Open Access Case Report

Impact of Early Rehabilitation in a Complex Case of Non-union of Tibial Plafond Fracture with Osteosynthesis Associated Infection – A Case Report

Harsh Nathani, Medhavi V. Joshi, Pratik A. Phansopkar

Journal of Pharmaceutical Research International, Page 55-61
DOI: 10.9734/jpri/2021/v33i51B33511

Background: Fractures of distal end of tibia associated with soft tissue injuries and fracture of distal fibular end are very complex and forms a total of 1-2% of all fracture of lower limb. These fractures are widely termed as plafond fractures.

Case Presentation: A 26- year-old male, a follow up case, gave a history of road traffic accident following which he underwent corticotomy and application of external Ilizarovring fixator. At present due to non-union of the fracture segments patient got readmitted after a year. Further management through a three-step surgical approach was carried out. Rehabilitation program began from post-operative day 1 and was continued for a period of three weeks.

Investigations: On the day of examination, the patient’s pain was severe on movement with presence of disuse trophy of lower limb musculature of the affected extremity. Ranges on the right lower limb at all joints were reduced due to pain. The X-ray showed presence of 9-hole recon plate fixed distally over talus and proximally to tibia.

Management: Physiotherapeutic intervention began with educating the patient and the caregivers about the condition, the precautions to be taken, the expected time of healing and extent of healing. The exercise program was based on the principles of variability and individuality. The protocol was changed weekly with the observed progression in the patients range, muscles strength and ability to perform more challenging in bed activities.

Conclusion: Early rehabilitation in complex cases of tibial plafond fracture facilitates the process of healing as well as maintain the patients level of functioning by maintain muscle properties. Post-operative complications are also reduced.

Open Access Case Study

A Case Report of ChAdOx1 nCoV- 19 Corona Virus Recombinant Vaccine Related Granuloma Annulare

S. Swetha Shri, Jayakar Thomas

Journal of Pharmaceutical Research International, Page 202-207
DOI: 10.9734/jpri/2021/v33i51B33533

Background: Granuloma annulare (GA) is a benign, self-limiting inflammatory skin condition of unknown origin that may occur following multiple etiological triggers. GA incited secondary to vaccinations has been rarely reported in the medical literature. The COVID-19 pandemic has introduced extensive global immunization against the SARS-COV-2 virus, bringing a gamut of vaccine-related complications. We elucidate a case report of the spontaneous eventuality of GA following ChAdOx1 nCoV-19 Corona Virus Recombinant Vaccine.

Case Report: A healthy 26-year male presented with a one-week history of asymptomatic single, flesh-pink patch with a raised margin over his left ventral forearm. On close examination, the margin of the lesion had multiple annularly arranged papules. Biopsy of lesion was done, and histopathology revealed numerous palisading granulomas in the dermis consistent with findings of localized GA. The patient was managed with once-daily external application high potent topical corticosteroids, which was used intermittently by the patient. However, the lesion showed spontaneous resolution in one month.

Conclusion: Identifying ChAdOx1 nCoV- 19 Vaccine-related adverse events following its first dose is paramount, as evidence of the proportion of local or systemic severe cutaneous adverse skin reaction (SCAR) on subsequent dosing is a paucity. A more extensive systematic review corroborating SCARs and safety profile following immunization with ChAdOx1 nCoV-19 Vaccine prevails to be the need of the hour.

Open Access Case Study

Physiotherapy Rehabilitation in Post Operative Tibia- Fibula Fracture with External Fixators

Gunjan Ambalkar, Deepak Jain, Pratik Phansopkar

Journal of Pharmaceutical Research International, Page 283-288
DOI: 10.9734/jpri/2021/v33i51B33543

Introduction: A tibia - fibula fracture occurs when a fall or trauma to the lower extremities puts more tension on the bones than they can tolerate. Diaphyseal tibial fractures are the most common long bone fracture. Lower extremity Tibia and fibula fractures are examples of fractures. Tibial shaft fractures are most typically associated with a history of severe trauma. The tibia is the most commonly fractured bone in the lower extremity. The bone's shaft is in the middle Fibula fractures are usually, but not always, accompanied by tibial shaft fractures.

Case Presentation: At the previous 15 days, a 49-year-old male patient accounted in a hospital with a road traffic accident.

Discussion: The physiotherapy was given to this patient for muscle energy technique resulting in a high degree of range of motion in the lower extremity, reduce pain, and improves flexibility and strength.

Conclusion: Physiotherapy has a significant effect on pain, strength, and range of motion. The result of this case report specifies that it may be effective for pain relief, improvement in strength, and functional ability.

Open Access Case Study

Efficacy of Intra-Lesional Bleomycin Sclerotherapy for the Treatment of Hemangioma-Case Report

Chitturi Venkata Sai Akhil, Sarika Bhimrao Gaikwad, V. V. S. S. Sagar

Journal of Pharmaceutical Research International, Page 294-298
DOI: 10.9734/jpri/2021/v33i51B33545

Vascular anomalies are one of the challenging diseases to manage, presenting in different age groups and with varied clinical course, of which hemangiomas are common which are vasoproliferative neoplasms and can occur in any organ. Depending on the age at presentation they are classified as congenital and infantile hemangiomas. Not much attention has been paid regarding the imaging and treatment modalities of vascular malformations particularly hemangiomas due to scarcity of literature related to this condition. Majority of these vascular malformations are self-limiting, but in a few cases these lesions may grow with age which can be treated surgically or by sclerotherapy which has been the safe, less invasive, economical and easily available modality for treating hemangiomas. Bleomycin is the main sclerosing agent used which is a cytotoxic anti-tumor antibiotic which was later found to have anti-cancer properties. In our case, a 9 year old male child presented to our institution with a lump in the left side of abdomen since birth. Contrast enhanced CT abdomens was suggestive of  a vascular malformation. Patient was treated with sclerotherapy with intralesional bleomycin for which good results were noted by decrease in the size and vascularity of the swelling.

