Open Access Case Report

A Multimodal Treatment Approach on Rare Case of Meningomyelocele

Anupam Sood, Ashish Varma, Sakshi P. Arora, Anuj Varma, Keta Vagha, Jayant Vagha, Sachin Damke

Journal of Pharmaceutical Research International, Page 299-303
DOI: 10.9734/jpri/2021/v33i50A33412

Meningomyelocele, one of the neural tube defect (NTD) variants, is a condition in which meninges and neural tissue protrudes through a defect in vertebral arch and forms a cyst-like sac with an incidence of 0.5–11/1000 live births. Hydrocephalus is a major problem for majority of patients with meningomyelocele due to the abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain. Meticulous preoperative evaluation with planning of the anesthetic technique, especially in regard to managing the airway, plays a crucial role in successful surgical management of these cases. Here, we report a case of lumbosacral meningomyelocele with hydrocephalus underwent a multimodal treatment approach for providing a comprehensive plan of care.

Open Access Case Study

Case Report on Hydatid Cysts with Hydropnemonothorax

Ekta Padmane, Samruddhi Gujar

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i50A33375

Introduction: Hydatid disease is caused by a parasite infection induced by an echinococcus tapeworm. The hydatid cyst is one recognized cause of liver mass. It is a significant pathogenic, zoonotic, and parasitic illness (acquired from animals) of humans after consumption of tapeworm eggs produced in the faeces of infected dogs. Hydatid disease is a serious endemic health concern in various regions of the world. Cystic hydatid disease is most often associated with the liver (50–70%), although it can also affect the lung, spleen, kidney, bones, and brain. A hydropneumothorax occurs gradually.

Case Presentation: A 35-year-old Man was taken to the Acharya Vinoba Bhave Rural Hospital with the chief complaint of abdominal discomfort, breathlessness (dyspnea) right side pain for 2 days. Approximately to the peritoneal cavity of the right chest by a hydatid cyst in the subscapular posterior part of the right lobe of the liver. For minimal ascites, a contrast study was conducted, revealing a multi-located hypodense cystic lesion spread across the abdomen was recognized as sign of hydatid disease.

Conclusion: In a patient with a hydatid disease, physical and psychological therapy should be put together. In this study, we primarily focus on professional management and outstanding nursing care, which may give the comprehensive care that hydatid cyst requires. The complete health care team works together to assist the patient to restore his or her prior level of independence and happiness after a full recovery.

Open Access Case Study

Case Report on Subarachnoid Hemorrhage

Reshma Tighare, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 274-278
DOI: 10.9734/jpri/2021/v33i50A33408

Introduction: Subarachnoid haemorrhage (SAH) is caused by intracranial bleeding into the cerebrospinal fluid-filled space between the arachnoid and pia mater membranes on the surface of the brain.

Patient History: The 65-year-old female patient was hospitalised to AVBR hospital in neurosurgery ward on December 25, 2020 with the chief complaints of headache, vomiting and episodes of seizures since three days. The patients had episodes of seizures on 21/12/2020 and 24/12/2020. The day later she was admitted to the Intensive Care Unit.she underwent all routine investigations like blood tests, and CT scan. After a thorough examination, the final diagnosis was subarachnoid haemorrhage.

Past History: Patient did not have any history of communicable disease, asthma, tuberculosis, or any hereditary disease. Patient was COVID – negative and did not have any significant surgical history.

Pharmacology: Patient was treated with proton pump inhibitor, antiemetic, antiepileptic, calcium channel blocker, stool softener analgesic and antipyretic.

Management: Inj. Levipril 500 mg, Inj.pan40-40mg, cap.nimodipine 60mg every four hourly, Inj.emset 4 mg, Inj. Neomol 100 ml, Syp. glycerol 30 ml, Syp. Zincovit 2tsp and Tablet Dolo 650mg.

Nursing Management: Patient’s vital sign (including blood pressure) and neurological status were monitored with bed rest, pain management and assessment of risk of bleeding.

Conclusion: Patient was hospitalised with a threeday history of headache, vomiting, and episodes of seizures actively managed; condition satisfactory.

Open Access Case Study

Physiotherapeutic Approach for Osteochondroma of 4th And 5th Ribs - A Case Report

Shruti Bhoge, Pratik Phansopkar, Neha Chitale

Journal of Pharmaceutical Research International, Page 287-291
DOI: 10.9734/jpri/2021/v33i50A33410

The most frequent benign bone tumor is osteochondroma, which account for 45 percent of all benign bone tumours. Although not a real neoplasm, osteochondroma (exostosis) is the most common lesion and is often classed as a tumour. The majority of them develop in the metaphyseal region of long bones like the femur and tibia. A 21-year-old female presented to the orthopedic OPD with complaints of pain and swelling over dorsal spine since 2 years with left upper limb radiculopathy since 1 month. Pain was insidious in onset which started 1 month back and it aggravated ever since. On inspection swelling present over paraspinal region of approximately 5cm in length and 4cm in width. On palpation swelling was not adherent to skin, immobile and firm in consistency. Osteochondroma represent the most common bone tumor accounting for 20 to 50% of all benign osseous tumors. In osteochondroma maintaining mobility is important for activities of daily living and to maintain the quality of life. Physiotherapy plays a significant role in maintaining the mobility and improving the quality of life.

Open Access Case Study

Functional and Esthetic Rehabilitation of a Child with Early Childhood Caries: a Case Report

Niharika Gahlod, Arun Sajjanar, Suryakant Kumar, Milind Wasnik, Sneha Khekade

Journal of Pharmaceutical Research International, Page 319-323
DOI: 10.9734/jpri/2021/v33i50A33415

Early Childhood Caries (ECC) can be defined as the presence of one or more carious lesions, may or may not be cavitated, and missing teeth due to caries in children up to five years of age. It is multifactorial involving the presence of bacterial plaque, poor oral hygiene, frequency and time of consumption of beverages containing sugar. It has several deleterious effects like it can damage speech, swallowing, feeding, development, esthetics and self-esteem of the child. Therefore, complete oral rehabilitation in such patients is utmost important for their normal growth and development. The current case report involves the oral rehabilitation using different treatment options.

Open Access Short Research Article

Assessment of Knowledge on Hemodialysis among Renal Patients

Abha Adlina Oriel, C. C. Linson

Journal of Pharmaceutical Research International, Page 255-259
DOI: 10.9734/jpri/2021/v33i50A33405

Patient knowledge about hemodialysis is important for effective self-management behaviors. The aim of the present study was to assess the knowledge on hemodialysis among renal patients in selected hospitals of Bhopal. The research design selected for this study was descriptive in nature. The target population for this study was renal patients and the method of sampling was purposive sampling. The sample size was 50. A self-structured questionnaire was used to assess the knowledge and the study findings revealed that knowledge of renal patients regarding hemodialysis was inadequate.

Open Access Short Communication

Coronavirus - Drug Discovery and Therapeutic Options

Abdul Samad Tayyab, Maria Qurban, Maryam Mazhar, Zaid Tayyab, Mariam Tahir, Zain Tayyab

Journal of Pharmaceutical Research International, Page 154-158
DOI: 10.9734/jpri/2021/v33i50A33391

COVID-19 is basically a medium size RNA virus and the nucleic acid is about 30 kb long, positive in sense, single stranded and polyadenylated. The RNA which is found in this virus is the largest known RNA and codes for a large polyprotein. In addition, coronaviruses are capable of genetic recombination if 2 viruses infect the same cell at the same time. SARS-CoV emerged first in southern China and rapidly spread around the globe in 2002–2003. In November 2002, an unusual epidemic of atypical pneumonia with a high rate of nosocomial transmission to health-care workers occurred in Foshan, Guangdong, China. In March 2003, a novel CoV was confirmed to be the causative agent for SARS, and was thus named SARS-CoV. Despite the report of a large number of virus-based and host-based treatment options with potent in vitro activities for SARS and MERS, only a few are likely to fulfil their potential in the clinical setting in the foreseeable future. Most drugs have one or more major limitations that prevent them from proceeding beyond the in vitro stage. First, many drugs have high EC50/Cmax ratios at clinically relevant dosages.

