Open Access Systematic Review Article

Knowledge and Attitude towards Chronic Musculoskeletal Pain Treated with Osteopathy

Yahya Abdullah Mohammed Al-Shareef, Ali Abdullah Mohammed Alshareef, Ibrahim Mohammed Almoftery

Journal of Pharmaceutical Research International, Page 166-175
DOI: 10.9734/jpri/2021/v33i48B33275

Background: Chronic pain is a common clinical feature that accompanies osteopathy.  Knowledge and attitudes of both patients and their treating clinicians would influence the patients' outcomes and pain control.

Objective: This systematic review will provide an understanding of the knowledge and attitudes of patients and clinicians towards musculoskeletal pain accompanying osteopathy.

Methods: Different keywords were used to search the medical literature, including: “knowledge” OR “Attitude” AND “Osteopathy” AND “Pain” AND “patient” OR “clinician." The search databases included Medline, Embase PubMed, and SCOPUS. The following step was reviewing the appearing results to ensure that they were original research articles that examined the knowledge and attitudes about chronic musculoskeletal pain with osteopathy. All the eligible studies should mention the type of participants examined (either patients or clinicians).

Results: A total of 89 studies were obtained. After removing review articles and choosing original research studies solely, 11 studies appeared from the filtration process. Eight research articles were eligible. All the included studies had a quantitative cross-sectional design. Only health care professionals were asked about osteopathy, where all the studies included osteopaths from different countries, except one study that included physiotherapists. Osteopaths knew about the benefits of osteopathy, particularly for lower back pain; however, their knowledge about biopsychosocial factors requires improvement.

Conclusion: Knowledge about osteopathy benefits for controlling chronic musculoskeletal pain should be improved even among osteopaths. Awareness campaigns are also needed for patients in orthopedic and physiotherapy clinics about osteopathy.

Open Access Case Study

Heart Failure Due to Secondary Haemochromatosis in a Case of Beta Thalassemia Major: A Rare Case Presentation

V. V. S. S. Sagar, Maharshi Patel, Pallavi Yelne, Shilpa Gaidhane, Chitturi Venkata Sai Akhil

Journal of Pharmaceutical Research International, Page 101-107
DOI: 10.9734/jpri/2021/v33i48B33266

Hemochromatosis is defined as abnormal accumulation of iron in various organs of the body such as liver, pancreas, skin, joints, heart due to raised gut absorption of iron due to low hepcidin yield. Hemochromatosis is secondary to thalassemia major in this case. In the absence of other concurrent processes, cardiac hemochromatosis is identified as the presence of cardiac dysfunction owing to increased iron accumulation in the heart leading to heart failure.

Unique: Cardiac involvement in secondary hemochromatosis due to thalassemia major.

Take Away lesson: Regular monitoring of serum iron, ferritin, echocardiographic monitoring among thalassemia major patients is essential. Despite the fact that heart failure due to iron overload could be fatal, early diagnosis and intervention could prevent and treat the disease.

Open Access Short Research Article

Virtual Screening to Identify the Protein Network Interaction of Hypericin with Red Complex Pathogens

C. Pratheebha, Jayaseelan Vijayshree Priyadharsini, A. S. Smiline Girija, P. Sankar Ganesh, Nidhi Poddar

Journal of Pharmaceutical Research International, Page 341-352
DOI: 10.9734/jpri/2021/v33i48B33292

Introduction: Hypericin is the anthraquinone derivative and has many properties like antiviral, antifungal and antibacterial. The red complex pathogens which include Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in association with other microbes found in the periodontal pockets, cause severe inflammation resulting in periodontitis. Novel bioactive agents from several sources have been tested against the microbial pathogens to deduce antimicrobial activity. 

Aim: The aim of the study is to virtually screen and identify the protein network interaction of hypericin in red complex pathogens.

Methodology: The STITCH v5.0 pipeline was primarily used to identify the drug-protein interactions. The VirulentPred and VICMPred software were used for elucidating the functional class of the proteins and virulence property. The sub cellular localization of virulent proteins was analysed with pSORTb v3.0 software. Further, the epitopes in virulent proteins were identified using BepiPred v1.0 linear epitope prediction tool.

Results: Heat shock protein 90 of Porphyromonas gingivalis were found to involve in the cellular process and DNA topoisomerase IV subunit B, heat shock protein 90, DNA gyrase subunit A and DNA gyrase subunit B of Treponema denticola were found to be the virulent factors. The virulent proteins were located in the cytoplasm, which would further increase the potential effect of the drug to serve as antimicrobial agents. Finally, epitopes were predicted on the virulent proteins which can be specifically docked to further ascertain their interactions with the phytocompound.

Conclusion: Hypericin with all its potential and biological benefits can be addressed, can be used as an antimicrobial agent to eradicate dental pathogens which are recalcitrant to treatment. The mode of action of hypericin is, it is targeting crucial proteins in red complex pathogens. Further in vitro studies should be performed on a wide range of pathogens to substantiate the true interactions between the drugs and the protein repertoire of pathogens.

Open Access Original Research Article

Study to Assess the Severity of Pancreatitis Based on Ranson’s Scoring and Modified CT Severity Index

A. Kishore Khannaa, Agil Selvam

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i48B33253

Background: Acute pancreatitis is an emergency condition requiring intensive care and 20% of patients fall under the severe category with severe complications and requires early assessment.

Objectives: To assess the severity of pancreatitis based on Modified CT severity index and Ransons’s score in a tertiary health care centre.

Materials and Methods: This is prospective study done on 80 patients diagnosed of acute pancreatitis, ranson's criteria was calculated within 48 hours and Modified CT severity index was measured in all the patients with CECT to identify the severity and prognosis of the disease.

Results: Out of the 80 patients 61 were males and 19 were females and alcohol was the commonest etiology of acute pancreatitis. Ranson's criteria showed 31 patients with mild and 49 with severe pancreatitis. MCTSI score showed 18 patients of severe pancreatitis and all were under the severe category of Ranson's criteria.

Conclusion: Ranson's score and Modified CT severity index helps in identifying severity in early stage and provide better treatment for the early prognosis of the patients.

Open Access Original Research Article

Beliefs and Factors Affecting the Usage and Compliance of Inhalers in Treatment of Asthma in Children

S. Dinesh Bhupathi, . Vidhyasagar

Journal of Pharmaceutical Research International, Page 18-24
DOI: 10.9734/jpri/2021/v33i48B33255

Background: Despite the availability of several treatment modalities-various formulations of inhaled corticosteroids and delivery devices, the prevalence of asthma is increasing in the developing countries, especially among the paediatric age group. Though Inhaled corticosteroids are effective in the management of asthma, parents prefer oral medications and nebulisers as the treatment modality for their children. Thus, there is a general reluctance amongst the parents towards the use of inhalers. This article focuses on the beliefs and factors affecting the usage and compliance of inhalers in the treatment of asthma.

Objectives: To assess Beliefs and factors affecting the usage and compliance of inhalers in treatment of asthma in children.

Materials and Methods: This study was conducted in Tamilnadu from March 2021 to June 2021.A cross -sectional study was conducted among 112 asthma patients of paediatric age group in a tertiary care medical college and hospital in Chennai through a questionnaire containing the demographic details, details regarding the treatment modalities, the inhalers and their usage. The results obtained were tabulated and analyzed.

Result: The study included 112 asthmatic patients,68 boys and 44 girls of whom 87.17% of the children had recurrent episodes of cough and cold. 45.53% of the patients used oral medications along with nebulisation,26.8% used inhalers and 27.67% used inhalers along with oral medications. 78.57% of the parents were aware about the use of inhalers in the treatment of asthma and 59.82% of the parents showed reluctance to use inhalers for their children.

Conclusion: In spite of inhaled corticosteroids being effective in the management of asthma, oral medications and nebulisers are the mainstay treatment in majority of the cases. Social stigma, fear of addiction and lack of knowledge are the major reasons for the reluctance of parents towards the use of inhalers.

Open Access Original Research Article

Evaluation of Antibacterial and Antifungal Activities of Crude Extract and Fractions of Morinda citrifolia Fruit on Multiple Drug Resistant Clinical Isolates

Ifeanyichukwu Foster Ene, Ifeoma Bessie Enweani, Monday Uchenna Obaji, Emmanuel Ifeanyi Obeagu

Journal of Pharmaceutical Research International, Page 25-31
DOI: 10.9734/jpri/2021/v33i48B33256

Background: Morinda citrifolia fruits are consumed by humans in tropical areas of Africa due to their nutritional and medicinal values.