Open Access Case Study

A Rare Case of Synchronous us Carcinoma Breast with Chronic Myeloid Leukemia

Varun S. Kulkarni, Anurag Bhattacharjee, Harshal Ramteke, Abhishek Gupta, Shubham Durge, Meenakshi Yeola

Journal of Pharmaceutical Research International, Page 299-305
DOI: 10.9734/jpri/2021/v33i51B33546

Chronic myeloid leukemia is an insidiously progressive condition and comparatively rare type of blood cell malignancy that begins in the bone marrow. Chronic myeloid leukemia typically affects adult population and is documented to be caused by chromosomal mutation that usually occurs spontaneously.

Chronic myeloid leukemia is more common in males than in females (male: female ratio of 1.4:1) and appears more commonly in the elderly with a median age at diagnosis of 65 years [1] Exposure to ionising radiation is one of the risk factors, based on a 50 fold higher incidence of CML in Hiroshima and Nagasaki nuclear bombing survivors [1] The rate of CML in these individuals seems to reach at its peak about 10 years after the exposure [1].

Carcinoma breast on the other hand is one of the most common causes of death in middle aged women in western countries. There are numerous factors contributing as its etiological factors such as age, gender, diet, endocrinal factors, previous radiation exposure, genetic factors and geographical factors.

We present a case report of a 44 old female who came to Acharya Vinoba Bhave Rural Hospital (Datta Meghe Institute of Medical Sciences and Research), with presenting complaint of lump in the left breast since 2 days and abdominal mass for 1 month. On investigations, patient was diagnosed with a rare case of chronic myeloid leukemia on the complete blood count and peripheral smear and the lump in the left breast also revealed invasive ductal carcinoma of the left breast.

Open Access Study Protocol

Evaluation and Comparison of Functional and Aesthetic Outcomes of McGregor and Stepped Lower Lip-Split Incisions for Extirpation of Primary Tumor in Cases of Squamous Cell Carcinoma of Oral Cavity (SCCOC)

Chetan Gupta, Nitin Bhola, Anendd Jadhav, Akhil Sharma

Journal of Pharmaceutical Research International, Page 40-47
DOI: 10.9734/jpri/2021/v33i51B33509

Background: Clear surgical margins are of utmost importance in surgical oncological procedures. Secondary consideration includes the functional and aesthetic outcomes of the patients after the procedure. The recognised surgical approach to the posteriorly located oral cavity and oropharyngeal tumors involves the splitting of the lower lip with or without mandibulectomy. In order to perk up postoperative function and aesthetics, quite a lot of modifications of the unique midline lower lip-splitting incision have been projected by various authors till date. A stepped ladder lower lip split incision (LLSI) helps in improved functional and aesthetic outcomes.

Objectives: The prime accent of the study is to compare the McGregor LLSI and the stepped LLSI with respect to functional and aesthetic outcomes in tumors ablation for SCCOC.

Methodology: The study population (n=22) is assigned randomly in two equal groups as a subject in the ratio of 1:1. Systemically healthy histologically diagnosed patients of SCCOC requiring LLSI for the tumours ablation will be included. In Group A- McGregor LLSI will be performed and in Group B- a Stepped LLSI would performed. Post-operative assessment of functional and aesthetic outcomes will be done.

Expected Results: A stepped ladder LLSI used for tumours ablation will be effective in preserving post-operative lip movement, lip competency and cosmesis.

Conclusion: Utility of a Stepped ladder LLSI for accessibility and ablation of posterior oral and oropharyngealtumors would be undoubtfully beneficial for improving post-operative functional and aesthetic outcomes and could be executed in routine oncologic surgery.

Open Access Study Protocol

A Randomized Controlled Trial to Study the Effectiveness of Interactive, Virtual Tele-Physiotherapy for Improving Motor Function and Quality of Life in Stroke Patients: A Study Protocol

Vandana Gudhe, Moh´d Irshad Qureshi, Rakesh Krishna Kovela

Journal of Pharmaceutical Research International, Page 187-193
DOI: 10.9734/jpri/2021/v33i51B33530

Introduction: Telephysiotherapy (TPT) is provision of physiotherapy services using telecommunication technology such as audio call or video call to facilitate the physiotherapy management of patients within their own homes. In the absence of which the patients may have to discontinue physiotherapy treatment that may result into poor motor outcomes leading to deterioration of the quality of life (QoL).

Methodology: This is a study protocol designed to study the effectiveness of TPT intervention in Stroke patients. The objective is to study whether TPT is effective for Stroke Rehabilitation in improving motor function and quality of life. An exercise protocol will be administered to patients suffering from mild to moderate stroke those grading less than or equal to 4 on a Modified Rankin Scale (mRS=<4). A total 40 patients will be recruited in the study, divided into 2 groups –Group A and Group B, where Group A will receive the exercise therapy through Tele Physiotherapy & Group B will receive Out-Patient-Based (OPD-based) Physiotherapy. Participants of both the groups will be called to the OPD at the baseline and at the end of 6 weeks intervention. The patients shall be assessed at the baseline and at the end of intervention using Fugl-Meyer Assessment (FMA), Dynamic Gait Index (DGI), Functional Independence Measure (FIM) and Stroke Specific Quality Of Life scale (SS-QOL) to evaluate their motor function, gait, functional status and quality of life respectively.

Ethical Considerations: Approval from the Institutional Ethics committee of the institute is obtained. Participation in study will be voluntary and only the patients willing to give the written informed consent will be recruited for the study.

Results: The results of the study will be published and disseminated in peer-reviewed journals.

Open Access Study Protocol

To Assess the Effectiveness of Breathing Exercise on Labour Pain and Behavioral Response of Primi Gravida Mothers during First Stage of Labour, at Selected Maternity Hospitals

Shalini Moon, Manjusha Mahakarkar, Pradnya Sakle

Journal of Pharmaceutical Research International, Page 321-326
DOI: 10.9734/jpri/2021/v33i51B33549

Background of the Study: Labour is tough and headaches occur, however mother's our bodies are designed to supply birth. The shape of the pelvis, hormones, effective muscle mass and further all paintings collectively that may help mother to convey her child into the globe - before, within the course of and after childbirth.