Open Access Minireview Article

Impact of COVID-19 Pandemic on the Number of Research and Publications-A Review

Mangesh Kohale, Anupama Dhobale, Obaid Noman, Neha Bhatt, Shweta Bahadure, Pratibha Dawande

Journal of Pharmaceutical Research International, Page 324-328
DOI: 10.9734/jpri/2021/v33i50A33416

COVID-19 is having a major effect not only on healthcare delivery systems but also on the science and research sector. The pandemic of COVID-19 immediately closed universities as well as colleges all over the world, amid government orders to adopt social distance, which could help to flatten the transmission curve and decrease the total mortality from the pandemic. Fundamental scientific studies have been especially difficult hit as a result of statewide lockdown restrictions, whilst clinical researchers have encountered similar difficulties as a result of the cessation of medical care and a sudden return to full-time clinical tasks. The number of publications on COVID-19 has rapidly and dramatically increased. This emphasizes the importance of collaborating with other medical research facilities in addition to intra-institute cooperation and collaboration. One method to modify the picture of clinical research is to incorporate additional innovation into the study's design.

Open Access Original Research Article

Efficacy of GeneXpert in Diagnosing Smear Negative Pulmonary Tuberculosis and Comparison to Culture

Muhammad Kashif Munir, Iftikhar Ali, Ahsan Sattar Sheikh, Arif Malik, Asif Hanif, Sana Rehman, Samina Khaliq Munir, Qurban Ali

Journal of Pharmaceutical Research International, Page 6-12
DOI: 10.9734/jpri/2021/v33i50A33376

Objectives: Aim of present study is to observe the efficiency of GeneXpert MTB/RIF Assay in comparison to MTB culture on Lowenstein Jensen media in diagnosis of smear negative pulmonary tuberculosis cases.

Methods: This descriptive study was carried out in The University of Lahore in collaboration with King Edward Medical University/Mayo Hospital Lahore 11th September, 2020 to 10th April 2021. Smear negative for acid fast bacilli patients enrolled for anti TB treatment were the target population. After taking informed consent, patients were asked to submit first morning sputum sample for culture on Lowenstein Jensen Medium and GeneXpert.

Results: A total of 345 smear negative TB patients were diagnosed clinically and/or on the basis of radiological findings with mean age of 38.28±17.93,consisting of 47.5% male and 52.5% females  recruited in this study. History of TB contact was present among 41.4% patients whereas history of smoking and diabetes remained to be 27.2% and 17.4% respectively. Culture showed significantly higher rate (35.1%) (p-value <0.05) of detection of MTB as compared to GeneXpert (21.5%). A sensitivity of 56.01% was calculated for GeneXpert whereas for culture on LJ medium it was 60.63%.

Conclusion: Sensitivity of GeneXpert MTB/RIF Assay is a bit low in diagnosing the SNPT patients as compared to the culture but still registers itself as a handsome tool in terms of promptness and definite detection of MTB complex. Further provision of rifampicin susceptibility is bonus in same time.

Open Access Original Research Article

An Experimental Study to determine the Impact of Active Release Technique, Core Strengthening on Pain, Muscle Stiffness, Hardness and Quality of Life on Non- Specific Low Back Pain

Laukik Vaidya, Pratik Phansopkar

Journal of Pharmaceutical Research International, Page 13-24
DOI: 10.9734/jpri/2021/v33i50A33377

Introduction: Active Release Technique (ART), works by releasing adhesions and repairing the integrity of soft tissue, thereby extending and restoring functional flexibility entirely. Core stabilization workout (CSE) aims to treat back pain by boosting your muscular strength and stamina, strengthening muscle motor patterns to relieve low-back pain.

Aim: Aim of the study was to evaluate impact of active release technique and core strengthening on pain, mobility and quality of life on non-specific low-back pain.

Study Design: Simple random convenient sampling, envelope method

Place and Duration: A study of 40 people with non-specific low back pain and aging between 18 and 25 years was conducted at Musculoskeletal OPD, Ravi Nair Physiotherapy College, DMIMS(DU), Sawangi (Meghe), and Wardha in the duration of one year.

Procedure: In this experimental investigation, the influence of active released and impacting non-specific low back pain on suffering, muscular soreness, hardness, strength, ODI, and quality of life was determined. Both groups received hot fomentation and core strengthening, but only the ART group was actively released. The findings have been obtained from NPRS to algometer, durometer, press biofeedback, ODI, and EQ-5D-5L in pre-treatment, post-treatment, and after four weeks of data to analysed impacts.

Results: in this study both the groups showed reduction in pain, muscle tenderness, muscle hardness as well as increase in core strength and quality of life. When compared ART group shows significant improvement with p value of 0.001.

Conclusion: In this study we find that the pain threshold, muscular hardness, muscle tenderness, deficiency and quality of life of both groups improved. The ART group was proven to be more effective than the Hpk group when the two groups were compared. In the two groups, the core strength did not change greatly, perhaps after four weeks, from pre- treatment to post- treatment to 4 weeks after.

Open Access Original Research Article

A Study to Evaluate the Knowledge and Attitude Regarding Polycystic Ovarian Syndrome among Adolescent Girls in Selected Higher Secondary Schools at Trivandrum with a View to Develop a Self-instructional Module

S. Sindhu, C. C. Linson

Journal of Pharmaceutical Research International, Page 33-39
DOI: 10.9734/jpri/2021/v33i50A33379

Poly cystic ovarian syndrome is a hormonal disorder common among women of reproductive age. Women with PCOD may have infrequent or prolonged menstrual periods or excess male hormone levels. This hormone imbalances cause them to skip menstrual periods and leads to infertility. The study is attempted to assess the knowledge and attitude regarding PCOD among adolescent girls in selected higher secondary schools. The research design of the study was non experimental descriptive survey design. Study was conducted among 60 adolescent girls in selected higher secondary schools at Trivandrum. The result shows that 88.33 percent of adolescent girls have less adequate knowledge regarding PCOD and only 11.67 percent have moderately adequate knowledge and 75 percent of samples have neutral attitude, 25 percent have negative attitude and no one have positive attitude regarding PCOD. The correlation shows moderately positive correlation between knowledge and attitude. The  above findings shows that adolescent girls having less adequate knowledge and negative attitude regarding PCOD, so it is important to develop a self instructional module regarding PCOD for an education program.

Open Access Original Research Article

Synthesis, Characterization and Biological Evaluation of some Novel Substituted Indole-Coumarin Derivatives as Potential Antibacterial and Antifungal Agents

Pallavi Kishor Vawhal, Shailaja B. Jadhav

Journal of Pharmaceutical Research International, Page 40-46
DOI: 10.9734/jpri/2021/v33i50A33380

Aim: In the present work, we have designed and synthesized indole-fused coumarin derivatives as potential antibacterial and antifungal agents.

Place and Duration of Study: The present work was carried out at PEA's Modern college of Pharmacy, Sector 21, Yamunanagar, Nigdi- 411044 between the duration of January-2021 to May-2021.

Methodology: The in vitro antibacterial and antifungal activity was performed by disc diffusion method. The antibacterial activities were tested using agar nutrient medium against Bacillus subtilis, Bacillus pumilus, Escherichia coli, and Pseudomonas aeruginosa that are representative types of gram-positive and gram-negative organisms respectively. The anti-fungal activity of all the compounds were determined on potato dextrose agar medium against Aspergillus niger and Candida albicans. Clotrimazole 100 μg/ml was used as a standard and DMF was used as control.

Results: It was observed that all the compounds were sensitive to the gram +ve bacteria. Compound 2c, 2e, and 2f were sensitive to gram –ve bacteria. Compounds 2a, 2b, and 2f were sensitive to both the fungal strains while all the derivatives were sensitive to Candida albicans.

