Open Access Case Report

A Case Report of Silent Cervical Spondylosis with Neck Pain

Mayuri Zoting, Shivani Uttamchandani, Mitushi Deshmukh, Om C. Wadhokar

Journal of Pharmaceutical Research International, Page 232-237
DOI: 10.9734/jpri/2021/v33i48A33244

Background: Cervical Spondylosis, commonly known as Cervical Osteoarthritis, is a kind of degenerative osteoarthritis of the joints between the spinal vertebrae's and the neural foramina. It's a condition characterized by changes in the cervical bones, discs, and joints as a result of regular aging wear and tear. Spondylosis of the cervical spine is most common in 40s and 50s.

Case Presentation: A 65 years old male came to physiotherapy department with complaints of pain in left upper limb and neck and weakness in his left upper back muscles and unilateral since 2 months. Clinical impression showed cervical non radiculopathy. X-ray of cervical spine revealed osteophytosis and narrowed inter- vertebral space, seen in C6 and C7 cervical vertebral bodies with straightening of cervical spine. Cervical Distraction and compression test was positive.

Conclusion: A well planned physical therapy intervention has shown significant improvement in cases with cervical spondylosis in relieving the symptoms and improving quality of life.

Open Access Systematic Review Article

Role of Letrozole in Management of Female Infertility; Review Article

Maha Fouad Messawa, Salma Yousef Omar, Reem Ahmed Babagi

Journal of Pharmaceutical Research International, Page 260-271
DOI: 10.9734/jpri/2021/v33i48A33249

Background: Letrozole is a highly steroidal and selective oral aromatase inhibitor (AI). Serval studies shows that Co-treatment with letrozole significantly reduced gonadotropin consumption and the incidence of Ovarian Hyperstimulation Syndrome in normal/high responders, with pregnancy outcomes comparable to or better than the other groups. In this article we will be looking at role of letrozole in treatment of infertility

Methodology: A simple systematic review was carried out, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted qualitative data, and then the author's names, year, study type, methodology, and the result were reported.

Results and Conclusion: Letrozole has effectiveness which is near the usage of the Human Menopausal Gonadotrophin in the numbers of pregnancies per cycle but have much less cost which indicates cost effectiveness of the drug. Furthermore, studies show that administration of the drug is effective in inducing pregnancy, with higher dose more than 5mg and 7.5mg more effective.

Open Access Case Study

Conservative Management of Cervical Rib- A Case Report

Ayush Agrawal, Shivani Uttamchandani, Mitushi Deshmukh, Madhu Lakhwani, Om C. Wadhokar

Journal of Pharmaceutical Research International, Page 218-222
DOI: 10.9734/jpri/2021/v33i48A33242

Background: An additional rib that develops from the seventh cervical vertebra is known as a cervical rib, a congenital anomaly placed above the typical first rib, affecting 0.2- 0.5 percent of the total population. It may be seen on either the left or right sides. The majority of patients have little or no complaints and are identified by chance during an X-ray or CT scan. Due to the extreme compression on the arteries, veins and nerves caused by the position of the rib, which varies in shape and size, they might develop thoracic outlet syndrome. A cervical rib is a prolonged ossification of the lateral costal segment of the Cervical 7th vertebra.

Clinical Presentation: A 18 years old female patient was diagnosed with cervical rib on X-ray due to persistent pain at right hand. Patient concern with reduced mobility of the right upper limb and unable to lift the hand. The patient went physiotherapy treatment which comprise of exercise and electro therapy for 10 weeks which resulted in improvements in pain and range of motion and functional activities

Conclusion: The case report suggest that a prompt structured physical rehab let to improving the functional goals progressively and significantly which is a measured aspect leading to a successful recovery.

Open Access Study Protocol

Evaluation of Comparative Efficacy of Brahmi vs. Haritaki Extract in the Management of Academic Stress in Adolescent Students- A Prakriti based Double-blind Randomized Controlled Trial

Vidya Bhushan Pandey, Renu Bharat Rathi, Bharat Rathi, Jitesh Verma

Journal of Pharmaceutical Research International, Page 159-169
DOI: 10.9734/jpri/2021/v33i48A33233

Introduction: Prevalence of mental illnesses among adolescents was found 7.3% (N=1191) by NMHS survey 2015-16 whereas the national crime record bureau in 2014 stated 1.8% of students committed suicide due to failure in their exams. The root cause, that is academic stress is often ignored which occurred due to various stressors like physical, mental, family, school, relationship, and social factors of which School factor (56.7%) and academic tests (45.6%) hold maximum association. Proper management can be provided with Ayurveda by Prakriti wise (exploring one physical, physiological and psychological factors) analysis of stress and their coping up strength and effect, when assisted with oral intakes of Ayurveda drugs like Brahmi and Haritaki along with Sattvavajaya Chikitsa having Achar Rasayana, Surya Namaskar, Dharna, and Dhyana practices.

Aim and Objectives: The aim is to evaluate the comparative efficacy of Brahmi extract with Sattvavajaya Chikitsa over the effect of Haritaki extract with Sattvavajaya Chikitsa in the management of Academic Stress among adolescent students of different Prakriti.

Material and Methods: A double-blind reference standard controlled stratified randomized superiority clinical trial is planned. The sample size of 198 participants with 13% dropout consideration will be enrolled after analysis of their Prakriti and stress level between 5-25 according to the SAAS scale. Total 6 subgroups (3 each for trial drug group and 3 for standard control) will have Vata, Pitta, and Kapha Doshic (V, P & K) dominant Prakriti participants of 10 to 17years of age. Total 33 participants in each subgroup will have the interventions for 90 days.

Observation and Results: Participants will be assessed for changes in salivary cortisol, level of academic stress, IQ, and memory before and after the trial. The standard descriptive and inferential statistical measures will be used to assess the effect of interventions.

Conclusion: Prakriti analysis will help stressed adolescents to know their strengths and interventions provided will be expected to help a stressed one to minimize stress level and also assist in developing their stress-coping mechanism.

Open Access Short Research Article

Association of Mean Platelet Volume (MPV) in Relation to Disease Activity in Lupus

M. Abhishek, A. Gowrishankar, M. Kavitha

Journal of Pharmaceutical Research International, Page 105-110
DOI: 10.9734/jpri/2021/v33i48A33225

Introduction: Among the various clinical and biochemical parameters which are employed to monitor the disease activity in Systemic Lupus Erythematosus (SLE), Mean Platelet Volume, which is a platelet activation biomarker has been recently studied. We intended at evaluating the MPV in patients with active SLE and comparing it with the same patients who were in clinical remission, and to study the correlation between MPV and SLEDAI. We also studied the correlation between MPV and ESR, complements C3 and C4.

Methods: This is a prospective study conducted for a period of 12 months, in which 50 consecutive patients who were recently diagnosed with SLE according to the SLICC classification criteria were included. Complete blood count with MPV levels along with ESR, were measured at the first visit to the hospital and were repeated at every visit till they attained clinical remission. Analysis of MPV was done at first visit and at remission. Complements C3 and C4 was done at the first visit and at remission. The results were then tabulated and statistically analysed using SPSS 25. A Pearson’s correlation test was done to assess the relation between MPV, ESR and SLEDAI.

Results: Patients with active disease had a decreased MPV as compared to those in clinical remission (10.91fl, 13.11fl, p=0.011). We observed a weak positive correlation between MPV and SLEDAI (r=0.034, p=0.011). We observed no correlation between MPV and ESR, C3 and C4. Meanwhile, SLEDAI showed a positive correlation with C3 and C4; there was no correlation with ESR though.