Objectives: 1. To assess pain intensity level among the Primi gravida mothers during first stage of labour in experimental and control group.2. To assess the behavioral response of primi gravid mothers during 1st stage of labour in control and Experimental group. 3. To determine the effectiveness of breathing exercise on labour pain among primi gravida mothers during first stage of labour.4. To determine the effectiveness of breathing exercise on behavioral response among primi gravida mothers during first stage of labour. 5. To determine the association between selected demographic variables and pain of primi gravida mothers during first stage of labour.6. To determine the association between selected demographic variables and behavioral response of prim gravid mothers during first stage of labour.

Material and Methods: The design of this research study was based on a True Experimental research design with a pre-test and post-test control group. A total of 400 mothers were included in the study (200 in experimental group and 200 in control group). The samples were chosen using the probability simple random sampling technique. The data will be gathered using Baseline Proforma and an observational check list.

Expected Results: At selected Maternity hospitals, this study will assess the effects of respiratory exercise on Childbirth pain and behavioral responses of primi gravida moms during the early stage of childbirth. After intervention, the degree of discomfort in primi gravida women should be reduced, and their behavioral reaction should improve.

Conclusion:  Final conclusion is drawn from the ultimate results of the statistical review.

Open Access Short Communication

Rice Fortification and Distribution: A Need of the Hour in Andhra Pradesh, India

B. Kishore Babu, Govardhan Sai, Madhukar Reddy

Journal of Pharmaceutical Research International, Page 48-54
DOI: 10.9734/jpri/2021/v33i51B33510

Malnutrition among mothers and children in India is extremely high. Every second woman in the nation is anaemic, and every third child is diminutive, according to the Food Ministry. On the Global Hunger Index (GHI), India ranks 94th out of 107 countries, placing it in the ‘serious hunger' category.  In the Indian state of Andhra Pradesh, micronutrient deficits are frequent among mothers and children. According to the NFHS-5 survey, In Andhra Pradesh, 59 % percent of non-pregnant women in the age group of 15-49 years are anaemic.  63.2 percent of children in the age group of 6 to 59 months are anaemic. 53.7 percent of pregnant women under the age of 35 are anaemic. Food fortification is consideration to be one of the most valuable ways to put a stop to malnutrition. Food fortification is a low-cost method that has been shown to provide health, economic, and social benefits. Rice is the most effective vehicle for reaching the poorest people and one of only two staples that can contain a spectrum of minerals and vitamins when properly enriched. Rice fortification activities are most successful when collaborations are developed between the civic and private sectors, as well as other parties who can help with sponsorship, management, capacity building, implementation, and regulatory oversight.

Open Access Minireview Article

Sculpting in Dentistry – Requirements, Methods and Limitations in Aesthetic Dentistry: A Minireview

N. Hegde, V. Sadananda, M. N. Hegde, R. Mathew, . Priya

Journal of Pharmaceutical Research International, Page 62-66
DOI: 10.9734/jpri/2021/v33i51B33513

The skill of sculpting is an interesting and important part of restorative and esthetic dentistry. This review article will help achieve an understanding on what we know about this art, the hurdles we have faced, advances achieved, the limitations we still face and would help to gain knowledge and information on how to further advance in the art of manipulation and sculpting of dental restorations. This article aimed to review available literature on manipulation techniques, to summarize the importance of sculpting and to identify methods to face the current limitations of the art. 

Open Access Minireview Article

A Review on Non-target Toxicity of Deltamethrin and Piperonyl Butoxide: Synergist

Mrinmoy Basak, Rejwan Ahmed Choudhury, Priyanka Goswami, Biplab Kumar Dey, Moksood Ahmed Laskar

Journal of Pharmaceutical Research International, Page 85-89
DOI: 10.9734/jpri/2021/v33i51B33517

Deltamethrin and piperonyl butoxide two synthetic pyrethroids, when used in a combination it produces synergistic effect. This two insecticide has found to be widely used in the management of mosquito, housefly and other insects to control the various vector born diseases. In this review we assessed the toxic effect of deltamethrin and piperonyl butoxide on beneficial organisms commonly available in the ecosystem. It was found to be toxic to fish, honey bees the prime pollinators of crop plant; earthworm is also susceptible at a lethal concentration for a particular exposure. As far the birds are concerned, they have a less toxic risk in lower concentration of exposure. The alterations obtained in the hematological, biochemical and histopathological studies, further conclude that it can cause environment hazards and toxic to the non-targeted organisms. This investigation gives an insight into the combined toxicological profile of deltamethrin and PBO for better risk assessment and safe use of pyrethroids and their synergist in non-targeted organisms.

Open Access Original Research Article

Prevalence of Tension-Type Headache among Medical Students in Tabuk University, Saudi Arabia

Hyder Osman Mirghani, Rayyan Fahad H. Altemani, Yousef Hussain J. Alharthi, Mohammed Abdulhafith R. Alotaibi, Ahmed Marwan A. Alamrani, Abdulaziz A. Altawili, AlTurki Abdulrahman Mohammed, Maram Yehia M. Alzahrani, Manar Abubaker A. Bawadood, Asawir Mohammed Al Qurashi, Mohammed Aboubaker R. Alshafey, Amal Mohammad H. Albalawi, Nahaa Eid B. Alsubaie, Aisha Abdullah Alamari, Saud Abdulrahman Saad Alghamdi

Journal of Pharmaceutical Research International, Page 1-10
DOI: 10.9734/jpri/2021/v33i51B33504

Background: Headaches disorders have a significant burden on the world. Tension Type Headache is the most common type among primary headaches. Since medical students are exposed to a lot of stress, and it is associated with a tension-type headache, the importance of this study comes.  This study aims to measure the prevalence of tension-type headache among medical students at Tabuk University 2020.

Methodology: A cross-sectional study in Tabuk, Saudi Arabia was conducted. The study included medical students at the University of Tabuk in the academic years from 2nd to 6th grades during the calendar year of 2020. An adapted semi-structured self-administered questionnaire was retrieved from other validated questionnaires. The internal validity and reliability of the questionnaire were tested using Cronbach's alpha test and was highly reliable (25 items, α = .715). Both medical and research experts assessed the face and content validity. The data were coded, tabulated, and analyzed using the Statistical Package for the Social Sciences (SPSS, version 27).

