaining their health, development, and growth during this age group is extremely important. These age groups of children face rapid mental and physical development and therefore proper nutrition is very crucial at this point in life. In children, the eating habits developed at birth usually persist into adulthood. Eating habits are influenced by food choices. During this time many dietary habits, likes, and dislikes are established. Parents, friends and especially television media affect their food choices and eating habits.

Open Access Review Article

Social Responsibilities in COVID-19: Pandemic

Mayur B. Wanjari, Deeplata Mendhe, Pratibha Wankhede, Sagar Alwadkar

Journal of Pharmaceutical Research International, Page 149-153
DOI: 10.9734/jpri/2021/v33i46A32851

Recent coronavirus discovered causes the coronavirus infection COVID-19 is also an infectious disease known to cause severe respiratory infections. This most recent virus and infection were unidentified until the epidemic in Wuhan in December 2019, China. Coronavirus has spread around the world and been declared a pandemic by the WHO. The disease has infected several nations, including Italy, Spain, and the United States, with brutality as the death rate rises day by day. The illness may transmit to cough or sneezes via small droplets. Therefore, social distancing is the only way to prevent the transmission as There is no vaccine available for prevention from thecoronavirus. One can reduce the chances of being infected by taking some social distancing measures which will reduce COVID-19 transmission. In the pandemic COVID-19, every individual’s responsibility is to follow all the social distancing measures, to follow the lockdown without being casual about the disease, to save our self, our family, community, and nation from novel coronavirus.

Open Access Review Article

An Overview of Aortopulmonary Window

Dhanvijay Roshani, Raut Arti, Dhobe Sonal, Dighikar Vrushali

Journal of Pharmaceutical Research International, Page 169-174
DOI: 10.9734/jpri/2021/v33i46A32854

Aortopulmonary (AP) window is exactly a rare congenital anomaly that represents approximately 0.2 and 0.5% of all congenital heart abnormalities. It consists of communication between the aorta and the pulmonary artery or its branches. Although closely related to AP window, the pulmonary artery origin from the ascending aorta (also termed “hemitruncus”) is classified as a separate defect. AP window was first described by Elliotson in 1830 in an autopsy study. In 1948, Robert Gross successfully ligated an AP window in a patient undergoing a thoracotomy for closure of a patent ductus arteriosus (PDA). In 1957, Cooley and associates described the first successful repair of AP window using cardiopulmonary bypass. Aortopulmonary window occurs due to the abnormal development of the heart’s major blood vessels during early fetal growth. In most cases, this heart defect occurs by chance, with no clear reason. This condition can occur on its own or with other heart defects such as: 1. Tetralogy of Fallot, 2. Pulmonary atresia, 3. Truncus arteriosus, 4. Atrial septal defect, 5. Patent ductus arteriosus, 6. Interrupted aortic arch. Treatment for aortopulmonary window involves surgery to close the hole between the aorta and the pulmonary artery with a patch or device. This surgery is normally done as soon as possible after the diagnosis is made, usually when the child is a newborn. Associated lesions are usually repaired during the same surgery. Associated lesions are usually repaired during the same surgery. More complex repairs and myocardial protection strategies are required in patients with associated lesions, increasing the morbidity and mortality associated with the operation.

Open Access Review Article

Clinical Presentations of Patients with Chronic Rhinosinusitis

Ahmad Mujahed Abdulqader Mousa, Zadorozhna Anna, Dieieva Julia, Tereshchenko Zhanna, Konovalov Serhii

Journal of Pharmaceutical Research International, Page 257-263
DOI: 10.9734/jpri/2021/v33i46A32864

Purpose of Review: Chronic rhinosinusitis (CRS) is denoted as the symptomatic inflammations of sin nasal mucosa persists for ≥12 weeks. The purpose of this study was to review the recent literatures for digging out a clear concept on the clinical presentations of patients with chronic rhinosinusitis and assess the potentialities of the features.

Recent Findings: According to the findings, descriptions and discussions of several recent studies it was observed that, a package of clinical features and presentations are associated with chronic rhinosinusitis. Some are major and some are minor potentials. The frequencies and severities of symptoms and features are directly dependent on the duration of that disease.

Summary: Basically, rhinosinusitis or CRS is an inflammatory and infectious disease which affects the nasal cavities as well as the paranasal sinuses of patients. Rhinosinusitis with polyps is more common in male than that in female. There are many possible clinical features of CRS. But as per the frequencies, duration and effects nasal congestion, nasal discharge (Anterior/posterior nasal drip), pain/pressure on the face, impaired ability to smell (Hyposmia/anosmia), dizziness, fever and cough are the most common clinical features of chronic rhinosinusitis.

Open Access Review Article

Global Perspective of Paediatric Pharmacovigilance and its Importance: Where Have We Reached?