Conclusion: MPV is reduced in patients with active SLE and displayed an inverse correlation with SLEDAI.

Open Access Short Research Article

Allergic Reaction of the Body to Drugs Used in Dental Practice

Anastasiia Vladimirovna Shefova, Andrey Olegovich Galustyan, Angelina Olegovna Shershneva, Olga Vladimirovna Tyukavina, Marina Mikhailovna Krekova, Alexander Markov

Journal of Pharmaceutical Research International, Page 182-187
DOI: 10.9734/jpri/2021/v33i48A33236

The article examines allergic reactions of the body to drugs used in dental practice. The authors note that adverse or allergic reactions of medicines to the human body are possible with any medications that are prescribed or administered in a dental office. Although most of the pharmacological agents used today have a favorable profile and they are relatively safe, a modern specialist should be aware of potential adverse reactions that may occur and one should be ready to cope with any complications.

Adverse or allergic reactions are possible when working with drugs such as local anesthetics, sedatives, analgesics and antibiotics, for this reason, it is necessary to study the possible reactions of the patient's body to them when administering such drugs to reduce the negative impact on the body. In general, the pharmacological arsenal of a practicing dentist is relatively safe today. However, a prudent clinician should be aware of potential adverse reactions that may occur as a result of taking medications, and be confident in the treatment of such complications.

Open Access Short Communication

The Role of Hyperhomocysteinemia in the Pathogenesis of Thromboocclusive Diseases

Ibragim Abdulganievich Yusupov, Mubarik Dziyaudinovna Akaeva, Natalia Yurievna Stepanova, Nikita Vladimirovich Slysarenko, Omar Ruslanovich Gaidarbekov, Eldar Abdurahmanovich Saidov, KhavraAdamovna Dudugova, Zaytun Said-Magomedovna Dikieva, Alina Yuryevna Maslova

Journal of Pharmaceutical Research International, Page 130-136
DOI: 10.9734/jpri/2021/v33i48A33229

Homocysteine is a sulfur-containing non-proteinogenic amino acid that is an intermediate product of methionine metabolism. With excessive accumulation of homocysteine in the body, a state of hyperhomocysteinemia occurs, which has attracted the attention of doctors since the middle of the last century and received a serious impetus for research after the publication of data on the role of hyperhomocysteinemia in the pathogenesis of thromboocclusive diseases. To date, there are more than 7.5 thousand scientific papers devoted to the study of hyperhomocysteinemia, monothematic international conferences on clinical and therapeutic aspects of hypermonocysteinemia are held every year. In the Russian Federation, a detailed study of the role of homocysteine and its side effects in excess is of particular interest due to the prevalence of cardiovascular pathologies (according to statistics of the Ministry of Health of Russia-49.27% of deaths of Russians fall on this cohort of diseases). This is an important fact in Russian medicine, which deserves close attention from researchers and scientists.

Open Access Original Research Article

Role of Anthropometric Data in Assessing Hamstring Graft Size in Anterior Cruciate Ligament Reconstruction

Sathesh Kumar Murthy, M. Sai Deiv Ramkumar, Niranjan M. Raghavn, B. Pooja, Shanmuga Sundaram

Journal of Pharmaceutical Research International, Page 1-9
DOI: 10.9734/jpri/2021/v33i48A33200

Background and Objective: Preoperative information of hamstring graft size for anterior cruciate ligament reconstruction (ACL) is critical for making optimal graft selections. The aim of the present study was to view whether anthropometric parameters including height, weight, BMI and thigh circumference have any bearing on the size of hamstring tendon grafts used in anterior cruciate ligament replacement.

Methods: Pre-operative anthropometric measurements were taken on 72 patients undergoing primary ACL reconstruction, including age, gender, height, weight, BMI, and thigh circumference. The Person correlation coefficient was used to assess the correlation of these anthropometric variables and simple logistic regression was used to evaluate the correlation of these anthropometric variables on the size of the graft that was acquired.

Results: Gracilis tendon [GT] length correlates with height (r 1/4 0,432), and semitendinosus [ST] length correlates with thigh circumference (r 1/4 0,255). Women's graft diameter (7.16 ± 0.82 mm) smaller than that of men (7.39 ± 0.63 mm) (p > 0.05), although not statistically significant. The diameter of the autograft was shown to be strongly linked with parameters.

Conclusion: As a consequence, our findings suggest that anthropometric measures can be used in the preoperative planning and prediction of hamstring graft length and diameter in anterior cruciate ligament reconstruction.

Open Access Original Research Article

Knowledge, Attitude and Practice among Dentists Regarding Tetracycline Teeth Staining and Treatment Protocol - A Questionnaire Study

Shivangi Gaur, M. Madhulaxmi

Journal of Pharmaceutical Research International, Page 10-21
DOI: 10.9734/jpri/2021/v33i48A33202

Introduction: Aesthetics is an important attribute to man’s overall view of himself .The term “tooth discoloration‟ refers to the fading away of the natural colour of the tooth or replacement with a stain, usually of a different colour to the point of notice. Tooth discoloration has been classified as extrinsic or intrinsic. Tetracycline staining which is characteristic in children born of mothers who were on tetracycline medication. These children develop a brown staining on most of their deciduous and permanent teeth. A variety of treatment methods including tooth-whitening options have been sought. The aim of this KAP survey was to assess the knowledge , attitude and practice of various clinical practitioners both undergraduate and postgraduate regarding Tetracycline tooth staining, its aetiology and treatment modalities.

Methodology: A cross-sectional study was conducted across various Dental Clinics and Hospitals in Chennai, Tamil Nadu.Theself-administered questionnaire was written in English was adapted based on many other previous surveys of similar nature. It was circulated as digital questionnaires (GoogleForms) It had 15 items, 5 in the knowledge, 5 practice components and 5 in the attitude component, and took about 10 min to complete.

Results: Among the 250 responses it was observed that 66.7% of the respondents were endodontists and the remaining 33.3% were general practitioners.33.3% of respondents had an experience of 2 to 6 years while 16.7% of respondents had a 8 year or more experience. All the respondents were based in and around Chennai, Tamil Nadu. The mean Knowledge score was 70%, while mean attitude and practice scores varied between 87% to 91% and were considerably much better.

Conclusion: The fabrication of a detailed treatment protocol for the treatment of tetracycline based tooth staining in various clinical scenarios and the standardization of such a protocol, while also upgrading the basic theoretical knowledge is necessary. This could in tern help delivering better treatment to the patient while considering both the affordability as well as aesthetic satisfaction of the patient.

Open Access Original Research Article

Effect of Fresh Frozen Plasma Transfusion Inpatients with Coagulation Abnormalities

S. Nagulan, A. Hariharan, I. Sureshkumar, S. Chitra

Journal of Pharmaceutical Research International, Page 22-26
DOI: 10.9734/jpri/2021/v33i48A33203

Aim: To study the efficacy of Fresh Frozen Plasma (FFP) transfusion practice in patients with coagulation abnormalities varies in clinical practice.

Study Design: A retrospective study.

Place and Duration of Study: This study was conducted in Department of Transfusion Medicine, SMCH, Chennai, between the period of 2019-2020.

Methodology: The medical records of each patient receiving FFP transfusions that occurred in patients with coagulation abnormalities were reviewed and the data were collected based on pre-and post transfusion PT (>12 sec), APTT (>70sec) and INR (>1.5) and then analysed statistically. Patients with normal coagulation parameters were excluded from study.

