Open Access Systematic Review Article

Effectiveness of Health Interventions towards HIV/AIDS in Developing Countries: A Systematic Review

Sarmad Jamal Siddiqui, Rosnah Sutan, Zaleeha Md Isa, Arshad Hussain Laghari, Vijia Kumar Gemnani

Journal of Pharmaceutical Research International, Page 540-555
DOI: 10.9734/jpri/2021/v33i47A33044

Background: Plentiful development has been achieved in interventions for the prevention of HIV. Although, progression of prevention programs based on evidence – informed methods that interpret the effectiveness of these approaches in population is still a challenge. In developing countries, not many interventions are implemented for reduction of HIV burden. The single most important identified problem is lack of demand, supply, and adherence approaches. In current systemic review, recent evidence for the prevention of HIV in a cascade manner is described to see status of current interventions and further needs for improvements.

Methodology: Systemic reviews regarding effectiveness on interventions of HIV prevention were searched. Primary studies were identified from eligible review that evaluated one of following factors: prevalence of HIV, incidence of HIV, testing uptake of HIV and use of condom. Interventions were categorized that pursued demand for prevention of HIV, improvement in supply for preventive approaches, support related to preventive behaviors or prevent HIV directly. A rating was assigned for each intervention based on evidence strength or randomized controlled trials.

Results: Out of 91 eligible reviews, 264 primary studies were included in this review. Primary studies related to direct mechanisms of prevention that showed strong data for circumcision and effectiveness of pre – exposure prophylaxis. Evidence implies that interventions related to increased supply of preventive methods including clean needles or condoms can be operative. Interventions related to demand – side and adherence approaches were less clear with some studies showing effectiveness. Quality evidence was assessed among various categories. Various interventions showed supportive outcomes and results. In our findings, it was observed that difference between behavioral and structural has not evidently distinguished the interventions.

Conclusion: Growing data is present for the support of effectiveness of products, behaviors, and procedures for prevention of HIV. In developing countries, negligible data is present for implementation of such approaches on community level. Interventions will be required for transforming this evidence to produce impact on population. It will empower the demand for prevention of HIV, supply of preventive technologies and utilization of preventive approaches against HIV. The findings can be eye opener to see actual burden of HIV and their implanted interventions and can be useful to design further intervention programs in future.

Open Access Case Study

Histopath Salpingo-oophorectomy Cervical Moderate Dysplasia: A Case Report

Kalyani Ambule, Manjusha Mahakarkar, Bali Thool

Journal of Pharmaceutical Research International, Page 66-71
DOI: 10.9734/jpri/2021/v33i47A32990

Introduction: Cervical dysplasia is a term used to describe a condition that is on the verge of becoming malignant where aberrant cell proliferation takes place on the cervix or endocervical canals surface lining. Another name for it is cervical intraepithelial neoplasia (CIN) can occur at any age. It has a strong relationship to human papillomavirus (HPV) infection spread through sexual contact.

Case History: A case of 34 year old woman admitted in gynecology unit on date June 3, 2021, a month ago when she started experiencing pain in abdomen. It was insidious in onset, continuous type, not associated with bleeding per vaginal. Patient has previous history of five abortions. Patient underwent investigations like complete blood count, kidney function test, liver function test, radiographic investigations and colposcopy where she was found to have moderate dysplasia and chronic cervicitis. Histopathology report also indicated moderate dysplasia with chronic cervicitis.

Interventions: Primarily, the pain management is necessary for such patients. Later on all further investigations and procedures performed to confirm the diagnosis and treat the patient accordingly. The aim during the treatment is to safeguard the life and further complications.

Outcomes: Over this period of long course treatment, the patient significantly reduced the severity of infection and pain. Improved the daily activities, appetite and sleep. Progress of patient towards her goal of recovering as early as possible.

Discussion: The patients response was quite good to treatment, however additional interventions could be used in the future for her greater improvements in disease.

Open Access Case Study

Case Report on Paranoid Schizophrenia with Capgras Syndrome

Pooja Kasturkar, Jaya Pranoykumar Gawai, Tessy Sebastian, Trupti Uke, Dharti Meshram, Shabnam Sayyad, Samual Vanlalpeka

Journal of Pharmaceutical Research International, Page 72-77
DOI: 10.9734/jpri/2021/v33i47A32991

Paranoid is the most common delusion in people living with schizophrenia spectrum disorders which are present in about half of all people seeking treatment for a psychotic disorder. Schizophrenia is a persistent mental illness characterized by a wide range of symptoms, including delusions, hallucinations, disorganized speech or behavior, and cognitive impairment. Capgras syndrome is a form of the delusional belief in which a person has been replaced by an imposter. It can be seen in mental disorders as well as in central nervous system diseases in the form of neurodegenerative and non- neurodegenerative diseases The Capgras Syndrome is not an unusual condition, but an infrequent one which is possibly often unnoticed. A 48- years- old woman was admitted in female psychiatric ward with known case of paranoid schizophrenia with capgras syndrome. In the present case, the treatment approach was mainly somatic therapy i.e. psychopharmacotherapy, Electro convulsive Therapy (ECT) and psychological therapy. Psychiatric nurses have to play an important role to identify the symptoms and they should think critically, take action immediately to provide care to such type of patients.

Open Access Case Study

A Case of Rheumatoid Arthritis Associated with Microcytic Anemia

Jaya Khandar, Achita Sawarkar, Madhuri Shambharkar, Pooja Kasturkar

Journal of Pharmaceutical Research International, Page 114-117
DOI: 10.9734/jpri/2021/v33i47A32996

Rheumatoid arthritis (RA) is one of the most common inflammatory arthritides. It is associated with multiple systemic features, including hematological manifestations such as anemia, neutropenia and thrombocytopenia. However, immune hemolytic anemia is extremely rare with only 3 reports indexed in medline, and one of them being due to methotrexate toxicity.

Microcytic anemia is a condition in which the body's tissues and organs do not get enough oxygen. This lack of oxygen can happen because the body does not have enough red blood cells, or because the red blood cells do not contain enough hemoglobin, which is a protein that transports oxygen in the blood.

Case Presentation: A 60 year old female a known case of rhematoid arthritis and hypothyrodisam in 2013 for last past 3 years. Who presented to us with history of recurrent anemia . In march 2021, she was admitted to hospital because of palpitations and shortness of breath due to severe anemia. Results of laboratory studies were hemoglobin, 6.9 gm/dl and haptoglobin, less than 29.8mg/dl. A diagnosis of anemia was made on the basis of the laboratory findings She was transfused with 1units packed red blood cells (pRBCs) over less than 6 hours. High-dose PSL (50 mg/day) was started, and the anemia improved. The hemoglobin level increased to 7.0 gm/dl within the 1st week.

Conclusion: The differential diagnosis of various hematological disorders should include rheumatic autoimmune diseases among other causes of blood cell and hemostasis abnormalities. It is crucial that hematologists be aware of Treatment should be administered promptly, with rheumatological consultation.

Open Access Case Study

Guillain-Barré Syndrome: A Rare Case Report

Roshani Dhanvijay, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 263-267
DOI: 10.9734/jpri/2021/v33i47A33012

Introduction: Guillain-Barré syndrome (GBS) is a rare neurodegenerative condition in which the immune system of the body mistakenly damages a portion of the peripheral nerve system. The initial signs are general weakness and numbness in the limbs. Initial symptoms occur within a few days or weeks of infection. These symptoms can spread fast, ultimately paralyzing the entire body. The peripheral system consists of the brain and spinal cord.  The nerve network is found outside of the brain and spinal cord. GBS can range from a minor case with short weakness to a completely fatal paralysis that renders the individual unable to breathe on their own. Fortunately, even the most severe instances of GBS may be recovered from. Some people will remain feeble even after they have recovered.

The majority of patients reach the peak of their weakness within the first two weeks of symptoms appearing; by the third week, 90 percent of those affected are at their weakest. Symptoms of muscle weakness include difficulty with muscles of the eyes and vision, swallowing difficulties, difficulty in speaking, or chewing, pricking or pins and needles sensations in the hands and feet, pain that can be severe, especially at night, coordination problems, and unsteadiness, abnormal heartbeat/rate or blood pressure, problems with digestion and/or bladder control, and problems with digestion and/or bladder control.

Background: Guillain-Barré syndrome can affect anyone. It can attack at any age (though it is more common in adults and the elderly), and both sexes are equally susceptible to the condition. GBS is predicted to afflict one in every 100,000 people each year. GBS affects between 3,000 and 6,000 persons in the United States each year.

Case Presentation: A 53 years old male patient came to the hospital with the chief complaint of weakness in all four limbs for 6 days. A patient was apparently alright 6 days back later he was experience weakness in the left side of the body following covid vaccination on 4th June, weakness was gradually progressive in nature and progress to the right side of the body after 2 days. Later on, 8th of June patient got admitted to GMC yavatmal where the routine investigation was done including a CT scan brain which normal and doctors ask for an MRI brain for which the patient and his relative had taken a DAMA discharge and brought the patient to AVBR Hospital. All investigation has been done after that the physician diagnosed the patient having Guillain barre syndrome. The patient weakness has been worse and the treatment start according to the disease condition. Medical treatment including physical therapy also been started to reducing physical weakness and the patient condition is improved day by day.

Intervention: The intervention was given to the patient such as injection ceftriaxone 1 gm BD, Inj pan 40 mg OD, Inj Emset 4 mg  TDS, Inj optinurone 1 Amp in 100 ml normal saline.

Open Access Case Study

Pulpectomy with Bi-Rooted Primary Maxillary Canine: A Case Report

Sneha Himmatrao Khekade, Arun Sajjanar, Miranda George, Niharika Gahlod, Suryakant Kumar, Milind Wasnik

Journal of Pharmaceutical Research International, Page 502-505
DOI: 10.9734/jpri/2021/v33i47A33039

Bi-rooted canines are extremely uncommon in the primary dentition and are only diagnosed after a radiographic examination. Endodontic success in teeth with more canals than are typically discovered necessitates an accurate diagnosis and a thorough clinical radiographic examination. To avoid complications, morphological differences in pulpal anatomy must be identified prior to treatment. Here we report a case of Pulpectomy in a bi-rooted primary maxillary canine.

Open Access Case Study

Case Report on Encephalitis

Pallavi Shridhar Dhulse, Bibin Kurian

Journal of Pharmaceutical Research International, Page 645-649
DOI: 10.9734/jpri/2021/v33i47A33055

Background: Encephalitis is type of brain inflammation caused by a virus, although it can also be caused by a bacterial or fungal infection or an autoimmune reaction. Encephalitis is a viral or inflammatory brain infection causes fever and headache as well as a low level of awareness, altered mental status (confusion, behavior abnormalities) localized neurologic impairments, and new onset seizure activity.

Case Presentation: The case 7 year, old female patient who was alright one month back admitted in “A.V.B.R. Hospital, Wardha, on date 01/12/2020 with the chief complaint of high grade fever, headache, vomiting, irritability, and alteration of speech and generalized weakness. The patient had undergone various investigation complete blood count, urine analysis, kidney function test, liver function test, peripheral smear and virology test. Cerebrospinal fluid, electroencephalogram (EEG) Test, Magnetic resonance imaging (MRI) test, in MRI report shows altered gyral signal intensity is right fronto-parietal lobe with edema with thickened overlying cortex with effacement of adjacent sulcal spaces features suggestive of viral encephalitis. The patient was treated with antipyretic, antibiotic, loop diuretic, steroid, antiemetic drug to treat vomiting. Monitor all vital signs, checked and recorded intake and output, administered medication as prescribed by doctors.

Conclusion: The inflammation of the brain causes encephalitis, which is a rare but deadly disorder. It can be life -threatening and necessitates immediate hospitalization. Anyone can be harmed, but the very young and elderly are the most vulnerable.

Open Access Case Study

Case Report on Sacroccygeal (Teratomas) Germ Cell Tumor

Payal Nanotkar, Vaishali Tembhare, Khushabu Meshram, Pooja Kasturkar, Savita Pohekar, Jaya Khandar, Samrudhi Gujar, Achita Sawarkar

Journal of Pharmaceutical Research International, Page 698-703
DOI: 10.9734/jpri/2021/v33i47A33063

Sacrococcygeal teratomas are a type of germ cell tumour (GCTs) accounting for 40% of all GCTs of all GCT,s in children. Interestingly 75% occurs in females. Reporting here a case of 3 years old female baby hospitalized for surgical excision of sacrococcygeal teratoma. A female (3-year-old) patient was referred to the pediatric outpatient department at Acharya Vinoba Bhave Rural Hospital Wardha on 19th May 2021. Complaining of swelling on right gluteal region Since 6 month and swelling is increases day by day, pain in back side, fever (Temperature - 101˚F) and tenderness in back side, leg weakness, constipation and she was admitted to Pediatric ward. Surgical excision of sacrocogygeal teratoma was done during her hospitalization. She received one cycle of chemotherapy with antineoplastic medicines. The client discharged after 10 days stay in hospital.

Open Access Case Study

A 1 Year Child with Hydrocephalus: A Case Report

Deeplata Mendhe, Divyani Kanholkar, Ranjana Sharma, Kavita Gomase, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 826-830
DOI: 10.9734/jpri/2021/v33i47A33078

Introduction: Hydrocephalus is the accumulation of fluid in the cavities deep within the brain. The extra fluids cause the ventricles to expand, putting pressure on the brain. The brain and spinal column are bathed in cerebrospinal fluid, which usually flows into the ventricles. Excessive cerebrospinal fluid pressure caused by hydrocephalus, on the other hand, can harm brain tissues and result in a variety of cognitive impairments.

Case Presentation: Here we have selected a case of hydrocephalus. In this case, when the complete history has been taken it found that patient having a history of NICU admission for prematurity and Low Birth Weight for 40 days. During history collection, it found that the child was all right until 4 months of age after which she started to notice that the child's head circumference was increasing at an abnormal rate and has now been brought to AVBRH for further management. After all investigation in MRI brain reveals extensive dilatation of ventricular system including bilateral lateral ventricle and III and IV ventricles associated with wide-open foramen of Luschka and Magendie with thinning of the adjacent cerebral cortex and cerebellar parenchyma. Features suggestive of communicating hydrocephalus. In the EEG record, the background record  shows rhythmic synchronous > 13 Hz beta activity in the bilateral hemisphere. Abnormal EEG record. Then, the doctor planned for the Endoscopic Third Ventriculostomy with general anesthesia.

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

Open Access Case Study

Case of 38 Years old Nulligravida with Primary Infertility with a Known Case of Diabetes Mellitus Came for in vitro Fertilization

Deeplata Mendhe, Maheshwari Bombale, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 850-853
DOI: 10.9734/jpri/2021/v33i47A33083

Introduction: The term “Primary infertility” refers to a couple’s inability to conceive a child. Endometriosis: affects mostly women in their 30s and 40s, with roughly 40%of women suffering from endometriosis. This occurs when the uterine lining is discovered outside of the uterus. Endometriosis will make it difficult to conceive. Not everyone aspires to be a parent, but for those who do, the inability to produce a child is a heart-breaking reality. Many of us spend a significant portion of our lives trying to avoid unintended pregnancies, assuming that when we are ready to have a family, it will have happened naturally. We tend to believe that transiting from preventing pregnancy to planning conception and childbirth will be relatively painless and orderly. As a result, the inability to conceive is a major life stressor that can wreak havoc on otherwise happy couples.

Case Presentation: She is a case of 48 yr. Primary Infertility nulligravida comes with DM. For 20 Year diagnostic hysteroscopy done. Ultrasonography done. A complete blood investigation is done. She is a history of Hypertension for 1 month and insulin-dependent diabetes for one 1year.

Conclusion: This study emphasized the opportunity of strengthening public health and hospital-based health promotion programs (e.g., smoking, obesity STIs, etc.). Furthermore, detecting, avoiding, and controlling modifiable risk factors through increased awareness, screening, and early management of chronic diseases may help to reduce the incidence and severity of chronic diseases.

Open Access Case Study

A Case Report on Permanent Dual Chamber Pacemaker

Prajwal Bhonde, Achita Sawarkar, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 873-877
DOI: 10.9734/jpri/2021/v33i47A33087

Background: The dual-chamber, rate-modulated mode (referred to as DDDR) is the most recent cardiac pacing mode to become available. It restores both rate responsiveness and atrioventricular synchronization in patients with sinus node dysfunction and atrioventricular block. This pacing method combines rate-modulated dual-chamber and single-chamber technology. As a result, it is required to program both a maximum and a minimum. tracking rate and a maximum sensor rate, as in dual-chamber and single-chamber rate-modulated devices, respectively.

Case Presentation: A 55-year-old female was admitted to A.V. B.R. Hospital with a complaint of breathlessness on exertion chest pain last 10 days. The patient has had hypothyroidism seen 2 years. No history of Hypertension and Diabetes Mellitus, Patient was conscious and oriented, All the investigation was done. FORTIFY SSURA VVED DDDR pacing (MRI compatible) was connected to lead, P-wave 3:2- 4.0, R- wave 9.2- 11.5mV. Device positioned in right infra-clavicular pocket.

Conclusions: A 55-year-old female patient was admitted to the hospital with the chief complaint of breathlessness on exertion chest pin last 10 days. After all investigation patient was diagnosed with a case of permanent DDDR pacemaker. Now she is going to under a pacemaker procedure and treatment. Now patient prognosis is better than the previous and I advise the patient for the regular 15 days follow-up.

Open Access Study Protocol

Protocol on the Effects of Postnatal Exercises on Musculoskeletal Pain among Postpartum Women

Kalyani Ambule, Manjusha Mahakarkar

Journal of Pharmaceutical Research International, Page 12-16
DOI: 10.9734/jpri/2021/v33i47A32985

Background: Pregnancy brings a slew of morphological and physiological changes to the body. The gravida must not only nourish the foetus, but also adjust to a new body habit and hormonal changes. These alterations, unsurprisingly, have an impact on the musculoskeletal system, which can lead to a number of issues, such as generalized arthralgias, back pain, separation of the pelvic bones, transient osteoporosis, and tendonitis.

Objectives: 1. To assess the pretest and posttest musculoskeletal pain among postpartum women in experimental and control group. 2. To assess the effectiveness of postnatal exercises related to musculoskeletal pain among postpartum women in experimental group. 3. To find association between posttest musculoskeletal pain score among postpartum women with selected demographic variables in experimental and control group.

Materials and Methods: Quasi-experimental pretest posttest design is used to assess the effectiveness of postnatal exercises, among postpartum women in selected hospitals of Wardha. 80 sample size taken who fulfils the inclusion criteria, 40 postpartum women for control and 40 for experimental group with non-probability convenience sampling.

Expected Results: This study is planned to assess the effectiveness of postnatal exercises to the postpartum women experiencing musculoskeletal pain syndrome. Hence, it is expected to identify the level of pain and may reduce their level of pain.

The conclusion will be drawn from the results and will be published in per review journal.

Open Access Study Protocol

Assessment of Efficacy of Novel Method of Quantifying and Grading Class II Malocclusion in Vidarbha Population

Niraj Nitin Tikar, Amit Reche, Vikrant Jadhav, Priyanka Paul Madhu, Kumar Gaurav Chhabra, Komal Vilas Dadgal, Juhi Manohar Pathekar

Journal of Pharmaceutical Research International, Page 230-234
DOI: 10.9734/jpri/2021/v33i47A33008

Background: It is important to quantify class II malocclusion for proper diagnosis of the case and adjusted treatment will aid in successful correction of malocclusion. Hence, the study will aid for proper treatment planning by classifying class II malocclusion established on the amount of overjet, overbite, distance and relation of maxillary and mandibular first molar and the relationship of canine and molar.

Objectives: To grade Class II malocclusion in form of overjet and overbite.

Materials and Methods: Patients visiting Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College, Wardha, having class II malocclusion will be chosen. The chi square test, student's paired and unpaired t test, and descriptive and inferential statistics will be used in the statistical analysis.

Expected Results: The outcome after conduction of the study is expected to have more patients with Type 1 overjet and Type B overbite kind of Class II malocclusion.

Conclusion: The establishment of this new classification will aid in concise analysis and proper treatment planning of Class II malocclusion thereby enhancing the esthetics and functional stability for the patient comfort.

Open Access Study Protocol

To Assess the Effectiveness of Planned Teaching on Knowledge Regarding Harlequin Ichthyosis among Post Basic B.Sc Nursing Students

Anushri Kale, Bibin Kurian

Journal of Pharmaceutical Research International, Page 633-638
DOI: 10.9734/jpri/2021/v33i47A33053

Background: Harlequin ichthyosis is an uncommon, extreme type of skin issue related with gigantic thickening of skin over whole body. The primary case was accounted for in 1750 by Reverend Oliver Hart. The general occurrence is 1 out of 300,000 births. Around 200 cases have been accounted for all through the world. In 1984, a newborn child with this issue was brought into the world in Pakistan and the child lived till 2008. One more such birth was recorded in the USA in 1994. As of late, one case was accounted for in June 2016 at Nagpur, India. A Harlequin child was brought into the world to a youthful couple in Lata Mangeshkar Hospital.