Methods: The fresh fruit of M. citrifolia were harvested, washed with clean water, dried under a shade, pulverized and extracted with methanol in a Soxhlet’s extractor. The crude methanolic filtrate was subjected to phytochemical analysis and fractionation using ethyl acetate, butanol, distilled water and n-hexane. The isolates, which comprises Staphylococcus aureus, Salmonella typhi and Candida albicans, were collected from diarrhoiec stool of patients aged 0-5 years using standard procedure. Antibiotic susceptibility assay was carried out using disc diffusion method. The antimicrobial susceptibility test of the fruit extract and fractions was carried out using agar well diffusion method.

Results: All the isolates were susceptible to the extract and the fractions with MICs range from 3.125 mg/mL to 12.5 mg/mL. S. aureus and S. typhi were resistant to more than two conventional antibiotics.

Conclusion: Crude and fractions of M. citrifolia have excellent antibacterial and antifungal activities against multiple antibiotic resistant strains of S. aureus, S. typhi and C. albicans.

Open Access Original Research Article

Antibiotic Susceptibility Patterns of Bacterial Isolates from Infected Wounds in a Tertiary Health Care Center, India

N. Krithik Jain, Rufus Ranjithsingh Edwin

Journal of Pharmaceutical Research International, Page 32-37
DOI: 10.9734/jpri/2021/v33i48B33257

Background: An infected wound prolongs the period of stay in hospital which results in further chances of getting affected by nosocomial infection leading to increased number of comorbidities. Hence adequate and appropriate treatment of the infective organism is of prime importance.

Objectives: To find out the most common antibiotics susceptible to the bacterial isolates from the pus samples. 

Materials and Methods: A cross sectional study was conducted of the bacterial isolates from pus samples in a hospital setup of Saveetha medical college and hospital, Chennai for 100 patients. Pus samples were collected from patients who came to the surgery OPD with complaints of ulcer and discharge were subjected to culture and sensitivity after obtaining proper consent and the bacterial growths were noted. Antibiotic susceptibilities of the isolates were determined according to disk diffusion method recommended by the Clinical and Laboratory Standard institute [1].

Results: Out of the total samples collected (n=200) 90% of the samples showed bacterial growth and the remaining 10% of the samples showed no growth. The most predominant bacteria in our study was found to be E. coli (33%) being most susceptible to Amikacin followed by S. aureus (19%) which was highly susceptible to Linezolid and Vancomycin.

Conclusion: There is a peak in the incidence of antimicrobial resistant cases which is a great threat for human mankind. Hence emphasis should be laid on rational use of antibiotics and proper sterile techniques to be followed.

Open Access Original Research Article

A Study to Assess the Effectiveness of Laughter Therapy on Reducing Level of Stress Among Primary School Teachers of Selected School in Hoshangabad MP India

Bincy Jacob, C. C. Linson

Journal of Pharmaceutical Research International, Page 38-46
DOI: 10.9734/jpri/2021/v33i48B33258

The purpose of the study was to assess the amount of stress among primary school teachers in Hoshangabad, evaluate the efficiency of laughing therapy in lowering their level of stress, and discover a relationship between their pre-test level of stress and chosen demographic characteristics. A pre-experimental research was carried out among primary school teachers at Servite Convent English Medium School in Hoshangabd, near Housing Board Road. The data collecting period was extended from January 21 to February 21. Thirty elementary school teachers were chosen using purposive sampling. There was a pre-test, an intervention, and a post-test. Descriptive and inferential statistics were used to analyse the data. The study found that most instructors' stress levels were moderate in the pre-test and mild in the post-test. It was severe in 10% of the instructors in the pre-test, but no one showed significant stress in the post-test. The mean stress score after the exam was lower than the mean stress score before the test. A substantial relationship was discovered between the amount of stress and certain demographic characteristics such as age and stress-reduction strategies. The majority of primary school instructors had mild to moderate stress, which was alleviated by laughing therapy.  As a result, laughing therapy should be employed to relieve stress among elementary school instructors.

Open Access Original Research Article

Epidemiology of Orthopaedic Injuries in Cases of Road Traffic Accidents

M. Meena, K. Jaganath, M. SathishKumar, Saidev Ramkumar, P. Shanmuga Sundaram

Journal of Pharmaceutical Research International, Page 47-52
DOI: 10.9734/jpri/2021/v33i48B33259

Background: Road traffic accidents are on the rise due to rapid urbanization, motorization, lack of appropriate road engineering, poor awareness levels, non existent injury prevention programs, and poor enforcement of traffic laws. From mild to severe injuries, a road traffic accident can have a significant social and economic impact on the individual, family and the society. It is believed that the outcome of this study should help in identifying risk factors, set priorities for prevention and aid in management of cases.

Materials and Methods: This study is a cross sectional prospective study conducted over a period of 6 months

Results: One hundred and twenty seven RTA victims were studied during the period. The most commonly affected age group was 21-40 years. Men were more involved in RTAs than women.

Most common fracture was tibial fracture and most common fractures were seen in people who drove motorcycles. Accidents were most commonly seen during the time period of 6pm to 6am.

Conclusion: Computerised trauma registry is needed urgently to highlight risk factors, circumstances, chain of events leading to accidents.

Strict licensure procedure should be followed and minimum level of education should be imparted especially to younger age groups. Doing so will be helpful in policy making and health management in India.

Open Access Original Research Article

A Retrospective Study on Management of the Distal End of the Radius Fractures

R. Sanjay, V. Aakash, Menakuru Sreya Reddy, G. Ram Kumar

Journal of Pharmaceutical Research International, Page 67-73
DOI: 10.9734/jpri/2021/v33i48B33261

Introduction: The distal end radius fracture is a common fracture type and represents about one sixth of all skeletal fractures. They commonly occur in young males and older females. In young adults it is more common to see a fracture of the Intra-articular component in distal radius, probably due to high-energy trauma such as road traffic accidents. The patient may come with symptoms of  pain and swelling around the wrist, sometimes with deformity around the wrist or tenderness at an area with no obvious deformity.

Objectives: To analyse the various treatment methods and their outcomes.

Materials and Methods: It is a retrospective study conducted on the distal end of radius fractures by the orthopedic department of Saveetha Medical College and Hospital in the years 2018, 2019 and 2020. All the patients were examined both clinically and radiologically. Anteroposterior (AP) and lateral views of the wrist joint on both sides were obtained at the time of injury presentation. Fractures were classified according to the AO classification and anatomical features like the presence of dorsal tilt, radial shortening and loss of radial inclination are also assessed using the Sarmiento’s modification of Lindstrom Criteria.

Results: Anatomical results evaluated according to Sarmiento’s modification of Lindstrom criteria showed excellent results were more frequent with open reduction and internal fixation techniques but the most frequently used treatment modality is closed reduction and cast immobilisation.

Conclusion: There is no customised treatment for all distal end of radius fractures hence the treatment depends on various factors like the fracture type, characters, patient’s demands and the surgeon’s preference.

Open Access Original Research Article

Risk Factors for the Formation of Inflammatory Diseases of the Upper Digestive Tract in Children in the Republic of North Ossetia-Alania

Tatiana Temirbolatovna Boraeva, Ulyana Viktorovna Matveeva, Asya Bekovna Revazova, Bela Zakharovna Albegova, Kharon Beslanovich Arapiev, Georgiy Georgievich Makiev, Maryana Vitalyevna Beslaneeva, Khairat Rasulovna Makhmudova, Alina Yuryevna Maslova, Artem Evgenevich Mishvelov

Journal of Pharmaceutical Research International, Page 74-79
DOI: 10.9734/jpri/2021/v33i48B33262

In recent years, cases of diseases of the digestive tract among preschool and school-age children have become significantly more frequent. This article analyzes the influence of various factors (heredity, living conditions, age, gender, lifestyle) on the likelihood of morbidity.

Chronic pathology of the upper digestive tract in the vast majority of children begins at preschool age with further significant growth from the moment they attend school. Close attention is required by children whose parents and immediate relatives suffer from gastroenterological diseases.