Results: The total number of the students was 380 (response rate, 78.6%). 55.22% were females, and 44.78% were males their mean age was 21.18 ± SD 1.78 years. Out of the 297 students, only 122 met the diagnostic criteria. The 1-year prevalence Tension Type Headache (TTH) included the three types: frequent TTH 67.2%, 18.0% infrequent TTH, and only 14.8% suffered from chronic TTH. The most common aggravating factors included studying stressors (82%), 68% of the participants reported daily activity interference, and 48.4% reported that headache aggravate with routine physical activities (e.g., walking or climbing stairs). The headache quality varied between throbbing/pulsating (54.9%), pressing/tightening (68.9%) and sharp/stabbing (10.7%). The median headache intensity was 5.25 at pain level score (IQR =2). Only 28% of the students sought counseling where the main analgesic used was Acetaminophen (74%). Many non-pharmacological therapies were practiced by the students to relieve headache, including sleep (60.7%), rest (63.1%) and caffeine (41.8%).23% of the medical students reported that they sought medical counseling to maintain their performance level. There was a statistically significant difference between the average age of medical students suffering from frequent and infrequent TTH,  t(102) = 2.31, p = .023.

Conclusion: Tension-type headache is a prevalent type of headache among Saudi medical students. Prevalence and aggravating factors in our study were comparable to previously reported literature. Future studies with large sample size may be required among all university students to define burden of the case in Saudi Arabia.

Open Access Original Research Article

Development of a Tool for Assessing Patient Compliance on Various Ayurvedic Formulations used for Internal Administration

A. Sumi, M. Abhilash, K. B. Sudhikumar

Journal of Pharmaceutical Research International, Page 11-22
DOI: 10.9734/jpri/2021/v33i51B33505

Introduction: Compliance is a process where the patient follows the prescribed and dispensed regimen as intended by the prescriber. Poor compliance has been reported as it is the most common cause of non-response to medication. There is no single best indicator to assess      patient compliance in Health Research. This study aims to develop and validate a new questionnaire considering the pharmaceutical properties of Ayurvedic medicines to measure patient compliance.

Methods: The first phase consisted of a qualitative phase to identify the variables to measure patient compliance through in-depth interviews among five doctors and focus group discussion with eight practitioners, and pre-test with respondents, experts, and peers. The second phase was a quantitative phase to assess the respective responses of patients towards the questionnaire through a cross-sectional survey among 106 subjects as a pilot study.

Results: The qualitative analysis reported variables that were seen spread across eight domains were used to measure compliance.

Conclusion: Ayurvedic treatment is personalized and there is always a scope for a remake of formulation designing for each individual. Sticking on to appropriate prescriptions after properly assessing the needs of the patient and the reason for their non-compliance can bring a revolution in terms of cost-effectiveness and time. The wastage of medicines, whether raw drugs or processed ones can be prevented by recognizing the factors for non-compliance. There is always a scope for improvement with further alike or more developed research in patient compliance in Ayurveda.

Open Access Original Research Article

Association of Dental Caries with Body Mass Index in Patients Attending Dental OPD of Tertiary Care Hospital, Pakistan: A Cross-Sectional Study

Mahwish Memon, Azizullah Muhammad Nawaz Qureshi, Aosaf Anwar Memon, Sheba Ramzan, Abdul Ghani Shaikh, Salman Shams

Journal of Pharmaceutical Research International, Page 23-28
DOI: 10.9734/jpri/2021/v33i51B33506

Background: Dental caries area public health problem. Its prevalence is about 60%  in the Pakistani population.

Purpose: The purpose of this study was to correlate the association between decayed, missing, and filled teeth (DMFT) score and its body mass index in patients visiting the Dental Department of Liaquat University of Medical and Health Sciences, Jamshoro.

Materials and Methods: This cross-sectional study was conducted from January 2021 to May 2021 at the Department of Operative Dentistry Liaquat University of Medical and Health Sciences. Patients with age 16 to 70 years with presence of atleast 15 to 18 permanent teeth were included in te study. Patients having primary teeth were set in exclusion criteria. For Dental caries status, decayed, missing, and filled teeth (DMFT) index was used. Height and weight were measured using digital scales. BMI was calculated according to the formula weight in kilograms/height in centimeters. Data were analyzed for descriptive statistics. One Way ANOVA test was used for association. The statistical significance level was evaluated at p<0.05

Results: We were able to obtain the data of a total of 203 patients of which 57% were female.The mean age was 36.7±13.8. ). The mean DMTF score was 5.7±3.7. In association of BMI with DMTF score, females BMI was statistically significant with DMTF score with p=0.039 and in overall was also significant p =0.002

Conclusion: DMFT score was higher in overweight and obese individuals and it was significant statistically. However, large community based studies are required to confirm the association.

Open Access Original Research Article

Study of Lesions in Bronchial Brush and Wash Cytology

S. Kavya, V. M. Shobini Vishali, M. Sridevi

Journal of Pharmaceutical Research International, Page 29-34
DOI: 10.9734/jpri/2021/v33i51B33507

Aims: The aim of the study is to compare and evaluate the efficacy of bronchial brush and wash cytology in diagnosing neoplastic and non- neoplastic bronchopulmonary lesions and to relate the cytological findings with the clinical diagnoses.

Study Design: Retrospective descriptive study.

Place and Duration of Study: Saveetha Medical College and Hospital, between January 2019 and December 2019.

Methodology: Cases with both Bronchoalveolar lavage (BAL) and Bronchial brush (BB) samples (35) were included in the study. The slides were stained with Hematoxylin & Eosin stain, Papanicolaou stain, and were studied under the light microscope. The clinical points of interest were obtained from the case records at the medical records division, and histopathological findings from the histopathology registers at the Department of Pathology.

Results: A total of 35 cases were studied. Follow up with histopathology after a cytological diagnosis revealed that the sensitivity of diagnosing malignancy from BAL specimen and bronchial brush sample was 58% and 92% respectively.

Conclusion: The study confirms that the efficacy in assessing the risk of malignancy by  respiratory cytology using a bronchial brush specimen is higher than the bronchoalveolar lavage specimen.