Results: A total of 1259 units of fresh frozen plasma were transfused to 315 patients between the year 2019-2020. Of the 1259 units transfused 1133 units where transfused to 283 patients with coagulation abnormalities. Apparently 32 patients were excluded from the study as they had normal coagulation profile. Among 251 patients, 37 patients PT were greater than 12 seconds before FFP transfusion out of which the PT was corrected for 14 patients (37.8%) after FFP transfusion. In 228 patients APTT was greater than 70 seconds before FFP transfusion, out of which APTT was corrected in 18 patients (8%) after transfusion. INR values for all 251 patients were greater than1.5 before FFP transfusion, out of which INR was corrected in 84 patients (29%) after transfusion.

Conclusion: We conclude that FFP transfusions in patients with coagulation abnormalities maycorrects the defect only in less percentage of patient population, as in our study it corrects only an average of 31% of patient population.

Open Access Original Research Article

Knowledge, Attitude, and Practices towards Needle Stick Injuries among Students and Staff in a Tertiary Medical Centre in Chennai, Tamil Nadu, India

P. S. Aswin, V. Vikrannth

Journal of Pharmaceutical Research International, Page 27-32
DOI: 10.9734/jpri/2021/v33i48A33206

Background: Needle stick injuries are one of the greatest fears that revolves around the health care workers all over the world, and the majority of them are avoidable by following proper precautionary methods in handling the devices. Even though, by following the precautionary methods, a few accidents may happen a few times and thus resulting in a needle stick injury. The aim of  our study was to assess the knowledge, attitude and practices towards Needle stick injuries among students and staff in a tertiary medical centre in Chennai, Tamil Nadu , India

Objectives: To assess the knowledge, attitude, practices about needle stick injuries among students and staff in a tertiary medical centre in Chennai, Tamil Nadu, India.

Materials and Methods: This descriptive cross-sectional study was conducted in Saveetha Medical College and Hospital.

Our study included students and staff of the institution, irrespective of their age and sex. Data collection was carried out using a standardized questionnaire.

Results: 62.1% of the participants know the last universal precaution guidelines of needle stick injuries management. 83.3% are fully vaccinated with anti-HBV.70.9% always use gloves when deal with needles. 14.3% had Needle stick Injury. 40.9% strongly believe that needle stick injury can be prevented. Since adequate awareness is created by the institution, participants in this study have higher knowledge, attitude and practices when compared to reference studies.

Open Access Original Research Article

Knowledge, Attitude and Beliefs of Parents Regarding Fever in Children

S. Dhanya Dedeepya, Vidhyasagar Krishnamoorthy, P. Ambikapathy

Journal of Pharmaceutical Research International, Page 33-40
DOI: 10.9734/jpri/2021/v33i48A33205

Aim: To assess the knowledge, attitude and belief of Parents about fever in their children and how they respond to it while at home and when they seek medical attention.

Objectives: The purpose of this study is to know the preexisting knowledge of parents about fever in their children and to impart additional knowledge to them.

Materials and Methods: A Cross- Sectional study in the form of a questionnaire was conducted at a tertiary care hospital among parents of children visiting the outpatient department and those admitted as inpatient with fever. Children who presented to the emergency room and those with chronic illnesses were not included. Majority of the primary caregivers was the child's mother, and family becomes the 1st point of contact for the intervention, hence we chose family. As per our department that at least 80% of children were primarily brought to OP for fever, and 90% of those admitted in wards were for febrile illnesses, with or without other associated problems, we asked the statistician to come up with an adequate number and we were given.

 Results: A total of 100 parents were selected and interviewed. The informants were mostly mothers (83%). Most of the children were brought to outpatient department within the first five days of onset of fever (68%). The parents said that they confirmed the fever by touch(86%)and most of them prefer to consult the pediatrician before giving any medication (56%).The most common symptoms which were seen associated with fever are cough, cold  and  running nose (54%).The most common cause for worry amongst parents are complications like febrile seizures (43%).

Conclusion: Fever is one of the most common complaints with which patients come to the hospital. Majority of parents in this study do not have the practice of documenting fever at home with a thermometer. Inadequate parental knowledge about the nature of fever can lead to poor management. Appropriate education helps them to take appropriate measures when their child develops fever.

Open Access Original Research Article

Association of Carpal Tunnel Syndrome in Diabetes Patient

K. Jaganath, Arun Kumar, Sathish Kumar, K. Nithish Raj, P. Sanmuga Sundaram

Journal of Pharmaceutical Research International, Page 41-45
DOI: 10.9734/jpri/2021/v33i48A33210

Objective: The objective of our study was to determine Prevalence of carpel tunnel syndrome among diabetic patients and the significant association between carpel tunnel syndrome and diabetes mellitus.

Materials and Methods: Study was conducted on 250 patients at Saveetha medical college and hospital. Study was conducted after getting proper ISE approval. Subjects were selected according to inclusion and exclusive criteria's. For every study subject after getting consent demographic information, past medical history of Diabetes such as type, duration, any associated complication (diabetic neuropathy, retinopathy, etc.), medication, and lifestyle modification were obtained via a self-reporting structured questionnaire and confirmed by the subject's medical record. For every subject, clinical tests such as Tinel's test and Phalen test were performed and nerve conduction study was used for diagnose carpal tunnel syndrome among the subjects who were showing positive clinical test. All data collected were entered into the standardized database and statistic analysis was calculated.

Results: After analysing the data collected on association between carpel tunnel syndrome and a diabetes patient.

Conclusion: It implies that there is a significant relationship between carpal tunnel syndrome and diabetes patients.

Open Access Original Research Article

COVID-19 Clinical Manifestations & Concerns among the Kingdom of Saudi Arabia's 937 Health Hotline Callers in Jeddah

Khalid Moammer, Najlaa Ahmed Mandoura

Journal of Pharmaceutical Research International, Page 46-56
DOI: 10.9734/jpri/2021/v33i48A33211

The on-going COVID-19 pandemic has highlighted telehealth as a crucial tool in delivering high quality healthcare with increased efficiency. In the Kingdom of Saudi Arabia this has been evidently clear with the establishment of the robust Ministry of Health 937 COVID-19 hotline.  The objectives of our study are to describe the clinical patterns of COVID-19, identify the most common concerns of the 937 hotline callers and to identify the associations between the clinical presentation of COVID-19 and risk factors of the patients. through an Analytic Cross-Sectional study design.

Results: The average age was 36.8 ± 15.7 years,  61.1% were males and 38.9% were females. 69.3% were Saudi and 30.7% were non-Saudis. 82.5% employed, whilst 17.5% were unemployed. The most commonly reported symptoms were fever, followed by fatigue and cough respectively. With 41.8%, 28.2% and 23.2% of participants reporting those symptoms respectively. The most significant predictors of developing shortness of breath due to COVID-19 was chronic lung disease OR=5.7, p value >0.01, chronic kidney disease, OR = 4.8, p value >0.02 and immunocompromised state OR = 19, p value >0.01. 82% of all calls to the hotline were related to COVID-19 testing, and 11% of all calls resulted in the caller receiving medical counselling and/or treatment without having to make a physical visit to a healthcare provider.

Conclusion:  A well-designed telehealth program can mitigate the need for a physical visit to the emergency room or clinic and as such reduce the load on front-line healthcare workers, reducing transmission and improving outcomes during infectious disease epidemics. It can also provide valuable insights into the presentation and risk factors of a new disease to aid in the prevention, diagnosis, management and control of the disease.