S. Narmada, M. P. Gowrav, Akhilesh Akki, Vishakharaju Motupalli, V. Balamuralidhara, M. P. Venkatesh

Journal of Pharmaceutical Research International, Page 276-288
DOI: 10.9734/jpri/2021/v33i46A32867

Pharmacovigilance is a tool proposed during the post-marketing process of the pharmaceutical product lifecycle to monitor drug safety in everyday life and to identify adverse drug reactions. The identification of adverse reactions, however, is a significant cause of concern and a challenge to pharmacovigilance structures. Regulators use three basic principles in determining the risk-benefit balance to decide whether to approve a drug or a biological product and to maintain it on the market: safety, quality and effectiveness. In particular, paediatric patients, especially new-borns and infants, are at risk of drug-related adverse reactions. Drugs are also prescribed in an unlicensed and/or off-label manner to new-borns, infants and teenagers, leading paediatric patients to a higher risk of experiencing adverse drug reactions (ADRs). ADRs in children < 2 years of age are often reported and can often be alarming. The practise of paediatric pharmacovigilance needs to be strengthened by stimulating spontaneous paediatric reporting and successful post-marketing surveillance. The current study highlights the importance of paediatric pharmacovigilance and the role of different stakeholders like healthcare providers, regulators, and consumers in increasing the ADR reporting rate. Also, it discusses the pharmacovigilance tools and various initiatives that are taken by various regulatory authorities like the United States, the United Kingdom, Japan, and India.

Open Access Review Article

Effects of Iron Deficiency Anaemia on HbA1c Levels in Non-Diabetics and Diabetics

Ayushi Singh, Arvind Bhake, Anil Agarwal, Sunita Vagha

Journal of Pharmaceutical Research International, Page 342-347
DOI: 10.9734/jpri/2021/v33i46A32874

Background: Iron deficiency anaemia is one of the most common anaemia striking in our country. The level up to which blood sugar level is regulated is measured by HbA1c. HbA1c represents sugar level in the blood for 120 days. HbA1c could be dependent upon an assemblage of factors like variants of haemoglobinopathies, haemolytic anaemia, other deficiency anaemia, acute loss of blood, uraemia, and pregnancy. Thus, it is crucial to determine the role of HbA1c in iron deficiency anemia in diabetics and non-diabetics before treating the patients.

Methods: Total of 58 articles were collected and based on our study objective total of 19 articles were included in this study. Iron deficiency anaemia, HbA1c, diabetics and non-diabetics has been added in pub med advanced searches and Google scholar. Original articles which compare the correlation between these two were taken. All the information was gathered from original and review articles.  Articles which were qualified for review, their inclusion criteria, exclusion criteria, quality of assessment and data collections were taken into consideration. Structure of heme particle, basic mechanism of HbA1c formation in RBCs is elaborated. Review articles which were taken include RCT, retrospective analysis and observational studies. The results were all compared and concluded of each articles. Basic mechanism of formation of HbA1c in RBCs is shown. Also necessary conclusions were derived from each study.

Results: In a wide range of studies, HbA1c was found to be raised in IDA. After iron supplements, studies showed a decrease in HbA1c. Our study showed there is a need to correct anemia in diabetic patients before starting treatment.

Conclusions: Strict HbA1c control is not a prerequisite and prior anaemia correction should be done. Nevertheless, a study which will be conducted in representative population matching to the prevalence and incident of disease in our country also which should be interventional is required for the highest correction value of HbA1c in DM and NDM population.

Open Access Review Article

Progress in Clinical Application of Positive End-Expiratory Pressure

Wu Zhaoxia, Wen Xianjie

Journal of Pharmaceutical Research International, Page 526-537
DOI: 10.9734/jpri/2021/v33i46A32896

In the surgery patient under general anesthesia doesn’t breathe spontaneously, and lung movement is completely dependent on the mechanical ventilation of the anesthesia machine. In order to achieve effective and safe mechanical ventilation of the patient’s lungs during the operation, the concept of lung protective ventilation strategy (LPVS) was proposed, that is, the use of a low tidal volume and an appropriate level of positive end expiratory pressure (PEEP) to reduce alveolar overexpansion and prevent alveolar collapse. In the past, PEEP was an important measure to treat acute lung injury(ALI) or acute respiratory distress syndrome(ARDS) by improving oxygenation and reducing pulmonary edema. Subsequent studies found that PEEP not only be used to treat patients with ALI or ARDS, but also can reduce the incidence of postoperative pulmonary complications(PPCs) in some thoracoabdominal operations. Moreover, PEEP can prevent atelectasis during and after surgery in patients undergoing thoracic and abdominal surgery under general anesthesia, and decrease the incidence of postoperative infection. However, PEEP can affect venous return by increasing intrathoracic pressure, thereby causing changes in heart function and hemodynamics, and indirectly affecting intracranial pressure and renal function. Therefore, with the widespread clinical application of PEEP, more and more people are starting to focus on how to choose the appropriate PEEP. This article reviews the research progress of PEEP selection method, the influence of PEEP on physiological function and the clinical application of PEEP during mechanical ventilation.