Open Access Original Research Article

Ondansetron for Prevention of Post-Operative Nausea and Vomiting (PONV) in General Surgery Patients

Muhammad Naeem, Rafia Tabassum, Muhammad Saleh Khaskheli, Aijaz Hussain Awan, Munazzah Meraj, Rao Irfan

Journal of Pharmaceutical Research International, Page 35-39
DOI: 10.9734/jpri/2021/v33i51B33508

Aim: To determine the efficacy of single dose ondansetron in preventing PONV in patients.

Methodology: In this cross sectional study 49 patients were given Ondansetron.  Every patient was evaluated for PONV at 1, 2, 3, 6, 12 and 24 hours post operatively. This study was conducted at General surgery operation theatres and surgical wards I, II, III and Department of Anesthesia and SICU Peoples University of Medical & Health Sciences for women Nawabshah, District Shaheed Benazirabad, Sindh.

Results: A sample of 49 patients with age between 20-60 years (mean age 43.72±5.67 years), 35% male and 65% female was included in this study. In this study ondansetron was given (N=49) 4 mg I/V before induction. Regarding complications there was not significant (p ≤0.05) POVN was observed.

Conclusion: Our study results showed in patients who received ondansetron regarding frequency of post operative complications (PONV) showed insignificant results as no p-value is found to be ≤0.05.It was concluded that a single dose of ondansetron is very effective in preventing PONV in general surgery patients.

Open Access Original Research Article

Radiographic Assessment of Impacted Mandibular Third Molar- An Ex-vivo study

Ujwala B. Kale, Anita D. Munde, Sunil S. Mishra, J. Farooqui Anjum Ara, Pooja B. Nayak, Anwesha S. Samanta

Journal of Pharmaceutical Research International, Page 67-77
DOI: 10.9734/jpri/2021/v33i51B33514

Background: Mandibular third molars are the most commonly impacted teeth and frequently associated with various pathologies including infection, traumatic, inflammatory and cystic lesions necessitating their surgical removal. To avoid complications, clinical and radiographic evaluation of impacted teeth is essential to provide information about tooth anatomy, position and condition of the surrounding bone.

Aim: To evaluate impacted mandibular third molars (IMTM) with the help of panoramic radiographs for the type of impaction, available third molar space, level of eruption, and relation to the inferior alveolar nerve (IAN).

Materials and Methods: Total 600 patients were selected and were divided into three groups; group I (18-27 years), group II (28-37 years), and group III (>38 years). Digital OPG were traced and evaluated for angulations, third molar space, level of eruption, and relation of third molar roots to IAN canal. The observations were subjected to statistical analysis using Chi-square test. Results: Out of 600 samples, 306 (51%) were males and 294 (49%) were females. Out of 1079 third molar sites, mesioangular impaction (40.22%) was the most common. Class II relation (84.24%) for third molar space and level A of eruption (45.69%) were most frequent. In true relation, interruption of the white line of the IAN canal (20.85%) was the most frequent relation of the IMTM roots to the IAN canal and others (false/no relation) was the most common in all relations.

Conclusion: Panoramic radiography is a relatively safe, reliable, inexpensive, and readily accessible technique for preoperative evaluation of IMTM and their relation to IAN canal.

Open Access Original Research Article

Measuring Prescription Pattern of Nutraceuticals with Special Focus on Protein Supplements in Tier-1 Indian City

Meenal Kulkarni, Prerana Dongre, Riya Tadas, Neha Ahire

Journal of Pharmaceutical Research International, Page 78-84
DOI: 10.9734/jpri/2021/v33i51B33515

Nutraceuticals are playing vital role in today’s time given the recent changes in lifestyle, dietary patterns, and increased stress due to work related pressure. They can be organized in several ways depending upon its ease of understanding and application, i.e. for academic instruction, clinical trial design, functional food development or dietary recommendations. A study was carried out for a period of two months to assess the awareness and prescription pattern of nutraceuticals with reference to protein supplements and to evaluate factors that will drive the future demand. Responses were obtained from Doctors and chemists from a single metro city in India. The analysis was performed using descriptive statistics and frequency distribution valid percentage was calculated. Chi-Square test was performed to measure the association between the demographic factors to preferences for protein supplements. p- Value was calculated and α- value of 0.05 or less was considered significant. The results show that the maximum protein supplement was prescribed in the age group of 20-40 years. Doctors usually prescribe protein (44%) for convalescent followed by pre and post-operative cases (40%). Haematinics are the drugs, which are co-prescribed 30% of the times with protein. Responses from Chemists showed that self-prescription was prevalent amongst their buyer and many factors were identified which leads to self-prescription, amongst which buyer’s own previous experience was found to be significant (p-value-0.03). The study has helped to reveal the prescription pattern and practise of the doctors and of the factors leading to self-prescription.

Open Access Original Research Article

A Study of Anxiety on Experimental Epileptic Rat Models using Dark Light Box

A. Mary Antony Praba, C. Venkatramanaiah, S. Jayakumari, Ganesan Murugaperumal

Journal of Pharmaceutical Research International, Page 90-96
DOI: 10.9734/jpri/2021/v33i51B33519

The word neurodegeneration refers to defects in neuronal structure and consequently its function. The main characteristics of these disorders are relentless progression and cognitive declination. Epilepsy is one of the neurodegenerative disorders, around 50 million people in the world are affected with. Though it is one of the major health problems in the present society, there are several gaps in understanding the consequences related to neurological disorders. As research works related to neurodegeneration is very much limited in India we have planned one as an initiative.

We segregated 8 animal groups, each with 6 animals for this work. The animal groups are LC, CO, AC15, AC25, AC35, BA10, BA15 and BA20. This study was conducted on 10th day after the lesion by considering the day of lesion as day ‘1’ and the next day as day 2nd. All the animals were recovered completely within these 10 days and were put in the dark light box to analyse the anxiety level of the animals, so as to analyse the effect of the drug employed. This particular study clearly supported the efficacy of the drug as the drug group animals were less anxious or even behaved normal. Both the crude extract and the selected active principle have proved their efficacy by the study.