Open Access Original Research Article

Knowledge and Practice of Mothers Regarding Child Safety at Home among Under Five Children and Its Correlation with Sociodemographic Details

L. M. Gauthamme Sai, Radha Kumar, Vemulapalli Harsha

Journal of Pharmaceutical Research International, Page 57-65
DOI: 10.9734/jpri/2021/v33i48A33212

Background: Young children are prone for accidental injuries in the home environment and these injuries can be easily prevented by better supervision and improving safety in the home.

Objectives: The aim of the study is to assess the knowledge and practice of mothers regarding child safety in under five children at home and its correlation with sociodemographic details.

Materials and Methods: A cross sectional study conducted in a tertiary care teaching hospital at Kancheepuram. The duration of the study was 2 months. Mothers with at least one child under 5 years of age who visited the pediatrics outpatient department during the study period were included in the study. The sample size was 160. After obtaining approval from the institutional review board (approval no SMC/IEC/2021/03/046) a self designed and validated questionnaire was administered to the participants after obtaining consent. The data was entered into an excel sheet and analysed using SPSS 24.

Results: A total of 160 mothers of under five children who visited the outpatient department of pediatrics during the study period were included in the study.  The mean age of mothers was 25 years. 73.12% of mothers who participated in the study had adequate knowledge about child safety at home and 53.12% mothers had adequate practice. The association of knowledge towards child safety at home and mothers’ education was statistically significant (P = 0.006). Graduate mothers were found to have more knowledge regarding child safety at home among under five children than mothers educated upto middle school and high school. The association of practice towards child safety and type of family was found to be statistically significant (P = 0.016). Mothers belonging to joint families were found to have better practices towards child safety than mothers belonging to nuclear and three generation families. 65% of the mothers stated that their child has suffered from home injuries earlier including minor and major injuries. 41.8% of mothers said that they have a first aid kit at home.

Conclusion: Although most of the mothers had adequate knowledge towards child safety at home among under five children, half of the mothers lacked adequate practice towards child safety. Hence it is essential to counsel and educate mothers to improve practices at home that would be beneficial in improving child safety.

Open Access Original Research Article

The Role of Leadership in Improving Efficiency, Effectiveness and Safety Measures of Hospitals, Primary Healthcare Centers, & Pharmaceutical Firms

Fahad Albejaidi

Journal of Pharmaceutical Research International, Page 66-73
DOI: 10.9734/jpri/2021/v33i48A33213

The aim of the current study is to investigate the impact of leadership of health care organizations on improving the efficiency, effectiveness and safety of their quality system and program. For this purpose data was collected from health care managers, directors of PHCs and hospitals of Saudi Arabia. Total 372 completed questionnaires were received and analyzed in the study. Non probability snow ball technique is used. PLS-SEM is used to analyze the data. Measurement model is developed to check the reliability and validity of the scales. It is found that scales are found reliable and valid after deleting two items from efficiency, two from effectiveness and two from safety. Structural model was run using bootstrapping. It is revealed that all the hypotheses are accepted and leadership of the hospitals and health organization has important role in improving quality of the services provided to hospitals.

Open Access Original Research Article

Antimicrobial Efficacy of Herbal Root Canal Irrigants and 3% Sodium Hypochlorite against Enterococcus faecalis: An In-vitro Study

Shafie Ahamed, Vignesh Guptha Raju, Madhuram Krishnamurthy, V. Naveen Kumar, K. E. Selvendran

Journal of Pharmaceutical Research International, Page 74-78
DOI: 10.9734/jpri/2021/v33i48A33214

Nigella sativa (kalonji) has been used since ancient times as a nutritional supplement and for treating various infections and chronic ailments. As pathogens become resistant to most drugs, kalonji can be used as an alternative compound in modern medicines. The use of herbal extracts as endodontic irrigants might be beneficial as a part of a growing trend to seek natural remedies for dental treatment.

Aim:  To compare the antibacterial potency of Aqueous Nigella sativa extract, Aqueous Neem leaf extract, and 3% Sodium Hypochlorite.

Materials and Methods: Test solutions were tested against E. faecalis (ATCC 29212) to check for their Minimum Inhibitory Concentration (MIC) by double dilution method and Kill time to measure their antimicrobial potency to be used as an intracanal irrigant.

Results: The study's limitations show that Aqueous Nigella sativa extract has a better antimicrobial effect than Aqueous Neem leaf extract and 3% Sodium Hypochlorite solution against E. faecalis.

Open Access Original Research Article

Standardization, Characterization and Isolation of Trichoderma-Silver Nanoparticle-A Pharmaceutical Approach in Field of Nano-Medicine

Bina Pani Gupta, Vikash Gaur

Journal of Pharmaceutical Research International, Page 79-91
DOI: 10.9734/jpri/2021/v33i48A33222

Silver is a well known antimicrobial agent. It is utilized in many antimicrobial and medication. The Trichoderma and its Metabolites have also been meant for antimicrobial activity against the various bacterial and fungal strain. In the present investigation Nanoparticle of silver is prepared by chemical method, green synthesis using plants and biosynthesis using microbes. Trichoderma secondary metabolite prepared by solvent extraction method from Trichoderma harzianum which act as a capping and reducing agent. The biosynthesised silver Nanoparticles were characterized by UV-Vis spectroscopy and TEM. UV-Vis spectra of silver Nanoparticle and trichoderma extract showed absorption spectra at 420nm & 430 nm respectively while the fused nanoparticle with Trichoderma secondary metabolite showed absorption spectra at 415 nm corresponding to the surface Plasmon resonance of silver Nanoparticle. It was determined the nanoparticle showed absorption spectra at 415 nm and morphology as spherical with size range 8 to 24 nm and providing good antimicrobial activity as Trichoderma silver fused nanoparticle against many microbial strain, so it can be prepared for pharmaceutical approach against the infectious disease caused by clinical pathogenic organisms.

Open Access Original Research Article

Prevalence of Hypertension in Patients with Nephrolithiasis

I. Adhavan, S. Prasanna Karthik

Journal of Pharmaceutical Research International, Page 92-96
DOI: 10.9734/jpri/2021/v33i48A33223

Introduction: Kidney stone disease, also known as nephrolithiasis, is a prevalent illness that affects people of all ages and genders. Hypertension is defined as persistent elevation of systemic arterial blood pressure (systolic pressure ≥ 140 mmHg and/or diastolic pressure ≥ 90 mmHg).

Methodology: This was a prospective study conducted over a period of 3 months between February 2021 and April 2021 at the Department of General Medicine in our tertiary care center. A total of 280 patients who came to the outpatient department (OPD) were included in the study as study participants. After recording blood pressure, participants were classified as normotensives (218) and hypertensives (62).  The study participants were examined for the development of kidney stone disease. In those study participants who had clinical features suggesting nephrolithiasis, the diagnosis was confirmed by Ultrasonography.

Results: It was observed that 25 of 62 hypertensives and 47 of 218 normotensives developed nephrolithiasis. And there were 43 men and 29 women among the 72 stone formers.

Conclusion: Our study showed a male preponderance for stone formers. And it is also evident that nephrolithiasis is more prevalent among hypertensives than normotensives though not statistically significant.

Open Access Original Research Article

Evaluation of Blood Pressure and Heart Rate Variability during Different Phases of Menstrual Cycle

T. Srigopika, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 97-104
DOI: 10.9734/jpri/2021/v33i48A33224

Introduction: Every month, between puberty and menopause, a woman’s body goes through a number of changes to get it ready for a possible pregnancy. This series of hormone-driven events is called the menstrual cycle. A woman’s menstrual cycle is divided into three phases- proliferative phase, secretory phase and menstrual phase.  The hormonal surge during each phase causes profound effects on the cardiovascular system as well. However, previous research reported conflicting results in this concept. Thus the controversial statements associating blood pressure and heart rate variability with menstrual cycle promoted this research.