Conclusion: From present investigation it has been observed that compound 2f was sensitive against gram +ve, gram –ve, and both the strains of fungal strains. Structurally, compound 2f possess aldehyde functional group at indole nucleus. Therefore, from present study we have concluded that compound 2f is a lead molecule for the further development of potential antibacterial and antifungal agents.

Open Access Original Research Article

In-vivo Study of the Efficacy of Sanjeevani Vati in Snake Venom Poisoining

Pradip S. Mohurle, Rajendra Lambat

Journal of Pharmaceutical Research International, Page 47-54
DOI: 10.9734/jpri/2021/v33i50A33381

Background: Visha (Poison) is a substance, which after entering the body, disturbs natural and physiological functions of body (i.e. Dosha, Dhatu, Mala). Due to its potency, it may potentially cause death in a relatively short period. A significant proportion of Indians live in villages distant from the city and work in agriculture with their lower extremities exposed. Snake-rat habitat is more prevalent in rice and sugarcane fields.

Aims and Objective: To study the efficacy of Sanjeevani Vati in common cobra venom poisoning and Russell’s viper venom as a first aid measure.

Materials and Methods: The preparation of Sanjeevani Vatiis carried out in Department of Rasashastra, Govt. Ayurved College, Nagpur and venom was collected from snake farm’, Haffkine Institute for Training Research and Testing, Mumbai. Animal Experiment for efficacy of Sanjeevani Vati as a first aid measure on Common cobra venom and Russell’s viper venom was carried out in National Toxicology Center (NTC) Pune.

Results: The results of survival period in Russell’s viper venom group were proved to be statistically significant. P value is 0.0055(Unpaired t-test; Two tail).But in results of Common Cobra venom, it was observed that there is no delay in appearance of paralysis, convulsion & survival period. In fact all these symptoms appear near about at same time, when Sanjeevani Vati was given orally after ingestion of Cobra Venom.

Conclusion: Sanjeevani Vati property is an ophidian. If you have Russell's viper venom, it is helpful as a first aid measure since it extends its life time. Poly Valent Anti snake venom serum does not interact with it (PVASVS).

Open Access Original Research Article

The Effects of Alkaloids Fraction of Cyperus esculentus on Some Biochemical Parameters and Histopathology of the Testis of Lead-Induced Toxicity

Godson Emeka Anyanwu, Luqman Adepoju Hassan, Ifeanacho Ezeteonu Abireh, Nto Johnson Nto

Journal of Pharmaceutical Research International, Page 55-62
DOI: 10.9734/jpri/2021/v33i50A33382

Aim: This study evaluated the protective effect of alkaloids fraction of Cyperus esculentus on lead-induced testicular toxicity in Wistar rat.

Methodology: Twenty-five adult male Wistar rats were randomly divided into five (5) groups, (n=5). Group 1 was administered with 1ml normal saline only, group 2 was administered with 30 mg/kg of lead, group 3 was administered with 50mg/kg of alkaloids and 30 mg/kg of lead, group 4 was administered with 100 mg/kg of alkaloids and 30 mg/kg of lead, group 5 was administered 150mg/kg of alkaloids and 30 mg/kg of lead orally for 28 days. The testes of the rats were harvested on day 29 of the experiment and histological studies done using the H&E and Verhoeff-Van Gieson (VVG) stains. Sperm parameters, sex hormones and antioxidant of testicular homogenates were analysed.

Results: Histological examination of the testes revealed increased spermatogenic cells and Leydig cell proliferation in the rats in groups 3, 4, and 5 administered with 50 mg/kg, 100 mg/kg, and 150 mg/kg of Alkaloids, and 30 mg/kg of lead, respectively, when compared with group 2 administered with 30 mg/kg of lead alone. Also there was significant increase in levels of serum testosterone (p < .05) in groups 3, 4, and 5 when compared with group 2. There was increase in levels of follicle stimulating hormone in groups 4, and 5 when compared with group 2. However, significant decreased in luteinizing hormone was observed in groups 3, 4 and 5. Group 2, treated with 30 mg/kg of lead only showed increased malondialdehyde levels when compared with group 1 that received 1ml normal saline. Group 3, 4, and 5, treated with 50 mg/kg, 100 mg/kg, and 150 mg/kg of alkaloid plus 30 mg/kg lead, respectively, showed significant growth of seminiferous epithelium, improved sperm quality, and decreased levels of malondialdehyde (p < .05).

Conclusion: This study shows that alkaloids fraction of Cyperus esculentus may have a protective effect on the testis of Wistar rat when it is exposed to toxicity from lead.

Open Access Original Research Article

Leadership Skills and their Associated Factors among Pharmacy Students at Umm Al-Qura University, Makkah, Saudi Arabia

Rahaf Nabil Alaaddin, Nahla Khamis Ibrahim, Mai Kadi

Journal of Pharmaceutical Research International, Page 63-76
DOI: 10.9734/jpri/2021/v33i50A33383

Background: Leadership is a vital attribute for the predictive quality of care in healthcare organizations. Leadership has an effective role in improving clinical outcomes, pharmacy practice, and patient satisfaction. However, limited studies have been done on leadership among pharmacy students in Makkah. The current study was conducted to describe the leadership skills and their associated factors among pharmacy students at Umm Al-Qura University (UQU), Makkah.

Methods: An analytical cross-sectional study was done. A multi-stage stratified random sampling technique was used. Stratification considered the gender, educational program (Pharm-D or B-Pharm), and educational year. A standardized data collection sheet was used and asked about personal, sociodemographic data, the Authentic Leadership Questionnaire (ALQ), Schutte Self-Report Emotional Intelligence (SSREI) scale, Depression Anxiety and Stress Scale (DASS).

Descriptive statistics were done. Inferential statistics were done using the Student’s t-test and ANOVA for comparing between means. Pearson’s product-moment correlations were also calculated. Multilinear regression models were constructed to determine the leadership predictors.

Results: A total of 400 pharmacy students participated in the study. Pharmacy students had high overall leadership competencies; the mean overall score of ALQ was 57.98 ±7.47. The highest leadership category score was for the internalized moral skills (15.04 ±2.43). Multiple linear regression analyses revealed that the predictors of the overall authentic leadership skills were high EI score (B= 0.4; 95% CI: 0.37-0.44) and absence of depression (B= -1.48; 95% CI: - 2.51, - 0.46). Depression was also negatively associated with self-awareness, internalized moral domains. Marital status, physical activity and father education also associated with different leadership domains.

Conclusion: The predictors of the total authentic leadership skills were the overall EI domain score and absence of depression. Training on both leadership skills, and emotional intelligence is essential. Management of depression and encouraging physical activities are needed for better leadership skills. These efforts may result in the development of highly qualified health care personnel.

Open Access Original Research Article

Virtual Screening through Molecular Docking Analysis to Identify Potential Natural Inhibitor(s) of Lyn Tyrosine Kinase- An In-silico Approach

Sohini Kulavi, Soham Banerjee, Titav Sengupta, Chandreyi Ghosh, Moumita Saha, Sirshendu Chatterjee

Journal of Pharmaceutical Research International, Page 85-105
DOI: 10.9734/jpri/2021/v33i50A33385

Breast cancer on becoming one of the leading cancer types, emerged as an important barrier in increasing life expectancy of the overall population. In the current study, some compounds were screened based on literature survey for the identification of natural bioactive compounds as potential inhibitors of Lyn tyrosine kinase. Therefore, a multi-step molecular docking was carried out using AutoDock embedded in the MGL Tools. After initial screening, molecules having a higher docking score and binding free energy compared to Tamoxifen were considered for further assessment. Some already known synthetic lyn tyrosine kinase inhibitor have been used for better understanding of the comparative study. Based on in silico Lipinski filter analysis, toxicity prediction, pharmacokinetic analysis, four compounds were proposed to be promising inhibitors of Lyn tyrosine kinase. Furthermore, the binding interactions of all proposed inhibitors of Lyn showed strong ligand efficiency in terms of energy score obtained with the help of molecular modelling analyses. Hence, the proposed compounds out of which three are bioactive compounds might be taken forward as potential next-generation Lyn kinase inhibitors for managing Lyn associated breast cancer after experimental authentication.