Open Access Original Research Article

Synthesis of Some Quinoxaline Sulfonamides as a Potential Antibacterial Agent

Festus O. Taiwo, Craig A. Obafemi, David A. Akinpelu

Journal of Pharmaceutical Research International, Page 116-132
DOI: 10.9734/jpri/2021/v33i51B33521

Aims: This studies aims at the synthesis of new heterocyclic systems and study its biological and pharmacological properties.

Objective: This study was designed to synthesized some quinoxaline-2,3-dione with sulfonamide moiety, characterize the synthesized compounds, and study the antimicrobial properties of the synthesized compounds on some bacterial strains.

Materials and Methods: Six quinoxaline-6-sulfonohydrazone derivatives were synthesized by reacting quinoxaline-6-sulfonohydrazine with some substituted benzaldehydes and ketones. The compounds were tested for their potential antibacterial properties.

Results: All the test compounds possessed promising antibacterial property against a panel of bacterial strains used for this study. The MIC values exhibited by these compounds ranged between 0.0313 and 0.250 mg/mL. Among the compounds tested, compound 2 showed appreciable antibacterial activity.

Discussion and Conclusion: The study concluded that all the compounds exhibited appreciable bactericidal effects towards all the bacterial strains, particularly, compound 2 This is an indication that such compounds possessing broad spectrum activities will be useful in formulating antimicrobial compounds which could be used to treat infections caused by pathogens that are now developing resistance against the available antibiotics.

Open Access Original Research Article

Clinico-Radiological Profile of Abdominal Pain in Children Admitted in a Tertiary Care Centre-A Retrospective Cohort Study

Jai Durairaj Paramasivam, Thangella Manasa, Melpakkam Venkatesan Srinath, Hari Prasaadh

Journal of Pharmaceutical Research International, Page 133-138
DOI: 10.9734/jpri/2021/v33i51B33522

Background and Aim: Mesenteric lymphadenitis in pediatric population usually presents with abdominal pain mimicking appendicitis mounting a challenging task for physicians to diagnose. It is a self-limiting inflammatory process and resolves spontaneously. In addition to clinical features, ultrasonography is the primary diagnostic modality. We aimed to evaluate the clinico-radiological characteristics of mesenteric adenitis in patients presenting with abdominal pain.
Materials and Methods: A total of 108 patients attending paediatric out-patient and paediatric surgery clinic in Saveetha Medical College and Hospital, Chennai, between January 2018 and December 2020 with abdominal pain for several aetiologies were included in this study. The clinical presentation, laboratory parameters and the ultrasonographic findings were noted. Data summarized as numbers, percentages and Mean ± Standard Deviation (SD).

Results: Peak prevalence was found to be at around 8 [range 6-10] years. Clinically, 58.3% had fever, 40.7% had dysuria and 36.1% had diarrhoea. Laboratory parameters were non-specific for this condition. Majority of the enlarged lymph nodes were found in the right lower quadrant (81.5%) followed by (10.2%) in the para-umbilical region and (8.3%) in left lower quadrant.

Conclusions: Mesenteric lymphadenitis as an individual clinical entity is a very challenging task for the paediatricians to evaluate and diagnose due to several possible variations in the clinical presentation. Although mesenteric lymphadenitis is usually a self limiting entity, a cohort of children warrant medical interventions.

Open Access Original Research Article

An Efficient Synthesis of 4-Aminomethyl-1-(2-Phenylethyl)-Piperidin-4-ol: A Key Intermediate in Fenspiride HCl Synthesis

Prasad Panchabhai, Neelakandan Kaliaperumal, Gopalakrishnan Mannathusamy, Anbuselvan Chinnadurai

Journal of Pharmaceutical Research International, Page 139-146
DOI: 10.9734/jpri/2021/v33i51B33523

The article confers a scalable manufacturing process of Fenspiride HCl. 4-aminomethyl-1-(2-phenylethyl)-piperidin-4-ol is the main building block in Fenspiride HCl synthesis. The reported reagents for 4-aminomethyl-1-(2-phenylethyl)-piperidin-4-ol synthesis are costly, explosive, highly toxic, produce hazardous waste, and also need to be handled with most care. The paper introduces aqueous ammonia as an alternate reagent in Fenspiride HCl and used in 4-aminomethyl-1-(2-phenylethyl)-piperidin-4-ol synthesis. The new green chemistry aspect makes the process environment-friendly and cheaper. It also eliminates toxic, sensitive, and hazardous reagents and makes the process safe on uncomplicated on bulk scale production.

The high pure Fenspiride HCl is obtained by following this process and meets the ICH limits with good yield.

Open Access Original Research Article

Assisted Vaginal Delivery - Preference of Vacuum or Forceps among Obstetricians

Vijayalakshmi Gnanasekaran, Shantha Kanamma, Shanthi Dhinakaran, Jikki Kalaiselvi

Journal of Pharmaceutical Research International, Page 147-155
DOI: 10.9734/jpri/2021/v33i51B33524

Objective: To determine the instrument preference among obstetricians practicing operative vaginal deliveries and to determine the prevalence and risks of vacuum or forceps Assisted Vaginal Delivery (AVD).

Methods: This cross-sectional study was carried out in ACS Medical and Hospital, Chennai. A total of 520 obstetricians were included in the study. An online questionnaire was sent to all obstetricians in Chennai. The choice of procedure for specific circumstances, instrument preference [use of vacuum or forceps] and views on the complications encountered in both vacuum and forceps use at vaginal delivery were explored. For the replies, we computed means and percentages for the entire group and distinct subgroups. Risk assessment of outcome with exposure as suitable p-value was included in the statistical analysis.

Results: Response rate for the questionnaire was 97% (504/520). The findings suggest that obstetricians preference was more towards vacuum due to their ease of usage.   Baseline characteristics were similar between the two groups. Failed vacuum due to slipping of the cup was the most common complication faced - 62%, followed by caput succedaneum 25%, both were statistically significant. The most significant finding was that maternal injuries in the vacuum group were only 2% which was way less than those who had forceps delivery (68%) with a p-value of < 0.001.

Conclusion: In this research, physician instrument choice is a significant predictor of results that should be taken into account. Use of vacuum for delivery seemed to be the choice of majority of obstetricians [334 (66%)]. Vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity, whereas neonatal injuries were more common in newborns delivered by vacuum. The choice of instrument should be personalized based on the patient's condition and the obstetrician's experience and expertise.