Objective: The aim of this study is to evaluate the blood pressure and heart rate variability during different phases of the menstrual cycle.

Materials and Methods: 20 healthy women belonging to the proliferative, secretory and menstrual phase of the menstrual cycle were analyzed for autonomic functions tests using systolic blood pressure, diastolic blood pressure, pulse rate and heart rate variability.

Results: It showed that there was a statistically significant increase in systolic blood pressure, diastolic blood pressure, and pulse rate during the secretory phase. There was an increase in heart rate variability during the menstrual phase but this was statistically insignificant.

Conclusion:  The study concluded that there were significant changes in blood pressure during the secretory phase and pulse rate and insignificant increase in heart rate variability during the menstrual phase. Thus, the study also concluded that sympathetic nervous activity in the secretory phase is significantly greater than in the proliferative phase, whereas parasympathetic nervous activity is predominant in the proliferative phase.

Open Access Original Research Article

The Awareness and Attitudes of the Public toward Complementary and Alternative Treatments

Nehad J. Ahmed, Ahmed A. Albassam, Mshari Alonazi, Maged S. Abdel-Kader

Journal of Pharmaceutical Research International, Page 111-118
DOI: 10.9734/jpri/2021/v33i48A33226

Introduction: Complementary and alternative medicine (CAM) is flourishing very fast and the usage of CAM in health care is quickly evolving. The behavior and attitude of the patients towards herbal medicines represents an important concern for policy makers and for regulators.

Objective: The aim of this study is to evaluate the pattern of natural products use among the public and the Attitudes towards natural health products in Al-kharj

Methodology: This is a cross-sectional study design. A questionnaire was prepared using Google drive tool and used to evaluate the pattern of natural products use among the public and the attitudes towards natural health products in Al-kharj governorate. The survey was filled by 442 participants.

Results: Most respondents used a natural health product in the past (only 319 of 442 have been used natural product), the most used products were Vitamins/Minerals (85.57%). Additionally, about 50 % of the respondents agreed that the natural health products are safe because they are made from natural ingredients. The majority of the respondents reported that there isn't enough information on natural health product labels to help them understand the Products. The majority reported that the family and friends were recommended and provided them with the information regarding the use of the natural health product (71.78%).

Conclusion: The present study showed that the use of herbal medicine is a common practice. The legislation is recommended to arrange the using of natural health products. The study results would surely require an active role for the Ministry of Health and Saudi Food and Drug Authority (SFDA) to insure enough information regard the risks and benefits of NHPs.

Open Access Original Research Article

Study of Platelet Count as a Prognostic Factor in Burns Patients

M. Krithiga, . Kumaran

Journal of Pharmaceutical Research International, Page 119-123
DOI: 10.9734/jpri/2021/v33i48A33227

Aim:  To study the platelet count as a prognostic indicator in burns patients

Objective: To evaluate the platelet count in patients with burns and its significance in early detection of post burn septicemia.

Methodology: A study was carried out in the department of surgery in Saveetha medical college from January to June 2021.

50 burns patients were included in the study and their platelet count was monitored on day 1 and assessed on day 7, 14 and 21 using standard methods. Based on the outcome the patients were grouped as survivors and non survivors.

Results: Out of the 50 patients 32 patients survived, 18 patients died. In both the groups the platelet count decreased initially. In the survivors group the platelet count increased gradually whereas in the non-survivors it was found to be decrease and continued till death.

Conclusion: A decline in platelet count is a poor prognostic factor. The outcome of burns patients can be improved by giving appropriate and timely treatment.

Open Access Original Research Article

Prevalence of Endocrine Abnormalities in Adolescent Girls with Menstrual Disorders in a Tertiary Care Hospital in Chennai

Shiva Shanmuganathan, M. Rajalekshmi

Journal of Pharmaceutical Research International, Page 124-129
DOI: 10.9734/jpri/2021/v33i48A33228

Purpose: To identify endocrine abnormalities such as hyperandrogensim, thyroid disorders, and hyperprolactinemia in adolescents with menstrual disorders.

Methods: This was a case–control study carried out in adolescent girls aged 10–19 years in the gynecology outpatient department of a tertiary care hospital. The participants’ demographic details, medical, surgical, family, and personal history was obtained. Data of hormonal evaluation, namely serum T3, T4, TSH, serum prolactin and serum testosterone was also collected. 

Results: The most common menstrual abnormality was oligomenorrhea at 66% followed by menorrhagia at 10%. Primary amenorrhea was seen in 8% cases, metrorrhagia was seen in 4% and polymenorrhea in 4% of cases. Secondary amenorrhea and hypomenorrhea were both seen in 2% of cases. 10% adolescents with menstrual abnormalities had biochemical hyperandrogenism. Only 2% had hyperandrogenism in the control group. Thyroid dysfunction was more prevalent in the adolescents with menstrual disorders (14%) when compared to controls (4%). Among those with oligomenorrhea, only in one case was serum prolactin raised (3.0%).

Conclusion: Immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, but endocrine abnormalities may be responsible in some cases. Therefore it is paramount to examine the prevalence endocrine abnormalities among among adolescents with menstrual problems to promote their quality of life, lower her risks for future disease, and ill health.

Open Access Original Research Article

A Study of D-Dimer Levels in Acute Febrile Non Covid Conditions in a Tertiary Care Hospital

S. Caroline Sylvia, S. Vinoth

Journal of Pharmaceutical Research International, Page 137-141
DOI: 10.9734/jpri/2021/v33i48A33230

Introduction: Acute undifferentiated febrile illness (AUFI) is caused by a multitude of diverse pathogens, with significant morbidity and mortality in the developing world. This study aims to highlight the gaps in our understanding of  the various differential diagnosis of acute febrile illness  and their prognostic outcomes. In this study, We used d-dimer levels to arrive at a differential diagnosis in acute febrile illness and also used it as a biomarker of disease severity and prognostic outcome.

Materials and Methods: A prospective study was conducted at medicine department, Saveetha  medical college and hospital, Thandalam, India  for a period of 3 months from January 2020 - March 2020. Patients who presented to the medicine outpatient department with symptoms of acute febrile illness with non specific symptoms were registered after getting written consent in the study. The plasma concentration of D -dimer levels ,prothrombin time , APTT from which INR were measured. The duration of hospital stay of patients in study was recorded. The data collected was entered into an excel sheet and analysed using SPCC software.

Results: A total of 50  patients with acute febrile illness were enrolled in the study. Out of which 37 patients (74./. of patients)  were found to have elevated D dimer levels.

These 37 patients with elevated D – dimer levels required longer duration of hospital stay, reflecting the need for more days for recovery.

Open Access Original Research Article

Agreement between Prehospital and Final Diagnosis in Patients with Acute Allergic Reactions: A Cross-Sectional Study

Saeed Golfiroozi, Nader Tavakoli, Peyman Namdar, Mohammad Amin Zare

Journal of Pharmaceutical Research International, Page 142-149
DOI: 10.9734/jpri/2021/v33i48A33231

Introduction: Acute allergic reactions are usually first encountered in the prehospital setting and account for about 0.3% to 0.8% of prehospital runs in different countries. Right, and rapid recognition and treatment are necessary to decrease mortality and morbidity, especially in severe critical cases. This study evaluates the accuracy of prehospital care providers’ diagnosis in patients with acute allergic reactions in comparison with final (discharge) diagnosis as the gold standard.