Modern diagnosis of the disease will reduce the risk of development and progression of the most common pathology of the digestive organs of childhood and avoid the development of severe complications.

Open Access Original Research Article

LUTS-Normal Stent VS Carbothene Stent in a Health Center- Retrospective and Prospective Study

Rohan V. Raval, M. Griffin, M. Sivasankar, P. S. Premanand, V. Kamaraj, N. Muthulatha

Journal of Pharmaceutical Research International, Page 80-86
DOI: 10.9734/jpri/2021/v33i48B33263

Background: Ureteral stent removal is associated with some post operative symptoms such as changes in the frequency of urine,frequent nocturia, occasional episodes of blood stained urine,pain in the suprapubic region which occurs due to the material composition and the dimensions of the stent as well. Polyurethane stent are regularly used in the operation theatres but in the recent years carbothane stent has showed some efficacy and hence necessitates a comparison.

Objectives: To study the prevalence of symptoms of lower urinary tract symptoms in patients with polyurethane stent and carbothane stents

Materials and Methodology: A prospective study was conducted among patients who had their stent removed to the Department of Urology in a tertiary health care hospital from January 2021 to April 2021. A simple random sampling technique was employed and 40 patients were identified for the study. The relationship between the different stents and the onset of symptoms

Results: It is seen that the onset of lower urinary tract symptoms had an equal incidence among the two genders hence the presence of symptoms plays a crucial role in distinguishing the efficacy of the stents. Here in this study only 5% of carbothane stent patients had changes in frequency of micturition where as 65% polyurethane stent patients reported change frequency similarly 60% of polyurethane stent patients had changes in Frequency of nocturia whereas same was reported in 20% of the patients. Loss of urine before reaching the toilet was the primary complaint in 30 % of polyurethane stent patients but only 2% of carbothane stent patients occasionally had this complaint. Apparently the stream of urine was occasionally continuous in 70% of polyurethane stent patients but was always continuous in 85% of carbothane stent patients. A sense of incomplete evacuation was experienced by 40% of polyurethane stent patients but only 1% of carbothane stent patients had such complications Similarly pain in the suprapubic region, straining oneself while micturition and presence of hematuria was experienced by a greater percentage of polyurethane stent patients than that of carbothane stent patients.

 Conclusion: It is seen that carbothane stent have a better patient compliance and a low onset of lower urinary tract symptoms when compared to the normal polyurethane stent and hence medical management of the symptoms was required in the postoperative period

Open Access Original Research Article

The Impact of the First Wave of Covid 19 on Orthopaedic Surgeries in a Tertiary Care Teaching Hospital

B. Jagadeesh, N. Adhishwar Kumaran, K. Gunalan, K. Midhuna, S. Natarajan

Journal of Pharmaceutical Research International, Page 95-100
DOI: 10.9734/jpri/2021/v33i48B33265

Background: The Covid 19 was declared a global pandemic that had a sizeable impact on the health care services in the surgical field including the orthopaedic department. There was additionally a decreased accessibility to healthcare personnel and facilities reallocated to manage the Covid patients. The study was mainly conducted to find out the impact of the first wave of COVID-19 on the orthopaedic surgeries.

Aim: The main aim of the study is to find out the alteration in the number, type of surgeries, financial implications, duration of hospital stay, delay in surgery during the first wave of the COVID-19 pandemic.

Study Design: Retrospective crossectional study.

Methods: All the surgeries conducted in the orthopaedic department in the year 2019 and 2020 following first peak in March including pre-op and post-op COVID cases are included in the study. The procedure conducted, date of admission, date of surgery, date of discharge, investigations done and the cost expenses are the various parameters that are taken into consideration. The results are analysed for each year and comparisons are made using statistical methods.

Results: The comparative analysis of the data collected from the years 2019 and 2020 showed an increase in the duration of hospital stay, delay in surgery, additional expenditure, back log in the number of elective surgeries done during the Pandemic.

Open Access Original Research Article

Myeloperoxidase and Paraoxonase Activity in Acute Coronary Syndrome Patients

Sowmya Varadhan, Ramesh Venkatachalam, A. Supriya Simon

Journal of Pharmaceutical Research International, Page 108-114
DOI: 10.9734/jpri/2021/v33i48B33267

Background: Myeloperoxidase (MPO), an oxidative stress related enzyme is elevated in Coronary Artery Disease (CAD) and is involved in development of atherosclerotic plaque. Paraoxonase (PON) an enzyme protein associated with HDL serves as an antioxidant and plays an important role in preventing the formation of Oxidized LDL (OxLDL). This suggests a conflicting role of MPO and PON in development of cardiovascular disease and atherosclerosis.

Aim: Present study was done to evaluate and compare MPO/PON ratio in Acute Coronary Syndrome (ACS) patients with controls. The study evaluates and compares the pro oxidant and pro inflammatory enzyme, MPO and anti-oxidant and anti-inflammatory enzyme, PON in ACS patients with controls. Oxidative marker, Malondialdehyde (MDA) and anti-oxidant marker, Reduced Glutathione (GSH) was assessed in ACS patients and compared with controls. An attempt was also made to correlate MPO/PON ratio to markers of oxidative stress (MDA and GSH).

Methods: Cross-sectional study carried out in Dr. Somervell Memorial CSI Medical College, Trivandrum, Kerala, India.50 ACS patients from Cardiac Care Unit and 50 age and sex matched controls without CAD from Medical College Health Checkup was selected.

Results: MPO and MPO/PON ratio were significantly high and PON  was significantly lower in ACS patients compared to controls. Total cholesterol, Triglyceride, LDL, MDA were significantly high in ACS patients. Statistically significant positive correlation was observed between MPO/PON and MDA. Significant negative correlation was observed between MPO/PON and GSH.

Conclusion: Myeloperoxidase and MPO/PON ratio was significantly high in ACS patients than controls. This is suggestive of the role of MPO in oxidative damage to lipoproteins in CAD patients. Prooxidant, Paraoxonase ,and antioxidant, GSH is lowered in ACS patients as a result of the increased oxidative stress. This study suggests that MPO/PON1 ratio can be used as a predictive marker of ACS.

Open Access Original Research Article

Knowledge and Attitude about Immunization Recommended by Government of India and Indian Academy of Paediatrics among Medical Students

Diwakar Thiagarajan, Vichithra Mohandoss, M. Benjamin Sagayaraj

Journal of Pharmaceutical Research International, Page 115-120
DOI: 10.9734/jpri/2021/v33i48B33268

Background: Immunization being the most cost-effective treatment for preventing disease and extending life, is essential to know about its schedule and be aware of vaccines that are available up to date.  Immunization is one of the most important strategies for protecting children from disease.

Aim: The aim of the study is to assess the knowledge and attitude of immunization among medical students recommended by Government of India (NIS) and Indian Academy of Paediatrics (IAP).

Methodology: A descriptive cross-sectional study was conducted in Saveetha Medical College and Hospital, Chennai among final year MBBS students, Medical Interns using a structured questionnaire. The study was conducted between February 2021 & April 2021.

Results: In a total of 259 study participants, around78(65%) of Medical Interns and 74(52%) of final year MBBS students are aware that as per NIS, BCG vaccine in catch up can be given until 1 year of age.

Conclusion: The degree of knowledge among medical students should be emphasised and various initiatives regarding the knowledge and awareness about immunization among the interns and the medical students should be introduced.

Open Access Original Research Article

Clinical Profile of Alcoholic Liver Disease in Saveetha Medical College and Hospital and Its Association with Type, Amount and duration of Alcohol Consumption

S. Aswathi, V. Vikrannth

Journal of Pharmaceutical Research International, Page 132-138
DOI: 10.9734/jpri/2021/v33i48B33270

Introduction: Alcoholic liver disease is a caused as a result of overconsuming alcohol that damages the liver, leading to inflammation, and scarring. It is often fatal with mortality and morbidity worldwide. Many studies in various countries show contradictory results about the role of amount, type and duration of alcohol exposure in determining the risk to develop ALD. This study aims to evaluate clinical profile of ALD in south Indian population and to correlation of disease severity with alcohol intake.