Objectives: To assess the existing knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students. To assess the effectiveness of planned teaching on knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students. To associate the post-test knowledge regarding Harlequin Ichthyosis among P.B.Bsc nursing students with selected demographic variables.

Materials and Methods: A one group pre-test and post-test research design study will undertaken to assess the effectiveness of planned teaching on knowledge regarding harlequin ichthyosis among P.B.B.Sc nursing students of selected colleges.

Expected Results: There will be significant association between pre-test and post-test knowledge regarding Harlequin ichthyosis among P.B.Bsc nursing students.

Open Access Study Protocol

To Assess the Effectiveness of Psycho Education on Medication Adherence among Schizophrenic Patients

Samuel Vanlalpeka, Sr. Tessy Sebastian, Jaya Gawai, Pooja Kasturkar

Journal of Pharmaceutical Research International, Page 656-661
DOI: 10.9734/jpri/2021/v33i47A33057

Background: Schizophrenia is one of the most leading perplexing complications, that creates a problem in an individual in which there is a disturbance in their thinking, emotion, and volition in the presence of their clear consciousness. Rehospitalization and reoccurrence of the symptoms are very common among these patients if medication is not taken properly.

Objective: 1) To assess pre test level of medication adherence among Schizophrenic patients. 2) To assess the effectiveness of psycho education on medication adherence among Schizophrenic patients after intervention. 3) To evaluate the effectiveness of psycho education on medication adherence among Schizophrenic patients. 4) To associate the post test level of psycho education on medication adherence score with their selected demographic variables.

Methodology: It is an interventional research approach study, and it will be conducted among 60schizophrenic inpatients who were selected by using a non-probability purposive sampling technique in psychiatric departments at Acharya Vinoba Bhava Rural Hospital, Sawangi (Meghe), Wardha. A standardized Medication Adherence Rating Scale (MARS) will be used to collect the data.

Expected Outcome: It is expected that the psycho education given to the patient will be effective and thus improve their medication adherence.

Conclusions: Medication non-adherence is not a recent problem among schizophrenic patients; it is a problem that remains for a long-time. This study thus will provide recent data regarding the effectiveness of psycho education among schizophrenic patients.

Open Access Study Protocol

Assess the Effectiveness of Planned Teaching on Assisting Self-care Activities of Patients with Plaster of Paris Casts of Lower Extremities among Caregivers

Amruta Kothe, Aarti Raut, Sheetal Sakharkar

Journal of Pharmaceutical Research International, Page 675-681
DOI: 10.9734/jpri/2021/v33i47A33060

Aim of the Study: To assess the effectiveness of planned teaching on assisting self-care activities of patients with plaster of Paris casts of lower extremities among caregivers.

Study Design: The design that will be used in the study is One Group Pretest Posttest research design. 

Methodology: A study used a pre-test post-test design with no control group and a pre-experimental design. The impact of planned teaching on assisting self-care activities of patients with plaster of Paris casts of the lower extremities among caregivers will be assessed using the purposive sampling technique. In this study Evaluatory research approach will be used. Selected 100 caregivers of patients with plaster of Paris cast of lower extremities will be assessed primarily for knowledge in assisting self-care activities by structured questionnaires and then planned teaching will be given to the selected sample developed by researcher as intervention.

Expected Results: To assess the effectiveness of planned teaching on assisting self-care activities of patients with plaster of Paris casts of lower extremities among caregivers. In this study the planned teaching will be useful in improving the caregivers knowledge in assisting selfcare activities.

Conclusion: The conclusion will be drawn from the results and will be published in per review journal.

Open Access Study Protocol

To Assess the Common Psychosocial Problems among Women with Alcoholic Spouse

Samuel Vanlalpeka, Pooja Kasturkar, Jaya Gawai

Journal of Pharmaceutical Research International, Page 682-690
DOI: 10.9734/jpri/2021/v33i47A33061

Background: Misuse of alcohol is the most leading bewildering problem, that cast off the happiness of many families with all their possessions, which further can lead to a severe mental problem for themselves as well as their wife and their innocent children who even doesn’t face the real world. It is a fact that the wife and children, who had suffered while their fathers gave up their everything.

Objective: 1) To assess the common psychosocial problems among women with alcoholic spouses. 2) To associate common psychosocial problems score among women of the alcoholic spouse with their demographic variables.

Methodology: It is a quantitative research approach study, and it will be conducted among 100 women with an alcoholic spouse in both outpatient and inpatient psychiatric departments at Acharya Vinoba Bhava Rural Hospital, Sawangi (Meghe), Wardha. A structured knowledge questionnaire will be used to collect the data.

Expected Outcome: It is expected that there will increase mental health problems for the spouses of alcoholic patients regarding depression, anxiety, their physical and mental well-being, and their financial conditions.

Conclusions: Alcohol-related problems are not a recent problem faced by their spouse; it is a problem that remains for a long-time. This study thus will provide recent data regarding the problem faced by the spouse of an alcoholic.

Open Access Study Protocol

Effectiveness of Planned Teaching on Knowledge Regarding Noonan Syndrome among Nursing Students

Pragati Alnewar, Seema Singh, Vaishali Tembhare

Journal of Pharmaceutical Research International, Page 709-713
DOI: 10.9734/jpri/2021/v33i47A33065

Background: Noonan syndrome is a genetic multisystem disorder characterized by distinctive facial features, developmental delay, learning difficulties, short stature, congenital heart disease, renal anomalies, lymphatic malformation and bleeding difficulties, mutations that cause Noonan syndrome alter genes encoding proteins with roles in the RAS-MAPK pathway, leading to pathway dysregulation. estimated prevalence of Noonan syndrome 1 in 1000-2500. Nursing student having insufficient knowledge regarding Noonan syndrome most responders perceive serious deficiencies in their preparation to care such patients As genetic advances increasingly impact nursing care, nurses are expected to have necessary knowledge to interpret genetic and genomic information and technology with translation into nursing care. The aim of the study is to aware a future nurse for Noonan syndrome, carrying the role of counsellor, care manager and teacher for patient and their families’ nurses will have an opportunity to expand as well as to create new leadership role in health care. Therefore, the development of educational program for nursing knowledge is essential for future nurses.

Objectives:

  1. To assess the existing knowledge level regarding Noonan Syndrome among Basic B.Sc. nursing students.
  2. To evaluate the effectiveness of planned teaching on knowledge regarding Noonan syndrome among Basic B.Sc. nursing students.
  3. To associate posttest knowledge score with selected demographic variable.

Materials and Methods: A one group pre-test and post-test design was adopted to assess the existing knowledge level regarding Noonan Syndrome among Basic B.Sc. nursing students. In this study, evaluatory research approach will be used. convenient sampling technique will be used to collect data.  Pre-test will be conducted to assessed primarily for the existing knowledge level regarding Noonan Syndrome among Basic B.Sc. nursing students. And then planned teaching on Noonan syndrome will be given to selected sample by researcher as intervention. Post-test outcomes involve evaluation of effectiveness of planned teaching.

Expected Results: This study is planned to assess the effectiveness of planned teaching on knowledge regarding Noonan syndrome among nursing students. Conducting planned teaching will be effective for improving knowledge of the respondents.

Open Access Study Protocol

To Assess Effectiveness of Informational Booklet on Knowledge Regarding Bardet- Biedl syndrome among Nursing Students

Payal Bawankar, Savita Pohekar

Journal of Pharmaceutical Research International, Page 861-865
DOI: 10.9734/jpri/2021/v33i47A33085

Background:  Biedl–Bardet syndrome (BBS) is an autosomal recessive disorder. It is classified as a "rare genetic disease" affecting about 1 in 250,000 persons worldwide. BBS is a disorder that affects many parts of the body and cause learning impairments, retinal degeneration, renal failure, obesity, post-axial polydactyly and hypogonadism. It is one of the most well-studied conditions in the family of diseases caused by defective cilia which is also known as ciliopathies. In this study, researcher provide an updated knowledge on clinical features, diagnostic developments and progress in the management of Bardet–Biedl syndrome. As Advancement occur in diagnostic technology including exome and whole genome studies and sequencing it is expanding the spectrum of patients who are diagnosed with this disorder and increasing the number of cases with diagnostic uncertainty.

Materials and Methods: A one-group pre-test-post-test research design was used to evaluate the effects of an information booklet on nursing students' understanding of Bardet-Biedl syndrome. Non probability purposive sampling technique is used. In this study a total number of 300 students who fulfilled the inclusion criteria were selected the setting of the study is selected nursing college Wardha.

Expected Results: This study is planned to evaluate the effectiveness of information booklet on knowledge regarding Bardet- Biedl syndrome among nursing students, as a result, it is expected to determine the nursing student's degree of knowledge of the Bardet-Biedl Syndrome and to improve that knowledge.

Open Access Short Research Article

Efficacy of Oral Clonidine as Premedication on Intraoperative Bleeding and Consumption of Inhalational Agent in Patients Undergoing Functional Endoscopic Sinus Surgery

Vivek Chakole, Shilpa Shankar, Sneha Kota, Jayashree Sen, Sheetal Madavi, Devavrat Vaishnav

Journal of Pharmaceutical Research International, Page 511-516
DOI: 10.9734/jpri/2021/v33i47A33041

Aim: To study the efficacy of oral clonidine on intraoperative bleeding and consumption of inhalational agent in patients undergoing FESS under general anesthesia.

Study Design: Prospective, comparative observational study.

Place and Duration of Study: Department of Anesthesiology, AVBRH, from June 2020 to May 2021.

Methodology: A total of 30 patients fulfilling inclusion criteria scheduled for FESS were randomly allocated into 2 groups of 15 each; GROUP C (Clonidine group, n=15) who received tab clonidine 5 mcg/kg, 90 minutes before surgery and GROUP M (Multivitamin group, n=15) who received multivitamin tablet. Mean ± standard deviation (SD) or absolute values were used to indicate data; comparison of qualitative data were done using Chi-square test and Fisher’s exact test and quantitative variables using the student ‘t’ Test. P value < 0.05 was taken as statistically        significant.

Results: Bleeding was considerably less in the group C [1.65 ± 0.4] as compared to group M [2.20 ± 0.6] and is statistically significant [ P value = 0.006]. The mean MAC value (%) of sevoflurane consumption is lesser in the group C [1.25 ±0.25] than the group M [1.30 ±0.20] but not statistically significant (P value = 0.55). The mean dose (microgram) of fentanyl requirement was more in group M [ 120 ±20] than the group C [100 ± 25] and this was statistically significant (P value = 0.02).

Conclusion: Oral Clonidine can be used as an excellent premedication and provides cost effective method to attain controlled hypotension as there is lesser requirement of costly inhalational agent and other analgesic drugs. Also, it maintains better hemodynamic stability with fewer side effects.

Open Access Short Communication

Nursing Skill and Responsibility in Administration of Low Molecular Weight Heparin by Prefilled Syringe

Vaishali Tembhare, Gaurav Mujbaile, Seema Singh, Achita Sawarkar, Maduri Shambharkar, Prerana Sakharwade

Journal of Pharmaceutical Research International, Page 85-92
DOI: 10.9734/jpri/2021/v33i47A32993

Abstract: Low-molecular-weight heparins (LMWHs) have proven to be effective in the prevention and treatment of thrombotic disorders, as well as   substitute for unfractionated heparin (UFH). LMWHs are a diverse collection of medicines with different biochemical and pharmacological characteristics, despite the fact that they all have antithrombotic actions. Medicine is administered into the subcutaneous tissues with these injections. Small amounts of injections are delivered by the subcutaneous approach, which involves inserting a small thin needle beneath the skin and slowly injecting the medicine. Low molecular weight heparins make up dalteparin and enoxaparin, two anticoagulants. The rights of medicine administration must be followed by nurses. For patients on LMWH medication, the most essential blood test is prothrombin time. Following administration, look for any signs of bleeding, such as occult blood in the stool, malena, bleeding gums, and skin discoloration/hematoma. The antidote for low molecular weight heparin is protamine sulphate. It is effective at counteracting the effects of LMWH. 100 units of LMWH are neutralised by 1 mg of protamine sulphate.If it's been more than 8 hours since you've given LMWH, provide 0.5 mg protamin per 100 units of LMWH.

Open Access Minireview Article

Association of Microbiota with Oral Potential Malignant Disorder: A Mini Review

Prasada Rao Namburi, Krishnan Mahalakshmi

Journal of Pharmaceutical Research International, Page 704-708
DOI: 10.9734/jpri/2021/v33i47A33064

Most of the oral squamous cell carcinoma (OSCC) are often preceded by oral potentially malignant disorders (OPMDs). OPMDs are defined as oral mucosal lesions and conditions which are at increased risk for undergoing alteration to oral cancer. OPMDs grow in a complex tissue microenvironment to acquire oral squamous cell carcinoma (OSCC) characteristics. Oral microbiota associated with OPMD may appear as potential biomarkers as these species may help in the diagnosis and prognosis of OPMD to OSCC. This association of microbiota to OPMD and may be helpful in the early treatment before the initiation of oral cancer. This article reviews the literature on association between microbiota and Oral potential malignant disorders.

Open Access Minireview Article

Social Impact of COVID-19 on Rohingya Refugees in Bangladesh and India’s Policy Stand: An Analytical Study

Nancy Puri, C. R. Akhouri

Journal of Pharmaceutical Research International, Page 773-785
DOI: 10.9734/jpri/2021/v33i47A33073

Aims: The Paper will explore about the COVID- 19 social challenges confronted by the Rohingya refugees in Cox’s Bazar of Bangladesh and will also discuss the role of India in providing medical assistance to Rohingyas in Bangladesh and further will explain a set of policy recommendations designed to improve the life chances of the Rohingya community both now and in the future.

Study Design:  Descriptive Study.

Methodology: A detailed and related Review of literature of the previous work has been collected in order to extract the information about the vulnerable conditions of Rohingyas refugees in Bangladesh amid novel coronavirus. The paper is based on qualitative research design and the data has been collected from official reports, documents, newspaper, journal articles, books based on Rohingyas refugees in Bangladesh.

Results: The COVID-19 pandemic represents a grave social threat to the Rohingya refugees in the camps of Bangladesh. Having fled decades of persecution by the Burmese military, the majority of Rohingya currently live in densely populated refugee camps in Bangladesh. Most are denied access to the internet, mobile phones, humanitarian aid, and sanitary conditions and living in congested camps—all of which heighten the risk of infection and contamination. Currently in 2021, Government of India and International Organization are providing COVID- 19 vaccines and medical assistance to Rohingyas in Bangladesh.

Conclusion: Despite facing social impact from COVID- 19, Government of India are taking imperative steps, both to protect the Rohingya from widespread infection and to create the conditions whereby future tragedy can be preempted.

Open Access Original Research Article

Effective Medicine Treatment for Corona Patients at Home in COVID 19 Pandemic - and Roles of Nurses and Doctors for Heart Failures Treatment Attached

Vu Thanh Binh, Dinh Tran Ngoc Huy, Pham Thi Bich Ngoc, Pham Thi Hong Nhung, Dinh Tran Ngoc Hien, Ngo Huy Hoang

Journal of Pharmaceutical Research International, Page 38-48
DOI: 10.9734/jpri/2021/v33i47A32987

In the case of developing countries such as Vietnam, we will have a new approach of attacking corona virus and help patients at home with effective medicine treatment solutions as presented in this paper, it will help other nations as well and they can use it as reference.

Authors will use qualitative analysis and experience and expertise from experts to explore this solution.

Our study results show that there are several methods to treat corona patients at home effectively and that are tested in some countries including Vietnam. Currently Vietnam is testing Molnupiravir and other methods of treatment which will be presented, while WHO and Japan also have other approaches as presented in the study. Last but not least, authors suggest treatment of heart failures attached for patients and self-care knowledge for these patients.

Open Access Original Research Article

The Effect of Antibiotics and Drugs on the Duration of COVID-19 in Hospitalized Patients

Amin Khattab, Fahad Dakilallah Aljohani, Roa Halawani, Heba Mahmoud Eltahir, Ahmed M. Shehata, Saleh K. Ihmaid, Ahmed Aldhafiri, Mekky Abouzied, Najwa M. Almaghrabi, Heba M. H. Matar, Hossein M. Elbadawy, Hanaa Wanas

Journal of Pharmaceutical Research International, Page 49-58
DOI: 10.9734/jpri/2021/v33i47A32988

This is a single center, retrospective, observational study carried out in Ohud hospital, the main referral hospital for SARS-CoV-2 infections in the region of Madinah, Kingdom of Saudi Arabia. The study was carried on hospitalized patients with moderate to severe symptoms, including critically ill patients in the intensive care unit mostly of them requiring oxygen or mechanical ventilator support. Medical records from 432 cases were investigated showing that the majority of infected population were adults with an average age of 48 years, where 68.3% were males and the mortality rate was 5.6%. Duration of the disease was determined as the period between the first positive and the first negative PCR results. Patients who received antibiotics or Metoclopramide showed shorter duration of the disease time course while those who received Hydroxychloroquine, Omeprazole or Calcium exhibited longer durations before obtaining a negative PCR result. Regression analysis furtherly confirmed that antibiotics administration was associated with shorter course of disease while hydroxychloroquine or omeprazole were correlated with longer duration of the disease. Antiviral drugs, however, showed no correlations to the COVID-19 duration of stay in hospital. Finally, combining antibiotics and antiviral agents did not result in a better outcome, suggesting that the use of antibacterial agents helps in the recovery of SARS-CoV-2 patients.

Open Access Original Research Article

Use of ATP, GTP, ADP and AMP as an Index of Energy Utilization and Storage in HIV Infected Individuals at NAUTH, Nigeria: A Longitudinal, Prospective, Case-Controlled Study

Uchenna Modestus Ezugwu, Chinedum Charles Onyenekwe, Nkiruka Rose Ukibe, Joseph Eberendu Ahaneku, Christian Ejike Onah, Emmanuel Ifeanyi Obeagu, Paul Isaac Emeje, Joseph Chimezie Awalu, Gabriel Ejike Igbokwe

Journal of Pharmaceutical Research International, Page 78-84
DOI: 10.9734/jpri/2021/v33i47A32992

Human immunodeficiency virus (HIV) is associated with altered metabolism and increased energy expenditure, this energy requirement increases significantly as the HIV disease progresses. This study aimed on the use of Adenosine triphosphate (ATP), Guanosine triphosphate (GTP), Adenosine diphosphate (ADP) and Adenosine monophosphate (AMP) as an index of energy utilization, storage and energy balance in HIV infected individuals. This is a longitudinal, prospective, case-controlled study involving seventy seven (77) HIV Sero-positive individuals newly diagnosed attending retroviral disease treatment centre of Nnamdi Azikiwe University University Teaching Hospital (NAUTH) aged 18-60 years both male and female not on highly active antiretroviral therapy (HAART), were enrolled in the study as test subjects and thirty six (36) apparently healthy HIV Sero-negative individuals both male and female as control subjects. ATP, GTP, ADP and AMP were estimated by enzyme linked immunosorbent assay (ELISA), while, total Energy Balance was determined by calculation. The data obtained were subjected to statistical analysis using SPSS software application (version 21.0) and the results expressed as mean ± standard deviation. The plasma ATP and GTP were significantly lower (P<0.05) in both HIV pre-treatment and post-treatment group compared with control group. Meanwhile, the plasma level of ADP and AMP were significantly lower (P<0.05) in HIV post-treatment group compared   with HIV pre-treatment and control group. There was also a significant difference (P<0.05) in ATP, ADP, AMP and GTP level between HIV pre-treatment and post-treatment group. Meanwhile, the energy balance was lower (P<0.05) in HIV groups compared with control group. However, the energy balance in HIV post-treatment group was significantly lower (P<0.05) compared to HIV pre- treatment group. In conclusion, the significant changes in the biochemical parameters measured suggest altered metabolism, increased energy expenditure and energy deficit/negative energy balance in HIV subjects resulting from increased energy expenditure. Hence, High energy molecules such ATP, ADP, GTP and AMP can be used to predict early energy deficit and manage energy imbalance in HIV infected individuals.