Open Access Review Article

Dental Management in the Immunocompromised Children: A Review

Abdulrahman Kamal Habash, Firas Walid basoudan, Hassan Adnan Alwayel, Bassam Walid Alarfaj, Ali Naji Alwayel, Jafar Ali Alaithan, Mushary abdullah alzuhiri, Ghada Sami Alduraye

Journal of Pharmaceutical Research International, Page 154-160
DOI: 10.9734/jpri/2021/v33i46A32852

Oral manifestations of oropharyngeal infections in immunocompromised individuals pose a unique challenge for medical and dental specialists, as clinical signs and symptoms could be minor, making correct diagnosis and treatment difficult. Effective infection control and oral symptom management are critical, and they can be done by the careful use of topical and systemic medicines, as well as proper oral hygiene. According to current guidelines, children should receive an oral examination before starting cancer treatment.  Before the commencement of cancer treatment–related oral issues, a pretreatment examination helps develop a dentist-child relationship. Intensive mouth care is critical because it reduces the chance of developing moderate/severe mucositis while also reducing the risk of septicemia and oral infections. Almost all of the therapy's oral side effects are caused by stomatotoxicity, either direct or indirect. The purpose of therapy for this patient group is to keep the oral mucosa healthy, avoid secondary infection, relieve pain, and maintain nutritional intake. In this narrative review we will be looking at evaluation, prevention and management of dental complications in immunosuppressed children.

Open Access Review Article

A Review on Nutritional and Dietary Intervention for Autism Spectrum Disorder

Ahmed Abdelsamie Fadl, S. Aljahdali, Sarah Mujir, S. Alraddadi, Shahad Awad

Journal of Pharmaceutical Research International, Page 550-558
DOI: 10.9734/jpri/2021/v33i46A32898

In this review we will be looking at nutritional intervention that can be used to achieve better results in management and treatment of autism spectrum disorder. Eating disorders are widespread in children with autism and autism spectrum disorders (ASDs). Their penchant for high-energy, low-nutrient foods can change their metabolism, creating an accumulation of reactive radicals and mental and physical deterioration. Probiotics, which are live microorganisms that provide a health benefit to the host when given in sufficient amounts, are gaining popularity as a potential treatment option for ASD. Studies shows that using of special and alternative nutritional diets can achieve better results for children with autism however some of these studies shows that the true effectiveness of such approaches is minimal if not lacking at all. It is recommended that there are many factors that play role in outcomes of theses treatment therefor more research is must in order to draw clear conclusion weather or not using of alternative diet is effective enough and if so, what’s the best guidelines for it.

Open Access Review Article

Complications of Covid-19 on Sickle Cell Patients in Children

Ahmed Abdelsamie Fadl, Duaa Salem Balkhi, Bayan Khalid Binyamien

Journal of Pharmaceutical Research International, Page 559-565
DOI: 10.9734/jpri/2021/v33i46A32899

Sickle cell anemia is serious condition. People who have the disease when get infected with Covid-19 are more likely to suffer more complications. In this paper, we report the prevalence of complications of sickle cells of children infected with covid-19 virus. As pathogen detection campaigns have gotten more prevalent, the number of patients diagnosed with COVID19 has increased substantially. The majority of children diagnosed with COVID19 have moderate symptoms; the most common clinical signs in children with COVID19 are fever and cough. Fatigue, myalgia, upper respiratory tract symptoms, sore throat, headache, dizziness, and gastrointestinal problems.

Open Access Review Article

Overview on Thyroid Disorders and Stress

Arub Adnan Yousef, Sultanah Rawi Abdullah Alanazi, Fatimah Mofareh Murid Alanazi, Sarah fereih meraid alenezi, Ahmed Mahmoud R Abdullah, Mohammed Ghannam Thallab Alharbi

Journal of Pharmaceutical Research International, Page 575-581
DOI: 10.9734/jpri/2021/v33i46A32901

Background: Several studies have found a link between stress and thyroid disorder, the majority of evidence supporting stress contributing to the start and progression of autoimmune illness is circumstantial, and the mechanisms by which stress impacts thyroid is not fully understood. Study aims to summarize the current evidence regarding relation between thyroid disorders and stress.

Methodology: MEDLINE, Embase, CINAHL, Psyc Info, and ASSIA were searched and reference lists of included studies were searched. Studies were included that described relation between stress and thyroid disorders. No software has been utilized to analyze the data. The data was extracted based on specific form that contains (Author’s name, publication year, country, methodology and results).