Material and Methods: A total of 50 patients of ALD were evaluated to correlate their clinical findings, biochemical parameters, prognostic markers (Discriminant function [DF] score, Model for end-stage liver disease [MELD] score and Child-Pugh score) and with their alcohol intake data in form of type, amount and duration of alcohol intake.

Results: Hepatic encephalopathy, neutrophil to lymphocyte ratio (NLR) and all three prognostic scores showed a dose-dependent relation with the amount of alcohol intake (p <0.05). The results showed that the duration of alcohol had a positive impact on the results. NLR correlates well with all prognostic markers (p <0.05 for NLR's Spearman correlation with DF score and Child-Pugh Score), more so with MELD score (p <0.0001); and complications like hepatic encephalopathy and hepato-renal syndrome.

Conclusion: In this study we conclude that there is significant dose dependent relation of ALD along with its complications, prognostic markers and NLR with the amount, type and duration of alcohol consumption. Although the type of alcohol consumption didn’t have much influence on the results, amount of intake had a correlation with NLR.

Open Access Original Research Article

Awareness and Attitude towards the Measles Vaccination in Hai’l Region of Saudi Arabia

Ramadevi Kundur, Ramaiah Itumalla, Aziz Unnisa

Journal of Pharmaceutical Research International, Page 139-145
DOI: 10.9734/jpri/2021/v33i48B33271

Aims: To present the awareness and attitude towards measles vaccination among the population of Hai’l region in Saudi Arabia.

Methodology: A cross-sectional electronic survey was conducted from October 2019 to January 2020 and received 469 samples from the residents of the Hai’l province. The convenient sampling technique was used to collect data through questionnaire sent by emails to participants.

Results: The prevalence of measles in Hai’l region was 7.8% and 96.1% of the population has been vaccinated. About 46% of the population did not know what caused measles, whereas, 37% knew it was a viral disease. About 85.5% believed vaccination is best method to prevent measles and 45.5% of population think that vaccine is the treatment for measles. And, 64.6% think the agencies do good work in promoting measles awareness.

Conclusion: The prevalence of measles in Hai’l province of Saudi Arabia is low with almost all vaccinated. The knowledge and awareness about measles is adequate. The study suggests that the surveillance, monitoring as well as educational and awareness programs needs more attention.

Open Access Original Research Article

Orthopantomography and use of Mandibular Indices for the Evaluation of Gender Distribution in Navi Mumbai Population - A Retrospective, Single Blind Study

Priyanka Vijay Patil, Manali Kulkarni, Sandeep Pagare, Naveen Shetty, Hemant Bhutani, Kapil Gavand

Journal of Pharmaceutical Research International, Page 87-94
DOI: 10.9734/jpri/2021/v33i48B33264

Introduction: The study of forensic sciences often leaves the forensic expert to draw conclusions from any and every material available in determining the identity of the deceased. The initial step in identifying a person is to determine their gender based on their adult skeleton. The human skeleton displays sexual dimorphism, of which the skull is most dimorphic providing an accurateness of 92%. However, in certain situations where the skull may not be found intact, the mandible plays a vital role. The mandible's thick covering of compact bone helps keep it from exploding during a mass tragedy. Dimorphism in the mandible is gender specific and is mainly reflected in its shape and size. The mandible is also easily radiographed and specific linear measurements of the mandibular rami as seen on an OPG are useful indices for gender determination. 

Aims: To examine the efficacy of mandibular rami measures such as maximum ramus breadth, maximum ramus height, minimum ramus breadth, condylar height, coronoid height, mandibular body length and gonial angles on the right and left side of an OPG in determining gender.

Materials and methods: 110 digital OPG’s (55 males, 55 females) of a Navi Mumbai population were obtained retrospectively from a reputed dental college and hospital. The OPG’s were taken using Xtropan 2000 OPG machine, 10x12 PSP plates, exposure parameters of 75 Kvp, 8 mas, 13 sec, and KODAK CR 7400 digitizer. Master View 3.0 software was used on the desktop computer to measure the mandibular ramus's width and thickness. Maximum ramus breadth, Maximum Ramus height and lowest ramus breadth of the mandibular rami, as well as the height of the condyle and the coronoid bone, and the length of the mandibular body and gonial angles on the right and left sides of the mouth, were all measured. Using a statistical formula, the measurements were substituted and gender was estimated.

Result: We used the IBM SPSS v 21.0 statistical software for social sciences to do our statistical study. p0.05 was deemed statistically significant, with a 5% margin of error and a 20% margin of error, giving the study an 80 percent power. In the study group, 51 of the 55 men were expected to be males, while 49 of the 55 females were anticipated to be females, while 6 of the 55 females were predicted to be males.

Conclusion: This research shows that the mandibular ramus is a useful tool for determining gender, and digital panoramic imaging yielded the best accurate linear measures. There was considerable sexual dimorphism in the mandibular ramus in the chosen Navi – Mumbai subpopulation, and the combination of 8 factors demonstrated an accuracy of 91.81 percent and was helpful for gender determination.

Open Access Original Research Article

Prevalence, Clinical Profile and Outcome of Patients Presenting with Stroke

N. Akshaya Thrinetrapriya, M. Jagadeesan

Journal of Pharmaceutical Research International, Page 146-157
DOI: 10.9734/jpri/2021/v33i48B33273

BACKGROUND: Stroke is a clinical condition that has a greatly increasing prevalence in the recent years owing to our ‘modern’ sedentary lifestyle. The aim of this study is to assess the prevalence, risk factors, clinical presentation and outcome of patients presenting with stroke in a tertiary care hospital.

METHODOLOGY: A prospective observational study was conducted in the Department of General Medicine, Saveetha Medical College & Hospital, Thandalam, Chennai for a period of 4 months, i.e., from January 2021 to April 2021.Stroke patients who met the eligibility criteria were included in the study. All sociodemographic and clinical data were recorded by reviewing the patient and his medical records regularly. Scores like NIHSS (National Institute of Health Stroke Scale) score and mRS (modified Rankin scale) scores were calculated and TOAST categorisation was done. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software.

RESULTS: Out of 100 stroke patients, 65% were males and 35% were females. Mean age was 57.95 years. Ischemic strokes were seen in 85% of patients and the rest 15% had hemorrhagic stroke. The most common presentation was facial palsy (67%), followed by hemiparesis (62%) and hemiplegia (38%). The important risk factors were hypertension (70%), diabetes mellitus (48%) and obesity (42%). Based on mRS scores, 59% of the patients had bad outcome.

CONCLUSION: Hypertension and diabetes were the most common risk factor in our study population. Preventive measures include creating awareness, lifestyle changes and compliance to medications. National programmes on stroke prevention initiate and coordinate awareness campaigns to reduce the incidence, morbidity and mortality of stroke. Finally, a multidimensional approach involving the patient community, general population, medical fraternity and government authorities is essential to curtail this modern epidemic.

Open Access Original Research Article

Frequency of Acute Ischemic Stroke in Patient with Type-II Diabetes Mellitus: Descriptive Cross Sectional Study

Salman Khan, Zubair Malik, Nisar Khan, Sajid Ali Mojai, Ata Ur Rehman, Alamgir Khan, Muhammad Ismail Khan, Najeeb Ullah, Hafiz Tahsin Ullah Jan, Tahseen Ahmed

Journal of Pharmaceutical Research International, Page 158-165
DOI: 10.9734/jpri/2021/v33i48B33274

Aim: To evaluate the frequency of acute ischemic stroke in patients with type-II diabetes mellitus.

Study Design: Descriptive Cross sectional Study

Place & Duration of Study: The study was carried out at Department of Medicine, DHQ Teaching Hospital, Dera Ismail Khan for the period of 06 months from 06 Feb, 2018 to 06 Aug, 2018.

Methodology: All patients admitted through OPD presented with type-II diabetes mellitus and having acute ischemic stroke after radiological confirmation using non-contrast enhanced CT scan brain with type-II diabetes (as per operational definitions above) were enrolled in study. Informed written consent was taken by the researcher with detailed history followed by detailed clinical examination and all patients who was give their consent to participate in the study was questioned about their medical history and was examined in detail for their neurological deficits. All the laboratory investigation was done from single hospital laboratory and all the radiological investigations were done from hospital radiology department.

Results: As per frequencies and percentages for acute ischemic stroke, 215 (74.65%) patients were found having acute ischemic stroke.