Open Access Original Research Article

Pharmacognostic Specifications of Calotropis procera (Aiton) W. T. Aiton Leaf and Tribulus terrestris L. Fruit: Important Medicinal Plants Used in Veterinary Products

. Monika, . Akanksha, Snigdha Lal

Journal of Pharmaceutical Research International, Page 93-103
DOI: 10.9734/jpri/2021/v33i47A32994

Present article deals with the pharmacognostic specification of selected medicinal plants used in veterinary products for the purpose of their standardization, as evidential support concerning quality determination of plant material in veterinary medicine is scarce and there is poor documentation on primary studies of many species. The plants undertaken for the study were Calotropis procera (Apocynaceae) and Tribulus terresteris (Zygophyllaceae) on the basis of their usage relevance in veterinary products. Both plants are official in Ayurvedic Pharmacopoeia of India.  Morphology as well as various pharmacognostic aspects of different parts of the plant were studied and have been described, which will help in authentication and quality control. The observed microscopic characters of Calotropis procera leaf were rubiaceous type apostomatic stomata, epidermis, collenchymas, parenchyma, vascular bundles, palisade cells, cortical fibres and lamina, trichomes on the cuticle of lamina. Microscopic characteristics of Tribulus terrestris fruit were epicarp cells showing clusters of calcium oxalate crystals, xylem vessels, group of thin walled sclerenchymatous fibres, group of stone cells of mesocarp. Powder microscopy of the Tribulus terrestris fruit shows abundance of epidermal trichomes - simple, short, long, thick walled, multicellular covered trichomes, sclereids. The qualitative microscopic features would prove useful for laying down their pharmacopoeial standards. The present study also provides the information with respect to identification and authentication of crude drug and serves as a reference point for the proper identification of Calotropis procera leaf and Tribulus terrestris fruit, thereby contributing to the scientific world of research.

Open Access Original Research Article

Autistic Effects of Nootropic Drug Brahmi against Propionic Acid-induced Behavior and Memory Impairment in Rat Model

P. K. Anamika, P. Muralidharan

Journal of Pharmaceutical Research International, Page 104-113
DOI: 10.9734/jpri/2021/v33i47A32995

Aims: To evaluate the hydro alcoholic effect of Brahmi against propionic acid-induced behavior and memory impairment in rat model.

Study Design: This includes preclinical study on Sprague Dawley rats in which Propionic acid induced and evaluation of in vivo and in vitro models were performed.

Place and Duration of Study: Department of Pharmacology, C L Baid Metha College of Pharmacy Jan 2019 to June 2021.

Methodology: We include a total of 27 adult Sprague Dawley Rats and induced propionic acid intracerebroventricular route to induce autism. Drug treatment using hydro alcoholic extract of Bacopa monnieri was given in 250 mg/kg and 500 mg/kg was compared with negative group rats and control groups. In vivo parameters like Actophotometer and marble burying test was done, In vitro analysis of Serotonin and Glutamate was estimated in the above treated groups.

Results: The locomotor activity of rat was recorded individually for each animal using Actophotometer. HAEBM (250 mg/kg and 500 mg/kg) treated rat produced an increase in the level of significance (P<0.0001) on day one. In marble burying test Rats were located for thirty minutes in a standard cage covered with 5 cm depth of wood chip bedding with ten marbles evenly spaced. HAEBM (250 mg/kg and 500 mg/kg) showed significant (P<0.001) level of burying when compared to group-II rats (P<0.01). In this research study 5HT level showed a significant (P<0.001) increase in Group III, Group IV when compared with group-II (P<0.01). Glutamate is an excitatory Neurotransmitter. Group II showed significant increase (P<0.001) in the level of Glutamate but on drug treated groups III and IV shows decrease in concentration of glutamate.

Conclusion: The present study findings showed that the hydro alcoholic root extract of brahmi possesses neuroprotective activity with significant nootropic effects. The hydro alcoholic root extract of Bacopa monnieri. L showed the presence of various Gabapentin and flavonoids phenols may be the reason for its neuroprotection and memory improvement effects.

Open Access Original Research Article

Diosgenin Nanoparticles Competes Plain Diosgenin on Reviving Biochemical and Histopathological Alterations in DMBA Induced Rat Mammary Carcinoma via Modulating the AhR-Nrf-2 Signaling Cascades

Manobharathi Vengaimaran, Kalaiyarasi Dhamodharan, Mirunalini Sankaran

Journal of Pharmaceutical Research International, Page 141-157
DOI: 10.9734/jpri/2021/v33i47A32998

Background: Diosgenin, a steroidal saponin spotted as a primary ingredient in many traditional Chinese medicines, has sparked the attention of researchers owing to its multi-targeted cytotoxicity towards a multitude of cancers. Regrettably, its true potential was bounded by its impoverished physicochemical properties. In order to fully exploit its ability, we plan to fabricate diosgenin into nanoparticle by encapsulating with biodegradable polymer chitosan.

Aim: The current research intends to uncover the therapeutic potency of diosgenin encapsulated chitosan nanoparticles (DG@CS-NP) on 7,12dimethylbenz(a)anthracene (DMBA) induced rat mammary carcinoma by optimizing biochemical and histopathological modifications via attenuating Aryl hydrocarbon receptor (AhR) - nuclear factor erythroid-derived 2-related factors (Nrf-2) signaling.

Methodology: Breast cancer was induced with a single dose of DMBA (25 mg/kg b.wt). Orally supplied DG 10mg/kg b.wt. and DG@CS-NP 5 mg/kg b.wt to DMBA-induced tumor-bearing rats shortly after tumor onset. After the experimental period, biochemical and histopathological studies were performed using mammary tissue sections. Furthermore, architectural immunohistochemistry was used to reveal the expression of AhR and Nrf-2 in experimental rats. Additionally, diosgenin interactions with these proteins were also evidently confirmed by molecular docking analysis.

Result: We noticed that there is an elevated level of lipid peroxidative marker, phase-I detoxification enzymes, total cholesterol (TC), phospholipids (PL), triglycerides (TG), and free fatty acids (FFA) with boosted AhR expressions as well as diminished levels of enzymatic and non-enzymatic antioxidants and Phase – II detoxification enzymes with downtrodden Nrf-2 expressions in the mammary tissues of DMBA-induced rats. On the other contrary, oral dosing of DG@CS-NP 5 mg/kg b.wt, dramatically reverted them to near-normal tiers. Interestingly, molecular docking analyses also corroborate these insights by highlighting diosgenin's significant interactions with AhR and Nrf-2 targets.

Conclusion: As an outcome of our observations, we conclude that nano-encapsulation of diosgenin is a potent targeted therapeutic candidate posing a massive impact on breast cancer than plain diosgenin.

Open Access Original Research Article

A Study to Assess the Effectiveness of Progressive Muscle Relaxation Technique among the Patient with Anxiety Disorders in the Selected Mental Health Centers

A. R. Bharathi

Journal of Pharmaceutical Research International, Page 158-163
DOI: 10.9734/jpri/2021/v33i47A32999

Nowadays, major impact of researchers’ toevaluate the intensity of anxiety between Anxiety Disorder with the Patient, and theirefficacy of enlightened muscle relaxation and disorder of anxiety to the patients, intensity of anxiety amongst mental health center describe the anxiety disorder patients with correlated with the social cum geographical values. Hypothesis,  nominated socio demographic variables around the difference between posttest level and pretestanxiety of disorder patients. Nearby is an important association among intensity of unease. In tangible background: Inaccurate Roy’s variation classical was cast-off for this study. Methodology: A Pre-experimental and progressive muscle and decreasetherapy by used as a posttest. 40 anxiety ailment patients were confident by successive sampling process.Hypothesis formulated between. Pre and posttest was shown progressive muscle relaxation on forty minutes trainingto the anxiety patients on 5 consecutive days. In our results suggested anxiety patients output of reduced levels of anxiety disorder on the 6th day of posttest. To evaluate the Reformist muscle slackening is non-invasive, cost effective, non – pharmacological complementary therapy to between disorder patients with anxiety and diminish anxiety. Also posttest levels varied with age, academic qualification, anxiety, social value and alcoholic addiction and its duration.

Open Access Original Research Article

Anti Ulceration Efficacy of Boiled Aqueous Leaf Extract of Morinda lucida on Ethanol Induced Gastric Ulceration Rats

Nkiruka Millicent Amadi, Peter Uwadiegwu Achukwu, S. O. Onwukwe, Emmanuel Ifeanyi Obeagu, Nonyelum V. Anoh, Victoria I. Okpokwu

Journal of Pharmaceutical Research International, Page 164-175
DOI: 10.9734/jpri/2021/v33i47A33000

Stomach ulceration study was carried on 25 groups (5 rats each of the groups), groups (E, E1, E2, , E3 and EC, placed on 24 hours fasting before the single dose of intra peritoneal dose administration of 5ml/kg body weight of 99% ethanol and  after one hour, received daily extract of dilution doses of ((500, 1000, 1500) mg /kg) body weight and 100 mg /kg body weight cimentidine (standard drug) respectively for 7 days. Groups (EA1, EA2, , EA3 and EAC, ) were treated with the same extract doses and drug concentration for 7 days before the dose ethanol administration. Group Eand 0 served as a positive control and a negative control respectively. On day 9, target organs; stomach and intestines were harvested under anaesthetize weighed, gross macroscopically and histomorphological studied. Result of the study showed plant inhibition on ethanol induced gastric ulceration; the standard drug (cemetidine) and the mapped extract doses of ((500, 1000, 1500) mg /kg) body weight respectively showed normal organ architecture. Ulcer index study activities 70% indicating evidence of curative and preventive index range 35 to 43% showed some inhibition as seen on the gastric mucosa of the treated group. It was observed that the treatment and anti- ulceration effect of boiled aqueous leaf extract metabolites showed reduction on the histomorphological changes in the gastric mucosa and provided inhibition effectiveness of ethanol induced injury.

Open Access Original Research Article

FTIR and XRD of Zinc Oxide Nano Particle from Mangifera indica L. anacardiaceae

S. Udhaya Geetha, S. Thilakavathy

Journal of Pharmaceutical Research International, Page 176-181
DOI: 10.9734/jpri/2021/v33i47A33001

Zinc Oxide nanoparticle (ZnO) is broadly used in food packaging industry. Synthesis of ZnO includes different methods like using chemical, gas and sol gel. But it contains more toxins. Hence biosynthesis of zinc oxide nanoparticle is eco-friendly and non toxic. It acts as an anticancer, antidiabetic, antibacterial activity and so on. Trace metals like zinc, magnesium and chromium are involved in glucose metabolism and have a role in controlling blood glucose and hence in diabetic therapy. Zinc is also known to keep the structure of insulin and plays an important role in insulin synthesis, secretion and storage. Nano -ZnO is commonly utilized as additive in food. In this article we discussed about biosynthesis of zinc oxide nanoparticles from Mangifera indica L. anacardiaceae extract. Synthesized nanoparticles is subjected to its characterization such as Fourier Transform Infrared Spectroscopy (FTIR) in the range between 4000cm-1 to 400cm-1 and X-Ray Diffraction (XRD). Functional group was identified in FTIR and nature, size, composition and degree of crystallinity were determined by using X−ray Diffraction analytical technique.

Open Access Original Research Article

Correlation of the Protein Expression of Salivary Cortisol, Serum Vitamin B12 and Interleukin 1 Beta in Patients with Recurrent Aphthous Stomatitis

R. Deepa Viswasini, Pratibha Ramani, J. Selvaraj

Journal of Pharmaceutical Research International, Page 189-193
DOI: 10.9734/jpri/2021/v33i47A33003

This study will help in determining which molecules participate in the ulceration with an integrated approach combining external and internal factors. Recurrent aphthous stomatitis (RAS) is a common condition affecting the oral mucosa. Clinically it is manifested through recurrent painful lesions. A total of 28 subjects were recruited for this systematic case-controlled study (14 Control and 14). Whole unstimulated saliva was used for measuring Cortisol and IL-1 b levels. Patients with RAS lesions exhibited an elevated salivary cortisol level as against their healthy counterparts. The mean value for salivary cortisol among RAS patients was determined to be 16.2 nM/dL as against the control group which had a mean salivary cortisol of 12 nM/dL. Overall, this study helps provide insights into the correlation of the different biomarkers and RAS patients which can eventually lead to better therapeutic options and prevent recurrence in patients.

Open Access Original Research Article

Evaluation of Patient-Oriented Medicines Supply Information on Russian Healthcare Providers’ Websites

Nikita V. Polukhin, Natalia V. Ekkert, Mikhail V. Vodolagin

Journal of Pharmaceutical Research International, Page 202-211
DOI: 10.9734/jpri/2021/v33i47A33005

Aims: To evaluate the Russian Federation healthcare providers’ websites compliance to legal requirements on availability of patient-oriented medicines supply information and compare the evaluation results between public and private healthcare facilities.

Study Design: Cross-sectional study.

Place and Duration of Study: The evaluation of compliance to legal requirements to medicines supply information on public and private healthcare providers’ websites available on the Internet was conducted in September 2021.

Methodology: The study included a simple random sample of 66 websites of Russian healthcare providers containing two groups:  public (n=33) and private (n=33) healthcare facilities’ websites. The compliance evaluation was performed by checking the availability of 4 medicines lists on the websites: (1) essential medicines list; (2) list of medicines for the most expensive chronic diseases to treat; (3) list of medicines that are prescribed only by shared decision of healthcare facility medical commission; (4) list of medicines that are dispensed for certain social groups with no charge or with 50% discount in outpatient care settings.

Results: The difference of availability of the first list was 90.9% (95% CI 77.7%–97.4%) vs. 33.3% (95% CI 19.2%–50.3%) on public and private healthcare facilities’ website, respectively, P<.001. The difference of that in the second list was 42.4% (95% CI 26.8%–59.3%) vs. 15.2% (95% CI 6.0%–30.1%), P<.028. For the third no statistical significance was revealed (P>.05). For the fourth list the difference was 66.7% (95% CI 49.7%–80.8%) vs. 21.2% (95% CI 10.0%–37.2%), P<.001.

Conclusion: It is required to improve the supervision approaches for both public and private healthcare facilities for better patient-oriented medicines supply information provision. The problem may be solved by the implementation of a centralized government policy repository with regularly updated lists, requirements, and best practices.

Open Access Original Research Article

Comparative Study of Compliance and Factors Affecting Compliance among Commonly Used Drugs in Deep Vein Thrombosis Patients

Sajid Ali, Kheraj Mal, Jaghat Ram, Rukhsana Malik, Muhammad Aslam Abbassi, Qararo Shah, Ufn Sahrish

Journal of Pharmaceutical Research International, Page 221-229
DOI: 10.9734/jpri/2021/v33i47A33007

Objectives: The objective of current research was to identify the compliance of antithrombotic drug (heparin, warfarin and Rivaroxaban) and factors of non-compliance associated with heparin, warfarin and rivaroxaban.

Methodology: A cross-sectional, observational study was conducted on patients suffering from Deep Vein Thrombosis (DVT) at government teaching hospital of Larkana. 348 DVT patients were selected by using online sample calculator software. Data was collected by using pre validated questionnaire after taking patient consent; finally the data was analyzed with statistical package of social sciences (SPSS) version 25.

Results: The compliance with rivaroxaban was present in 103 (80.5%) patients followed by heparin drug compliance in 95 (74.2%) DVT patients and warfarin drug compliance in 98 (76.6%) DVT patients. Non-compliance factors with rivaroxaban were; cost in 4 (16.0%) patients, polypharmacy in 6 (24.0%) patients, side effects in 4 (16.0%) patients and prolong therapy in 11 (44.0%) patients. Non-compliance factors with heparin were; monitoring in 13 (39.4%) patients, diet restriction in 6 (18.2%) patients, injectable in 10 (30.3%) patients and ADR in 4 (12.1%) patients. Non-compliance factors with warfarin were; cost in 4 (13.3%) patients, polypharmacy in 8 (26.7%) patients, prolong therapy in 5 (16.7%) patients and ADR in 13 (43.3%) patients. 

Conclusion: This study concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance.

Open Access Original Research Article

Analysis of Drug Compliance among Patients Suffering from Deep Vein Thrombosis

Sajid Ali, Kheraj Mal, Abdul Manan Soomro, Jaghat Ram, Muhammad Aslam Abbassi, Qararo Shah, Arslan Ahmer

Journal of Pharmaceutical Research International, Page 235-244
DOI: 10.9734/jpri/2021/v33i47A33009

Objective: The objective of current research was to identify the compliance of commonly prescribed antithrombotic drug among patients who suffering from Deep Vein Thrombosis (DVT).

Methodology: Descriptive cross-sectional research on adults with age of 18-65 years suffering from DVT were conducted on medicine department of Shaheed Mohtarma Benazir Bhutto Medical University Hospital of Larkana. Three hundred and forty eight DVT patients were consecutive selected during the period of six months from January 2021 to June 2021. Data of DVT  patients was collected by using standard proforma and analyzed with statistical package of social sciences (SPSS) version 25. 

Results: Majority of DVT patients evaluated during study period were male 237 (61.7%) patients and 147 (38.3%) DVT patients were female. Mean age of DVT patients was 43.78 ± 12.43 (18-65) years. Most of the patients were in age group of 51-65 years having 126 (32.8%) patients followed by 41-50 years having 104 (27.1%) patients, 31-40 years having 93 (24.2%) patients and 18-30 years having 61 (15.9%) patients. Majority of DVT patients were from urban areas 217 (56.5%) patients followed by rural areas 167 (43.5%) patients. Drug compliance in illiterate patients was 107 (36.1%). Drug compliance in indoor job patients was 102 (34.5%) whereas drug compliance in jobless patients was 59 (19.1%). Drug compliance in positive medication history was 207 (69.9%). Drug compliance in Hypertensive patients was 33 (11.1%) in congestive heart failure patients 27 (9.1%), in ischemic stroke 15 (5.1%). Whereas, the drug compliance among diabetes mellitus patients was 13 (4.4%). Overall drug compliance with antithrombotic drugs was reported in 296 (77.1%) DVT patients.

Conclusion: Current research concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance.

Open Access Original Research Article

Evaluation of Co-Relation between Maternal Behavior Characteristics and Early Childhood Caries in Children of Wardha District

Thosar Nilima, Wayakar Rutuja, Sphurti Pramod Bane

Journal of Pharmaceutical Research International, Page 245-253
DOI: 10.9734/jpri/2021/v33i47A33010

Aim: To find the prevalence of ECC with respect to various maternal behavioral characteristics.

Study Design: Cross-sectional study

Place and Duration of Study: Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental college, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India between 2012-2013

Methodology: The study comprised of 540 children aged 6 months to 6 years attending the OPD. Structured questionnaire consisting of questions related to maternal factors affecting ECC was formatted for the study. Maternal factors included number of siblings in family, education, occupation, socioeconomic status, feeding practices, oral hygiene practices of mother and child. Age wise comparison of dental caries was done with every parameter along with number of teeth affected.

Results: Out of 540 children, 43.33% children were affected with dental caries and   56.67% children were not affected with dental caries. There was no statistically significant difference among the variables like number of siblings, occupation, socioeconomic status, feeding habits, oral hygiene status of mother and child except for educational qualification of mother.

Conclusions: Epidemiological data of the present study evaluating the co-relation between maternal behavior characteristics and ECC in children of Wardha district can be utilized for improved public oral health service planning within the region.

Open Access Original Research Article

New Validated Method for the Estimation of Pioglitazone and Rosiglitazone Using RP-HPLC

Syed Rafi, Kantipudi Rambabu

Journal of Pharmaceutical Research International, Page 254-262
DOI: 10.9734/jpri/2021/v33i47A33011

New, simple and economical high pressure liquid chromatography method has been developed for the simultaneous quantification of Pioglitazone and Rosiglitazone.By using Waters HPLC e-2695 quaternary pump with a PDA detector of 2998 instrument the chromatographic separation of Pioglitazone and Rosiglitazone was achieved on the column of Inertsil ODS (150x4.6mm, 3.5 µ) using an isocratic elution with a buffer containing 0.1percentformic acid and acetonitrile at a rate of 30:70 as a mobile phase with a flow rate of 1 ml/min at ambient temperature. A detector wavelength of 261 nm utilizing the PDA detector were given in the instrumental settings. The linearity was studied between the concentration range of 3-45 µg/ml of Pioglitazone and 1-15 µg/ml of Rosiglitazone were injected.The plotted calibration curves were linear with a regression coefficient of R2> 0.999, indicates that the linearity was with in the limit. As a part of method validation the parameters like specificity, linearity, accuracy, ruggedness, robustness were determined and the results were found to be within the allowable limit. The method developed was found to be applicable to routine analysis and to be used for the measurement of both active pharmaceutical ingredients (i.e, Pioglitazone and Rosiglitazone).Validation of the proposed method was carried out according to an International Conference on Harmonization (ICH) guidelines. Since, there is no HPLC method reported in the literature for the estimation of Pioglitazone and Rosiglitazone, there is a need to develop quantitative methods under different conditions to achieve improvement in specificity, selecivity etc.