Open Access Original Research Article

Application of Design of Experiment in Design, Development and Optimization of Stability Indicating RP-HPLC Method for Simultaneous Determination of Montelukast Sodium and Rupatadine Fumarate in Bulk and Formulation

A. S. Sutar, C. S. Magdum

Journal of Pharmaceutical Research International, Page 126-144
DOI: 10.9734/jpri/2021/v33i50A33388

Design of Experiment assisted stability indicating RP-HPLC wasdesigned, developed and optimized using response surface methodology for simultaneous determination of Montelukast sodium and Rupatadine fumarate. Separation was achieved using Acetonitrile: Phosphate buffer (75:25) v/v with pH adjusted to 4.0, flow rate of 1 ml/min with UV detection at 246 nm on RP-C18 column. Stress degradation studies were performed as per scientific guidelines. Method was validated in accordance with regulatory requirements. Results obtained in validation were found to be within specified limit. Montelukast was eluted at 3.99 min and Rupatadine was eluted at 13.25 min respectively. All stress degradation products are very well resolved from drug peak which indicate suitability indicating nature of the developed method. Design of Experiment technique can help in fast and economical optimization of mobile phase which in turn will save time for method development. The developed method is, accurate, sensitive which can be utilized as stability indicating method for identification of degradation products in routine analysis of the drug.

Open Access Original Research Article

Estimation of Microbial Contamination in Fresh and Commercial Fruit Juices: A Comparative Study

Vanessa James, Hiral Panchal

Journal of Pharmaceutical Research International, Page 145-153
DOI: 10.9734/jpri/2021/v33i50A33389

Aim and Objective: The objective of the present study is to determine microbial contamination in fresh and packaged commercial fruit juices (including a combination of Aloe vera with fruit juices) available in the Ahmedabad city of Gujarat, India.

Materials and Methods: Seventeen samples were collected from various parts of the city which includes 9 commercial fruit juice samples and 8 street vended fresh fruit juice samples. Samples were examined for Total plate count, Yeast and mould count, coliform count, Escherichia coli, Salmonella, Staphylococcus aureus, Shigella, Enterobacteriaceae, Listeria monocytogens and Vibrio Cholerae.

Results: Commercial fruit juices do not exceed the FSSAI standards for fruit juices and are free of harmful pathogens making themsafe for human consumption. Street vended fresh fruit juice samples exceedthe FSSAI limit for Total Plate count, Yeast and mould count and Coliform count. Street vended Fresh fruit juices demonstratethepresence of Ecoli, Salmonella and Staphylococcus aureus in 75% (6/8) samples. Enterobacteriaceae were identified in street vended fruit juices which exceeds the FSSAI standard limit.

Conclusion: The study demonstrates that commercial fruit juices were safe for human consumption but fresh juices showed significant microbial growth and harmful pathogens which must be controlled to ensure consumer’s safety and health. However regular monitoring of commercial and fresh fruit juices is recommended to avoid food borne illness resulting from pathogens encountered in the study.

Open Access Original Research Article

Clinical and Immunological Characteristics of Patients with Odontogenic Maxillary Sinusitis

Artem Viktorovich Eldzharov, Diana Arturovna Niazyan, Ruslan Kazbekovich Esiev, George Vladimirovich Toboev, Jamilya Khuseinovna Uzdenova, Zainab Magomednurovna Shabanova, Zainutdin Abakarovich Abakarov, Askerbiy Berslanovich Abrekov, Adam Saidalvievich Babatkhanov, Artem Evgenevich Mishvelov

Journal of Pharmaceutical Research International, Page 184-195
DOI: 10.9734/jpri/2021/v33i50A33394

Inflammatory diseases of the maxillary sinus of odontogenic aetiology have a high prevalence and hold leading positions in the structure of otorhinolaryngological and dental morbidity. High-intensity lesions in all age and social groups, the lack of over the last decade a downward trend in frequency, refractory to traditional drug therapy determine the high medical and social problem significance.To date, the main treatment standard is the surgical removal of the “causal” infection focus, but this stage is not always resolved by complete recovery, in consequence of which the disease acquires a cyclical character. Many authors point out the role of the immune system in chronization of the inflammatory process in the sinuses and the development of exacerbation frequent periods. Treatment of odontogenic sinusitis is more complex and prone to relapses. The main objectives of treatment are differential diagnosis of odontogenic sinusitis and its treatment.In this regard, determination of the immunological reactivity state and search for pathogenetically significant disorders in the effector protective link in patients with odontogenic sinusitis becomes especially relevant. The article presents a detailed analysis of the immune status of 60 patients with odontogenic maxillary sinusitis caused by acute periodontitis, radicular cyst, and filling material. Clearly demonstated the results of the paranasal sinuses x-ray examination and clinical examination of patients. In the course of the research were found significant changes of immunological indicators for several considered criteria. They indicate the presence of pronounced autoimmune shifts in the subjects, which play a key role in aggravating the disease severity and its outcome. This type of research is crucial for the development of improved drug therapy strategies for individuals with odontogenic sinusitis aimed at correcting immune disorders. The aim of the article is research of the immunological molecular changes that occur in odontogenic sinusitis, and to lay the foundation for studying the molecular mechanism of odontogenic sinusitis.

Open Access Original Research Article

Female Sexual Dysfunction in Patients Treated with Antidepressants: A Comparison between Agomelatine and Escitalopram

Virinder Kaur, Ng Chong Guan, Jesjeet Singh Gill, Low Sue-Yin

Journal of Pharmaceutical Research International, Page 196-204
DOI: 10.9734/jpri/2021/v33i50A33395

Aim: This study aims to determine and compare the prevalence of Female Sexual Dysfunction (FSD) between patients on escitalopram and agomelatine, as well as to investigate possible factors associated with their usage.

Study Design: Cross-sectional.

Place and Duration of Study: Psychiatric Day Care Clinic, Department of Psychological Medicine, University Malaya Medical Centre (UMMC), Malaysia, between November 1, 2020 until February 1, 2021.

Methodology: This study is a cross-sectional study involving 66 women with depression from the outpatient psychiatric clinic of a university hospital; 35 of whom were prescribed with escitalopram and 31 with agomelatine. The subjects were in remission and had no significant signs or symptoms of depression for at least 2 months. The prevalence of FSD between the two groups were compared after adjusting for underlying depression severity.

Results: This study showed that the overall prevalence rate of FSD was 33.3%, with the prevalence being higher for those on escitalopram (42.9%) than those on agomelatine (22.6%), but did not achieve statistical significance (P=0.081). Out of the six domains of FSD, multivariate analyses revealed that there was a significant reduction of 69% in sexual desire disorder (95% CI:0.110, 0.855), P=0.022 for those on agomelatine compared to escitalopram. Controlling for drug dosage and depression severity (as measured using Montgomery-Asberg Depression Rating Scale), the odds for patients on agomelatine developing sexual desire disorder was 0.267 (95% CI:0.091, 0.783), P=0.016.

Conclusion: There was no significant difference in FSD risk between patients on agomelatine and those on escitalopram. Patients on agomelatine were however less likely to develop sexual desire disorder, which demonstrates a slightly better sexual acceptability profile of agomelatine in women in this respect compared to escitalopram.