Conclusion: In this study, we concluded that there is a significant age difference between the diabetes-stroke co-morbid patient and non-diabetic stroke patient. Therefore, health education on preventive measures for type 2 DM, adequate regulation of blood pressure and blood sugar level through compliance to medical advice and medication, regular clinic attendance and periodic measurement of blood pressure and blood sugar level.

Open Access Original Research Article

Formulation and Evaluation of Ibuprofen Fast Dissolving Tablets Employing Starch Malonate (Modified Starch) as a Superdisintegrant

Annu Kumari, R. Santosh Kumar

Journal of Pharmaceutical Research International, Page 176-198
DOI: 10.9734/jpri/2021/v33i48B33276

Aim: The goal of the study was to prepare a superdisintegrant named starch malonate followed by its evaluation for physicochemical properties. Prepared starch malonate was optimized in the preparation of fast dissolving tablets of ibuprofen by using 23 factorial designs.

Methods: Compatibility studies like FTIR, TLC and DSC were performed to check any interaction between starch malonate and ibuprofen. Fast dissolving tablets were compressed by direct compression method and subjected to various official tests like hardness, friability, drug content, dissolution etc. Wetting time and water absorption ratio were also performed. At last response surface plot and contour plot was plotted to check the effects of starch malonate, croscarmellose sodium and crospovidone (independent variables) on disintegration time and dissolution efficiency in 5 minutes (dependent variables). Stability studies were also performed to check the stability of prepared fast dissolving tablets of ibuprofen.

Results: Results of the studies showed that all the results are within acceptable limits and complying with the criteria of fast dissolving tablets. Drug content was found to be (100±5%), hardness of all tablets were found in between 3.8 -4 kg/cm2, friability was found less than 0.15%. Optimized formulation has showed less wetting time, less disintegration time followed by enhanced drug release. Among all formulation, formulation F2 has shown least disintegration time and enhanced drug release (99.89%) as compared to other formulations. We can conclude that starch malonate can be used as a novel superdisintegrant.

Open Access Original Research Article

To Evaluate Knowledge, Attitude, Practice of Natural Family Planning Method and Associated Factors among Reproductive Age Group of Women’s at Jimma Town, Jimma Zone, South West Ethiopia

Vinod V. Bagilkar, Dheeraj Lamba, Rebecca Moren, Markos Mehertab, Rinu J. George

Journal of Pharmaceutical Research International, Page 199-211
DOI: 10.9734/jpri/2021/v33i48B33277

Background: The high fertility rate leading to the rapid growth of country’s population is a major hindrance towards the development of a nation. Sub-Saharan Africa has the highest fertility rate in the world, which is further promoted by the low utilization of contraceptive methods. Yet, many communities claim to have natural methods of family planning that pre-date the introduction of modern contraceptives, implying that contraception is a culturally acceptable norm.

Objective: To Evaluate the Knowledge, Attitude and Practice towards Natural family planning among reproductive age women of Jimma town, Oromia, Ethiopia.

Methods: Across sectional community based quantitative study was done in Jimma town, among reproductive age group women from February to March; 2020. A total of3 99 sample size is calculated using single population proportion formula with a proportion (P) of 50 %.Systematic random sampling technique issued to draw the study participants among the target population. The data was collected using structured questionnaire adapted from similar and the tools modified to fit the local context. The collected data was tallied and analyzed by using scientific calculator.

Results: From the total of 399 respondents who responded the questionnaire Majority, 90% of women in Jimma town had a good level of knowledge of natural family planning methods. A positive attitude towards natural family planning methods was seen in (68%) of the respondents.

Conclusion: A fair level of knowledge of natural family planning methods is seen among reproductive women in Jimma town, yet differences in knowledge of specific natural family planning methods exist. Therefore, physicians and other health care providers‟ limited knowledge of and experience with Natural family planning methods inhibits broader use as reproductive age women reported getting information about NFFP methods from health providers and friends, therefore, their level of knowledge will depend largely on the   information received.

Open Access Original Research Article

Microbial Load in Kitchen Dish Wash Scrubber

P. Harini, N. P. Muralidharan

Journal of Pharmaceutical Research International, Page 212-217
DOI: 10.9734/jpri/2021/v33i48B33278

Introduction: Kitchen sponges are most commonly used cleaning equipment. These sponges were heavily contaminated with the microorganisms which acts as a carrier of food borne diseases. It provides favourable conditions for the growth of bacteria and other microorganisms. It acts as a reservoir of pathogens and a vector of cross contamination. Proper sanitization techniques must be followed to avoid cross contamination.

Aim: The aim of the study was to evaluate the microbial load in used kitchen dish wash scrubbers.

Materials and Method: Twenty dish wash scrubbers were collected in a sterile disposable container. Moisture was removed by drying the scrubber. The procedures were conducted after 5 days. Measured the weight of the scrubber weighing 1 gram and soaked it in 500 ml of sterile saline for 30 minutes, agitated it and transferred 10 microliter to the media. And identified the organisms by the growth characters on the media for the possible pathogens.

Result: From the growth characters the organisms identified were Coliform, Bacillus and Staphylococcus.

Conclusion: This study showed that scrubbers were not clean and were at increased risk of food poisoning. Kitchen sponges were highly contaminated with potentially pathogenic bacteria which might be transferred from the overall kitchen environment to food contact surfaces and consequently cause food contamination.

Open Access Original Research Article

Evaluation on Lung Functions after Examination Stress in Student Population

J. Noor Fathima, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 225-234
DOI: 10.9734/jpri/2021/v33i48B33280

Background: Professional degrees are daunting to the learning group because of a modern curriculum that is dramatically different from high school curricula and other educational courses. It is more pronounced among first year students in educational institutions because of rivalry and demands from institution managers, academic staff and parents. Stress causes many detrimental effects in the body.

Aim: The present study planned to evaluate the effect of examination stress on the changes in lung functions among dental college students.

Materials and Methods: 20 normal students were selected and categorised into normal and stressed students. They were assessed for a lung function test using RMS helios 702 Spirometer. The parameters such as FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 were assessed.

Results: It is observed that there was a decrease in the values of FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 in exam stressed students when compared to normal students. The values of FEV1/FVC and FEF25-75 were statistically significant.

Conclusion: Thus, the study concluded an innovative finding that there was an inverse association with depressive symptoms in the pulmonary function test of exam stressed students which was shown by a statistically significant decrease in FEV1/FVC and FEF25-75. Exam is really a stressful experience and affects both male and female students. Awareness should be conducted among students about ill effects of stress. Decreased stress, increased lung function results in increased academic performance.

Open Access Original Research Article

Detection of Drug Resistant Genes among A. baumannii by In silico PCR Method

A. Roshan, A. S. Smiline Girija, P. Sankar Ganesh, J. Vijayashree Priyadharshini

Journal of Pharmaceutical Research International, Page 242-253
DOI: 10.9734/jpri/2021/v33i48B33282

Background: Acinetobacter baumannii is a gram-negative bacterium classified as an opportunistic pathogen in humans by the World Health Organization. Different genetic determinants contribute to multidrug resistance, and transform it as a nosocomial pathogen.

Aim: Using in-silico PCR, this analysis aims to characterize the 13 distinct drug resistant genes found in 19 virulent A.baumannii strains.

Materials & Methods: There were 11 A.baumannii multidrug resistance genes chosen. In-silico PCR amplification was performed using forward and reverse primers from the 11 genes described in previous research. The amplicon bands were detected in 19 strains of A.baumannii that were set as default on the server.

Results: Among the 13 multidrug resistance genes studied, tet A, tet B, Sul 1, Sul 2, DfrA1,  ISAba-1 and ISAba-125 were detected among the 19 virulent strains of ​A.baumannii​.

Conclusion: The findings of the study documents the frequency of tet A, tet B, Sul 1, Sul 2, DfrA1, ISAba-1 and ISAba-125 like from the selected strains of A. baumannii. However, more experimental validation is needed in order to conduct routine surveillance on drug-resistant A. baumannii strains in hospital settings.