Open Access Original Research Article

Effectiveness of Metformin and its Combination with Probiotic in Polycystic Ovarian Disease with Hyperprolactinemia: A Randomized Clinical Trial

Urooj Zafar, Syeda Amber Zaidi, Hafiz Syed Muhammad Osama Jafri, Sana Imran, Afreen Bhatty, Fizza Abidi

Journal of Pharmaceutical Research International, Page 268-274
DOI: 10.9734/jpri/2021/v33i47A33013

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder that predominantly affects women of the reproductive age. Anovulation and abnormal uterine bleeding are caused by hyperprolactinemia, which affects the hypothalamic-pituitary-ovarian axis.

Aim: In this study, the efficacy of combined Probiotic and Metformin therapy on hyperprolactinemia levels in PCOS patients was compared to Metformin therapy alone.

Methodology: 102 participants having hyperprolactinemia were enrolled via convenient sampling technique between January 2019 to August 2019. Out of them women having Polycystic Ovarian Syndrome (PCOS) and high serum prolactin levels were randomly assigned to one of two groups: group one received oral Metformin tablet 500 mg T.D. for three months, and group two received oral Metformin tablet 500 mg T.D  and Probiotic capsule 180 mg O.D for three months. Serum prolactin levels in both groups were compared before and after treatment.

Results: 54 (53%) of the 102 hyperprolactinemia women had PCOS. The Combination group showed improvement in reduction in hyperprolactinemia levels after 12 weeks of intervention.

Conclusion: The addition of Probiotic to Metformin improved prolactin levels in women with polycystic ovarian syndrome with hyperprolactinemia more than Metformin alone.

Open Access Original Research Article

Bioanalytical Method Development and Validation for the Determination of Favipiravir in Spiked Human Plasma by using RP-HPLC

Pallavi V. Duse, Kamalkishor G. Baheti

Journal of Pharmaceutical Research International, Page 275-281
DOI: 10.9734/jpri/2021/v33i47A33014

A precise, simple and reproducible reverse phase liquid chromatography (RP-HPLC) method was developed and validated for determination of Favipiravir by using Carbamazepine as internal standard in spiked human plasma. A chromatographic separation was accomplished with Cromasil C18 (250mm x 4.6ID, Particle size: 5 micron) column using mobile phase consists of methanol: water in the ratio (35:65, %v/v), at pH 3.0 with binary gradient system-maintained flow rate at 0.8ml/min. The detection wavelength of drug sample was at 225 nm. Extraction was done by using ethyl acetate as extracting solvent. The retention time of Favipiravir was found to be 6.62 min.  The method was found to be linear in the concentration range of 0.2-3.2 µg/ml. Limit of quantitation (LOQ) value was found to be 0.72. The intra- and inter day precision and accuracy lies within the specified range. The recovery studies were found to be in the range of 97.6 to 100.2%. %Relative standard deviation (RSD) was found to be in the range of 0.07-2.80%. All parameters were found to be validated from spiked human plasma. The proposed RP-HPLC method is highly accurate and rapid for the determination of favipiravir in human plasma and can be applied for pharmacokinetic studies and Therapeutic drug monitoring.

Open Access Original Research Article

Forensic Odontology Knowledge Analysis among Undergraduates Dental Students in Saudi Aribia

Kholod Alsowayigh, Rawan Almajaishe, Shatha shareef, Hassan Alateeq, Norah Alaskar, Asmahan Alamoudi, Khames Alzahrani

Journal of Pharmaceutical Research International, Page 282-290
DOI: 10.9734/jpri/2021/v33i47A33015

Aims: This study aims to measure the knowledge and awareness level towards Forensic odontology and Bite mark analysis among Dental students in Saudi Arabia.

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

Place and Duration of Study: Conducted in Saudi Arabia from July to August 2021.

Methodology: The study’s population consisted of Dental undergraduate in Saudi Arabia. Our Inclusion criteria: Male and Female, Private or Public, Dental Intern and dental students in Saudi national or non-Saudi. And Agree to Participate. The sample size was estimated using the Qualtrics calculator with a confidence level of 95%; a sample size of 386. Google Form was used as study tools the questionnaire contained 8 Questions. The First question includes information about years of study, the second question Name the College of a student, and other questions include questions on knowledge about Forensic odontology and Bite Mark analysis, and would they wish this specialization would be Available to us in Saudi Arabia

Results: A total of 386 participants completed the survey questionnaire. The results showed that the 75.4% of the study participants were females compared to 24.6% of them were males. it can be noted that approximately 75% of the study participants were in advance levels of their education (fourth year or after) compared to 25% of students were at inception phase of their study.

Conclusion: Every dental student must have knowledge of forensic dentistry because it is important to preserve the rights and assist the legal and security authorities in identifying victims and suspects and gaining awareness to accurately.

Open Access Original Research Article

Comparative Evaluation of Gastroprotective Potential of Dypsis lutescens (H. Wendl.) and Caryota Urens(L.) on Experimentally Induced Gastric Ulcer in Rats

Manasa Chiduruppa, P. Pandian, Sorabh Kumar Agrawal

Journal of Pharmaceutical Research International, Page 291-298
DOI: 10.9734/jpri/2021/v33i47A33016

The present study was carried out to find out the gastroprotective effects of the leaves extracts of Dypsis lutescens (H.Wendl.)  and Caryota Urens (L.)   in aspirin-induced gastric ulcer in rats. The ethanolic and aqueous extracts were prepared from the leaves of Dypsis lutescens and Caryota Urens and were used for this study. All procured animals were divided into seven groups. Each group contain n = 6, all groups except the normal control treated with aspirin 150 mg/kg oral. Group, I served as the normal control group which received normal saline, group II served as negative control and group III as standard group receiving 20 mg/kg omeprazole and 4th to 7th groups treated with leaves extracts of Dypsis lutescens and Caryota urens respectively. Treatment was given to group II to group VII rats in every 24 h for seven days. After 24 h fasting, on the 8th-day stomach contents were aspirated under anaesthetic condition to check free and total acidity. Stomachs were opened in all sacrificed animals along the greater curvature to estimate ulcer index, percentage protection and histopathology studies.

The results of the present study revealed that the severity of aspirin-induced ulceration was significantly (P < 0.05) decreased in Dypsis lutescens extracts treated groups in comparison with the control and Caryota urens treated groups.  It was observed that the free and total acidity significantly decreased in the aqueous extract of Dypsis lutescens treated group when compared with the negative control and Caryota urens treated groups.

Open Access Original Research Article

Formulation and Characterization of Modified Release Microspheres of Lornoxicam Using Okra Gum as Natural Polymer and Ethyl Cellulose as Synthetic Polymer

Ashwin Kumar Saxena, Navneet Verma

Journal of Pharmaceutical Research International, Page 299-326
DOI: 10.9734/jpri/2021/v33i47A33017

Objective: The nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely used medications in the world because of their demonstrated efficacy in reducing pain and inflammation. The arthritis, pain and inflammation are effectively treated with Lornoxicam, an effective NSAIDs. Because the drug is weakly acidic, it is absorbed easily in the GI tract, and has a short biological half-life of 3 to 5 hours. To meet the objectives of this investigation, we developed a modified release dosage form to provide the delivery of lornoxicam at sustained rate which was designed to prolong its efficacy, reduce dosage frequency, and enhance patient compliance. The present research work was focused on the development of lornoxicam microspheres using natural polymer like okra gum extracted from the pods of Abelmoschus esculentus Linn. and synthetic polymer like ethyl cellulose along with sodium alginate prepared by Ca2+ induced ionic-gelation cross-linking in a complete aqueous environment were successfully formulated.

Materials and Method: The microspheres were prepared by using sodium alginate with natural polymer (okra gum) and synthetic polymer (ethyl cellulose) in different ratios by Ca2+ induced ionic-gelation cross-linking. The formulations were optimized on the basis of drug release up to 12 hrs. The physicochemical characteristics of Lornoxicam microspheres such as drug polymer interaction study by Fourier Transform Infrared (FTIR) and further confirmation by Differential Scanning Calorimetry (DSC) and X-ray Diffraction (XRD). The formulated microspheres were characterized for particle size, percentage drug entrapment efficiency, micromeritic properties, surface morphology, percentage swelling index, in-vitro drug release study and mechanism of drug release.

Results and Discussion: The FTIR Spectra revealed that there was no interaction between polymer and Lornoxicam which was further confirmed by DSC and XRD. All the formulated Lornoxicam microspheres were spherical in shape confirmed by SEM. The microspheres exhibited good flow properties and also showed high percentage drug entrapment efficiency. All the batches have excellent flow properties with angle of repose in the range of 25.38° ± 0.04 to 30.41° ± 0.07, carr’s index and hausner’s ratios in the range of 10.40% ± 0.018 to 16.66% ± 0.012 and 1.128 ± 0.09 to 2.225 ± 0.01, respectively. The optical microscopic studies revealed that the mean particle size of all the formulations were found in the range of 819.46 ± 0.07 to 959.88 ± 0.02 μm and percentage of drug entrapment were found to be between 72.35 ± 0.02 to 90.00 ± 0.05. Swelling index of prepared microspheres revealed that with increasing the polymer ratios, there were increase in the swelling of prepared microspheres, showing in the range of 600.76 ± 0.42 to 690.11 ± 0.03% for okra gum microspheres at the end of 9 hr in comparison with ethyl cellulose microspheres which ranges between 179.71 ± 0.07 to 227.73 ± 0.05% at the end of 7 hr. In-vitro drug release of prepared microspheres formulation code LSO4 and LSE4 were found to be 88.654 ± 0.25% and 93.971 ± 0.20% respectively at the end of 12 hr. It was suggested that increase in polymer concentration, the drug release from the prepared microspheres got retarded producing sustained release of lornoxicam. In-vitro drug release data obtained were fitted to various release kinetic models to access the suitable mechanism of drug release. Drug release from lornoxicam-loaded alginate-okra gum microspheres followed a pattern that resembled sustained release (Korsemeyer-Peppas model) (R2 = 0.9925 to 0.9951), and n ≤ 1 indicated anomalous diffusion (non-Fickian), supercase-II transport mechanism LSO4 (n = 1.039) over a period of 12 hour underlying in-vitro drug release. Moreover, zero order model (R2 = 0.9720 to 0.9949) were found closer to the best-fit Korsemeyer - Peppas model.

In addition, the drug release from lornoxicam-loaded alginate-ethyl cellulose microspheres also follow Korsemeyer-Peppas model (R2 = 0.9741 to 0.9973) with near to Hixson-Crowell model (R2 = 0.9953 to 0.9985) and n < 1 indicated non-Fickian diffusion or anomalous transport mechanism. Moreover, first order model with non-Fickian diffusion mechanism (R2 = 0.9788 to 0.9918) were found closer to the best-fit Korsemeyer-Peppas model/ Hixson-Crowell model.

Conclusion: The present study conclusively demonstrates the feasibility of effectively encapsulating Lornoxicam into natural polymer (okra gum) and synthetic polymer (ethyl cellulose) to form potential sustained drug delivery system. In conclusion, drug release over a period of 12 hrs, could be achieved from these prepared microspheres. A pH-dependent swelling and degradation of the optimized microspheres were also observed, which indicates that these microspheres could potentially be used for intestinal drug delivery.

Open Access Original Research Article

BSA Adsorption and Antibiofilm Properties of (N-Cyclohexylacrylamide-co-Acrylamide/AMPSNa) Hydrogels

K. Jayanthi, P. Pazhanisamy

Journal of Pharmaceutical Research International, Page 335-343
DOI: 10.9734/jpri/2021/v33i47A33019

The hydrogels poly (N-cyclohexylacrylamide-co-acrylamide/2-acrylamido-2-methyl-1-propanesodiumsulfonate) i.e.poly(NCA-co-AM/AMPSNa) (HG41,HG42,HG43&HG44) were synthesised via  free-radical copolymerization of NCA and (AM) in a fixed proportion  (50:50), but varying the ionic monomer-AMPSNa (0.1g,0.3g,0.5 d 0.7g) in a medium of mixture of water and methanol  at 60°C in an oil bath, Potassium persulfate (KPS) was used as an initiator, while N,N'-methylene-bisacrylamide (MBA) was used as a cross-linker. FT-IR spectral data, SEM, XRD, and TGA techniques were used to characterise the synthesised hydrogel (HG43). On changing pH(3.0, 5.0, 7.0 & 9.0), the amount of Bovine Serum Albumin (BSA) adsorption efficiency by  these hydrogels was evaluated. At pH 5.0, which is near to BSA's isoelectric point (4.7)., the maximum adsorption was found. BSA adsorption increased as the amount of AMPSNa increased. SEM and XRD were used to examine the BSA-adsorbed hydrogel (HG43). The antibiofilm abilities of the hydrogel (HG43) by Microtiter plate Assay(MTP), Fluorescence microscopy and SEMl against Staphylococcus aureus and Pseudomonas aureginosa displayed outstanding efficacy.

Open Access Original Research Article

A Brief Review on Topical Gels as Drug Delivery System

Chinmoy Bhuyan, Dipankar Saha, Bipul Rabha

Journal of Pharmaceutical Research International, Page 344-357
DOI: 10.9734/jpri/2021/v33i47A33020

The method of applying prescription dosage forms to the skin for direct treatment of a cutaneous disorder is known as a topical drug delivery system. Topical gels are semisolid dosage forms in which a liquid phase is constrained within a three-dimensional polymeric matrix derived from natural or semi-synthetic sources with high physical or chemical cross-linking. Because of their intermediate behavior between solid and liquid materials, topical gels are an excellent candidate for transdermal drug delivery. Clinical evidence indicates that topical gel is a safe and effective treatment choice for the management of skin-related diseases, especially when used for local action to avoid the side effects of other conventional dosage forms. Gels, cream, ointment, and paste are the most commonly used semi-solid formulations for topical drug delivery. Gels are colloids in which the liquid medium has thickened to the extent that it behaves like a solid. Since topical gel formulations are less greasy and can be quickly removed from the skin, they offer better drug delivery. In comparison to cream, ointment, and paste, gel formulations have improved application properties and consistency. This article aims to review the principles and recent developments in topical gels, including classification, methods of preparation, applications, and so on.

Open Access Original Research Article

Extra Analysis of Health Care Policy for Patients with Corona Virus during COVID 19 and with Chronic Heart Failures and Roles of Nurses at Hospitals in Vietnam

Pham Thi Bich Ngoc, Dinh Tran Ngoc Huy, Vu Thanh Binh, Pham Thi Hong Nhung, Ngo Huy Hoang

Journal of Pharmaceutical Research International, Page 358-368
DOI: 10.9734/jpri/2021/v33i47A33021

The study aims to provide knowledge of self-care for patients with COVID 19 and with heart failures. In the United States, between 2011 and 2014, an estimated 6.5 million Americans over the age of 20 had chronic heart failure The estimated prevalence of heart failure in Asia ranges from 1.26% to 6.7%, in Southeast Asian countries from 4.5% to 6.7%. This study used Health education intervention that was carried out for 90 patients with chronic heart failure inpatient treatment at Cardiology Department - Nam Dinh General Hospital.
The rate of heart failure in Korea was estimated at 1.53% in 2013. The frequency of heart failure in Korea is expected to double, from 1.60% in 2015 to 3.35% in 2040. By 2040, more than 1.7 million Koreans are expected to have heart failure .In Japan, an estimated 1.0 million patients have heart failure and the number of outpatients with left ventricular dysfunction is expected to gradually increase to 1.3 million by 2030 In China, 4.2 million people suffer from heart failure and 500,000 new cases are diagnosed each year). We perform method of one-group intervention study with before-after comparison. Health education intervention was carried out in 90 patients with chronic heart failure inpatient treatment at Cardiology Department - Nam Dinh General Hospital.  Our results show that patients with cardiovascular disease need to be aware that they are a very high risk group for infection as well as serious complications that may occur if they are unfortunately infected with COVID-19. This research finding and recommended healthy foods to support for better health of patients with chronic heart failure in many developing countries. Last but not least, vital roles of nurses in Nam Dinh and Vietnam hospitals have been increasing in recent years in helping patients and help them to gain knowledge for self-care with COVID 19 and with heart failures and practice “Maintenance of care” of patients with chronic heart failure.

Open Access Original Research Article

Histopathological Correlation in Different Types of Leprosy in a Tertiary Health Care Centre

M. Ravali, Jayakar Thomas

Journal of Pharmaceutical Research International, Page 369-378
DOI: 10.9734/jpri/2021/v33i47A33022

Hansen’s disease or Leprosy, is a chronic infectious disease that is contagious and has a slow evolution. It affects mainly skin and schwann cells in the peripheral nerves and causes peripheral neuropathy which contributes to the permanent functional impairments [1]. It is caused by a rod shaped,acid fast staining bacteria known as Mycobacterium Leprae which has parallel sides, round ends and a characteristic bundle of cigar appearance due to the presence of a glial substance which is a surface lipid that makes the bacilli to be arranged side by side in parallel arrays [2]. It has a distinctive empathy towards the peripheral nerves where it establishes originally therefore it is the site where the pathological processes start mainly with the principal target being Schwann cell [3,4].  Amidst the communicable diseases, Leprosy is the most common cause of physical disabilities which is permanent. When the bacterium enters a person with good cell-mediated immunity against it, it gets destroyed. If there is a slight impairment in the cell-mediated immunity against it, some bacilli will multiply and a lesion develops. Depending upon the immune status of a host, it expresses itself in different clinico-histopathological forms [5]. Ridley and Jopling suggested a five-group classification of leprosy known as immunological classification based upon the immunological status of the patient as (a) tuberculoid (TT), (b) borderline tuberculoid (BT), (c) mid-borderline (BB), (d) borderline lepromatous (BL) and (e) lepromatous (LL) [6]. Bacteriological, immunological, clinical and histopathological features exhibit continuous but slow changes from one pole to another pole. The main disadvantage of this classification is that there is no specific position for pure neuritic as well as indeterminate leprosy in the spectrum [7].

Open Access Original Research Article

Prevalence of Adverse Reactions to Different COVID-19 Vaccinations among Karachi Residents

Hira Ahmed Malik, Aisha Faraz, Afreen Bhatty, Tayyaba Mumtaz, Urooj Zafar, Samreen Khurram

Journal of Pharmaceutical Research International, Page 379-386
DOI: 10.9734/jpri/2021/v33i47A33023

Background: Coronavirus disease 2019 (COVID-19) pandemic emerged in Karachi and rapidly spread throughout Pakistan Since February 26, 2020. 

Objectives: Vaccination is currently one of the most effective COVID-19 eradication approach. The purpose of this study was to gather data on the adverse effects of the COVID-19 vaccine.

Methodology: It was an observational study that was carried out between the 11th and 23rd of April 2021, and the participants were Karachi residents. We looked at the proportion of self-reported local and systemic adverse effects within seven days of immunization in people who filled out Google forms and received one or two doses of the vaccine.

Results: The vaccination ratio for male was slight higher than females. Participants aged between 51 to 60 years and 41 to 50 years had higher number of vaccinations. Sinopharm is by far the most widely used vaccine. After the first dose of vaccination, the majority of participants complained of fever, chills, muscle pain, and arm pain, whereas after the second dose, the majority of participants had no symptoms, with a few participants complaining of fever, chills, diarrhea, and muscle pain.

Conclusion: The first and second doses' post-vaccination adverse effects were mild and predictable, and there were no hospitalizations; this data can help lessen vaccine hesitancy.

Open Access Original Research Article

To Assess the Prevalence of Bacterial Vaginosis among Women in Selected Rural Areas

Snehal N. Dhobe, Manjusha Mahakarkar

Journal of Pharmaceutical Research International, Page 410-414
DOI: 10.9734/jpri/2021/v33i47A33027

Bacterial vaginosis is condition in which abnormal vaginal discharge can cause. Due to this sexually transmitted diseases are causing in the women. In the bacterial vaginosis there is an imbalance in the vaginal acidity the pH becomes more than 5 the bacteria becomes overgrowth and due to this bacterial infection or bacterial vaginosis leads [1].

Objective: 1: To assess the prevalence of bacterial vaginosis among women. 2: To find out the association between prevalence of bacterial vaginosis among women with socio-demographic variable.

Materials and Methods: Research Approach- Quantitative research approach. Research Design: Cross sectional survey design. Setting of the Study: The study was conducted at rural hospital and primary health centre. Population: women Sampling technique: non-probability convenient sampling technique. Sample size: 115.

Results: The data obtained to describe the sample characteristics including demographic variables (age of women, education, marital status, occupation, age of menarche ,menstrual history, use of contraception, types of contraception), prevalence of bacterial vaginosis women the total participant was 115 women age of 30-50 years. Hence the all findings were describes there was no association between socio demographic variables and prevalence of bacterial vaginosis is 6.1%. Conclusion In this study the finding of the study shows that overall there was n association between bacterial vaginosis and demographic variables. The prevalence of bacterial vaginosis was 6.1% in the present study which was relatively low. However it vaginosis was common among sexually active women. The test was done by pap smear test which gave exact result and interpretation of test.