Open Access Original Research Article

Effectiveness of Structured Teaching Programme on the Knowledge of Mothers Regarding the use of Zinc Supplementation in the Management of Diarrhea among the under Five Children in Selected Rural Areas of Indore, MP

Rakhi Patel, C. C. Linson

Journal of Pharmaceutical Research International, Page 205-209
DOI: 10.9734/jpri/2021/v33i50A33396

The present study was semi exploratory survey type of study. The data was gathered using a pretest and post test approach. Subjects or mothers were selected using purposive sampling technique method. 40 samples were selected for the present study. The survey was done by the researcher to evaluate the information especially with respect to the advantages of zinc supplementation and to get organized information and to provide a structured teaching program regarding the benefits of zinc in the diarrheal disease. The mean pre test score of the study was around 11.95 which were increased to 20.33 in the posttest. This reveals the effectiveness of structured teaching programme. The difference between the pre test and post test was found to be very highly significant, which was evident by the paired t test value 13.60. The chi square was test also done to find out the significant association between the socio demographic characteristics and the knowledge score. There was no significant association between the demographic characteristics and the knowledge score when compared with age, number of kids, occupation, monthly family income, and religion. Significant association was found especially between the instructive status of mothers and the knowledge score 9.95. The findings of the present study concludes that the structured teaching programme with respect to the zinc supplementation in the pre test was very less which was improved drastically in the posttest. Structured teaching programme was found to be really very effective which is evident by the post test score. The findings of the data also reveals that the structured teaching programme is viable system of providing data and helps in the improvement in the knowledge of the mothers.

Open Access Original Research Article

Periodontal Disease in Pregnant Women and Impact on in Tabuk Region, Saudi Arabia

Reham M. Al-Hawiti, Sarah H. Al-Qahtani, Abdullah Bedaiwi, Asma A. Alharbi

Journal of Pharmaceutical Research International, Page 210-219
DOI: 10.9734/jpri/2021/v33i50A33397

Background: Periodontal disease is amongst the top ten most common diseases to affect humans and the leading cause of tooth loss for adults, so it’s important to be aware of the condition and how it can develop.Periodontitis is an inflammatory process initiated by bacterial plaque involving the supporting structures of the tooth which include the gingiva, the junctional epithelium, root cementum, periodontal ligament, and alveolar bone.

Methods: A cross-sectional study using a self-managed questionnaire conducted among 127 pregnant women in King Salman Armed Forces Hospital in Tabuk region, Saudi Arabia            (2020).

Results: the study found that 69.3% of cases had symptoms of periodontitis. Also, the study found that there were no significant correlations betweensymptoms of periodontitis and all variables like; age group, marital status, educational level, employment, number of children, brushing daily, and visiting dental clinic during pregnancy (p>0.05). As regards symptoms of periodontitisassociated with pregnancy, our study reported that 56.7% had Bleeding per gum, 44.9% had gum swelling and 40.9% had an offensive odor from the mouth.

Conclusion: The study concluded that the majority of pregnant women cases had periodontitis and there was no significant association found with different variables like age, educational level, marital status. Also, there was good practice and attitude toward pregnancy-associated periodontitis.

Open Access Original Research Article

Formulation and Quality Control Tests for Nanoemulsion of Tofacitinib: A Novel Approach

Suchitra Nishal, Vikas Jhawat, Parmita Phaugat, Rohit Dutt

Journal of Pharmaceutical Research International, Page 224-234
DOI: 10.9734/jpri/2021/v33i50A33399

Background: Tofacitinib (TFB) is a pioneer JAK (Janus kinase) inhibitor mainly employed to treat rheumatoid arthritis. It has proven efficacy for the treatment of rheumatoid arthritis in the oral dosage form. Oral TFB exhibited several toxic effects. Current research aims to develop a topical formulation of TFB to achieve effective treatment without any adverse effects.

Study Design: Ultrsonication Methods.

Place and Duration of Study: Sample: Swami Dayanand Postgraduate Institute of Pharmaceuticals Sciences, University of Health Sciences, Rohtak; 2020-2021.

Methods: Oleic acid, tween 80, and propylene glycol were selected as oil, surfactant, and co-surfactant, respectively. The ratio of oil:surfactant:co-surfactant was selected based on a ternary phase diagram using the aqueous titration method. The selected ratio was employed to develop eight formulations of TFB by ultra-sonication. The formulations (F1-F8) were characterized using several physicochemical methods like pH, viscosity, particle size distribution, zeta potential, drug content, and in vitro release.

Results: The formulations (F1-F8) were formulated by using the ultrasonication (high energy) method. The optimized formulation selected on the basis of characterization methods for instance, F8 possessed particle size 127.4 nm, and -18.4 (mV) zeta potential. The in vitro release of F8 was found to be 88.1 ± 2.5% at 24 hours. It also passed the thermodynamic stability tests.

Conclusion:  The current investigations conclude that tofacitinib-nanoemulsion (TFB-NE) can be used as an alternative to the oral route of TFB and is also useful in reducing the adverse effects associated with oral TFB.

Open Access Original Research Article

To Determine the Frequency of Thrombocytopenia in Pre Eclamptic Presented at Isra University Hospital

Hafiza Khatoon, Rukhsana Ahmed, Ambreen Naz, Nousheen Mushtaq, Asma Irfan, . Safia

Journal of Pharmaceutical Research International, Page 242-247
DOI: 10.9734/jpri/2021/v33i50A33402

Objective: To determine the frequency of thrombocytopenia in pre-eclamptic women presented at Isra University Hospital Hyderabad.

Patients and Methods: This cross sectional descriptive study of six months study was conducted at Isra university hospital from April 2019 to September 2019. All the patients between ≥18 - 45 years of age diagnosed preeclampsia were admitted and evaluated for thrombocytopenia.

Results: During six month study period, total of 177 patients with preeclampsia were evaluated for thrombocytopenia. The majority of patients were from urban areas 125/177 (70.6%). The mean ±SD for maternal and gestational age of the preeclamptic patient was 32.75±8.85 and 28.75±7.63 whereas the mean platelet count was 93200±10.74 respectively. The majority of the patients were 21-30 years of age (54.8%) and the finding was statistically significant with gestational age [p=0.002]. The thrombocytopenia was observed in 99/177 (55.9%) and is statistically with relation to maternal age, gestational age and parity while in context to gravida and duration of disease it is non significant.

Conclusion: A significantly high frequency of thrombocytopenia (55.9%) was recorded in the patients with preeclampsia and is statistically with relation to maternal and gestational age and parity.

Open Access Original Research Article

Effectiveness of Visual Intervention Tool in Improving LATCH Score in Mothers

S. Pramodita, Harish Sudarsanan, A. Asha, H Benazer, J. Kumutha

Journal of Pharmaceutical Research International, Page 248-254
DOI: 10.9734/jpri/2021/v33i50A33404

Background: World Health Organization (WHO) recommends exclusive breast feeding for at least 6 months and thereafter until the child is 2 years of age which has largely been achieved by Baby Friendly Hospital Initiative put forth by WHO. The vital role played by mother in breastfeeding delivers passive immunity and nutrients to the child and for it to be practiced in an effective way, counselling and education is neededfor postpartum mothers. For an objective evaluation of effectiveness of breastfeeding counselling with visual aids in our unit, LATCH scoring was used to assess breastfeeding quality.

Materials and Methods: Breastfeeding education was given to postpartum mothersin the form of video assisted teaching as intervention. Pre and post intervention LATCH score were done to assess the quality of breastfeeding. Score for Latching (L), Audible swallowing (A), Type of nipple (T), Mother comfort (C), Help needed (H) were scored as 0,1 or 2. The total maximum score was 10 and minimum was 0. Maternal and neonatal demographic data and LATCH scores were collected and analyzed.

Results: The difference between pre intervention and post intervention mean LATCH score was statistically significant.

Conclusion: The visual intervention helped the mothers to understand breastfeeding techniques and lactate effectively.