Open Access Original Research Article

Analytical Method Development and Validation and Forced Degradation Stability-Indicating Studies of Favipiravir by RP-HPLC and UV in Bulk and Pharmaceutical Dosage Form

Sayyed Nazifa Sabir Ali, Lajporiya Mobina, Manjra Mehfuza, Patel Seema, Aejaz Ahmed, G. J. Khan

Journal of Pharmaceutical Research International, Page 254-271
DOI: 10.9734/jpri/2021/v33i48B33283

Aims: To develop and validate a new, simple, rapid, precise, and accurate An Eco-friendly RP-HPLC and UV-Method Development and Validation for an estimation of Favipiravir in Bulk and pharmaceutical dosage form followed by Forced Degradation Studies.

Study Design: This was employed for UV-visible (200-400 nm and 400-800 nm respectively) and RP-HPLC method development using C 18 inertsil column and optimization of variables for Favipiravir estimation in bulk and formulations.

Place and Duration of the Study: The present work was carried out at Ali-allana College of Pharmacy, Akkalkuwa between the duration of November-2020 to February-2021.

Methodology: UV-Spectroscopic method was developed for the estimation of Favipiravir in the bulk and pharmaceutical dosage form. The solvent selected for the Favipiravir UV analysis was water, the solution in a range of 2-10µg/ml was scanned in the UV region from 200-400 nm and the λmax value was determined. The RP-HPLC method was developed on inertsil ODS-3V C18 150 mm x 4.6mm x 5μ column using buffer pH 3.5: acetonitrile [90:10] as mobile phase at flow rate 1.0 ml/min and PDA detection at 358 nm.

Results: The maximum absorbance was observed at 358 nm. The wavelength 358 nm was selected for further analysis of Favipiravir. The calibration curve was determined using drug concentrations ranging from 2-10 µg/ml. The % recovery for accuracy was 100.50-100.76%. The method was to be precise with a % RSD value 0.51-1.37 and 0.77-1.78 for intraday and Interday respectively. The limit of detection (LOD) and limit of quantification (LOQ) was found to be 0.0723 &0.219 µg/ml respectively by UV method. The RP-HPLC method was shown to be linear in the 50-250 μg/ml concentration range. The limit of detection (LOD) and limit of quantification (LOQ) was found to be 2.186 & 6.626 μg/ml respectively. The method was to be precise with a % RSD value 0.25-1.53 and 0.86-1.68 for intraday and inter-day respectively.

Conclusion: Here we conclude that the developed UV and RP-HPLC methods are precise, accurate, sensitive, and reproducible for the quantitative estimation of Favipiravir bulk and its formulation. The developed method can be used by the pharmaceutical industries for the routine analysis of Favipiravir, in particular by UV and RP-HPLC. The main features of the proposed method are economic and eco-friendly with less retention time around 5.0 min.

Open Access Original Research Article

In silico Analysis of Plant Based Quorum Sensing Inhibitor against Chromobacterium violaceum CviR

P. Nandini, P. Sankar Ganesh, A. S. Smiline Girija, J. Vijayashree Priyadharshini

Journal of Pharmaceutical Research International, Page 272-277
DOI: 10.9734/jpri/2021/v33i48B33284

Background: Chromobacterium violaceum (C. violaceum), a Gram-negative, facultative anaerobic, non-sporing coccobacillus has a quorum-sensing system consisting of CviI/CviR, a homologous gene. Quorum sensing (QS) is a mechanism of intercellular communication in bacteria that received substantial attention as an alternate strategy for combating bacterial resistance and the development of new anti-infective agents.

Methods: DATA SET Information of photochemical from the natural source deposited as a machine readable format in PubChem database was utilized to retrieve the compound for the study. To study ligand - receptor interactions, docking paves way to accomplish the protein ligand interaction was docked through rigid docking CviR protein (PDB ID: 3QP5) was prepared and energy minimized to evaluate the best affinity among the complex.

Results: The results showed that the Alpha.,2.Alpha.- Epoxy-1.Beta.- Methyl Cholesta-4,6- Dien-3-One had high affinity for CviR receptor protein and Alpha.,2.Alpha.- Epoxy-1.Beta.- Methyl Cholesta-4,6- Dien-3-One binds to the active site of CviR with binding energy of -9.6 kcal/mol.

Conclusion: Overall study concluded that 1. Alpha., 2. Alpha.- Epoxy-1.Beta.-Methyl Cholesta-4,6-Dien-3-One with highest binding affinity for the CviR protein possessing strong inhibitory binding interaction. Hence, we concluded that 1.Alpha.,2.Alpha.-Epoxy-1.Beta.- Methyl Cholesta-4, 6-Dien-3-One good serves as potential an anti-quorum sensing molecule for treating C. violaceum infection.

Open Access Original Research Article

Effects of Preservatives Added in Cookies on Intestinal Bacteria

G. S. Sutharshan, N. P. Muralidharan

Journal of Pharmaceutical Research International, Page 278-284
DOI: 10.9734/jpri/2021/v33i48B33285

Introduction: An essential thing for human survival is food which provides nutritional support for the body or for pleasure. All the food used today has some preservatives, except our own garden plants. Preservatives prevent food spoilage from microorganisms but it will inhibit the growth of bacteria and fungi. Antimicrobial preservatives are the preservatives which inhibit the growth of fungi and bacteria. Methods of preserving foods have been used for centuries and include natural techniques such as smoking fish and meat as well as adding salts.

Aim: The main aim of the study is to find the effects of preservatives added in cookies on intestinal bacteria.

Materials and Method: Take a sample of 10 biscuits. Crush and mix 10 gms in 10 ml of sterile saline. soak for 30 mins and centrifuge and take the supernatant. Transfer 1 ml to each tube and add the selected organisms (lactobacilli). Add 10 microlitre of the selected organism (lactobacilli) to the supernatant. Hold for 30 mins and transfer 10 microlitre to BHI and count the CFU after incubation for 12 hours.

Results and Discussion:  After 12 hrs of incubation, colonies are formed. Using colony counter app colonies are counted. Biscuits 4 showed the highest growth of colonies of 797. The control of the bacteria shows confluence growth where the unlimited colonies are formed. This indicates the presence of antimicrobial activity on preservatives added in biscuits. This antimicrobial activity affects the health of the oral cavity and intestine.

Conclusion: From the above study, it is evident that the antimicrobial activity of preservatives that are added in biscuits could affect the health of oral cavity and intestine.

Open Access Original Research Article

Evaluation and Comparison of the Effectiveness of Physical Methods of Disinfection on Heat-Polymerized Polymethyl Methacrylate – An In-vitro Study

Kapil Soni, Vivek Choukse, Rajeev Srivastava, Umesh Palekar, Prabha Shakya Newaskar, Vaibhav Awinashe

Journal of Pharmaceutical Research International, Page 285-293
DOI: 10.9734/jpri/2021/v33i48B33286

Introduction: The common relationship of Candida and the ample proof that acrylic resin dentures are related to denture stomatitis in the oral cavity, which can range from simple mucosal lesions to a fatal systemic form. The current study aims to assess and compare the efficacy of microwave irradiation and UV radiation in the disinfection of Candida albicans infection in heat-polymerized polymethyl methacrylate.

Materials and Methods: A total of 90 specimens were prepared with heat-polymerized acrylic resin, out of which 30 were used for Microwave irradiation, and 30 were used for UV irradiation, and 30 were used for positive control. There were three groups: Group A (Positive Control group); Group B (Microwave irradiation); Group C (UV radiation). After preparing the samples they were chemically sterilized, then infected with C. Albicans, and again Group B is disinfected with Microwave irradiation, Group C is disinfected by UV light and Group A is kept as Positive control without disinfection. Turbidity was measured for each group after re-infection of every specimen in CFU/ml.

Results: In the present study, the CFU/ml of Candida albicans in the control group was 2.97x107±0.6 x 107 (P= .000), for microwave irradiation, the mean value was 5.3±11.1 (P= .000), and for UV radiation, the mean value was 19.3±22.9 (P= .003).

Conclusion: According to the results of the current study, microwave irradiation (6 minutes at 650W) is more effective than UV radiation (10 minutes each side at 254nm wavelength) of Candida albicans infection on the heat-polymerized acrylic resin in laboratory conditions.