Open Access Original Research Article

Comparative Evaluation of Effectiveness of Denture Adhesive after Incorporating Antifungal Agent – An In-vitro Study

Jay Mamtora, Tripty Rahangdale, Prabha Shakya Newaskar, Nikita Agrawal, Saurabh Shrivastava, Karvika Nayak

Journal of Pharmaceutical Research International, Page 156-163
DOI: 10.9734/jpri/2021/v33i51B33525

Aims: The aim of current study is to evaluate adhesive force and qualitative mycological culture analysis of Denture adhesive (DA) after incorporating antifungal agent in various concentrations.

Study Design: Experimental study.

Place and Duration of Study: The current study was conducted at the Department of   Prosthodontics, Mansarovar Dental College and Hospital, Bhopal (M. P.) from September 2017 to October 2018.

Methodology: A total of 80 specimens were prepared with heat cured acrylic resin, out of which 40 were used for qualitative anti-microbiological test, and 40 were used for Adhesive force measurement test. Both test had four groups: Group A (Control group DA without MN); Group B (DA+MN 10%); Group C (DA+MN 20%); and Group D (DA+MN 30%).

Results: The mean zone of inhibition was 8.85 ± 0.28 mm for 10% w/w Miconazole Nitrate (MN), 12.95±0.30 mm for 20% w/w MN, and 22.25 ± 0.38 mm for 30% w/w MN. There was a statistically highly significant (P< .001) difference between the groups, with an F value of 1077.8.

Conclusion: Within the limitation of the study qualitative anti-microbial property for favorable laboratory performance can be achieved only after the addition of 20% w/w Miconazole Nitrate to denture adhesive paste.

Open Access Original Research Article

Effect of Nigella sativa on Testosterone Level in Albino Rats Treated with Doxorubicin

Ashok Kumar, Sadia Sundus, Ata-Ur-Rehman ., Sarwat Fatmee, Muhammad Imran, Safia Naz

Journal of Pharmaceutical Research International, Page 164-169
DOI: 10.9734/jpri/2021/v33i51B33526

Objective: To measure the influence of Nigella sativa on testosterone level of albino rats treated with doxorubicin

Study Design: Investigational study.

Place of Study: Animal House, JPMC, Karachi,

Materials and Methods: This study was accompanied on 3-4 months old, 40 albino rats, in the animal house of BMSI, Anatomy department, Karachi for 5 weeks were taken for this study and distributed into 4 groups, A1, A2, A3 &A4. A1 served as control, A2 receive Doxorubicin 3 mg/kg /week intraperitonealy, A3 receive extract of Nigella sativa 1000mg/kg daily orally along with Doxorubicin 3 mg / kg /week intraperitonealy and A4 receive extract of Nigella sativa 1000mg/kg daily orally. At completion of study, animals were sacrifice and tissues were preserved for staining.

Time of Study: The time of study was 35 days.

Results: In A2 serum Testosterone was markedly decreased, i.e 3.093+0.091 ng/ml as compared to A1 though serum levels were extremely substantial raise in A3 when compared with A2. This shows amended role of Nigella sativa on Doxorubicin induced kidney.

Conclusion: This study reveals that Nigella sativa amended the serum levels of testosterone of doxorubicin induced kidney.

Open Access Original Research Article

Clinicopathological Study of Uterine Leiomyomas – A Retrospective Study

Mahati Sundar, Chitra Srinivasan

Journal of Pharmaceutical Research International, Page 170-176
DOI: 10.9734/jpri/2021/v33i51B33527

Leiomyomas are benign tumors of the uterus affecting women of the reproductive age group. They are the most common gynaecologic neoplasms in women. The aim of our study was to analyse and correlate the histopathological findings of leiomyomas in 203 hysterectomy specimens received in the department of Pathology at Saveetha Medical College and to further delineate the associated changes and variants that were observed in the leiomyoma specimens. In this study we found that the dominant age group was 31-50 years of age with multiple leiomyomas being more common than solitary ones. The most commonly observed location was intramural. Majority of the hysterectomy specimens showed a proliferative pattern of endometrium. Degenerative changes were observed in 26 cases with hyaline degeneration being the most common secondary change. There were multiple uterine pathologies associated with the uterine leiomyomas of which ovarian cortical cysts were the most frequently noted. The histopathological study of leiomyomas is important as it helps to further ascertain the diagnosis and ensure optimal patient management.

Open Access Original Research Article

Virtual Screening of FDA Approved Drugs Library to Identify a Potential Inhibitor against NS2B-NS3 Protease of Yellow Fever Virus

Hasanain Abdulhameed Odhar, Salam Waheed Ahjel, Ali A. Mohammed Ali Albeer, Ahmed Fadhil Hashim, Suhad Sami Humadi

Journal of Pharmaceutical Research International, Page 177-186
DOI: 10.9734/jpri/2021/v33i51B33528

Yellow fever is a neglected hemorrhagic disease with a high case fatality rate ranging between 25% and 50% for the hospitalized patients. Yellow fever disease is caused by a zoonotic pathogen known as yellow fever virus. This RNA virus is usually transmitted by mosquitos and it is considered endemic in the tropical regions of South America and Africa. Although an effective vaccine is available for yellow fever virus, no antiviral drug is yet licensed against the disease. Thus, yellow fever virus is still representing a re-emerging threat among unvaccinated individuals in endemic regions. The NS2B-NS3 protease seems to play an important role in yellow fever virus replication cycle. As such, the NS2B-NS3 protease may represent a potential target for structure-based drug design and discovery. In this direction, computational approaches like virtual screening can be utilized to hasten the design of novel antivirals and/ or repurposing an already FDA approved drugs. In this in silico study, an FDA approved drugs library was screened against NS2B-NS3 protease crystal of yellow fever virus. Then the best hits with least energy of binding and ability of hydrogen bonding with key residues of protease active site were then selected and submitted to molecular dynamics simulation. And throughout simulation interval, only Olsalazine was able to stay in close proximity to the active site of protease crystal with least average MM-PBSA binding energy as compared to Dantrolene, Belinostat and Linezolid. This indicates that Olsalazine may have the best capacity to bind to NS2B-NS3 protease and interfere with its activity.