Open Access Original Research Article

Utility of Microvessel Density (MVD) by CD34 in Different Histological Grades of Oral Squamous Cell Carcinoma

Ayushi Singh, Miheer Jagtap, Samarth Shukla, Sunita Vagha

Journal of Pharmaceutical Research International, Page 266-273
DOI: 10.9734/jpri/2021/v33i50A33407

Oral squamous cell carcinoma is one of the leading causes of cancer related death and is preventable. Different grade at which a carcinoma presents determines the treatment modality and prognosis of the disease. Microvessel density measures formation of new vessels around tumor mass and is very important criteria for tumor metastasis and disease spread. Immunohistochemistry provide very definitive measures to determine the micro vessel density. Our study showed a positive correlation between Microvessel density and tumor size and dysplasia.

Open Access Original Research Article

Comparison of Dexamethasone and Ondansetrone Use in Prevention of Post-operative Nausea and Vomiting

Shakil Alam, Haris Rashid, Sagufta Khan, Mir Arsalan Ali, Obaidul Haseeb, Santosh Kumar Sidhwani

Journal of Pharmaceutical Research International, Page 279-286
DOI: 10.9734/jpri/2021/v33i50A33409

Background: PONV remained the common cause of patient’s discomfort after anaesthesia 30% in all post-surgical patients and 80% in high-risk patients. With other common and serious complications of surgeries vomiting and nausea remained unpleasant trigger for patients who underwent the surgeries that prolongs the hospital stay and also leads to recurrent admissions. Therefore in this study we want to compare the effectiveness of pre-operative single-dose dexamethasone versus ondansetron in reducing post-operative nausea and vomiting after laparoscopic surgeries.

Methods: Patients admitted for laparoscopic procedures at Ziauddin Hospital North site were recruited for this quasi-experimental study. All consecutive patients were assigned to one of the two groups (1 or 2) using computer generated simple randomised numbers and given either of the two treatments: single dose dexamethasone (5-8mg) or ondansetron (4mg). Researcher assessed post-operative nausea and vomiting at thirty minutes, two, four, eight, and twenty-four hours after the procedure. For statistical association the chi-square test and independent t-test were applied. Significant was defined as a P-value of less than 0.05.

Results: The mean age of patients was 42.9±16.6years with mean weight of 62.9±8.8 kilograms. All the operation performed as laparoscopic and common procedure was cholecystectomy (72/98: 73.5%), followed by appendectomy (17/98: 17.3%). Patients with ondansetron had more episodes of vomiting after 30 minutes of laparoscopic surgery. In addition, we discovered a correlation between the two groups' nausea episodes 30 minutes after surgery. After 30 minutes of laparoscopic surgery, patients who took ondansetron reported more nausea episodes.

Conclusion:  Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic surgery.

Open Access Original Research Article

Comparison of Efficacy and Antibody Levels among Healthcare Providers after Second Dose of Two Different COVID Vaccines

Iqra Ejaz, Adeena Rasheed, Mian Seher Munir, Fawzia Shahid, Areeba Zia, Shahnila Mukhtar

Journal of Pharmaceutical Research International, Page 292-298
DOI: 10.9734/jpri/2021/v33i50A33411

The ongoing COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant death and morbidity rates around the globe. SARS-CoV-2 infection has been linked to 43.3 million confirmed cases worldwide, killing 1.15 million people. Physical separation, quarantine, and isolation were successful in minimizing the number of individuals who became sick during the epidemic, but the lack of immunity in the community makes them vulnerable to further waves of SARS-CoV-2 infection. Elderly persons (those 60 and older) and those with pre-existing medical problems are particularly vulnerable.

Material and Methods: In this observation study, people who were vaccinated with sinopharm vaccine and sinovac vaccine were included to see the response of vaccine in the body. The aim of the study was to compare the rise in the antibody level after 2 doses of two different COVID-19 vaccines i.e sinopharm and sinovac. Initially, in this pilot study, 40 people were included randomly from our health care team, after proper informed consent regarding the study.

Results: Among total 40 people were involved, male were 21 of 40 (52.5%) and female were 19 of 40 (47.5%). Most of the individuals were doctors (26 of 40, 65%). Mean age, weight, height and body mass index (BMI) are also shown below.

Conclusion: This study was to report the response of people of Pakistan toward sinopharm and sinoVac vaccines in terms of COVID antibody level. Response of the body was around 40 to 50% for sinopharm and 50 to 70 percent towards CoronaVac vaccine. Further data collection is being done to improve sample size and better outcome.

Open Access Original Research Article

Antioxidant and Anti-Aging Activity of Green Mustard Ethanol Extract Gel

Silvia Handayani, Edy Fachrial, Adek Amansyah, I. Nyoman Encrich Lister

Journal of Pharmaceutical Research International, Page 304-311
DOI: 10.9734/jpri/2021/v33i50A33413

The skin is the organ of the body that is frequently exposed to direct UV rays from the sun, which causes the formation of ROS (reactive oxygen species), leading to cell death and tissue damage. This health problem can be overcome by using antioxidants to stabilize the free radicals. Mustard as an organic substance which contains polysaccharide compounds, vitamin C, carotene, quercetin, routine compounds, kaempferol and β-cytostreol, all of these are beneficial to skin health and beauty. Therefore, this study aims to determine the antioxidant activity of the total flavonoids and phenol content of mustard ethanol extract using the DPPH method. Furthermore, the extract at concentrations of 2, 4, and 6% was also tested for its anti-aging activity using the following parameters: moisture and oil content, texture, collagen, wrinkles, pigment, sensitivity, and pores. The results showed that the antioxidant activity of the green mustard had an IC50 value of 170.7839 µg/ml, a total phenol content of 14.471 mg GAE/g extract and flavonoid content of 12.753 mg QE/g extract. The effectiveness of the aging activity of the extract was tested using formulation 6%, which is better than 2%, and 4%. Thus, the percentage of water content recovery, oil content, texture, collagen, wrinkles, stains, sensitivity and pores respectively was 36.41, 39.33, 64.07, 17.65, 65.28, 50.14, 49.10 and 35.09%.  Consequently, it was concluded that the extract has the potential of being developed into a herbal beauty product.

Open Access Original Research Article

Effect of Amphiphilic Graft Co-Polymer Carrier on Solubility and Dissolution Enhancement of Ambrisentan

Rahul Radke, Neetesh K. Jain

Journal of Pharmaceutical Research International, Page 329-338
DOI: 10.9734/jpri/2021/v33i50A33417

Aim: Ambrisentan is a endothelin type A selective receptor antagonist used in the management of pulmonary arterial hypertension. Ambrisentan is BCS Class II drug haves very poor solubility in water and shows incomplete absorption after oral administration. The present work was aimed to study the effect of amphiphilic graft co-polymer carrier on enhancement of solubility and dissolution rate of poorly water soluble drug ambrisentan. To improve the aqueous solubility of ambrisentan solid dispersion was formulated by using novel carrier amphiphilic graft co-polymer (Soluplus® ).

Materials and Methods: Solid dispersion was prepared by kneading technique by utilizing various ratios of carrier. Obtained solid dispersions ware evaluated for solubility, percentage yield, drug content and in vitro dissolution study. Powder characterization was performed by infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and X-ray diffraction (XRD).

Results: FTIR spectroscopy shows no interaction between drug and polymer. DSC study showed that endothermic peak of drug was completely disappeared in Solid dispersion suggesting complete miscibility of drug in Soluplus®. XRD study suggest the conversion of crystalline ambrisentan in to amorphous form. All solid dispersions prepared with Soluplus® as a carrier showed increase in solubility. Solubility of ambrisentan was found to be increased 7.17 fold in optimized SD formulation ASD5. In vitro dissolution study showed the faster drug release from SD formulation compare to its pure form. All solid dispersion formulation’s release more than 50% of drug in first 10 min.

Conclusion: This study conclude that the preparation of amphiphilic graft co-polymer based solid dispersion prepared by kneading technique is found to be useful in enhancement the solubility and dissolution rate of ambrisentan.