Open Access Original Research Article

Survey on the Incidence of Covid19 Among Dentists Working in Dental Hospital Attached with Dental College

N. Mohamed Arsath, N. P. Muralidharan

Journal of Pharmaceutical Research International, Page 294-303
DOI: 10.9734/jpri/2021/v33i48B33287

Introduction: Covid 19 is primarily a pneumonia associated viral infection that originated from Wuhan city in December 2019.The spread of novel coronavirus occurs through direct close contact with COVID-19 patients within one metre of the infected person and the rate of spread is enhanced especially if they do not cover their face when coughing or sneezing. The novel virus also spreads by the droplets surviving on surfaces and clothes for many days. The current study focuses on analysing the vulnerability of the dental population to covid19, and the study also deals with analysis of the knowledge among the dentists regarding the diagnosis, prevention and treatment protocols of Covid19.

Materials And Method: A manual survey was conducted with the self structured questionnaire prepared using google docs. An total of 1000 responses were received. The responses recorded were analysed and statistical analysis was performed

Results: The current survey results depict that around 97.14% of the participants were [1] [2] affected with covid19 and among them around 74.23% of the population did not get admitted in hospital and self quarantined themselves and took nutrition rich diet to recover from covid19 infection.

Conclusion: The study results within the limitation depicted that there is adequate awareness,knowledge on all aspects with regards to the pandemic outbreak novel corona virus. Study also shows the vulnerability of dentists in any community outbreak of any also shows the disease management strategy handled by the local community.

Open Access Original Research Article

Estimation of Bacterial Contamination on Toothbrush used by Different Students for a Different Time Period

B. Kiran Srinivas, R. V. Geetha

Journal of Pharmaceutical Research International, Page 304-311
DOI: 10.9734/jpri/2021/v33i48B33288

Introduction: Contamination of a surface occurs by microorganisms when it inhabits any surface or an object when the count of the bacteria increases. The degree of contamination can be estimated by counting the number of colonies, when a sample collected from that site is cultured. Streptococcus mutans is considered to be the normal commensal of our oral cavity. When it’s count is increased in the oral cavity, it causes dental caries and other tooth related problems. The main aim of this study is to estimate the bacterial contamination in the tooth brush head used by students for varying time periods.

Materials and Methods: Used toothbrushes for varying time periods are collected from students. Then their bristles are plucked with the sterilized forceps for the prevention of bacterial contamination and agitated in the saline and inoculated in the brain heart infusion broth agar with the help of sterilized bacterial loops and incubated for 24 hours at 37oC. Then the colonies are counted and record as CFU/ml.

Results: The bacterial count is directly proportional to period of usage, but it is affected by certain factors like duration of brushing and using brushes. On an average the count was estimated to be 47 CFU/ml for two months, 57 CFU/ml for six months, 68 CFU/ml for eight  months and 81 CFU/ml for a year. The p1 value (for sample 1 and 2) was 0.046 (p<0.05), so it is statistically significant.

Conclusion: The study shows that in prolonged usage of tooth brushes the bacterial contamination also increases. So the tooth brushes should be protected in tooth brush holders, to avoid contamination and the toothbrushes should be changed once in a  month for betterment of oral health.

Open Access Original Research Article

Knowledge and Attitude Concerning the Dental Treatment of Patients with HIV/AIDS among Dental Students and Dentists in Saudi Arabia

Aisha Mostafa, Noor Alrefaei, Afnan Alraddadi, Salwa Alharbi, Ahmed Alahmari, Ahmed Alturaiki, Khames Alzahrani

Journal of Pharmaceutical Research International, Page 312-322
DOI: 10.9734/jpri/2021/v33i48B33289

Aims: to assess the HIV/AIDS-related knowledge and attitude among dental students and dentists in KSA, to explore the association between the dental students’ knowledge toward HIV, their age, gender, and academic year and to compare the level of knowledge among dental students, interns, and dentists.

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

Place and Duration of Study: Conducted in Saudi Arabia at Jeddah, Riyadh, Almadina, Hail, Dammam, Jazan, and Sakaka cities from December 2020 to August 2021.

Methodology: Self-administered questionnaires were used to collect data. Background information and HIV/AIDS-related knowledge and attitudes were collected using a self-administered -based questionnaire, the first section assessed demographic data, while the second section assessed knowledge and attitudes towards dental treatment for HIV/AIDS patients.

Results: The total number of participants was 461. The percentage of age distribution 49.7% were 30 years. Following; knowledge-based group 50.5%, 1.5% and 47.1% 14 considered blood, saliva are possible HIV origins. 83.3% believe that HIV is transfusion origin. 15 While, 3.3% considered disease is contiguous and 4.8% believe it is due to sharing of food.

Conclusion: Current study reveals a lack of knowledge and attitude among dental students 17 and dentists, with insignificant variations. More education regarding AIDS patients is needed 18 in dentistry community.

Open Access Original Research Article

Targeting Omp-A Protein of Acinetobacter Baumannii with the Bio-Active Compounds from Azadirachta Indica - an in-silico Approach

R. Nandita, A. S. Smiline Girija, P. Sankar Ganesh, J. Vijayashree Priyadharsini

Journal of Pharmaceutical Research International, Page 323-334
DOI: 10.9734/jpri/2021/v33i48B33290

Background: Acinetobacter baumannii is a gram negative bacterium which is typically short, round, coccobacillus and was named after the bacteriologist Paul Baumann. It is an emerging dental pathogen since it acquires  drug resistance and expression of several virulence genes. It is an opportunistic pathogen in humans, affecting people with compromised immune systems. Acinetobacter baumannii is an arising nosocomial microorganism causing serious complications because of the propensity of its multi-drug resistant property.

Aim: The aim of the present study was to target omp-A protein of Acinetobacter baumannii with the bio active compounds from Azadirachta indica an in-silico approach.

Materials and Methods: The crystal structure of ompA protein was obtained from the PDB protein data bank. The structures of the bio-active derivatives of A. indica were obtained from the chemsketch software. The generated 3D structures were then optimised. Auto Dock instrument was utilized for docking investigation to interpret the affinity between bio-compounds of A. indica against ompA protein of A. baumannii.

Results: The 3D crystal structure of OmpA-like domain from A.baumannii was retrieved from PDB database and its PDB ID was 3TD3 – A chain. 3D Structure of OmpA visualization using Biovia-Discovery studio visualizer. The 2D structure of compounds from Azadirachta indica was drawn using ACD chemsketch and saved in MDL-mol format and converted to PDB format using open babel converter. The final docked structures for the drug ligand interactions were assessed for their binding energies and hydrogen bonds.

Conclusion: The present study had achieved the anti-biofilm inhibitory effect of imidazole-2-carboxylic acid from A. indica exhibiting a great interaction between activity with ompA utilizing computational investigation.

Open Access Original Research Article

Assessment of Risk Factors and Prevalence of under Nutrition Using Composite Index of Anthropometric Failure (CIAF) among under 5 Children in a Tertiary Care Center

M. Devika, N. Kishore

Journal of Pharmaceutical Research International, Page 353-360
DOI: 10.9734/jpri/2021/v33i48B33293

Background: Under nutrition is a major health problem in the developing countries especially India. It has a significant impact to child morbidity and mortality.

Objective: To assess the risk factor and prevalence of under nutrition among children under 5 years of age, using conventional indices and the Composite Index of Anthropometric Failure (CIAF), and then comparing their estimated results.

Materials and Methods: This cross-sectional study was carried out in the pediatrics department (outpatient and inpatient) from January 2021 to March 2021 using sample size of 300. Attendants of Toddler’s were interviewed with semi structured proforma and height and weight of toddler were measured by measuring tape and weighing machine respectively. Informed consent was obtained. MS excel was used for data analysis after compilation.

Results: CIAF identified 96% of childrens to have under nutrition. By using conventional indices it was seen that 62.8% of the children were underweight, 50% were stunted and 44.4% were wasted.

Conclusion: CIAF gives a better estimate of under nutrition than currently used conventional indices; and identifies more children with multiple anthropometric failures.