Open Access Original Research Article

Impact of Skills Training Program on First Aid Management Knowledge among the Secondary School Student’s

Roma Patel, H. N. Ravindra, Swapnil Rahane, Devraj Singh Chouhan

Journal of Pharmaceutical Research International, Page 415-419
DOI: 10.9734/jpri/2021/v33i47A33028

Background of the Study: First aid involving simple but life-preserving techniques which can be performed with minimum facilities and without having any medical experience. Snowballing in the number of educated individuals, comprising the school pupils who can play a vital role in the First Aid field is an expectation of public health. The objectives of this study were to assess existing knowledge of students regarding first aid skills, to evaluate the effectiveness of organized skill training program on first aid skills. A quantitative research approach and one group pre-test and post-test research design were adopted to accomplish the main objective of the present study. 60 students were selected from the secondary school of Vadodara city by using a simple random sampling technique. Data was collected through a structured knowledge questionnaire on first aid skills. A skill training program on first aid skills was presented after the pretest. Post-test data were collected from the secondary school students after seven days of implementation of the skill training program on first aid skills. The prior consent was obtained from the students as well as their parents. The collected data were tabulated and analyzed using descriptive and inferential statistics.

Results: The results of the study discovered that among 60 respondents, the majority of the respondents (53.3%) had average inadequate & 46.7% had moderate knowledge score and in post-test among 60 respondents, majority of the respondents 75%) had adequate knowledge, 25% had moderate knowledge score. The ‘t’ value 57.808 was observed at 0.05 level & the P-value =0.00 which is <0.05 that shows that there is an increase in the post-test level of knowledge. This shows that the skill training program on selected aspects of first aid skills is effective. Among all socio-demographic variables, the obtained x2 value for the age demographic variable is 3.1 only age was significantly associated with posttest knowledge score, which is greater than the table of x2 at 0.05 level of significance. The remaining demographic variables gender, type of family & source available for information on first aid was less than the table of x2 at 0.05 level of significance, so they are not associated with posttest knowledge score.

Conclusion: The study finding revealed that an organized skill training program on selected aspects of first aid skills was effective among the students. The result of the present study shows that there is a great need for secondary and above standard school students to update their knowledge regarding first aid skill management of minor injuries & important aspects of first aid.

Open Access Original Research Article

Calreticulin and JAK2 Exon 12 Mutation Screening in Patients with Myeloproliferative Neoplasms’ in Jeddah Region, Saudi Arabia

Heba Alkhatabi, Heyam Abdulqayoom, Raed Alserihi, Raed Felimban, Aisha Elaimi, Zinab Allala, Afaf Magboli, Salem Bahashwan, Hashem Alsalmi, Abdulelah Shihah, Adel Abuzenadah, Elrashed B. Yasin

Journal of Pharmaceutical Research International, Page 420-428
DOI: 10.9734/jpri/2021/v33i47A33029

Background: The JAK2 V617F mutation’s discovery has largely facilitated the comprehension of the myeloproliferative neoplasms’(MPNs) pathogenesis. In recent times, calreticulin (CALR) mutations have been detected in patients with JAK2V617F negative primary myelofibrosis (PMF), and essential thrombocythemia (ET).

Methods: This study analyzed the impact of JAK 2 Exon 12 and CALR common mutations in 65 patients with JAK2V617F negative MPN from the Jeddah region. An allele-specific polymerase chain reaction (PCR) method was used to screen four common mutations on Exon 12 and direct sequencing and PCR analysis were utilized to screen all patients for CALR.

Results: None of the patients were positive for the Exon 12 mutation and eight patients were positive for CALR mutations.

Conclusions: This is the first Saudi Arabian research that focused on screening CALR hotspot mutations and this mutation exists. This fact highlights the importance of implementing diagnostic screening of CALR on MPN patients, in general, and patients with high platelet count, in particular. Further screening of other predisposing genetic markers might facilitate the identification of an important genetic variant, which could aid in the understanding of disease pathogenesis.

Open Access Original Research Article

Association between COVID-19 Pandemic Conditions and Perceived Stress Level among College Students in Saudi Arabia

Shaimaa M. Ata, Manal Eltahir, Ahad Albadah, Hind Harun, Harun Hadeel, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Page 429-436
DOI: 10.9734/jpri/2021/v33i47A33030

Aims: To assess the levels of perceived stress among college students in Saudi Arabia after changing the learning protocols because of covid-19 pandemic.

Study Design: This was a cross-sectional study.

Place and Duration of Study: The study was conducted in Saudi Arabia, from May 2020 to October 2021.

Methodology: A cross-sectional survey study that was carried out in Saudi Arabia. A self-administered, pre-designed questionnaire, including Perceived Stress Scale of 10 items was used to measure the stress levels. The participants were selected randomly from different social media users  who lived and studied in Saudi Arabian universities.  In this study, 10-item questions of the Perceived Stress Scale (PSS-10) was used based on a 5-point Likert scale to score each item (0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often).

Results: A total of 2034 students living in Saudi Arabia participated in the study. The results showed that 76.84% of total participants had strong stress, males reported higher score as compared to their Female counterparts.  Also, students older than 28 years reported higher level of stress, the students in Qassim region showed highest scores of stress. In addition, excellent academic achievement was strongly associated with high level of stress.

Conclusion: The findings suggest that significant number of students had higher stress levels using the perceived stress scale. Therefore, this cross-sectional study identified a high stress level in COVID-19 crisis among university students in Saudi Arabia.

Open Access Original Research Article

Trends in Productivity Growth of Indian Pharmaceutical Industry: A Growth Accounting Analysis

Ariful Hoque, Subhrabaran Das

Journal of Pharmaceutical Research International, Page 437-446
DOI: 10.9734/jpri/2021/v33i47A33031

The pharmaceutical industry of India is one of the most rapidly expanding research-based industries of Indian manufacturing. This paper attempts to examine the trends in partial and total factor productivity (TFP) growth of India’s pharmaceutical industry using industry-level time series data covering a period of 25 years from 1993-94 to 2017-18, which is further divided into pre-product and post-product patent periods. Three alternative indices of growth accounting approach viz., Translog, Solow, and Kendrick have been used to measure the growth of total factor productivity with four input production framework. The study results indicate significant increasing trends in capital intensity as well as labour, energy and material productivity and a significant declining trend in capital productivity over the entire study period. This study also finds a positive turnaround in the TFP growth of Indian’s pharmaceutical industry during the post-product patent era. The decomposition analysis confirms that output growth in the pharmaceutical industry is input-driven rather than productivity-driven as TFP growth contributes only 8.5 percent to the observed output growth. From the policy standpoint, this paper also suggests greater emphasis on resource efficiency by improving the quality of factor inputs, particularly capital, through increased R&D activities and adoption of cutting-edge technology.

Open Access Original Research Article

Diagnostic Accuracy of Doppler Ultrasound in the Diagnosis of Testicular Carcinoma by Taking Histopathology as Gold Standard

Abid Ali Sahito, . Ahsanullah, Vicky Kumar, Mohsim Hussain, Humaira Ashraf, Humera Jabeen

Journal of Pharmaceutical Research International, Page 447-451
DOI: 10.9734/jpri/2021/v33i47A33032

Objective: To determine the diagnostic accuracy of doppler ultrasound in the diagnosis of testicular carcinoma, by taking histopathology as gold standard.

Methods: This cross-sectional study was carried out at Radiology department of Liaquat University of Medical and health Sciences (LUMHS), from November 2017 to October 2019. All the clinically diagnosed cases of testicular carcinoma, those who referred for doppler ultrasound and histopathology of testes, were included. After taking informed consent all the study participants underwent testicular histopathology after doppler ultrasound. All of the information was entered into a research proforma. SPSS version 20 was used to analyze the data.

Results: Overall, 70 patients of suspected testicular carcinoma were studied. The mean age of the cases was 38.38+4.55 years. Most of the cases 47(67.1%) were poor. As per Doppler ultrasound (U/S) findings out of all 55.7% cases had diagnosed testicular carcinoma, while histopathologically it was observed in 45.7% of the cases. Diagnostic accuracy of Doppler U/S in testicular carcinoma diagnosis was observed to be 77%, followed by sensitivity (SE) 84%, specificity (SP) 71%, positive predictive value (PPV) 78% and negative predictive value (NPV) 84%.

Conclusion: Doppler ultrasound observed to be a non-invasive, uncomplicated, lack of pain, effective and easily available diagnostic tool for early diagnosis of testicular carcinoma.

Open Access Original Research Article

Methylation Profiling SOCS2 in Philadelphia-Negative Myeloproliferative Neoplasm

Elrashed B. Yasin

Journal of Pharmaceutical Research International, Page 452-461
DOI: 10.9734/jpri/2021/v33i47A33033

The Janus kinase signal transducer and activator of transcription (JAK / STAT) signalling, which is crucial in Philadelphia-negative myeloproliferative neoplasms’ (MPNs), is negatively regulated by molecules such as SOCS, CISH, and SHP1. SOCS2 methylation has been studied in MPN with conflicting results. Here we examine the methylation status of SOCS2 by specific methylation-specific polymerase chain reaction (MSP) in cell lines and 130 diagnostic prepheral blood samples from Ph-ve MPN. Furthermore, we tried to explain the mismatch of the methylation frequency by assigning the investigated MSP primers to the respective genes. Methylation was detected in normal controls using SOCS2-MSP primers in the 3 'translated exon sequence, but not with primers around the transcription start site in the 5' untranslated regions (5'UTR). SOCS2 was completely unmethylated in primary MPN samples and cell lines. In contrast, SOCS2 methylation when using MSP primers located at the 5'UTR is rare in all studies.

In conclusion, SOCS2 methylation is rare in Ph-ve MPN. The appropriate MSP primers are important for an accurate estimate of the methylation frequency. The role of SOCS2 methylation in MPN pathogenesis requires further investigation.

Open Access Original Research Article

Evaluation of COX-2 Inhibitor Injurious Effects on Proximal Convoluted Tubular Diameter of Kidney with Favorable Impact of Lycopene in Albino Rats on the Basis of Microscopic Features

Sadia Sundus, Aisha Hassan, Ashok Kumar, Shah Jabeen, Nadira Hameed, Madiha Ajaz

Journal of Pharmaceutical Research International, Page 462-468
DOI: 10.9734/jpri/2021/v33i47A33034

Objective: To analyze the harmful effect of COX-2 inhibitor on proximal convoluted tubular diameter of kidney, amendment by lycopene. 

Research Design: Experimental Research.

Abode of Research: Animal House, JPMC, Karachi.

Materials and Methods: 90-120 days old, forty healthy adult male Albino rats of 200-220gm weight were taken for this study and distributed into 4 cliques, set 1was chosen as control, in Set 2 Celecoxib was given 0.05g/1000g by gavage, in set 3 Celecoxib was given0.05g/1000g by gavage with lycopene 0.05g/1000g by gavage and set4 lycopene was given0.05g/1000g by gavage for 30 days. At accomplishment of study, animals were sacrifice and tissues were preserved for staining.

Results: Inset 2 proximal convoluted tubular diameter became distended due to apoptosis of lining epithelial cells. They turn into low cuboidal from simple cuboidal cells along with ill-defined brush border at the luminal surface due to scarce microvilli and had disrupted basement membrane, however renal structure were amended in set3 which were given celecoxib with lycopene.

Conclusion: This study reveals that lycopene amended the apoptotic changes of set2.

Open Access Original Research Article

Modifiable and Non-modifiable Risk Factors Association with Functional Dyspepsia

Prem Kumar Maheshwari, Hassan Liaquat Memon, Kapeel Raja, Shaista Zeb, Kamran Ahmed Almani

Journal of Pharmaceutical Research International, Page 489-493
DOI: 10.9734/jpri/2021/v33i47A33036

Objective: To determine the frequency of modifiable and non-modifiable risk factors of functional dyspepsia in our population.

Materials and Methods: This cross-sectional study has been conducted department of gastroenterology of Isra University Hospital from February 2019 to January 2020. All the patients of all age groups presented with functional dyspepsia and either of gender were included in the study. Patients were interviewed regarding modifiable and nonmodifiable risk factors like age, gender, smoking, body mass index, alcohol consumption and stress. All the data was gathered via study proforma.

Results: Total 200 cases of functional dyspepsia were studied for modifiable and non-modifiable risk factors. Mean age of the cases was 49.45+6.33 years. Most of the cases were more than 40 years of the age. Males were 64.5% and females were 40.5%. According to the ethnicity Sindhi and Punjabi were commonest as 40.5% and 35.0% respectively. Inadequate physical activity and smoking habits were highly prevalent as 57.5% and 36.0% respectively.

Conclusion: As per study conclusion age more than thirty years, male gender, ethnicity of Sindhi and Punjabi, smoking and inadequate physical activity were observed to be highly prevalent modifiable and non-modifiable risk factor of the functional dyspepsia.

Open Access Original Research Article

To Assess the Level of Anxiety of Parents Regarding Invasive Procedures among Hospitalized Children

Ashwini Thawkar, Archana Maurya

Journal of Pharmaceutical Research International, Page 494-501
DOI: 10.9734/jpri/2021/v33i47A33038

Background: Hospitalization is a completely new experience to infants and young children. Some parents know the illness about their child but some have not but most of them don’t know the treatment regimen on illness of child through which he/ she is going through. When the child is admitted in patient department he or she has go through. As they don’t know about the procedures through which their child undergone; that responsible for the increase in anxiety level of father and mother both. Various questions are there in their mind; about which kind of procedure is this, my child is bearing or not? How painful it is? Is my child crying? All these questions are arises. As they don’t know about the procedures so these questions are increasing the stress level and anxiety level of parents.

Objective: To assess the level of anxiety of parents regarding invasive procedures among hospitalized children 2. To compare the level of anxiety of mother and father regarding invasive procedures among hospitalized children 3. To associate the level of anxiety of parents regarding invasive procedures with selected demographic variables.

Methods and Materials: Descriptive survey method.

Tool: Standardized and validated STAI anxiety tool.

 Research Approach: Descriptive approach.

Sample Size: 100.

Sampling technique: Non convenient sampling technique

Sample: Parents of hospitalized child.

Setting: Selected hospital.

Results: In these study the level of anxiety were seen into 4 categories; no anxiety, mild, moderate and severe anxiety. No anxiety had been seen in parents having score range (0  - 25%), mild anxiety is assessed in 15 parents having anxiety score (26 – 50%) while in 80 parents an moderate anxiety is assessed having score range in between (51 – 75%)  and  severe anxiety  was assessed in 5 parents of an hospitalized child who were undergoing selected invasive procedures and having anxiety score in between (76 – 100%) on Comparison of level of anxiety of mother and father regarding invasive procedures in hospitalized children shows that mother had more anxiety level than father.

Conclusion: In the study, moderate anxiety is assessed in 80% of parents while shown an association in between anxiety level and knowledge of a parents as well as the age of hospitalized child.

Open Access Original Research Article

Sero-Prevalence of Dengue Fever Virus Antibodies in Red Sea State, Sudan- A Cross-Sectional Study

Israa Abbas, Manar G. Shalabi, Anass M. Abbas, Hatem Mohamed, Asaad M. A. Babker, Al Fadhil A. Omer

Journal of Pharmaceutical Research International, Page 506-510
DOI: 10.9734/jpri/2021/v33i47A33040

Background: Dengue fever (DF) is caused by dengue virus (DENV), a positive-sense single stranded RNA virus of the genus Flavivirus in the family Flaviviridae. The DF has been reported as one of the most important arboviral diseases in many parts of the world including Sudan. DENV is a widely spreading disease that has resulted in an emerging infectious disease world-wide.

Aim: The aim of this study was to estimate the prevalence of dengue virus in Red sea state, Sudan.

Materials and Methods: This study is a cross sectional study, carried out in Eastern part of Sudan with an impartial method to determine the DENV antibodies status in Red Sea state, Sudan, Dengue Virus (DENV) antibody test was done for each sample. Blood samples were collected from each patient in a plain container, and then serum was separated and tested for (DENV) IgM by using ELISA.

Results: Of the total 380 dengue cases tested 106 (27.9%) were identified as anti-dengue IgM positive. 57.1% (n=217) were females and 42.9% (n=163) were males, the highest numbers of cases; 152 (40%) from the age group between 40 years and above and least numbers of cases; 47(12.4%) from the age group of 10-19 years. 55 (14.5%) cases among age groups of less than 10 years, 73 (19.2%) from the age group 20-29 years and six 53 (13.9%) from the age group between 30-39 years of age.

Conclusion: We can conclude that serotypes (IgM) of dengue virus prevalence is 27.9% in Red Sea State, Sudan and this finding indicate that the residents of the Red State are at risk of developing the disease. Also, there was significant variation between age and the occurrence of the disease. The Ministry of health should initiate dengue surveillance and commence an integrated vector control programme.

Open Access Original Research Article

Assess the Effectiveness of Planned Teaching on Knowledge Regarding Kangaroo Mother Care among Husbands of Primigravida Mother

Suwarna Ghugare, Tessy Sebastian, Manjusha Gulabrao Mahakalkar, Darshana Durgadass Wankhede

Journal of Pharmaceutical Research International, Page 532-539
DOI: 10.9734/jpri/2021/v33i47A33043

Kangaroo care is a practise that allows moms and fathers to have direct skin-to-skin contact with their infants. It has been demonstrated to promote the mother's mental health, strengthen mother-infant connection, and increase maternal lactation. Many studies feel that returning to the original paradigm of infant-mother early care, rather than our current incubator, bottle, and formula-feeding model, will result in happier and healthier newborns [1].

Objective: 1) To determine whether primigravida women' spouses have any awareness of kangaroo mother care. 2) To assess the efficiency of a planned education programme on kangaroo mother care among primigravida moms' husbands.3) To see if there's a link between post-test knowledge scores on kangaroo mother care among primigravida moms' spouses and certain demographic variables.

 Methodology: A total of 60 people took part in the research. Husbands of primigravida women from various hospitals will be used as study subjects.

Results: There is a significant difference between pre-test and post-test knowledge scores when measuring effective planned training on knowledge about kangaroo mother care among husbands. The pretest has a mean of 8.18, while the posttest has a mean of 16.30, and the pretest has a standard deviation of 2.855, while the posttest has a standard deviation of 1.710. The t-value is 18.57, and the p-value is 0.000.

Conclusion: As a result, the planned education on knowledge about kangaroo mother care among primigravida moms' husband is statistically interpreted. The research hypothesis was accepted in this study, while the null hypothesis was denied.

Open Access Original Research Article

Roman Domination of Some Chemical Graphs

Pallavi Sangolli, Manjula C. Gudgeri, . Varsha, Shailaja S. Shirkol

Journal of Pharmaceutical Research International, Page 556-562
DOI: 10.9734/jpri/2021/v33i47A33045

The concept of Domination in graphs has application to the study of DNA structures. For investigating the chemical and physical properties, several topological indices used are Wiener index, Randic index, Zagreb index, Kier & Hall index that depends on vertex degree and distance sum, and have been used extensively for QSAR and QSPR studies.

A Roman Dominating Function of G is function f: V→ {0, 1, 2} such that every vertex v for which f (v) = 0 has a neighbor u with f(u) = 2. The weight of a Roman dominating function f is w (f) =   . The Roman domination number of a graph G is denoted by (G) and is the minimum weight of all possible Roman dominating functions. In this paper, we find Roman domination number of some chemicals graphs such as saturated hydrocarbons and unsaturated hydrocarbons, hexagonal chain, pyrene, Hexabenzocoronene, H-Phenylenic nanotube and N-Napthelenic nanotube.

Open Access Original Research Article

Application of Box–Behnken Design and Desirability Function in the Development and Optimization of Stealth Liposomes of Microtubule Inhibitor

Bandaru Lakshmi Narayana Rao, S. Parimala Krishnan, Challa Balashekar Reddy

Journal of Pharmaceutical Research International, Page 563-575
DOI: 10.9734/jpri/2021/v33i47A33046

Aims: The aim of the present study was to develop and optimize a Stealth Liposomal Drug Delivery System of microtubule inhibitor using Box–Behnken Design and Desirability function.

Study Design: Development and Optimization of Stealth Liposomes.

Place and Duration of Study: The study was carried out in the Department of Pharmacy, Annamalai University, between September 2020 and May 2021.

Methodology: Stealth Liposomes were prepared by the thin-film hydration method (TFH). The formulation was optimized using Box – Behnken design to study the effect of independent variables, Amount of Egg Phosphatidylcholine (X1), Amount of Cholesterol (X2), and Amount of DSPE-PEG 2000(X3) on dependent variables Entrapment Efficiency (Y1) and In-vitro drug release (Y2).

Results: Entrapment efficiency of the Stealth Liposomes ranges from 56.35 to 84.25%and in-vitro release ranges from 62.38 to 94.26%. The optimized formulation was found using the desirability function to get maximum entrapment with maximum drug release. The optimized formulation showed entrapment efficiency of 80.46% and in-vitro release of 90.11%.