Open Access Review Article

The Effects of Artificial Intelligence and Medical Technology on the Life of Human

Raja Sarath Kumar Boddu, Dhruva Sreenivasa Chakravarthi, Nallanti Venkateswararao, D. S. K. Chakravarthy, Agilandeswari Devarajan, Pankaj Ramakant Kunekar

Journal of Pharmaceutical Research International, Page 25-32
DOI: 10.9734/jpri/2021/v33i50A33378

The study explores because of the rising complexity and volume of data in medical technology, artificial intelligence (AI) will be used more frequently. Various forms of artificial intelligence (AI) have already been used by consumers and providers of care, as well as health sciences firms. Diagnose and therapy suggestions, patient involvement and compliance, and administrative tasks are the most common types of applications. Although there are numerous cases where AI can do medical technology activities as well as or superior than humans, operational issues will prohibit large-scale automation of medical technology professional positions for a long time. Moral considerations about the use of AI in medical technologies are also addressed. Healthcare is one of the most significant great achievements of modern time. Medical research and technology have advanced fast, increasing life expectancy across the worldwide. However, as life expectancy rises, healthcare systems face increased demands for their operations, rising expenses, and a staff that is failing to fulfill the requirements of its patients. Aging population, changing patients ’ expectations, a shift in lifestyle decisions, and the never-ending cycle of development are just a few of the inexorable forces driving need. The consequences of an ageing population stand out among these. Healthcare expenditure just isn't keeping pace. Medical technology will struggle to stay sustainable unless substantial structural and transformation changes are made. Healthcare also requires a larger staff, but while the world economy might produce 40 million new health-care jobs by 2030, the World Health Organization predicts a 9.9 million doctor, nurse, and midwife shortage over the same time frame. Without a question, contemporary technology has had a significant influence on every area of our lives.

Open Access Review Article

Overview of the Updated Evidence of Multiple Endocrinal Neoplasia (MEN) in Children and Adolescents

Laila Ahmed Albishi, Nazim Faisal Hamed, Naif Mutkhan Alsharari, Wurud Muteb D. Alshammari

Journal of Pharmaceutical Research International, Page 77-84
DOI: 10.9734/jpri/2021/v33i50A33384

MEN syndromes are a collection of autosomal dominant disease including MEN 1 and MEN 2. Multiple endocrine neoplasia (MEN) syndromes are infrequent inherited disorders in which more than one endocrine glands develop noncancerous (benign) or cancerous (malignant) tumors or grow excessively without forming tumors. There are 3 famous and well-known forms of MEN syndromes (MEN 1, MEN 2A, and MEN 2B) and a newly documented one (MEN4). These syndromes are infrequent and occurred in all ages and both men and women. MEN1 is the most often happening form of MENs. The information of MEN’s genetic alterations and the connection among genotype and phenotype could be beneficial for MEN disease management. (MEN1) implicated IN primarily by tumors of the parathyroid glands, endocrine gastroenteropancreatic (GEP) tract and anterior pituitary. Before MEN-1 can be diagnosed it must be suspected, genetic screening for MEN-1 is recommended when an individual has 2 or more MEN-1 related tumors, MEN2 associates with medullary thyroid carcinoma, pheochromocytoma, and primaryhype- rparathyroidism. MEN2A and MEN2B should be suspected in any patient diagnosed with MTC or pheochromocytoma, particularly when the age of presentation is very young (younger than 35), the genetic testing for RET proto-oncogene is employed to diagnose and identify a specific type of mutation present. Treatment is mainly surgical in most cases of multiple endocrine neoplasia syndrome.

Open Access Review Article

Medicolegal Issues in Teledentistry in India

Anumeha Morey, Vaibhavi Boradkar, Kumar Gaurav Chhabra, Amit Reche, Priyanka Paul Madhu, Avanti Date, Dimpal Rohankar

Journal of Pharmaceutical Research International, Page 106-112
DOI: 10.9734/jpri/2021/v33i50A33386

Long –distance linguistics involves the use of telecommunications technology to transfer data from one element to another element usage of telecommunications technology. Teledentia is a completely original subject that syndicates telecommunication technology and dental care. It offers innovative training besides care chances that bring a lot of prospective and confrontation. Teledenty also benefits accessible to medical education and preserving with medical education, screening, and communique with dental laboratory. In rural areas, in which there may be a scarcity of specialists, loss of complete and sophisticated telehealth centres can make it affordable and complex to extend care to rural patients. Complicated by the lack of dental consultant.

The subject of dentistry has visible massive enhancements in technology in current years. There had been many advances within side the use of computers, telecommunications technology, digital diagnostic imaging services, and evaluation and monitoring devices and software. Using cutting-edge information technology, dental science today has come further than ever before. New information technology have now no longer most effective progressed the high satisfactory of take care of dental patients, however additionally made it possible for them to provide partial or complete care hundreds of kilometres far-far from clinical facilities or dental clinic certified. The whole system of networking, digital information sharing, remote consultation, interviewing and evaluation is handled via way of means of division the technological of dental telemedicine acknowledged as "telentia".

Open Access Review Article

Molar Incisor Hypomineralization from Inception to Intervention–Evidence Based Review

Rana A. Alamoudi

Journal of Pharmaceutical Research International, Page 113-125
DOI: 10.9734/jpri/2021/v33i50A33387

Background: Molar Incisor Hypomineralization (MIH) is considered a highly prevalent clinical problem worldwide. The etiology of MIH involves a complex interaction between systemic and environmental insults with possible genetic contribution. Early diagnosis is facilitated by collaboration between clinicians responsible for oral health management of the patient and is the key for enhancing the long-term prognosis and quality of life of affected children. MIH management is a formidable oral health challenge due to the wide spectrum of clinical presentation with the need for tailored treatment for the child affected by MIH condition.

Objective: To provide dental practitioners with an updated and evidence-based overview of MIH etiology, diagnosis, and treatments modalities available for its management.

Conclusion: In this review, recent clinical evidence on MIH etiology, diagnosis and treatment is presented. Given recent availability of sophisticated technologies there is an increasing number of treatment modalities now at the fingertips of all oral health clinicians alike, ranging from preventive measures, management of hypersensitivity to advanced restorative techniques. The tailored treatment plan should encompass a short and long-term approach requiring more frequent dental check-ups in order to achieve better outcomes and prognosis. Future translational clinical research to best practice that will enhance our understanding of the exact causes of MIH and allow development of standardized diagnostic criteria as well as optimal treatment strategies are warranted.

Open Access Review Article

Modern Solutions in the Treatment of HIV: From Antiretroviral Drug Therapy to Human Genome Editing

Milana Ruslanovna Sebaeva, Iman Vladimirovna Gelogaeva, Naida Ramizovna Suleymanova, Kamila Umarovna Balaeva, Aishat Arslanovna Dauletova, Zuhra Magomedovna Zakoroeva, Saida Hanbertovna Kasheshova, Takis Albertovich Kozmov, Madina Muslimovna Minatulaeva, Alina Yuryevna Maslova

Journal of Pharmaceutical Research International, Page 159-169
DOI: 10.9734/jpri/2021/v33i50A33392

The human immunodeficiency virus (HIV) belongs to a group of anthroponotic viral diseases that cause HIV infection in the human body, apotheosely transforming into acquired immunodeficiency syndrome (AIDS). HIV infection, in people without adequate treatment, can lead to serious damage to the immune system (hereinafter referred to as IS), which leads to a sharp decrease in resistance to conditionally pathogenic microbes, as well as to the prevalence of oncological pathologies that may lead to death. Due to its simplicity, convenience, efficiency and cost-effectiveness, CRISPR/Cas has found application in a short period of time in a wide variety of fields of fundamental and applied medicine and biotechnology.