Results: The search of the mentioned databases returned a total of 87 studies that were included for title screening. 54 of them were included for abstract screening, which lead to the exclusion of 32 articles. The remaining 22 publications full-texts were reviewed. The full-text revision lead to the exclusion of 13 studies, and 9 were enrolled for final data extraction.

Conclusion: There is evidence regarding the association of thyroid disorders with stress. These findings add to the growing literature suggesting that thyroid function changes may be associated with stress.

Open Access Review Article

A Review on Recommendations for the Maintenance of Implant Supported Restorations

Ashwag Siddik Noorsaeed, Asiri, Alaa Mohammad A., Abdulmalk Abdulatif A. Almaghrabi, Alshawi, Eyad Ibrahim N., Rinad Ameer Nawab, Fahad Khaled M. Alkahtani, Abdullah Saad Alqarni, Reema Abdulaziz D. Alsaadi, Deemah Muneer Alhamawi, Ayman Hasan Kaabi, Khalid Ahmed H. Aljehani, Sana Zaki Alburaiki, Osama Saeed Aljuraysh

Journal of Pharmaceutical Research International, Page 593-600
DOI: 10.9734/jpri/2021/v33i46A32903

Implant placement necessitates an interdisciplinary approach in which a team of dental implant specialists, including an oral surgeon, prosthodontist, periodontist, and oral radiologist, collaborate on the design, execution, and maintenance of the implants to provide the best possible result. According to the data, the vast majority of the participating dentists provide implant-supported restorations to their patients on a regular basis. Surprisingly, the percentage of dentists who plan implant placement and employ backward planning methods was significantly lower. This finding implies that dentists do not always follow the current scientific consensus that the placement of an implant should be based on prosthetic principles.

Open Access Review Article

Total Laparoscopic Hysterectomy Versus Abdominal Total Hysterectomy

Mazen Bishrah, Abdullah Mohammedamin M. Tashkandi, Abdulelah Khalid A. Bahabri, Hessa Khalid Almuhaisen, Mawadah Ismaeel Nooh, Fatimah Hussain Ali Dallak, Joud Awad Alhamdi, Rahaf Ahmed Alrashidi, Ahmad Abdulrahman Rahbeeni, Amjad Ali Albannay, Albatool Wali Gotah, Yousuf Loai F. Ramadan, Sara Abdulmohsen Almulhim, Alanoud Abdulaziz Alharkan

Journal of Pharmaceutical Research International, Page 607-614
DOI: 10.9734/jpri/2021/v33i46A32905

Hysterectomy is one of the most prevalent surgical procedures in the United States. Vaginal hysterectomies have been successfully performed for nearly two centuries. Abdominal hysterectomy remains the most prevalent surgical strategy, with laparotomies accounting for well over half of all hysterectomies With technology advancement more and more better surgical procedures are being developed which are less invasive and have less complications, Abdominal total Hysterectomy was for many years the gold standard for many cases until development of Total Laparoscopic Hysterectomy, which overall has better recovery time, less blood loss, less tendency of infection and less minor complications. This review aims to compare abdominal total hysterectomy and total laparoscopic hysterectomy in terms of recovery and complications.

Open Access Review Article

Causes and Management of Lower Gastro-Intestinal Bleeding

Mohammed Salah Hussein, Ziyad Abdullah Alshagawi, Noor Abdulhakim M. Al Fateel, Hossam Mohammed Alashhab, Alenzi Meshari Mosleh, Osamah Abdulmonem Almutawa, Abdulrahman Oun Alshahrani, Mohammed Faisal G. Alahmadi, Saleh Kamal Alzahrani, Wed Mohammed Khorami, Naif Mohammed Al-Wagdani, Abdalrhman Nbil Bokhari, Wafa Faisal W. Aljadrawi

Journal of Pharmaceutical Research International, Page 629-635
DOI: 10.9734/jpri/2021/v33i46A32907

Gastrointestinal (GI) bleeding from the colon is a communal reason for hospitalization and is being more frequent in older patients. Gastrointestinal bleeding is known as any bleeding that takes place in the GIT from mouth to anus. Lower GI bleeding is defined as bleeding distal to the ligament of Treitz. Lower GI bleed is typically presented as hematochezia which is the passing of bright red blood clots or burgundy stools through the rectum. The causes of lower GI bleeding are changing over the past several decades from diverticulosis (which is the protrusion of the colon wall at the site of penetrating vessels), infectious colitis, ischemic colitis, angiodysplasia, inflammatory bowel disease, colon cancer, hemorrhoids, anal fissures, rectal varices, dieulafoy lesion, radiation-induced damage following cancer treatment to post-surgical. Management of lower GI bleeding is done through assessing the severity of symptoms and the condition of the overall case.