Methods: Patients who were transported to 2 urban referral hospitals between 2008 and 2014 under the dispatch code of “acute allergic reaction” were included in the study, retrospectively. Demographic data, etiology of an allergic reaction, clinical presentations, vital signs stability, and need for epinephrine injection were evaluated. The prehospital care providers’ diagnosis (documented on-call report) was compared with the final diagnosis (documented on discharge summary form).

Results: A total of 300 patients were included in the study. In 55 (18.3%) cases the prehospital care providers’ and final diagnoses were different. Diagnoses were similar in 245 (81.6%) patients. Kappa coefficient was calculated as 0.621which shows a moderate-to-substantial agreement between prehospital and final diagnoses. Fifteen patients (5%) were discharged from the hospital with a diagnosis of anaphylaxis and only 4 cases (26.6%) were diagnosed in the prehospital setting.

Conclusion: Although the overall agreement between prehospital and final diagnosis of acute allergic reactions calculated in this study was good, the accuracy of diagnosing the anaphylaxis (as the most critical allergic reaction with a potential fatality) was less than optimal.

Open Access Original Research Article

Thyroid Function Test in Patients with Chronic Kidney Disease

V. Abhinaya, S. Magesh Kumar

Journal of Pharmaceutical Research International, Page 150-158
DOI: 10.9734/jpri/2021/v33i48A33232

Background: Kidneys have a significant role in the metabolism, degradation and excretion of thyroid hormones. Both thyroid hormones and kidney functions have a multifaceted mutual interdependence.

Objectives: To find out the possible association between the severity of chronic kidney disease and thyroid dysfunction; To estimate the correlation between thyroid dysfunction and various stages of chronic kidney disease.

Materials and Methods: A prospective Cross-sectional study was done on 50 patients with Chronic kidney disease who were not on dialysis and fulfilled all the inclusion criteria at Saveetha medical college over a period of 6 months. Free T3, Free T4 and TSH levels were estimated for those patients.

Results: Results of this study showed that majority of subjects included in our study were in the age group of 50-60 years with Male predominance. Out of 50 patients included in our study, 8 patients(16%) were found to hypothyroidism; 5 patients (10%) were having subclinical hypothyroidism; 20 patients (40%) were having low T3 syndrome and 17 patients (34%) were having normal functioning thyroid gland. Staging of CKD was done in relation to the glomerular filtration rate .Most of the patients(n=20) were in Stage 5 of Chronic kidney disease out of which 18 patients were having thyroid disorders.

Conclusion: There is a positive correlation between the severity of CKD and thyroid dysfunction. Hence a routine thyroid function status should be evaluated in each and every patient of CKD to reduce the morbidity and mortality rate of CKD patients as well as reduce the social burden and health expenditure.

Open Access Original Research Article

Assessment of Depression in Patients with Acute Stroke

. Dayanandan, V. Bavaani

Journal of Pharmaceutical Research International, Page 170-173
DOI: 10.9734/jpri/2021/v33i48A33234

Objectives:

  • To assess degree and severity of depression
  • To describe the symptomatic profile of depression
  • Analyse the relation between depression and demographic, predisposing and precipitating factors.

Materials and Methods: A cross-sectional study was done on 160 subjects chosen by random sampling technique from the Department of General Medicine of Saveetha Medical College and Hospital using Montgomery-Asberg Depression Rating Scale.

Results: 68% of the cases with acute stroke was assessed and found to have depression according to Montgomery-Asberg Depression Rating Scale.

Conclusion: Post-Stroke Depression is expected in patients diagnosed with acute stroke.

Open Access Original Research Article

Knowledge and Attitude of Primary School Teachers Regarding Early Identification and Management of Learning Disability

Betty Koshy, Nikita Gamit, Aarohi Fernandes, Devraj Singh Chouhan

Journal of Pharmaceutical Research International, Page 174-181
DOI: 10.9734/jpri/2021/v33i48A33235

Introduction: In India, 1% to 19% of the total students have Learning Disability. Learning disability may vary from person to person and is incurable but can be controlled if diagnosed earlier. Teachers play a vital role in its identification.

 Aims: Assessing the Knowledge and Attitude of primary school teachers regarding early identification and management of Learning Disability.

Study Design: The study design is Descriptive cross sectional design.

Place and Duration of Study: selected school at Tapi District, Gujarat, between 2020 – 2021.

Methodology: The research was carried out by using Quantitative research approach and on 150 primary school teachers. The non probability sampling technique was used. The tool includes socio demographic variables, Knowledge questionnaire and Attitude scale.

Results: No teacher have excellent knowledge i.e 0.00% regarding Learning Disabilty. 59.33% have good knowledge and 40.66% teachers are poor in knowledge regarding Learning Disability. 96.66% teachers have positive attitude towards children having Learning Disability while 3.33% teachers have negative Knowledge. There is positive correlation between Knowledge and Attitude. There is significant association of knowledge with age and classes allotted at p< 0.05. There is significant association of Attitude with classes allotted at p< 0.05.

Conclusion: Majority of the teachers have good Knowledge and most of them have positive attitude towards the children with Learning disability.

Open Access Original Research Article

Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

Celastina Synthia, . Rameshwar

Journal of Pharmaceutical Research International, Page 188-194
DOI: 10.9734/jpri/2021/v33i48A33237

Background: Traumatic brain injury is a common secondary cause of  Benign Paroxysmal  Positional Vertigo(BPPV).

Objective: To determine the incidence and clinical profile of patients with BPPV in mild and moderate head injury.

Materials and Methods: A prospective observational study done in patients admitted with  mild and moderate head injury who developed BPPV from January 2020 to March 2020 in a tertiary care hospital of  South India. Demographic and clinical parameters were noted and were treated with canalith repositioning procedures.

Results: Among 42 patients admitted with mild and moderate head injury, 9(21.4%) were diagnosed with BPPV in the follow up. The male female ratio was 2.5:1. The mean age was 44 ±21.4years.Two wheeler accidents contributed to nearly half of (55.6%) traumatic BPPV. Posterior canal was commonly involved in 7(77.8%) followed by horizontal in 2 (22.2%).The type of head injury was mild in 7 (77.8%) and moderate in 2 (22.2%) in traumatic BPPV patients. 5 (55.6%) patients with BPPV had abnormal findings in neuroimaging. 4 (44.4%) patients developed recurrent BPPV in our cohort.

Conclusion: The incidence of traumatic BPPV was 21.4% in our study. Road traffic accidents due to two wheeler accidents were the common mode of head trauma. Posterior canal was commonly involved in three fourth of cases. Recurrence of vertigo was documented in 4 (44.4%).

Open Access Original Research Article

The Outpatient Prescribing of Silver Sulfadiazine in Al-Kharj

Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 195-199
DOI: 10.9734/jpri/2021/v33i48A33238

Aim: The aim of the present study was to describe the outpatient prescription of silver sulfadiazine in Al-Kharj.

Methodology: This study was conducted in a public hospital in Alkharj. The data were collected from the outpatient pharmacy in the hospital and includes outpatients who received silver sulfadiazine in 2018.

Results: All of the silver sulfadiazine prescriptions were prescribed for 7 days. The prescriptions were made mainly by residents (96.67%). Most of the prescriptions were prescribed by emergency department (90.00%).

Conclusion: The use of silver sulfadiazine was uncommon in Alkharj possibly due to the use of effective natural medicines. Silver sulfadiazine could lead to several adverse effects so it is important to increase the awareness about the wise use of silver sulfadiazine and other topical antibiotics.