Conclusion: Stealth Liposomal Drug Delivery System for microtubule inhibitor was successfully developed and optimized using desirability function in Design Expert software by a three-factor, three level Box – Behnken design.

Open Access Original Research Article

Quality of Life and Psychological Distress during Cancer: A Prospective Observational Study Involving Liver Cancer Patients

Madeeha Malik, Iqra Parveen Kiyani, Shazana Rana, Azhar Hussain, Muhammad Bin Aslam Zahid

Journal of Pharmaceutical Research International, Page 576-585
DOI: 10.9734/jpri/2021/v33i47A33047

Introduction: Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients.

Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan.

Study Design:  A descriptive cross-sectional study design was used.

Place and Duration of Study: The study was conducted in healthcare facilities of Islamabad and Rawalpindi, Pakistan between June 2020-December 2020.

Methodology: Two pre-validated questionnaires i.e. EORTC QLQ-C30 and HADS were self-administered to a sample of 100 liver cancer patients selected using a convenience sampling technique for measuring QoL and depression, respectively. After data collection, data was cleaned, coded, and entered in SPSS.

Results: The results highlighted that the lowest scores observed in the domain of symptom scale were: Nausea and Vomiting (23.72, ± 28.238), Dyspnea (25.27, ± 26.90), Constipation (26.03, ± 34.75) followed by Diarrhea (22.63, ± 28.42), whereas highest scores in the symptom scale were observed in the domain of fatigue (37.69, ± 20.06), pain (40.37, ± 18.44), insomnia (41.65, ± 32.37) and financial difficulties (60.33, ± 33.830). On the other hand, highest score on the functional scale was observed for physical functioning (64, ± 21.76) and the lowest score was observed in social functioning (53.19, ± 20.66).

Conclusion: The present study concluded that liver cancer had a negative impact on risk factors/past medical history, co-morbidities, and poor socio-economic of life across all domains along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk factors/past medical history, co-morbidities and poor socio-economic status negatively affected functional and symptom scale. Appropriate health educational and psychological interventional programs targeting patients should be initiated to improve awareness and reduce depression among liver cancer patients.

Open Access Original Research Article

Gasdermin A Single Nucleotide Polymorphisms and Alopecia Susceptibility in Punjabi Population from North-West India

Suman Rani, Praveen P. Balgir

Journal of Pharmaceutical Research International, Page 586-596
DOI: 10.9734/jpri/2021/v33i47A33048

Human Gasdermin A (GSDMA), a member of gasdermin gene family, is mainly expressed in skin and stomach. Mutations in its mouse counterpart Gsdma3, were found to cause skin diseases characterized by hair loss/ alopecia. As human and mice genes share 75% sequence similarity, present study was designed to check whether natural variability in human GSDMA gene was associated with alopecia. Blood samples of 100 alopecia patients and 100 age matched controls were collected and genomic DNA Isolated. All the samples were genotyped for two GSDMA SNPs, rs7212938 (V128L) and rs200722398 (V253I) for distribution of alleles along with haplotype analysis. Out of the T and G allele of rs7212938, the G allele count was found to be significantly increased (0.29 to 0.39) among alopecia patients and out of G/A alleles at rs200722398, allele A count was found to be significantly increased (0.06 to 0.13) among alopecia patients. Further haplotype analysis revealed that haplotype combination TGTAGG of rs7212938 and rs200722398 enhanced the susceptibility to alopecia significantly among Punjabi men. Studies on large population sample, other interacting genes and mechanism underlying the observed enhanced susceptibility are required to delineate the role of the observed association between GSDMA alleles and relative risk of alopecia.

Open Access Original Research Article

Detect Drug Interactions with Metronidazole

Ibrahim Dighriri, Ahmed Mobarki, Naif Althomali, Khalid Alqurashi, Othman Daghriri, Bashaer Bin Howimel, Izdihar Alahmad, Rawan Alsaadi, Manar Alsufyani, Manar Balobade, Reem Altemani, Bayader Alatawi, Wejdan Sharoufna, Taif Almuntashiri, Sultan Almushawwah

Journal of Pharmaceutical Research International, Page 597-604
DOI: 10.9734/jpri/2021/v33i47A33049

Introduction: Metronidazole has been prescribed to treat infections for over a century and continues to be helpful in the therapy of amoebiasis, trichomoniasis, and giardiasis. Metronidazole is a cost-effective medication because of its low price, few adverse effects, and favorable pharmacokinetic and pharmacodynamic properties; nevertheless, it interacts with a wide variety of other medications. Some interactions with other medicines diminish its effectiveness, while others increase it.

Aims: The study aims to detect and evaluate metronidazole interactions with other medicines at King Abdulaziz Specialist Hospital.

Methodology: This retrospective study encompasses the review of 360 computerized prescriptions inside the outpatient clinic at King Abdulaziz Specialist Hospital in Saudi Arabia between March and September 2020 to detect and evaluate interactions among metronidazole and different medications.

Results: Metronidazole interactions are mostly major or moderate. Metronidazole had the most common interactions with domperidone (15.83 %), famotidine (13.89 %), and ciprofloxacin (11.67 %). Metronidazole contains a nitroimidazole ring, which suppresses the metabolism in the liver of numerous medications, including those that may be metabolized by the CYP3A4 and/or CYP450 2C9 isoenzymes. The combination of metronidazole with phenytoin or phenobarbital can cause metronidazole elimination to be accelerated and phenytoin clearance to be reduced. Metronidazole may improve warfarin's anticoagulant effects, leading to a longer prothrombin time and a higher risk of bleeding. Concurrent use of metronidazole with alfuzosin, escitalopram, and ondansetron may raise the risks of QT-interval prolongation and arrhythmias.

Conclusion: Most metronidazole drug interactions can be avoided by following excellent clinical care and clinical pharmacology concepts, such as avoiding complex treatment regimens, educating patients. and identifying patient risk factors. Furthermore, before prescribing and dispensing medicines, physicians and pharmacists should utilize drug-drug interactions checkers such as Micromedex and Lexicomp or a book such as Stockley's Drug Interactions.

Open Access Original Research Article

Cyber Bullying Awareness: - Major Cause of Mental Health Problems among Adolescent of Selected School, Chhotaudepur

Bhoomika Patel, V. Suresh, Bhavisha Patel, Jinal Patel, Ketu Patel, Kima Patel, Krena Patel

Journal of Pharmaceutical Research International, Page 605-610
DOI: 10.9734/jpri/2021/v33i47A33050

Introduction: Cyberbullying is a pervasive public health issue, affecting 10% to 50% of adolescents and resulting in significant negative health outcomes. Cyberbullying is when someone, typically a teenager, bullies or harasses others on the internet and other digital spaces, particularly on social media sites. Harmful bullying behavior can include posting rumors, threats, sexual remarks, a victims' personal information, or pejorative labels.

Aim: The Present research study aimed to assess the knowledge on cyber bullying & it’s effect on mental health.

Materials and Methods: The data for main study was collected from 150 adolescents. Adolescents were selected using convenient sampling technique. Self-structured questionnaire was used to assess the level of knowledge about cyberbullying. Descriptive and inferential statistics such as mean, standard deviation, chi- square, t-test were applied to analyzed the data.

Results: The pre-test Post-test score of Level of knowledge was compared using paired t-test (Independent t-test) revealed that (t=-29.679, df=149, p=0.05) the programme was effective to improve the level of knowledge on cyberbullying among adolescent. Chi square was use to assess the association of pre - test knowledge scores with selected demographical variable found non-significant for all the variables (p=0.05).

Conclusion: Data collection done of the data collected from 150 adolescent’s students studying in 11th &12th standard adolescent’s students descriptive and inferential statistics were used for analysis of the data and interpreted by the forms of tables and graphs.

Open Access Original Research Article

The Effect of Parent Pressure and Peer Factors Affecting on the Performance of Nursing Students

Bhavisha Patel, Bhoomika Patel, V. Suresh, Shivangi Patel, Trupti Patel, Urvashi Patel, Roma Patel

Journal of Pharmaceutical Research International, Page 611-616
DOI: 10.9734/jpri/2021/v33i47A33051

Background: People cannot live alone in society. Basically people need social contacts that suit them. Sometimes they need parent’s help, love, care and guidance and some time they need friend’s intimacy, affection and love. The persons first contact is with parents and then with friends. Parent attachment is stronger during infancy and childhood whereas friend’s attachment is strong during adolescence. Attachment level varies with the ages and stages of life. This attachment influences their feelings, thinking, decisions and living styles. The persons first contact is with parents and then with friends.

Aims: To assess the parental pressure and peer factors affecting the academic performance of nursing students studying in selected nursing college of Vadodara.

Methods: A cross sectional research design was carried out for this study. The study was carried out on 300 students. Students were selected using stratified sampling technique. A five-point rating scale was used to assess the academic performance of students. Descriptive and inferential statistics such as mean, standard deviation, chi-square test were applied to analyze the data.

Results: The effect of peer and parental pressure on the performance showed that more than half participants 61% (n=183) were having average intensity. And about 39% (n=117) of them were having high intensity.

Conclusion: the present study concluded that majority of the students are having average intensity in their academics and some students are having high intensity in their academics.

Open Access Original Research Article

Design, Synthesis and Biological Investigation of Some Novel Quinazolin-4(3H)-One Tethered 1, 3, 4-Thiadiazole-Thiol Motifs as Direct Enoyl Acyl Carrier Protein Reductase Inhibitors

Anant Deshpande, Shashikant Dhawale, Sanjaykumar Bari, Chandrakant Bonde

Journal of Pharmaceutical Research International, Page 617-632
DOI: 10.9734/jpri/2021/v33i47A33052

Aims: In this study was two noteworthy pharmacophores quinazolin-4(3H)-one and 1,3,4-thiadiazole through methylene bridge were utilized to design, synthesize and characterize some novel 2-methyl quinazolin-4(3H)-one and 6-chloro-2-methyl quinazolin-4(3H)-one tethered S-substituted-1,3,4-thiadiazole-thiol structural analogs respectively as direct Mycobacterium Tuberculosis (MTB) enoyl acyl carrier protein reductase (InhA) inhibitors.

Study Design: Design of structural analogs of quinazolin-4(3H)-one tethered 1,3,4-thiadiazole-thiol through methylene bridge by functional group modifications in core scaffold followed by computational studies to select promising compounds. Synthesis of some novel compounds, structural characterization and screening of biological activity of the same.

Methodology: The molecular docking of designed compunds was carried out using schrodinger Glide XP into the active site of MTB InhA with protein data bank code (PDB ID: 2H7M). The interactions were evaluated based on the glide G score compared with reference standard isoniazid. Ten new compounds 7(A1-A10) were synthesized, characterized and screened for their in-vitro antitubercular activity by Microplate Almar Blue Assay (MABA) method followed by cytotoxicity evaluation of compounds 7A4 and 7A10 using Vero cell line.

Results: All the designed compounds of series 7(A1-A10) had drug-like characteristics and were non-toxic to normal cells. In the molecular docking studies, compounds 7A4, 7A5, and 7A10 demonstrated strong binding affinity in the active region of MTB InhA protein and retained necessary amino acid interaction, similar to co-crystal 2H7M. Synthesized compounds 7(A1-A10) were found to have good antitubercular activity. Out of the series the compounds 7A4 and 7A10 were found to possess excellent antitubercular activity equipotent to reference standard streptomycin with minimum inhibitory concentration (MIC) value of 6.25µg/ml. The cytotoxic potential of compounds 7A4 and 7A10 showed remarkable selectivity index against Vero cell line.

Conclusion: The findings of this study highlights the importance of tethering two pharmacophoric motifs in one compound to develop novel antitubercular agents that can be exploited as promising leads as direct InhA inhibitors.

Open Access Original Research Article

A Prospective Study on the Degree of Hyponatremia in Transurethral Resection of Prostate

Maryam Fatima, Zainab Ali, Zubia Zafar

Journal of Pharmaceutical Research International, Page 639-644
DOI: 10.9734/jpri/2021/v33i47A33054

Background: Systemic uptake of hypotonic fluid during irrigation performed at the time of Transurethral Resection of the Prostate (TURP) may cause electrolyte changes including sodium, potassium and calcium. The present study was aimed to assess the degree of sodium changes during Transurethral Resection of Prostate (TURP).

Methods: 50 males aged 54 to 86 years, presented for TURP, were enrolled in the study with ASA classification of I to IV grades. Glycine 1.5% was used with height of irrigation kept at 60 cm. One day preoperatively and one hour postoperative, levels of serum sodium were measured for all the patients.

Results: Spinal anaesthesia was given in 31 patients, whereas 19 patients were managed under general anaesthesia, with mean duration time being 72.42 ± 24.77min. The mean size of the resected prostate was 54.82 ± 25.04g. 58% patients developed mild hyponatremia, 4% had asymptomatic moderate hyponatremia and no patient developed severe hyponatremia or TURP Syndrome. The systemic diseases like hypertension, DM, or IHD found to be insignificant.

Conclusion: TURP was associated with a high incidence of asymptomatic mild hyponatremia. Duration of operation was one of the most important factors.

Open Access Original Research Article

Assess the Level of Stress among Parents of Children with Autism at Selected Autism Schools of Vadodara with a View to Give Need Based Education

Bhavisha Patel, V. Suresh, Bhoomika Patel, Mihir Patel, Monali Patel, Nidhi Patel, Om Patel

Journal of Pharmaceutical Research International, Page 650-655
DOI: 10.9734/jpri/2021/v33i47A33056

Introduction: Children with a Autism spectrum disorders have impairment in the area of communication and social interaction and often display repetitive and non often display. Their parents having stress a to manage their children to education and future purpose. This study has assessed the stress level in parents and manage their stress with coping mechanism.

Aims and Objective: 1) To assess the level of stress among parents of children with autism.2) To find association between level of stress and selected demographic variables.

Methods: The data for main study collection was 30 Parents. Description of the tools refers to the explanation of the content of the tool. The researcher lists the number of items and the scoring for each item in the tool. The tool used for the present study is Parenting stress index - Scale. Descriptive and inferential statistics were applied to analyses the data by using SPSS-20 software. We use purposive sampling technique.

Results: The majority of the parents having a moderate stress (83.3%), and severe stress (10%) and mild stress (6.66%) and nonstress level (0.0%). the stress level analysis showed that stress in parents (R=0.321, p=0.00) at significance of 0.05 level present.

Conclusion: The present study concluded that there is a stress level of parents among children having a moderate stress and there is a no any association between the level of stress and selected demographic variable.

Open Access Original Research Article

Identify Contributing Factors of Myocardial Infarction among Cardiac Patients

Rupal Patel, Nirali Soni, Rathod Aayushi, Rathod Kinjal, Rathva Jaypal

Journal of Pharmaceutical Research International, Page 662-667
DOI: 10.9734/jpri/2021/v33i47A33058

Background: Cardiovascular disease is becoming a major burden in developing countries, It is considered as important public health problem not only in the developed countries but also in developing countries like India. It has emerged as a major health burden worldwide. It contributed to 15.3 million deaths in 1996 of which 5.5 million was from developed countries and 9077 million from developing countries. A rise in the prevalence decline in the latter half have been well documented in the industrialized countries. However, the scenario is reversed in developing countries especially India with a steady escalation in prevalence of Cardio Vascular disease

Aims and Objectives: The purpose of this study was to assess contributing factors   among Myocardial Infarction,to find out the association between contributing factors of myocardial infarction with their demographic variable and to identify contributing factors of myocardial infarction. 

Methods and Mateials: A descriptive study was carried out on 100 myocardial infarction patients who were admitted to the Intensive coronary care unit of selected cardiology ward in selected hospital, Vadodara. Patients were selected by Non- Probability convenient Sampling technique. The collected data was analyzed though SPSS software.

Results: The majority contributing level of Myocardial infarction 42(42%) were mild, 32(32%) of the patients were moderate, 26(26%) of the patients were severe. There was no significant association was found between contributing factors of myocardial infarction with their demographic variables.

Conclusion: Result revealed that most of the patients (42%) were having mild contributing factors and were having moderate contributing factors (32%) and least percentage (26%) were having severe contributing factors among myocardial infarction patients.

Open Access Original Research Article

Development and Validation of HPTLC Method for Simultaneous Estimation of Resveratrol and Piperine in Its Pharmaceutical Dosage Form

Ankita Gaikwad, Madhuri Shelar, Ganesh Andhale, Jyoti Kadam

Journal of Pharmaceutical Research International, Page 691-697
DOI: 10.9734/jpri/2021/v33i47A33062

Resveratrol is a plant compound that work as antioxidant and it also has anti-aging properties whereas Piperine is a alkaloid and it majorly used in spices.  A HPTLC (High performance thin layer chromatography) study is conducted for estimation of Resveratrol and Piperine. The Mobile phase used was Chloroform: Ethyl Acetate (50:50 v/v). Rf Value of Resveratrol 0.59 and Piperine 0.79 was found. Stationary phase of Silica gel 60 F254 was used. Densitometric analysis was performed at 325 nm. The method was found to be linear. Recovery (ranging from 97% to 102.24 %), limit of detection (40.26 ng/spot, 1.64 ng/spot respectively for resveratrol & piperine), limit of quantification (122.02 ng/spot, 4.98 ng/spot respectively for resveratrol & piperine) and precision (≤ 2.00%) were found to be satisfactory. Validation performed with linearity, accuracy, precision, specificity, robustness, limit of detection and limit of quantification. Every parameter found within the range. The developed method allows to confirm that an accurate and reliable potency measurement of a pharmaceutical preparation can be performed.

Open Access Original Research Article

Evaluation of Antimicrobial Activity of Commiphora myrrh against Standard Bacterial Strains and Clinical Isolates with Chemical Analysis Profiling

Doaa Alasady, Kwather H. Mhadei, Maryam Sabah Naser

Journal of Pharmaceutical Research International, Page 714-723
DOI: 10.9734/jpri/2021/v33i47A33066

Aims: The objective of present study was to investigate the chemical analysis biological activates of commiphora myrrh the chemical analysis of myrrh was analyzed several ways.

Study Design: Where wet digestion was used to estimate the concentrations of a number of chemical elements in it, which are of great importance to humans and are also attributed to many of its medicinal uses.

Place and Duration of Study:  Clinical isolates from wound infections obtained from laboratory of Marjan Hospital Hilla city Iraq during period Fed. 2020 which include (four  E. coli  and  4  of  S. aureus,  and 4 pseudomonas aeruginosa ). All clinical isolates were classified and by laboratory of marjan hospital: Hilla city Iraq.

Methodology: In order to know the nature of the groups present in it, in addition to the quality of the organic materials, FTIR analysis and G.C analysis were used by using the ethanolic extract, where some of the organic materials within their compositions in identified.

Results: The antimicrobial potential of ethanolic extracts of myrrh were studied against many standard strains of gram positive and gram negative bacteria and (12) clinical isolated from patients with wound infections obtained from the bacteriology section of the clinical microbiology laboratory of marjan hospital Hill city/Iraq during period Feb. 2020 to Nov. 2020. The clinical isolates include (4) isolates of staphylococcus aureus, (4) isolates of E.coli and (4) isolates of pseudomonas aeruginosa, and it was confirmed using the usual methods of diagnosis. The broth dilution method was used for determination of the MICs of (minimal inhibitory concentration) of myrrh extract against pathogens under study. Six concentration (80, 60, 30, 12, 6, 3 mg/mL) of myrrh extracts were tested.

Conclusion: The result revealed that the highest activity was against S. Aureus at concentration (80, 60, 30 mg/mL) which showed completely inhibition of the growth (100%). While the gram-negative bacteria E.coli and P. auroginosa the concentration (80 – 60 mg/mL) showed 100% inhibition in contrast the concentration (12, 6, 3 mg/mL) showed no activity of myrrh extract against all pathogens under study. The result indicates that myrrh is an antibacterial agent that can be used in the future by making appropriate doses.

Open Access Original Research Article

Outcomes of Ilizarov Ring Fixator in Infected Nonunion of Tibia

Muhammad Hamayun Hameed, Abdul Hamid Kakar, Hassan Amir Us Saqlain, Syed Sajid Hussain, Masood Ahmed Qureshi, Niaz Hussain Keerio, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 724-730
DOI: 10.9734/jpri/2021/v33i47A33067

Objective: This study was designed to evaluate the effectiveness of Ilizarov. We aimed to explore the infection rate, bony union, and functional outcomes of Ilizarov fixators.

Methodology: This retrospective study was conducted in Orthopedic department of Bolan Medical Complex Hospital Quetta Pakistan from June 2020 to June 2021. In this timeframe total of fifty-five patients of infected nonunion tibia were enrolled for Ilizarov technique treatment. For surgical intervention, patients were placed in a supine position on a radiolucent table. Ilizarov fixator was prepared on the behalf of patient's limb length, infection site, and ankle and knee functional status. We applied assembled Ilizarov fixator at the tibial shaft while keeping in mind that the rings were positioned in on the proximal and distal fragments. The ring was placed parallel to the joints whereas pins were inserted perpendicular to the tibial mechanical axis.