Open Access Review Article

Mechanism of Anticancer Activity of Compounds Isolated from Two Species of Ziziphus (Z. jujube and Z. mauritiana)

Sana Khurshid, Sana Javaid Awan, Ateeqa Naz, Safdar Hayat Khan, Saira Fiaz

Journal of Pharmaceutical Research International, Page 170-183
DOI: 10.9734/jpri/2021/v33i50A33393

Medicinal plants have been used to treat diseases for centuries. One group of such plants is Ziziphus species belonging to Rhamnaceae family. The extracts from plants of this genus has been found beneficial for the treatment of cancer caused by high production of reactive oxygen species resulting from different oxidative stress mediated conditions. The mechanism of anticancer activity of two different species of this plant (Z.jujube and Z.mauritiana) have been discussed in this review. The constituents of this plant include the flavonoids, triterpenes, potassium, calcium, phosphorus, iron, zinc, copper and polysaccharides such as reducing and non-reducing sugars. The underlying mechanisms of both species include the (Tumor protein P53) P53, (signal transducer and activator of transcription) STAT, (Matrix metalloproteinases) MMPs, (clustered regularly interspaced short palindromic repeats) CRISPR and flavonoids and triterpenic acid mechanisms. The effects of the extract on different cells lines in both in vitro and in vivo models have been studied by observing the induction of apoptosis and reduction in angiogenesis leading to reduction in progression and proliferation of cancer cell lines. The biological properties of Ziziphus include the anti-inflammatory, antioxidant, anticancer and hepato-protective characteristics.

Open Access Review Article

Review on Coexistence of Hypertension with Diabetes Mellitus

Nargis Saharan

Journal of Pharmaceutical Research International, Page 220-223
DOI: 10.9734/jpri/2021/v33i50A33398

The coexistence of both diabetes mellitus and hypertension affect the some major target organs. Their common target organ is heart and kidney. The primary goal in the management of the hypertensive diabetic patients is lowering blood pressure to less than 130/80mm Hg Beta- blockers have been reported to adversely affect the overall risk factor profile in the diabetic patient. Initially ACE inhibitors and ARB are initially can be given to diabetic hypertensive. Beta blockers also show great effects in preventing further cardiovascular diseases in diabetic hypertensive. Although combined drug therapy is usually required to achieve goal but in addition to drug therapy some other precautions should also plays effective role like exercise، low sodium chloride intake, lower lipids in diet, maintaining glucose level, stress less patients environment.

Calcium channels blockers and diuretics in combination with ACE inhibitors and antidiabetic drugs will also exerts beneficial effects.

Open Access Review Article

Management of Septic Arthritis in Emergency Department

Mohammed H. Abushal, Yazeed Ali S. Albalawi, Muflih Abdullah S. Albalawi, AlTurki Abdulrahman Mohammed, Amal Sulaiman A. Albalawi, Rola Ali S. Alotabi, Abdulrahim Oudah A. Albalawi, Sultan Suliman Q. Al-Ruwaili, Zahraa Abbas A. Kassarah Al-nakhli, Nada Saleem S. alhawiti, Abdalah Emad Almhmd, Naif Abdullah M. Alzahrani, Turki Abdullah A. Alzahrani, Hassan Ahmed A. Arishi, Musab Ismail Y. Ezzi

Journal of Pharmaceutical Research International, Page 235-241
DOI: 10.9734/jpri/2021/v33i50A33400

Bacterial arthritis is an inflammation of the joints caused by an infectious etiology, usually bacterial, but there are also fungi, mycobacteria, viruses, or other rare pathogens. Both healthy and predisposed people can be infected.

Nongonococcal infectious arthritis, usually a monoarticular disease,  affects multiple joints in about 10% of patients and  is a new form of septic arthritis. Without treatment, it can progress rapidly and cause irreversible damage to the joints. The overall incidence of bacterial arthritis  is  2 to 6  per 100,000, depending on the presence of risk factors. Bacterial arthritis is more common in children than in adults. The incidence of septic arthritis peaks between the ages of 2 and 3  and is predominantly male (2: 1). Most septic joints develop as a result of hematogenous dissemination of the vascular synovium due to bacterial episodes. Osteoarthritis, rheumatoid arthritis, and corticosteroid therapy are the most common predisposing conditions. Typical symptoms of acute  septic arthritis without gonorrhea include recent  fever, malaise, and local findings of pain, warmth, swelling, and restricted mobility of the affected joint. Accurate history and assessment of risk factors can provide important clues for diagnosis. Careful assessment of risk factors can significantly change the likelihood of a provider developing septic arthritis prior to testing. Laboratory findings, diagnostic imaging, and synovial fluid assessment are all useful for diagnosis. Management components include early detection and treatment with joint aspiration, antibiotics, and orthopedic advice for possible surgical management. Widespread antibiotics are often needed due to the potential for rapid joint destruction. A combination of cefepime or anti-Pseudomonas aeruginosa beta-lactams and vancomycin is recommended to cover both Gram-negative and MRSA bacteria.

Open Access Review Article

Review on Drug Utilization Assessment of Cephalosporin

Awais Ahmed Juno, Mirza Tasawer Baig, Aisha Jabeen, Shahzada Azam Khan, Saleem Ahmed khoso, Sultan Othman Alolayan

Journal of Pharmaceutical Research International, Page 260-265
DOI: 10.9734/jpri/2021/v33i50A33406

Pediatric is the field of medicine that is concerned with the health of infants, children and adolescents. Globally, many infectious diseases have been controlled in the 20th century by improving People’s standard of living through public health campaigns and the use of various antimicrobial agents. Evidence suggests that the manner in which Primary Healthcare centers prescribe drugs has contributed to the high rise in Anti-Microbial Resistance (AMR). The extent of the resistance is determined by the site of antibiotic application and in this study oral usage of antibiotics was found to be the highest contributor to Anti-Microbial Resistance.  A systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies was done using databases searched included MEDLINE, Educational Resources Information Center, PsycLIT (, Google Scholar, EMBASE, International Pharmaceutical Abstracts and the Current Index to Statistics. It was concluded that most of the articles reported that cephalosporin were widely used antibiotics and therefore its use must be rational; to avoid its abuse which may result to high level of resistance.

Open Access Review Article

Prevalence, Causes and Management of Encephalitis

Ibrahim Mahmoud H. Ajwah, Samirah Nawaf Naif Alrashidi, Nouf Zayed Omer Al mutairi, Ahmad Mazroa Almazroa, Abdulrahman Jaser F. Almutairi, Bushra Saad Alsakran, Mujeb Mosfer Mujeb Alzhrani, Maryam Jafar Alhashim, Sara Mohammed Alsakran, Wejdan Hani Alhakeem, Abdulaziz Fahad Salamh, Mubarak Ali M. Almanaah, Wa’ad Massoud Almonser Alqahtani

Journal of Pharmaceutical Research International, Page 312-318
DOI: 10.9734/jpri/2021/v33i50A33414

Encephalitis is a major cause of morbidity, mortality, and permanent neurological disability in both adults and children. The term "encephalitis" literally means inflammation of part or all of the "brain" or the brain parenchyma. Encephalitis affects people of all ages; however, the incidence is higher in the pediatric population. Although both genders are affected, most studies showed slight dominance in men. There are two main types with different causes: primary or infectious encephalitis can develop when a fungus, virus, or bacteria infects the brain and accounts for approximately 70% of confirmed cases of encephalitis, and secondary or post-infectious encephalitis when the immune system is active and reacts. to a previous infection and mistakenly attacks the brain. The clinical manifestations depend on whether the brain parenchyma or the meninges are predominantly involved and cause an encephalitic or meningitis syndrome. Diagnostic tests should include a lumbar puncture, an MRI of the brain, and an EEG for suspected  encephalitis. In encephalitis, a broad differential diagnosis, both infectious and non-infectious, should be considered. These alternatives include malignancy, autoimmune or paraneoplastic diseases (eg, anti-NMDA receptor encephalitis), brain abscess, drug-induced tuberculosis or delirium, neurosyphilis, or bacterial, fungal, protozoal, or helminthic encephalitis. Antiviral medications, such as intravenous acyclovir, are often given at the initial diagnosis of encephalitis before the cause is known. Acyclovir is the best treatment for herpes simplex encephalitis. If medication can be started soon after symptoms appear, the chance of a full recovery is much higher.