Open Access Original Research Article

Incidence of Heart Diseases in Children with Cleft Lip and Cleft Palate

. Deepika, . Manasa, Framton Retna Bell

Journal of Pharmaceutical Research International, Page 200-204
DOI: 10.9734/jpri/2021/v33i48A33239

Introduction:  Cleft lip and cleft palate are one of the most common craniofacial malformations that occur in children. Congenital heart diseases are more prevalent among children with cleft lip and cleft palate. Early intervention is necessary to improve the survival and for proper development of children.

Materials and Methods: A retrospective study is conducted at Paediatrics Department in Saveetha medical College for a period of one year. In the present study medical records of patients with cleft lip and palate are evaluated and analysed for the incidence of heart diseases.

Results: In the present study medical records of patients with cleft lip and palate are evaluated and analysed for the incidence of heart diseases. Out of 163 children with cleft lip and cleft palate, 56 children (71.42% male and 28.57% female) had cleft lip, 30 children (66.66% male and 33.33% female) had cleft palate, 77 children (66.23% male and 33.76% female) had both cleft lip and cleft palate.VSD is reported as the most common cardiac anomaly (42.86%) in children with cleft lip and cleft palate.

Conclusion:  There is an increased incidence of congenital heart diseases in children with cleft lip and cleft palate. Echocardiography is an important investigation done for early identification and proper management.

Open Access Original Research Article

A Study to Assess the Prevalence of Nomophobia among School Going Children

Binu Joe, C. C. Linson

Journal of Pharmaceutical Research International, Page 205-211
DOI: 10.9734/jpri/2021/v33i48A33240

Our lives have been drastically altered by smart phones. Nowadays, we can't do anything without our phones. We must analyse ourselves or think clearly in order to determine whether a cell phone is a boon or a curse. We are all a part of technoculture. Schoolchildren have also been immersed in this aspect of techno-culture during the previous two years. We must properly prepare technology because each technology has both positive and negative elements. Overuse of mobile phones is extremely dangerous to one's health. Students need to have mobile phone to attend classes from the comforts of their home. Smart phone has become the basic necessity of school children daily life and students are slowly coping with this new method of technology for their academic progress.  Over usage of mobile phone leads to such an extent that children comes across a situation where they cannot live without the use of mobile phone. Such a situation when students start to have fear when they cannot access their smart phones is known has nomophobia. The present study was carried among the school going children in the Surendernagar district of Gujarat. The findings of the study reveal that overall 52.58 % of the study subjects had moderate level of Nomophobia. Around 32.58 % of the study subjects had mild level of nomophobia. 14.40 of the school children had severe level of nomophobia, while only 0.44% had no signs and symptoms of Nomophobia. Mobile phones have lead to disturbance in the family relationship.

Open Access Original Research Article

Psychological Changes in Children during Pre and Post Covid Time Due to Lockdown

Gowrishankar Palaniswamy, D. V. Lal

Journal of Pharmaceutical Research International, Page 212-217
DOI: 10.9734/jpri/2021/v33i48A33241

Background and aim: The COVID pandemic and the lockdown measures  has affected majority age group of people including children.

This study aims to analyze the  notable psychological changes between parents and their children during this COVID pandemic.

Objectives: To understand the difference in presentation and prevalence of conflicts leading to psychological changes.

Materials and methods: 120 participants were included in this study who had at least one school going children and were asked to fill out the Questionnaire with questions testing the parents whether there was any pre and post COVID changes.

Descriptive analysis was done and the findings were discussed.

Results:Major notable behavioral change was in adventurous activity went from 66.66% before this pandemic to 29.16% during pandemic most probably due to lockdown effects. Sleep pattern and other factors under study had negligible changes.

Conclusion: Psychological and behavioral changes were notable by the study participants in their children during this lockdown resulting from COVID pandemic.

Open Access Original Research Article

Thyromental Height - As a Predictor of Difficult Laryngoscopy

Harivarshan Velusamy Gothandaramalingam, Muralidharan Vittobaraju

Journal of Pharmaceutical Research International, Page 223-231
DOI: 10.9734/jpri/2021/v33i48A33243

The fundamental responsibility of the anaesthesiologist and one of the most important steps in anaesthesia practice is the intubation and maintenance of the airway. The integral part of pre-anaesthetic evaluation to recognize a potentially difficult airway is the airway assessment. There are multitude of bedside screening tests which are helpful to predict a difficult airway but the accuracy is doubtful. Thus, pointing out a single reliable predictor of difficult intubation is important. Accordingly, this study aims to evaluate the practicality of thyromental height test alone as a sole predictor of difficult laryngoscopy in our present population. Ethical clearance was obtained and after taking an informed consent, a randomised prospective observational study was conducted on 315 adult patients who were posted for elective surgical procedures under general anaesthesia with endotracheal intubation. On the day before the surgery, airway was assessed and Thyromental height (TMHT) was measured. Laryngoscopy was performed intra-operatively and Cormack Lehane’s grading was noted. The evaluation of the accuracy of thyromental height in predicting difficult laryngoscopy was done by comparing the preoperative assessment data and laryngoscopy findings. In our study, the mean thyromental height observed was 5.4cm. Thyromental height at cut off of 50mm had a high negative predictive value of 94.1% and high sensitivity of 72.5%, but with low specificity of 64.2% (P value 0.000). When the cut off was emended to 48mm, sensitivity of the test decreased to 56.2% and specificity increased to 79.8% (P value 0.002).The conducted study demonstrates the usefulness of thyromental height. It substantiates the good sensitivity of thyromental height for predicting difficult intubation. But, the validation will require further studies in more diverse patient population. 

Open Access Original Research Article

To Assess the KAP Study about HPV Vaccination among Women of Reproductive Age Group

G. Shivani, M. Rajalekshmi

Journal of Pharmaceutical Research International, Page 238-244
DOI: 10.9734/jpri/2021/v33i48A33245

Background: Human papillomavirus vaccines prevent infection by certain types of human papillomavirus. HPV vaccine is recommended at age 11-12 years.

Objectives: This study aims to assess the knowledge, attitude and practice about HPV vaccination among Women of reproductive age group.

Materials and Methods: This community based cross sectional study was conducted over a period of three months from January 2021- March 2021 at the Obstetrics and Gynaecology Department OPD at Saveetha Medical College and Hospital. A total of 193 women who attended the Obstetrics and Gynaecology Department were included as study participants. A pretested, semi-structured data tool was used. Descriptive variables were presented as proportions and frequencies. Chi-square test was used to ascertain the associations.

Results: About 55.9% of them had knowledge about HPV vaccination and 52.6% with the risk factors, signs and symptoms, and prevention of cervical carcinoma among the study population.

Conclusion: Advancement of health facilities, encouragement of service provider, sustainable health programs and creating awareness will support to achieve decrease in incidence of cervical cancer.

Open Access Original Research Article

The Prevalence of using Prescribed & Unprescribed “Roaccutane (Isotretinoin)” among Females Riyadh, Saudi Arabia: A Cross Sectional Study

Mahmoud A Mahmoud, Reem A. Almohaini, Raghad A. Assiri, Reema A. Alkhatabi, Reema S. Alobaishi, Rola F. Alharbi

Journal of Pharmaceutical Research International, Page 245-254
DOI: 10.9734/jpri/2021/v33i48A33246

Aims: To determine the prevalence of using prescribed and unprescribed Isotretinoin and to assess knowledge of its adverse effects among females in Riyadh, SA.

Study design:  cross-sectional study.