Results: A total of 55 patients were recruited for this study. The mean age of the selected participants was 45.65±16.69 years. The overall successful bone results of the ASAMI score were observed as 80% whereas 88% functional outcomes were achieved. In bone results, we observed 28 (50.9%) cases with excellent results, 16 (29%) with good, 7 (12.7%) with fair, and 3 (5.4%) with poor outcomes. On the other hand, 25 (45.4%) cases observed excellent functional results, 25 (45.4%) with good, 4 (7.6%) with fair, and 2 (3.6%) with poor outcomes.

Conclusion: Our results show a high success ratio therefore we recommend Ilizarov external fixators for infected nonunion tibial fracture. This method helps to recover limbs without any amputations. However, the discomfort of patients is one of the main problems with this method of treatment.

Open Access Original Research Article

Spectrophotometric and High Performance Liquid Chromatographic Determination of Carbamazepine in Tablets Dosage Form

Ibrahim Bulduk, Serdar Gungor

Journal of Pharmaceutical Research International, Page 731-741
DOI: 10.9734/jpri/2021/v33i47A33068

Today, millions of people suffer from epilepsy, one of the most common chronic neurological diseases worldwide. Carbamazepine is a first-line drug used in the treatment of epilepsy. High performance liquid chromatographic and spectrophotometric methods have been developed for the determination of carbamazepine in tablet dosage forms. UV spectrums were recorded in the wavelength range of 200-800 nm using methanol solvent, and the wavelength for determining carbamazepine was selected as 286 nm. LC analysis was performed using Agilent Extend-C18 column and mobile phase composed of KH2PO4 solution(pH: 3.5) and acetonitrile (40:60 v/v) at a flow rate of 1.2 mlmin-1. These analytical methods were validated in agreement with the International Conference on Harmonization (ICH) guidelines using the following analytical parameters: specificity, linearity, precision, accuracy, detection and quantification limits, and robustnes. Analytical methods showed wonderful linearity (r2>0.999) in the concentration range of 5-25 μg mL-1 for boths methods. Precision (R.S.D%<1.17) and recevery for both methods was in the range of 99-101%, which shows accuracy of these methods. These proposed methods were found to be accurate, reliable, fast, simple, The F-test and t-test were used to perform statistical comparison of these methods, and the results of both analytical methods indicated no significant difference. As a result, the proposed methods can be used to analyze carbamazepine in pharmaceutical formulations.

Open Access Original Research Article

Measurement Extraction using Fuzzy Set Rule for Segmented Features of Brain Tumor in T-1 & T-2 Weighted Images

Manini Singh, Vineeta Saxena Nigam

Journal of Pharmaceutical Research International, Page 742-749
DOI: 10.9734/jpri/2021/v33i47A33069

Aims: For neuro radiologist it becomes hard to accumulate features with minute dissimilarity in plenty of cases, so it is hard to make a correct decision. Therefore, the need is to generate some rules for prediction of degree of malignancy in tumors.

Design: The pre-operative analysis of brain lesion is based on magnetic resonance imaging and clinical data set. Analysis of MRI finding and medical data set gives the relationship between regular pattern & interpretable pattern to acquire desired degree of malignancy.  Until now the edge detection, segmentation and morphological operators are used to detect exact location of brain tumor. As uncertainty exits; here fuzzy set rules are evaluated to predict the degree by which a benign tumor is converted into malignant tumor.

Methods: Fuzzy extraction theory has been applied along with image progressing algorithms like edge detection; segmentation and morphological operation based on spectral transformation are used to detect exact location of brain tumor to predict the degree malignancy. Step of Image analysis: a) Preprocessing: input 2D gif or tiff image b) Filtering of image using Anisodiff filter c) Thresholding, applying morphological operators and tumor line detection.

Statistical Analysis used: A diagnostic feature includes blood flow, mass effect, temperature, calcification, edema, signal intensity & so on. Numerous features can be taken into consideration for better outcome.

Results: Fuzzy set rule is one of the promising methods along with MR finding to achieve accuracy higher than 85% by considering few of the medical symptoms on different features.

Conclusions: This research is limited to specific region and type of glioma and thus cannot deal heterogeneous cases in which situation is much complicated. The result evaluated here are usually retroactive. As studied, by analyzing signal intensity of T-1 & T-2 weighted image alone, accuracy of 60-70% has been achieved. So in order to get higher accuracy feature like cyst generation, oedema, blood supply are included to achieve 85% accuracy.

Open Access Original Research Article

Clinical Evaluation of Surgical Orthodontic Procedure with Bone Grafts for Patients with Cleft Palate during Adolescence

Ravindra Manerikar, Shilpa Pharande, N. G Toshniwal, Kishor Chougule, Abhijit Misal

Journal of Pharmaceutical Research International, Page 750-755
DOI: 10.9734/jpri/2021/v33i47A33070

Background: Cleft lip and palate is a congenital anomaly, presenting in a wide variety of forms and combinations. Successful cleft lip and cleft palate rehabilitation requires a multidisciplinary approach employing the skills of different specialists.

Aims & Objectives: The aim of this paper was to present orthodontic preparation of patients prior to alveolar bone grafting & to review our findings in a group of patients treated by secondary and delayed bone-grafting procedures at our institution.

Methodology: Thirty eight patients were examined for the type of cleft and the age at the time of examination. 10 patients were treated in our institution with presurgical orthodontics & operated by a delayed bone-grafting technique.  Duration and type of expansion was noted at pre-operative, 2 months and 6 months. Crestal bone heights and the quality of the bone in the grafted areas was examined radiographically, along with presence of any fistulas.

Results: All the patients demonstrated improved alar base and upper lip support, also better dental stability was seen in the region of cleft.

Conclusion: All the patients included in this study appeared to benefit from the procedure with improved facial balance. In all ten patients the oronasal fistulas remained closed, hence was reported to be a success.

Open Access Original Research Article

Development and Validation of Three Potential Genotoxic Impurities by Liquid Chromatography Single Quad Mass Detector in Iomeprol

Rayala Rama Rao, Gundapaneni Ravi Kumar, Vadde Megha Vardhan, Veeraswami Boddu

Journal of Pharmaceutical Research International, Page 756-767
DOI: 10.9734/jpri/2021/v33i47A33071

A liquid chromatography with single quadrupole mass detection method was developed for the determination of potential genotoxic impurities (PGIs) in the Iomeprol active pharmaceutical ingredient. Chromatographic separation was achieved on an Agilent Eclipse plus C8 column (100 mm x 2.1 mm x 1.8 μm) with 0.1% formic acid in water as mobile phase A and acetonitrile as mobile phase B in gradient elution mode at a 0.1 mL/min. Executed validation summary demonstrated that the mass detection method had highly sensitive and selective. A linear calibration curve (correlation coefficient, r> 0.999) was attained at the concentration range of 0.1-125 ppm for three PGI’s. The Limit of Detection of Imp-A, Imp-B and Imp-C in drug substance of Iomeprol is 0.05 ppm. The accuracy was confirmed by calculated recoveries (98.4-101.5%). The precision was tested at three levels: injection repeatability, analysis repeatability and intermediate precision. The calculated relative standard deviations were within the specification. The developed method was able to quantitate all three PGI’s at a concentration level of 1 µg/mL.

Open Access Original Research Article

Histopathological and Histochemical Study of Human Cholecystitis

V. Dhamodharan

Journal of Pharmaceutical Research International, Page 768-772
DOI: 10.9734/jpri/2021/v33i47A33072

In our study the following inferences were made. Chronic calculous cholecystitis was seen in the age group of 41 to 50 years. A female preponderance was noted with male to female ratio of 2:3. The most common signs and symptoms were upper abdominal tenderness and right hypochondria pain. The mucosa showed ulceration in 63%, hyperplastic mucosa in 34% and metaplasia in 5%. 22% of cases showed mild (Grade-I) inflammation while 41 % of cases and 27% of cases showed moderate(Grade-2) and severe (Grade-3) inflammation respectively. 44 % of cases showed mild (Grade-I) fibrosis while 22% of cases and 15% of cases showed moderate (Grade-2) and severe (Grade-3) fibrosis. With increase 1n severity of inflammation and fibrosis, the total acid mucin content decreased while the neutral mucin content increased. Similar changes were observed in cases of metaplasia too.

Open Access Original Research Article

Impact of Safety Measures in Endoscopic Procedures in Health Care Professionals during Corona Virus Pandemic

Harish Kumur, Jibran Saeed Malik

Journal of Pharmaceutical Research International, Page 786-793
DOI: 10.9734/jpri/2021/v33i47A33074

Background and Aims: During the Corona Virus Disease-19 outbreak, it is believed that ten percent of all health care professionals (HCPs) were affected. HCPs' safety measures have changed because of aerosol-generating techniques. As a result, we looked at the effectiveness of endoscopic safety measures and prevalence among HCPs who operate in an endoscopy unit.

Methods: Techniques such as polymerase chain reaction (PCR) and immunoglobulin G (IgG) serum-assay were used to assess the COVID-19 status of 117 healthcare workers (HCWs). It has been shown that the existence of the COVID-19 is related to demographic variables, work profile, location of employment, & medical history in research.

Results: 38 HCWs tested positive for COVID-19 using either a PCR assay (23.93%) or simply an IgG testing (32.48 percent) (8.55%). COVID-19 incidence was significantly greater (P = 0.003) among endoscopy technicians when compared to doctors (68.75% (20.69%). Those who worked in critical care units were shown to be more susceptible to COVID-19 (42.86%). One hundred and sixty-six healthcare workers who received enough hydroxychloroquine prophylaxis were tested for COVID-19, and none were positive. Everyone who had been exposed to COVID-19 recovered. There was also a substantial decrease in the number of "man-days" worked.

Conclusion: We discovered a statistically significant COVID-19 risk among healthcare workers in the Gastroenterology department, with endoscopy technologists having the highest risk. More stringent triaging & pre-testing of patients and healthcare workers may help to decrease the risk of COVID-19 infection. Additional multicenter studies are needed to further understand the risk and its related variables.

Open Access Original Research Article

Formulation and Evaluation of Topical Microemulgel Containing Terbinafine Hydrochloride

Zingade Sarika G., Nagoba Shivappa N., Agwane Shanta G., Swami Avinash B.

Journal of Pharmaceutical Research International, Page 794-803
DOI: 10.9734/jpri/2021/v33i47A33075

The purpose of this study is to create and test a Terbinafine hydrochloride microemulgel. Terbinafine hydrochloride is an FDA-approved antifungal medication used to treat fungal infections on the skin. It's a BCS class II medication with little bioavailability. In the realm of pharmaceutical sciences, microemulgel has evolved into one of the most intriguing topical preparations. Microemulgel as a delivery technique has several advantages over simple traditional formulations, including simplicity of administration, increased residence duration at the application site, consistent drug release with improved bioavailability, superior thermodynamic stability, and excellent transdermal permeability. Terbinafine hydrochloride microemulgels were made with carbopol 940 and HPMC as gelling agents, oleic acid as an oil, parabens as a preservative, and tween 20 as an emulgent and penetration enhancer. The appearance, spreadability, homogeneity, viscosity, pH, percent drug content, and in vitro diffusion studies of the generated microemulgel formulation were all visually checked. The findings show that developing a terbinafine-containing microemulgel is more effective, but clinical efficacy must be determined through clinical trials.

Open Access Original Research Article

Transition of Pharmaceutical Regulations: The New Regulatory Era after Brexit

Trivedi Ankit, Deshpande Shrikalp, Zaveri Maitreyi, Jain Praveen Kumar, Kolhe Kiran

Journal of Pharmaceutical Research International, Page 804-817
DOI: 10.9734/jpri/2021/v33i47A33076

Aims: The current research paper describes the regulatory changes in different pharmaceutical sectors, which are affected after the Brexit and build new guidelines that were derived from the Medicines and Healthcare Products Regulatory Agency (MHRA).

Study Design: Retrospective and concurrent review were employed to get idea regarding the regulatory changes in various pharmaceutical sectors that took place after dissimilation of Europe and Britain.

Place and Duration of Study: The present study was carried out at Amneal Pharmaceutical Ltd., from January 2021 to April 2021.

Methodology: On January 1, 2021, the MHRA had published a library of new guidance that applied as the transition period came to an end. This guidance covers the various sectors of pharmaceuticals like Clinical trials, medical devices, Importing and Exporting of pharmaceuticals, Legislation, New licensing, Pharmacovigilance and Pediatrics, which are affected due to Brexit.

Results: The MHRA laid out the future BRITAIN requirements for registering clinical trials, legal representation and importing Investigational Medicinal Products (IMPs) after the end of the Brexit, Pediatric Investigation Plan (PIP) must be included in an application for BRITAIN marketing authorization (MA). Change in Licensing procedure and the Innovative licensing and access Pathway (ILAP) provides opportunities for enhanced regulatory and other stakeholder input, including interactions with National Institute for Health and Care Excellence. Early Access to Medicines Scheme (NICE.EAMS) providing access to unlicensed, promising treatments to patients who have life threatening or rare disease indications.

Conclusion: To ensure the new approach builds on our previous success and exploits the opportunities that arise from Brexit, the industrial strategy should adopt a sophisticated supply chain view to develop an empirical base for pragmatic, joined up policies to help pharmaceutical sector grow. These policies and support will drive the BRITAIN’s pharmaceutical sector in a Post-Brexit era.

Open Access Original Research Article

Effect of Avarai Kudineer on α- Amylase and α- Glucosidase Inhibition: A Preclinical Antidiabetic Study

K. Rajalakshmi, P. Shanmugapriya, G. J. Christian, R. Jeeva Gladys

Journal of Pharmaceutical Research International, Page 818-825
DOI: 10.9734/jpri/2021/v33i47A33077

In recent years there has been a mounting interest towards the traditional medicine globally for the treatment of type 2 diabetes. Avarai Kudineer (AK) is a Siddha classical polyherbal formulation that has been indicated for the management of Diabetes mellitus in Siddha literature. The goal of the present study is to provide an in-vitro evidence for the  antidiabetic potential of Avarai Kudineer in terms of  inhibiting the carbohydrate digesting enzymes alpha amylase and alpha glucosidase. Aavirai Kudineer (1/4) was prepared by boiling the ingredients weighed 20g in 80ml and reduced to 20ml and filtered according to the decoction preparation method as indicted in the Siddha literature. The filtrate was dissolved in DMSO to make stock solution and serially diluted to make different concentrations ranging from 10,20,40,80 and 100 µg/ml. The triplicates (n=3) were maintained. The invitro alpha amylase and alpha glucosidase enzyme inhibition of AK sample was compared with standard drug acarbose and the IC 50 value was calculated.The data was statistically analysed and expressed as Mean ± SD (n=3). The results showed that AK had maximum activity towards the inhibition of the enzyme alpha amylase (59.83± 7.10) and alpha glucosidase (71.94 ± 1.22) when compared with the standard acarbose81.42± 5.51 and 91.59 ±12.79respectively. The results reveal that the test drug AK has appreciable alpha amylase and alpha glucosidase inhibitory activity.

Open Access Original Research Article

Traganum nudatum Possesses Anticancer Efficacy against Breast Cancer MDA-MB-231 Cells

Ibrahim O. Barnawi

Journal of Pharmaceutical Research International, Page 831-838
DOI: 10.9734/jpri/2021/v33i47A33081

Background: Medicinal plants are effective sources for both traditional and modern medicines; herbal medicine has been shown to have genuine utility. 80% of rural population depends on natural products as primary health care. Traganum nudatum (T. nudatum) is a medicinal plant widely used in alternative medicine. T. nudatum has not been greatly investigated for its anticancer potential.

Aim: This study aimed to evaluate the in vitro anticancer efficacy of T. nudatum against breast cancer cell line; MDA-MB-231.

Materials and Methods: Extracts of T. nudatum were evaluated to assess their in vitro cytotoxicity against the MDA-MB-231 breast cancer cell line. Leaves, flowers, and stems of T. nudatum were extracted by using 70 % ethanol. the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays were used to evaluate the in vitro cytotoxicity of these extracts against MDA-MB-231 cell line. The apoptotic cellular morphological changes were investigated using inverted and fluorescence microscopes.

Results: The results showed that T. nudatum extracts exhibited anticancer activity with a half-maximal inhibitory concentration (IC50) of 150 µg/mL against MDA-MB-231 cell line. Loss of cell integrity, shrinkage of the cytoplasm, and cell detachment were observed in the extract-treated MDA-MB-231 cells.

Conclusion: T. nudatum extracts showed cytotoxic effects against MDA-MB-231 cell line. It may be used as a future medication to cure breast cancer.

Open Access Original Research Article

A Pharmaceutical Analysis of Rajanyadi Syrup –A Polyherbal Ayurvedic Anthelminthic Drug

Ishita Swami, Aboli Patil, C. R. Swapnil, Sudhir Pani, Vishal Prajapati

Journal of Pharmaceutical Research International, Page 854-860
DOI: 10.9734/jpri/2021/v33i47A33084

Context: According to Ayurveda Acharyas for getting desirable outcome of any medication, it should be precisely analysed. Most of the Ayurveda classical formulations need to be standardized based on newer techniques for their Worldwide acceptance.  Rajanyadi churna is one of the widely used formulation by Ayurveda physicians for all types of paediatric disorders mainly GI tract related conditions. Rajanyadi Churna is traditionally used in Churna form, in this study churna was converted into Syrup form for better palatability and convenience of administration. The present study mainly deals with the preparation and standardization of Rajanyadi syrup on the basis of organoleptic characteristics, physicochemical parameters and HPTLC fingerprinting.

Open Access Original Research Article

Stability Study of Mucoadhesive Microsphere Containing Nateglinide by Using Biodegradable Polymer Chitosan

Varun Dasari, Anis Shaikh, Dharmesh Sisodiya, Tanu Bhargava, Rameshwar Dangi, Sunil Nagwe, Sharuk L. Khan, Falak A. Siddiqui

Journal of Pharmaceutical Research International, Page 866-872
DOI: 10.9734/jpri/2021/v33i47A33086

Aim: Stability Study of Mucoadhesive Microsphere Containing Nateglinide by Using Biodegradable Polymer Chitosan

Study Design: The investigation of the stability of Nateglindine containing mucoadhesive microsphere by using chitosan was carried out.

Methodology: The present study was performed to test the stability of microspheres formulation. The promising formulations were selected for in-vitro stability studies. Formulations were stored in screw-capped, amber color small glass bottles at 4±1°C, 27±2°C, and 42 ± 2°C for 45 days. After 0, 15, 30, and 45 days they were evaluated for the following parameters like particle size, and percent residual drug content.

Results: The particle size of the microspheres was found to increase slightly at 4±1°C from initial to 45 days which might be due to the agglomeration of particles. While at a higher temperature that is 27±2°C, an increased in particle size was observed to more as compared to particle stored at 4±1°C could be due to agglomeration of microspheres more at a higher temperature. As the period passed, the concentration of the drug in the formulation was decreased with time but at the highest (42±2°C) temperature degradation rate was maximum.

Conclusions: The stability study of microsphere containing Nateglinide concludes that the formulation CM-4326F was the best formulation in drug stability studies. As the period passed, the concentration of the drug in the formulation was decreased with time but at the highest (42±2°C) temperature degradation rate was maximum. Hence it was concluded that temperature 4±1°C or 27±2°C are suitable for storage of formulation because little changed was found in particle size and residual drug content.

Open Access Review Article

A Systematic Review on the Role of Topical Corticosteroids for the Management of Radiation Dermatitis

Hyder Osman Mirghani, Abdulmajeed Faisal Albalawi, Nawal Mohammed Alanazi, Dina Nasser Abusabir, Abrar Marwan Alamrani, Wejdan Mohammed Alshehri, Omar Abdullah Alsayari, Hasan Mohssen Alabbadi, Abdulrahman Mousa Aljohani, Anas Sulaiman Aljohani, Raghad Essam Abdullah, Mohammed Abdulrahman Alshuhayeb, Renad Abdulwahab Al Gaedy, Hassan Sulaiman Alahmadi, Ali Marwan Bahabri

Journal of Pharmaceutical Research International, Page 1-11
DOI: 10.9734/jpri/2021/v33i47A32984

Background: Radiation dermatitis (RD) is a widespread complication of radiation therapy; however, there is still no agreement on the best treatment. The goal of this review is to go over how corticosteroids work throughout the treatment of radiation dermatitis.

Methodology: A comprehensive evaluation of randomized controlled trials, retrospective and prospective studies involving topical corticosteroid (TC) for the treatment of radiation dermatitis. A thorough search was carried out in Medline, Embase, the Cochrane library, Clinical trials.gov, and Google scholar. The original search took place in August and was updated on September 2021. There were no restrictions on terminology or dates. Two reviewers independently examined each of the listed papers. A search of the relevant studies of all of the mentioned publications yielded additional papers.