Open Access Review Article

Niosomes: A Promising Drug Delivery System in Transdermal Drug Delivery (TDDS)

Vibhavari M. Chatur, Shashikant N. Dhole

Journal of Pharmaceutical Research International, Page 6-17
DOI: 10.9734/jpri/2021/v33i48B33254

Infectious disease treatment and immunisation have undergone a transformative change in recent years. With the advancement of biotechnology and genetic engineering, a large number of disease-specific biological have been created, as well as a focus on delivering these biological effectively. Niosomes are vesicular Nano carriers that are gaining popularity as a potential transdermal drug delivery system due to properties like enhanced drug penetration, a local depot for sustained drug release, and a rate-limiting membrane for modulating systemic absorption of drugs through the skin. Niosomes are non-ionic surfactant-based vesicles that are biodegradable, relatively nontoxic, more stable, and less expensive than liposomes. This analysis gives a high-level overview of niosomes, including their chemical composition, structure, benefits, and applications, as well as some general observations on niosomes as percutaneous permeation enhancers.

Open Access Review Article

Niosomes: A Promising Novel Nano Carrier for Drug Delivery

Nirmal Shah, Rahul Prajapati, Dipti Gohil, Piyush Sadhu, Snehal Patel

Journal of Pharmaceutical Research International, Page 53-66
DOI: 10.9734/jpri/2021/v33i48B33260

Niosomes are vesicles, which are formulated by hydrating the mixture of cholesterol, non-ionic surfactant and other biodegradable lipids. Niosomes increase the drug activity as compare to their conventional dosage form of a drug. Niosomes can be used as carrier of amphiphilic and lipophilic drugs. Niosomes may overcome the issues related to instability, fast degradation, low bioavailability, and insolubility of medications. The structure of niosomes either multilamellar or unilamellar, is depends on the method of formulation. Niosomes contain very efficient drug delivery potential for site-specific delivery of anti-cancer, anti-infective agents, etc. Niosomes are stable as well as cost effective carriers as compared with other drug formulations. Niosomes also have various applications in parental drug delivery system, topical drug delivery system, oral drug delivery system and novel drug delivery system such as targeted drug delivery system and controlled drug release system.

Open Access Review Article

The Administration of Probiotics in Extremely Low-Birth-Weight Infants and the Incidence of Necrotizing Enterocolitis and Mortality: A Systematic Review

Mohammed Khalid Harasani, Sarah Abdulrahman Almosaiteer, Faisal Saleh Aloraini, Saleh Khalid Aldakhil, Jamilah Sulaiman Alsaiari, Abdulrahman Muhaidib Almuhaidib, Omar Muhaidib Almuhaidib, Mohammed Atiah Alisi, Othman Majed Alothman, Thamer Saleh Alanazi, Asalah Tariq Alsaigh

Journal of Pharmaceutical Research International, Page 121-131
DOI: 10.9734/jpri/2021/v33i48B33269

Encouraging findings were previously demonstrated in a previous meta-analysis that analyzed the results of randomized controlled trials (RCTs) that investigated the potential favorable effects of probiotics administration in preterm infants to prevent necrotizing enterocolitis (NEC) and feeding intolerance. This evidence has only been linked to low birth-weight infants (<1000 g), while evidence regarding the impact of administration of these modalities for Extremely Low-Birth-Weight Infants (ELBW) infants is still controversial among the different studies in the literature. A systematic review was conducted to retrieve all the relevant randomized controlled trials in the literature that investigated the impact of probiotics administration on the different outcomes in ELBW infants, including the incidence of mortality and NEC. A thorough search was then conducted through the different databases to find the relevant articles.A total of 11 RCTs were included in the present systematic review. All articles were published between 2007 and 2021, with a total of 3225 ELBW infants were included in both the intervention and control groups across the different included trials. Our results indicate that the administration of these modalities does not have a significant impact on these outcomes. However, it has been reported that they enhance the growth rate, especially head growth circumference, which has been reported to be superior to the placebo effect. Further investigations for ELBW should be encouraged to furtherly validate these modalities, although no adverse events have been reported for their administration among trials in the current systematic review.

Open Access Review Article

A Review on Pediatric Social Phobia and Selective Mutism

Ahmed Abdel Samie Fadl, S. Alharthi, Saad Mohammed, A. Aldhneen, Baqer Ali, A. Alahdal, Saud Mohammed, F. Abdulrahim, Noor Mohammed, S. Alotaibi, Nada Atiah, M. Al Samti, Amnah Ibrahim, Alharthi, A. Elham Mohammed, Y. Aljabri, Fatimah Assad, A. Alrsheed, Nourah Rsheed

Journal of Pharmaceutical Research International, Page 218-224
DOI: 10.9734/jpri/2021/v33i48B33279

Selective mutism (SM) is a psychological disease that affects children and is defined by a complete lack of speech in certain social contexts while speech production appears normal in others. Separation anxiety disorder, social anxiety disorder (previously known as social phobia), agoraphobia, and panic disorder, as well as shyness and anxiety, can all be associated with selective mutism. SM is a rather uncommon condition. Estimates of its point prevalence have been found in clinic or school samples in a variety of countries, and typically range between 0.03 percent and 1.9 percent depending on the setting. To properly establish the disorder's diagnosis, clinicians can use the SM module of the Anxiety Disorders Interview Schedule for Children and Parents (ADIS-C/P) or the Schedule for Affective Disorders and Schizophrenia for Children (Kiddie- or K-SADS). Nonmedication and medication-based therapies are the two basic types of treatment for selective mutism. Psychodynamic therapy, behavioural therapy, and family therapy are among the most common nonmedication-based or psychotherapy treatments. Selective seratonin reuptake inhibitors (SSRIs) (fluoxetine in particular) have been demonstrated to improve mutism and anxiety when used as a treatment option. The study aims to evaluate and treat selective silence and social phobia in children.

Open Access Review Article

Overview of Subaxial Cervical Spine Fractures and Dislocations

AbdulWahab Ahmed Alzahrani, Mohammad Saeed M. Al Fehaid, Abdullah Saleh A. Alaboudi, Mohammed Ahmed Abed I. Abualsaoud, Faisal Abdulmohsen A. Bintalib, Ahmed Asim A. Almuallimi, Nawaf Faisal M. Alotaibi, Othman Yaqoub Yousef Aldayhan, Abdulrahman Nasser A. Alshabanat, Sama Ali A. Halawi, Osied Hesham M. Almadani

Journal of Pharmaceutical Research International, Page 235-241
DOI: 10.9734/jpri/2021/v33i48B33281

Injuries of the subaxial cervical spine are among the most common and potentially most devastating injuries involving the axial skeleton. The lower cervical spine can suffer minor bony or ligamentous injury that nevertheless results in severe neurologic injury. Plain radiography, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans are all part of the standard imaging regimen. The delayed timing of dislocation reduction and cost-effectiveness are two issues with routine use of MRI in the diagnosis of cervical facet dislocations. Serval treatment options and approaches can be used. However Orthopedic treatment can be used to reduce the fracture or dislocation returns the vertebral canal to its normal shape and dimensions and decompresses the spinal cord. Immediate treatment should be started if there are signs of spinal cord injury or any factor that could lead to such injuries. In this review we will be looking at epidemiology, causes, evaluation and treatment of such cases.

Open Access Review Article

An Overview on Etiology, Diagnosis and Management of Ovarian Dermoied Cyst: Simple Review Article

Hesham Mohamed Hamad Morcy, Feryal Ayed L. Alanazi, Waad Mohammed Oqla Alanazi, Marwa Mutlaq Awwad Alanazi, Haifa Suaylm Khalaf Aldahmshi

Journal of Pharmaceutical Research International, Page 335-340
DOI: 10.9734/jpri/2021/v33i48B33291

The most common neoplastic ovarian lesions in teens are mature cystic teratomas (MCTs) or dermoid cysts. Little is known about the cause of dermoid cysts. Elevated levels of estrogen and progesterone have been suggested to stimulate the sebum components of these tumors, which may explain why MCTs grow after puberty and stop growing after menopause. MCTs are often asymptomatic and are randomly identified during examination or diagnostic imaging. MCTs show a special appearance during ultrasonography. Most studies suggest that  most  ovarian dermoid cysts can be successfully treated surgically using laparoscopic surgery. Reduced adhesion formation is one of the benefits of laparoscopic treatment for dermoid cysts. Studies also suggest that laparoscopy causes less blood loss. Less hospitalization and less postoperative pain. And there are fewer postoperative problems than the laparotomy approach. In this article, we will look at the etiology, diagnosis, and treatment of dermoid cysts in the ovary.