Place and Duration of Study: online questionnaire collected throughout two months by distributing the questionnaire via. social media platforms.

Methodology: We included 385 female patients (age range 15-45 years) use Roaccutane (Isotretinoin) with or without prescribed.  Statistical analysis was performed using Rv 3.6.3. Counts and percentages was used to summarize the distribution of categorical variables and data. Chi-square test was used to estimate the association between categorical variables. Hypothesis testing was performed at a 5% level of significance.

Results: 568 respondents completed the questionnaire. Of these, 440 were from Riyadh. The majority of respondents were aged 15 – 20 (46.4%) and 21 – 25 (35.2%). Knowledge regarding some side effects of Roaccutane was significantly higher in respondents who reported using Roaccutane than those who did not. Knowledge of dry and cracked lips as a side effect was significantly higher in users (91.9%) than non-users (73.1%). Similarly, knowledge regarding dry eyes, depression, continuous thirst, nose dryness, bleeds, and effect of Roaccutane on liver biochemical profile, lipid profile, and bones was higher in users than non-users, regarding the teratogenic effect of Roaccutane was insignificantly different between groups.

Conclusion: Females in Riyadh are aware of the side effects of isotretinoin, particularly dryness of the skin, eyes, and lips. Yet there is insufficient knowledge regarding its teratogenic effect. Based on the reported results, a few participants obtained Roaccutane without a prescription from the doctor, and some obtained their information from unreliable sources (i.e., friends/relatives). Our results suggest good practice towards the prescription of isotretinoin.

Open Access Original Research Article

Role of Ultrasonogram in Acute Abdomen in a Tertiary Hospital

Vaishnavi Venkat Pazhambalacode, N. Paarthipan, G. Naveen Kumar, C. R. Seena

Journal of Pharmaceutical Research International, Page 255-259
DOI: 10.9734/jpri/2021/v33i48A33247

Introduction: Acute abdomen is a common presentation seen in the emergency department.Patients most commonly present with pain, which is a broad spectrum for assessment. Hence the clinician often needs an aid to come to a diagnosis. Ultrasonography is one of the leading imaging modality that helps to confirm the diagnosis made by the clinician.

Methodology: This was a retrospective study conducted in the Department of Radiology at Saveetha Medical College and Hospital between January 2021 to April 2021 with the objective to assess the efficacy of ultrasound in acute abdomen. Hundred patients who were admitted in the hospital with abdominal pain were chosen. Patients with the history of trauma, history of chronic abdominal pain and pregnant women were excluded from the study.Clinical history, physical examination, ultrasonogram, per-operative clinical findings and histopathological examination were used to come to the final conclusion.

Results: Out of hundred patients sixty-four (64%) were managed surgically. After obtaining histopathological results it was found that the sensitivity of ultrasound to diagnose a surgical condition was less compared to the histopathological investigation. The remaining thirty-six(36%) were managed medically after obtaining the diagnosis from ultrasound,lab investigations and higher imaging modalities like magnetic resonance imaging(MRI) and computerized tomography(CT). The specificity of ultrasonogram was found to be really high while the sensitivity was less compared to other imaging modalities.

Conclusion: Ultrasonogram has established itself as a rapid,safe and cost effective imaging modality. It aids the clinician to come to a diagnosis or to confirm it leading to accurate treatment and patient survival.

Open Access Original Research Article

Incidence of Autonomic Neuropathy during Assessment in Diabetes Mellitus Patients in PAC

Joseph Swithin Fernando, Sathesh Kumar

Journal of Pharmaceutical Research International, Page 272-278
DOI: 10.9734/jpri/2021/v33i48A33250

Background: Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycaemia due to absolute or relative insulin deficiency. Autonomic neuropathy invokes potentially life threatening outcomes especially in poorly controlled diabetic patients.

Objectives: The objective of this study is to assess the incidence of autonomic neuropathy in patients with type 2 diabetes mellitus.

Materials and Methods: The Study was conducted on 80 Type 2 Diabetes Mellitus patients in Pre Anesthetic Clinic of Department of Anesthesiology, Saveetha Medical College and Hospital during the period of March 2021 to August 2021. Informed consent was obtained from all those who met the inclusion criteria and their BP and Heart Rate variability to various manoeuvres were assessed.

Results: According to our study 40% and 30% had borderline and definite autonomic neuropathy respectively.

Conclusion: Autonomic neuropathy is common in patients with poorly controlled Diabetes Mellitus, especially those on oral hypoglycemic agents. As nowadays no therapy is able to effectively reverse this process, prevention with strict glycemic control, multifactorial intervention, and lifestyle modification remains essential.

Open Access Original Research Article

A Review on the Reported Antibacterial Activity of 1,3,5-Triazine

Mrinmoy Basak, Biplab Kumar Dey, Sajidul Hoque Ansari, Moksood Ahmed Laskar, Priyanka Goswami, Rosamund Jyrwa, Pal Gogoi, Md. Rejwan Ahmed Choudhury

Journal of Pharmaceutical Research International, Page 279-292
DOI: 10.9734/jpri/2021/v33i48A33251

Antibiotics are the class of drugs used for bacterial, viral & fungal infection. Antibiotic resistance is the ability of microorganism to withstand themselves against the effects of a drug. Every year antibiotic resistance causes more than 38000 deaths in Thailand, 23000 deaths in USA. In South Asia one new born child dies every 5 minutes from blood stream infection because antibiotics given are ineffective due to bacterial resistance. Now antibiotic resistance is a threat to global health. In this paper, triazene derivatives are kept in concern.  Triazines are six-membered, nitrogen-containing heterocyclic scaffold with a wide range of pharmaceutical properties such as antibacterial, antifungal, anticancer, antioxidants, antitubercular, antimalarial and anti-inflammatory. Due to lack of new antibiotics as well older antibiotic are rapidly proving ineffective, derivatives of triazine would be of great significance in future prospective.

Open Access Original Research Article

Incidence of H. pylori in all Endoscopies Done at Saveetha Medical College over the Last Two Years (2018-2020)

S. Kirthika, M. Vinoth

Journal of Pharmaceutical Research International, Page 293-298
DOI: 10.9734/jpri/2021/v33i48A33252

Background: H. pylori infection is a major health ailment in most of the developing countries. The infection is associated with increasing morbidity and mortality ranging from chronic gastritis to gastric malignancies. The aim of this study is to assess the prevalence of H. pylori among patients tested positive for the same in Saveetha Medical College, Thandalam over the period of 2018-2020 and assess the incidence with factors like socioeconomic status, age and sex of the patients.

Objectives:

  • To determine the incidence of pylori for the patients who tested positive for the same over the period of 2018-2020.
  • To assess the patients infected with pylori for various factors like age, sex and socioeconomic status.

Materials and Methods: It is a retrospective type of study. The patients who tested positive for H. pylori infection in Saveetha Medical College over the period of 2018-2020 was taken into study. A total of 300 H. pylori infected patients were assessed for various factors like age, sex and socioeconomic status.

Results: Out of 300 patients who tested positive for H.pylori were categorized based on age sex and socioeconomic status. Among 300 infected patients, 230 turned out to be men while only 70 cases seen among women. The prevalence was high among the age group > 60 (n=150; 50%) while the 40-60 recorded the second highest number of cases (30% n=90). 20-40 was the least affected group. Most of the cases were associated with low socioeconomic status, alcohol and smoking which contributes to the increased risk of acquiring the H. pylori infection.

Conclusion: The incidence of H. pylori infection is high among the study group. Hence it is essential to provide prompt treatment and take adequate measures to prevent the risk factors.