Results: We identified 19 studies on the role of corticosteroids for the prevention of radiation therapy. All the papers were published between 2001 and 2021. The total sample size of the included studies was 1974 with a mean sample size of 103.89. Among the included studies, four studies (21.05 %) represented head and neck cancer, 14 studies (73.68 %) were regarding breast cancer and 1 (5.26 %) hospital-based cross-sectional study represented multiple malignancies such as head and neck, breast and cervix carcinoma, respectively. Among all the participants, 1696 (85.91 %) were females while 278 (14.08 %) were males.

Conclusion: Prophylactic treatment with TC was found to minimize the rate of RD and wet desquamation. Participants who used topical steroids reported improved symptoms and a higher quality of life, whereas the use of topical steroids during radiation had few side effects. ARD can be prevented using topical corticosteroids, based on these findings. As a result, further research must be done on the most effective TC to utilize during radiation.

Open Access Review Article

Eradication of Malaria: Present Situations and New Strategies

Muslimah N. Alsulami

Journal of Pharmaceutical Research International, Page 17-37
DOI: 10.9734/jpri/2021/v33i47A32986

Malaria is a serious disease caused by the protozoon parasite Plasmodium and transmitted by the female Anopheles mosquito as a vector.  P. falciparum is the gravest infection for all other species P. ovale, P. vivax, P. Malariae and P. knowlesi in terms of morbidity or mortality, which is why most research focused on P. falciparum. The disease affects about 300-500 million people, mostly in the tropics. In regions with a weak economic downturn in tropical and subtropical capital, morbidity and mortality have elevated. Malaria remains a persistent threat in recent research. At the beginning of the 20th century, scientists tried to describe a successful way of eradicating malaria.  However, the presence of drug resistance and social and environmental problems, no acceptable and positive future solution has been pointed out. Several studies have highlighted the need to establish advanced nano-biotechnology treatment, novel anti-malarial drug targets, an efficient malaria vaccine technique, and Anopheles gene editing, which opened the door to a healthy, environmentally friendly malaria treatment method over the last two decades. In recent years, the use of mosquito microbiota has shown great potential for cutting down the transmission of mosquito-borne pathogens. This review aims to cover important issues in malarial eradication as rapid diagnostic technology, novel anti-malarial drug targets, Anopheles gene editing, use of mosquito microbiota, and recent vaccines.

Open Access Review Article

Bone Deformity due to Rickets and Osteomalacia in Children and Adolescents

Awadh Saeed Alqahtani, Hayazi Mohammed Alshehri, Nazim Faisal Ahmed, Mohammed Hassan Alatawi, Wurud Muteb D. Alshammari, Ahmed SaeedAlshahrani

Journal of Pharmaceutical Research International, Page 59-65
DOI: 10.9734/jpri/2021/v33i47A32989

Rickets is a worldwide bone disease that is associated with disorders of calcium and phosphate homeostasis and can lead to short stature and joint deformities. Osteomalacia is a major metabolic bone disease that results from a chronic and severe deficiency of vitamin D or phosphate from any cause after growth has stopped. A deficiency of vitamin D or phosphate leads to defective bone mineralization and generalized or localized vague bone pain in various parts of the skeleton and / or proximal muscle weakness. Rickets and osteomalacia are two different clinical diseases with impaired bone mineralization. Rickets occurs throughout the growing skeleton in infants and children, while osteomalacia occurs in adults after fusion of the growth plates. Rickets and osteomalacia are increasingly common in Saudi Arabia, with vitamin D deficiency being the most common etiological cause. Early skeletal deformities can occur in infants, such as soft, thin skull bones, a condition known as craniotabes. In adults, as a result of demineralization, the bones become less rigid (soft bone) with pathological fractures. The diagnosis of both diseases is based on the medical history and physical examination, radiological characteristics, and biochemical tests. Management depends on the underlying etiology.

Open Access Review Article

Oxidative Modification of Lipoproteins: A Potential Role of Oxidized Small dense LDL in Enhanced Atherogenicity

Mohammed Alsaweed

Journal of Pharmaceutical Research International, Page 118-140
DOI: 10.9734/jpri/2021/v33i47A32997

Atherosclerosis (AS) is a multifaceted inflammatory syndrome of the arterial wall to which number of mediators have been implicated in lesion progression. Triglyceride (TG)-rich lipoproteins consist of the large diversity of lipoprotein particles that fluctuate in density, size, and apolipoprotein composition. Two foremost phenotypes, on basis of size, chemical configuration, and density, of low-density-lipoprotein (LDL) have been recognized i.e., pattern A, having LDL diameter greater than 25.5nm (large buoyant LDL or lb-LDL) and pattern B, having LDL diameter less than or equal to 25.5nm (small-dense LDL or sd-LDL). Small-dense low-density-lipoprotein (sd-LDL) particles are produced by potential intravascular hydrolysis of TG-rich VLDL particles via lipoprotein lipases (LPLs), hepatic lipases (HLs) and cholesterol ester transfer protein (CETP). sd-LDL is more atherogenic due to its smaller size, increased penetration into the arterial wall, extended plasma half-life, lesser binding affinity for LDL receptors (LDL-R) as well as lower resistance to oxidative stress when equated with lb-LDL. The higher atherogenic potential of sd-LDL is due to its enhanced susceptibility to oxidation, owing to high polyunsaturated fatty acids (PUFA), low cholesterol and Apoprotein B (ApoB) content. An enhanced understanding of sd-LDL metabolism at the molecular level, transport and clearance may result in the development of sd-LDL as an independent predictive marker for AS events and may be used to maintain cholesterol homeostasis and prevent the succession of AS.

Open Access Review Article

Ancient Concept of Simulation in Perspective of Ayurveda

Tawalare Kiran, Chavan Sucheta, Tawalare Kalpana, Meshram Sumedh

Journal of Pharmaceutical Research International, Page 182-188
DOI: 10.9734/jpri/2021/v33i47A33002

Ayurveda, the native healthcare system of India, is a rich resource of well-documented ancient medical knowledge. Although the roots of this knowledge date back to the Vedic and post-Vedic eras, it is generally believed that a dedicated branch for healthcare was gradually established approximately between 400 BC and 200 AD.

Objective of this review is to hint at preliminary understanding of ancient concept of simulation and to record the Ayurveda as trailblazer when reviewing the mile stone in the history of simulation. Literature regading simulation were collected through various search engeens like as PubMed, Medline, Google scholar. Classical text of Ayurveda Charak, Sushrut, Vagbhat and Chakrapani, Dalhan commentary were reffered to collect ancient view of simulation. Literature available was analysed critically. It was found that preliminary concept of simulation hinted in Ayurveda as imblaze in establishing the basic concept of simulation.

Open Access Review Article

A Mini-Review: Nanoparticles as Vaccine Delivery System

Frial G. Abd, Lubna Abdulazeem, Saade Abdalkareem Jasim, Ahamed H. Rasheed, Sumaya Ayad Abdulrazzaq

Journal of Pharmaceutical Research International, Page 194-201
DOI: 10.9734/jpri/2021/v33i47A33004

Vaccination has proven to be one of the most important medical breakthroughs in history. Three important features must be present in every vaccine that is effective over time: Safety, stability, and the ability to elicit a sustained and sufficient immune response with a modest number of doses are all important requirements. To develop protective immunity against diseases, vaccinations using attenuated or dead entire animals (first generation), subunit vaccines (second generation), and RNA or DNA vaccines (third generation) have all been employed . Traditional vaccines, on the other hand, have issues such as returning to their virulent condition or only giving protection for a short period of time. As a result of these limitations, scientists have resorted to recombinant proteins, such as subunit vaccines, which target a specific portion of the pathogen. Subunit vaccines are preferred over live or inactivated whole organism vaccines because they are more pure and identified with respect to cell receptoes, have a better safety profile, and are easier to scale up. Despite their advantages, subunit vaccinations have certain disadvantages. For example, most antigens are only mildly immunogenic on their own, necessitating the inclusion of an adjuvant in the formulation.

Open Access Review Article

Overview on Cardiac Cirrhosis and Congestive Hepatopathy - A Review

Mohammed Salah Hussein, Sarah Jamal Almujil, Ahmed Saeed S. Banheem, Nasser Naif Alsuhaymi, Mansour Hemaid Alhelali, Dhiyaa Hassan A. Aldukhi, Khalil Rafed B. Alsaedi, Naif Mohammed Al-Wagdani, Ebtesam Ali S. Almadi, Khalid Mohammed A. Aladhadh, Fahad A. M. R. H. AlAjmi

Journal of Pharmaceutical Research International, Page 212-220
DOI: 10.9734/jpri/2021/v33i47A33006

Cardiac cirrhosis (congestive hepatopathy) refers to a group of hepatic abnormalities that develop as a result of right-sided heart failure.  Cirrhosis of the liver can be induced by any right-sided pathology that leads to right-sided heart failure, which leads to increased venous congestion and pressure in the hepatic sinusoids. Because cardiac cirrhosis might be asymptomatic or diagnosed incorrectly due to other types of liver disease, determining its prevalence is difficult. The underlying heart disease, rather than the hepatic congestion and damage, is usually the cause of death in cardiac cirrhosis. The control of the underlying cardiac disease, as well as the optimization of cardiac output, are the mainstays of congestive hepatopathy treatment. Diuresis can help with hepatic congestion, but it must be used with caution to avoid causing hepatic ischemia. Hemodynamic therapy may be able to reverse the early stages of congestive hepatitis. The widespread use of heart transplantation (HT) and considerable breakthroughs in medical and surgical treatments have drastically altered the profile of CH patients. In this overview we will be looking at the disease cause, epidemiology, diagnosis, and treatment.

Open Access Review Article

An Overview of Surgical Treatment of Perforated Peptic Ulcer

Hashem Bark Awadh Abood, Rakan Ali Alshehri, Yasir Salah Aljohani, Abdullah Yousef Almusallam, Norah Sulaiman Aljabarah, Abeer Ali Hakami, Talal Mohammed Alzahrani, Ohud Mohammed M. Alqahtani, Osama Hassan alqahtani, Ahmed Abdullah Almuhanna

Journal of Pharmaceutical Research International, Page 327-334
DOI: 10.9734/jpri/2021/v33i47A33018

A number of advancements in the therapy of perforated duodenal ulcers have been made in the recent two decades, suggesting that the disease's morbidity and mortality may be reduced. Recently, there has been a return to a more conservative first approach, with reports of either delayed resection or two-stage surgery, in which a non-radical resection is performed first, followed by lymphadenectomy at a later date. Furthermore, because gastric lymphoma can be cured without resection, many upper GI surgeons recommend performing a biopsy and repair at the index operation and then considering how best to continue if adenocarcinoma is discovered later.

Open Access Review Article

COVID-19: Cross Reactive Immunity, Herd Immunity, and Convalescent Serum Therapy

Nahla Khamis Ibrahim, Hala Abubaker A. Bagabir

Journal of Pharmaceutical Research International, Page 387-402
DOI: 10.9734/jpri/2021/v33i47A33024

Objective: To present various types of vaccines and viral infections which can induce cross-reactive immunity against COVID-19. In addition, this article discusses the role of herd immunity and convalescent serum therapy in preventing and controlling SARS CoV-2. The study also determined the claims and counterclaims about their protective and therapeutic effects.

Method: Non-systematic review was done using different articles done on cross-reactive immunity against COVID-19 through vaccinations, previous infections, herd immunity and the therapeutic effects of convalescence serum. The search was done on the PubMed, Google Scholar, and Science Direct, WHO, Euro-surveillance, CDC databases.  

Results: Many observational correlational studies reported that BCG decreases the incidence and mortality from COVID-19. Furthermore, homology between the COVID-19 virus and the measles, mumps, and rubella (MMR) viruses was discovered. Few studies suggested the presence of cross-immunity between MMR vaccine and SARS-CoV-2. Similarly, few studies suggested protective effects of Oral Polio Vaccine (OPV) against SARS-CoV-2; since both viruses are positive-single-strand RNA (+ssRNA). Diphtheria, pertussis, and tetanus (DPT) vaccines, particularly those that include inactivated whole pertussis vaccine, might induce B and T cell cross-reactive immunity against SARS-CoV-2. Other vaccines against Streptococcus pneumonia, Haemophilus influenza, and Meningococcal meningitis vaccines are suggested also to induce some immunity against Covid-19.  It is hypothesized that infections with other Coronaviruses may cause protection against SARS-CoV-2. However, the studies done on these suggestions were mostly observational that can carry a high chance of inherent biases. There are also claims and counterclaims about the effect of herd immunity and convalescence serum on the prevention and control of Covid-19. So, appropriately designed RCTs are needed to prove or disprove their protective and therapeutic effects.

Conclusions: There are claims and counterclaims about the protective effects of different vaccines, previous infections, and herd immunity and regarding the therapeutic effects of convalescence serum. Comparing with other vaccines, BCG was suggested to have the highest cross-reactive epitopes against SARS-Cov-2 virus. MMR, OPV, DPT, Influenza, Pneumococcal and meningococcal vaccines are suggested to protect against Covid-19. Previous infection with other Corona viruses, herd immunity and convalescence serum may play roles in the prevention and control of Covid-19. Many large clinical trials are undergoing nowadays and their results are needed to prove or disprove the cross-immunity related to SARS-CoV-2 and the effect of convalescence serum.

Open Access Review Article

Updates in Digoxin Toxicity and Outcome of Management: A Review

Imad Ahmad Ibrahim, Raghad Abdullah Alotaibi, Abdalah Emad Almhmd, Rahaf Ibrahim Alghamdi, Adnan Tawfiq Almogbel, Amer Saleh Alsaeri

Journal of Pharmaceutical Research International, Page 403-409
DOI: 10.9734/jpri/2021/v33i47A33025

Cardiac glycosides, including digitalis and digoxin, have long-standing use in clinical practice. Digoxin has a half-life that varies from 36 to 48 hours, which may increase in cases of renal failure. Approximately 1% of Congestive Heart Failure patients treated with digoxin develop toxicity. The clinical features of toxicity are often non-specific. Diagnosis is difficult and usually made clinically, as levels of digoxin in the blood do not necessarily correlate with toxicity. Treatment involves early recognition and the administration of antibodies specifically against digoxin also known as Fab fragments. Digoxin concentration does not necessarily correlate with clinical symptoms of toxicity however digoxin concentrations may be used for calculating the amount of antidote therapy. Digoxin-specific antibody fragments are used when there is a risk of a life-threatening arrhythmia.

Open Access Review Article

Vaccines against COVID-19 – Catching the Rays of Hope

Suresh Kumar Srinivasamurthy, Laxminarayana Kurady Bairy

Journal of Pharmaceutical Research International, Page 469-488
DOI: 10.9734/jpri/2021/v33i47A33035

COVID-19 pandemic has affected the world in all its dimensions. With herd immunity being a distant and non-practical possibility, vaccination remains most tractable approach to reduce morbidity and mortality. Several early phase clinical trials have proved the immunogenicity of vaccines. The efficacy trials have shown reduction in chance of acquiring COVID-19 disease after vaccination. The vaccines approved for emergency use have reported efficacy above 50% thus making them important public health tool in controlling the pandemic. Nevertheless, several questions remain elusive such as whether these approved vaccines are effective against newer variants of the virus; whether vaccination prevents transmission of the virus in the community; clinical impact of vaccination on morbidity and mortality. This review aims to elucidate the status of vaccine candidates in advanced trials along with the vaccines, which have been granted emergency approvals. Further, we collate the data on vaccines efficacy phase 3 trials and their probability of efficacy against newer variants.

Open Access Review Article

Corticosteroid Resistant Pulmonary Fibrosis: Pathophysiology and Management

Doha O. Alghamdi, Hala S. Abdel Kawy, Zoheir A. Damanhouri

Journal of Pharmaceutical Research International, Page 517-531
DOI: 10.9734/jpri/2021/v33i47A33042

Pulmonary fibrosis is a disease of the lower respiratory system. It might be as Idiopathic fibrosis which is obscure reason for disease or might be as an optional impact from different causes, for example, the environmental causes, for example, toxins and smoking, some connective tissue illnesses., infection diseases, for example, tuberculosis (TB) and corona virus, a few medications, for example, bleomycin, methotrexate, and radiation treatment. Glucocorticoid are used for treating inflammatory and immune diseases, like asthma, but interstitial lung disease, cystic fibrosis, and chronic obstructive pulmonary disease (COPD) at some stage, may become resistant to corticosteroid treatment. Glucocorticoids inhibit inflammation by many mechanisms. The oxidative stress leads to significantly decrease in activity and expression of Histone deacetylase 2 (HDAC-2) which causes resistant to the action of glucocorticoid. However, the dissociated glucocorticoids have been developed to decrease side effects, the dissociated glucocorticoid receptor agonists (DIGRAs) are a class of experimental drugs designed to share many of the desirable anti-inflammatory,  immunosuppressive, or  anticancer  properties of classical glucocorticoid drugs with fewer side effects, but it is so difficult to dissociate anti-inflammatory effects from adverse effects. Patients with glucocorticoid resistance must use alternative anti-inflammatory treatments as well as drugs that may reverse the molecular mechanism of glucocorticoid resistant. Objective: This paper is to review the corticosteroid resistant pulmonary fibrosis and how overcome this resistance.

The data was collected from December 2020 to September 2021.

Open Access Review Article

A Review on Diagnosis and Management of Cervical Spondylosis

Ahmed Abdulaziz G. Ibrahim, Ali Mohammed A. Alahmari, Abdullah Hassan F. Alsuayri, Abdullah Misfer M. Algomshah, Saeed Ghanem S. Almlfi, Ayman Dhaifallah A. Alamri, Sara Saeed Al-Akalbi, Kady Hassan Althunayan, Sarah Ibrahim Ali Alhammad, Wejdan Ibrahim Ali alhammad, Sadaf Esmail Buarish, Ahmad Abdullah A. Alsaleh, Noura Ali Abdullah Alnamazi, Mariyah Ihab Alzayer

Journal of Pharmaceutical Research International, Page 668-674
DOI: 10.9734/jpri/2021/v33i47A33059

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all components of the cervical spine (i.e., intervertebral discs, facet joints, Luschka joints, flava ligaments, and laminae). It is a natural aging process and occurs in most people after the age of five. Most people with radiographic spondylotic changes in the cervical spine  remain asymptomatic, and 25% of those under  40, 50% of those over  40, and 85% of those over  60 show some evidence of degenerative changes , including changes in  the environment. Uncovertebral joints, facet joints, posterior longitudinal ligament (PLL) and yellow ligament lead to  narrowing of the spinal canal and intervertebral foramina. As a result, the spinal cord, spinal vasculature, and nerve roots can become compressed, leading to the three clinical syndromes that occur with cervical spondylosis: axial neck pain, cervical myelopathy, and cervical radiculopathy. Cervical spondylosis is usually diagnosed for clinical reasons only, but imaging is also required. Treatment for cervical spondylosis can be medical or surgical, depending on whether the patient has symptoms of myelopathy, radicular pain, or neck pain.

Open Access Review Article

Literature Review on History and Pharmacotherapy of Parkinson`s Disease

P. Supriya, S. Rajaram

Journal of Pharmaceutical Research International, Page 839-849
DOI: 10.9734/jpri/2021/v33i47A33082

Introduction: Parkinson’s disease (PD) is a slowly progressive neurodegenerative disease characterized by: Pill rolling tremors, Akathisia (inability to sit still), Rigidity, Kinesis (akinesia, dyskinesia), Instable (stooped) posture, no arm swinging in rhythm with legs, Sialorrhea Oculogyric crisiseyes are held fixed for a variable length of time), Nervous depression, Involuntary tremors, Seborrhoea and Masked facial expression.

Parkinson’s disease is a chronic, progressive, neurodegenerative disorder with an estimated prevalence of 31 to 328 per 100,000 people worldwide. It is estimated that more than 1 percent of the population over age 65 are afflicted with Parkinson’s disease; incidence and prevalence increase with age. There are numerous unanswered questions regarding the diagnosis and management of Parkinson’s disease. Surgical treatment for Parkinson’s disease is generally considered for patients who respond to medications but have intolerable side effects. Surgical options include ablative procedures, deep brain stimulation, and tissue transplantation. This review focused on History and management of Parkinson’s disease. The purpose of this literature review is to gain an understanding of the existing research relevant to history and pharmacotherapy of Parkinson’s disease.

Conclusion: Pharmacological treatment of PD should be tailored to the individual patient. Drug therapy is not obligatory in early PD; many patients can be managed for a time with exercise and lifestyle interventions. For patients with mild symptoms, MAO-B inhibitors, amantadine, or (in younger patients) anticholinergics are reasonable choices.