Open Access Original Research Article

Bromhexine Use in the Outpatient Department in a Public Hospital in Al-Kharj

Nehad J. Ahmed, Menshawy A. Menshawy

Journal of Pharmaceutical Research International, Page 208-211
DOI: 10.9734/jpri/2021/v33i51B33534

Aim: This study was conducted to demonstrate the prescribing pattern of bromhexine in a public hospital in Alkharj.

Methodology: This is a retrospective study that included evaluating outpatient antibiotic prescriptions from 1st of January/2018 to 30th of June/2018 in a public hospital Al-kharj. The collected data were the personal data of the patients, the prescribing’ departments, the duration of bromhexine use, and the level of the prescribers.

Results: Most of the patients were in the age group of 20-29 (32.35%) followed by 10-19 (20.59%). About 73.53% of the prescriptions were written by the emergency department, followed by the chest department (20.59%). All of the prescriptions were written by residents. Most of the patients used bromhexine for 5 days (76.47%) followed by 1 week (20.59%).

Conclusion: The present study showed that bromhexine use in the outpatient setting was uncommon. More studies are needed to explore the frequency of prescribing other mucolytic agents.

Open Access Original Research Article

Tramadol Induced Ovarian and Uterine Changes in Albino Rats

Girish Rathod, Somanath Reddy Patil, Md. Liyakat Ahmed, K. Vijaykumar

Journal of Pharmaceutical Research International, Page 212-217
DOI: 10.9734/jpri/2021/v33i51B33535

Tramadol at the dose levels of 1mg and 3mg/100g body weight was administered to normal cycling rats for 20 days through intraperitoneal routes. At autopsy on 21st day significant reduction in the ovarian, uterine and body weight was observed. Histological observations showed decrease in the number and size of Graafian follicles, corpora lutea and increase in the atretic follicles in the ovary. The uterus showed absences of endometrial glands, decrease in the height of myometrium, endometrium and its epithelial cells. The total protein and glycogen content of the ovary and uterus is decreased whereas the cholesterol content is increased. The hypothalamo-hypophyseal gonadal axis is prominent regulator of reproductive activities in animals through neuro-endocrine regulation. In this study action of tramadol on ovary and uterine parameters is discussed.

Open Access Original Research Article

Deep Learning-based Models of Molecular Phenotypes for Predicting the Overall Survival in Cancer

Gerardo Cazzato, Anjali Oak, Asim Mustafa Khan, . Jayesh

Journal of Pharmaceutical Research International, Page 218-234
DOI: 10.9734/jpri/2021/v33i51B33536

Aims: The aim of the study is to justify the need of deep learning predictive model in obtaining molecular phenotypes of overall cancer survival.

Study Design: The study is based on the secondary qualitative data analysis through usage of systematic review.

Methodology: A qualitative study has been conducted to analyse the necessity of deep learning.  It also includes the need for deep learning models to obtain the imaging of the cancer cells. In the study, a detailed discussion on deep learning has been made. The analysis of the primary sources has been obtained by evaluating the quality of the resources in the study. The study also comprises of a thematic analysis that enlightens the benefits of deep learning. The study is based on the analysis of 14 primary research-based articles out of 112 quantitative articles and structuring of a systematic review from the collected data.

Results: The morphological and physiological changes that occur in the cancerous cells have been clearly evaluated in the research. The result signifies the prediction can be made by implementing deep learning in terms of cancer survival. Advancements in terms of technology in the medical field can thus be improved with the help of the deep learning process. It states the advancements of the deep learning models that are helpful in predicting the model of cancer to determine survival rate.

Conclusion: Deep learning is a process that is considered to be a subset of artificial intelligence. Deep learning programmes are meant to be performed for complex learning models. Although there is difference in the concept of deep learning and image processing still artificial intelligence brings both together so as to ensure better performance in image processing. The need for deep learning models has become invasive, and it helps to build a strong ground for cancer survival.

Open Access Original Research Article

Public Awareness of the Need to Call the Emergency Medical Services Following the Onset of Acute Myocardial Infarction and Associated Factors in Jazan Region, Saudi Arabia

Tawfeeq I. Altherwi, Luai Alhazmi, Abdulsamad Yahya A. Ahmadi, Faisal Ali M. Othathi, Abdulaziz Ali M. Othathi, Ahmed Hussein M. Awaji, Mohammed Ibrahim Y. Dabsh, Nasser Ahmed H. Batt, Mohammed Aboubaker R. Alshafey, Abdulghani Ahmed M. Alkaeeal, Mohammed O. Shami

Journal of Pharmaceutical Research International, Page 235-245
DOI: 10.9734/jpri/2021/v33i51B33537

Background: Acute Myocardial Infarction is usually a complication of an ongoing atherosclerotic pathophysiological process inside the distribution of the coronary arterial supply. For many years, acute myocardial infarction has been one of the leading causes of death worldwide. One of the major complications of acute myocardial infarction is the event of “cardiac arrest”. However, with an early approach to emergency medical services and early seeking of healthcare, the potential mortality chance can be reduced. Despite the significance of the situation and its vulnerability, delays in approaching emergency medical services exist due to variable influences. This study had investigated the reasons behind the delays and the awareness of the general public on acute myocardial infarction and its associated symptoms.

Methods:  This study is a cross-sectional type of research that was conducted in October 2021 through November 2021 period that invited 427 participants through social media platforms.

Results: The online questionnaire was distributed and administered by 427 subjects. The mean age of the participants was (27.62 years, SD=11.692) with a minimum age of 18 years and a maximum age of 89 years. The majority of the study participants were females (n=237, 55.5%), of those who called during the daytime, 97.4% of them have mentioned that they would call the EMS directly but when investigated about the time to wait before calling EMS, 55.3% of the participants who chose to call during the daytime would call in less than an hour.

Conclusion: For initiating public campaigns and providing the public with the consequences of an ignored myocardial infarction and the potential mortality that could be associated with delaying the emergency medicine services approach.

Open Access Original Research Article

Synthesis of Some Phenylisoindoline-1,3-Diones and their Acetylcholinesterase and Butyryl Cholinesterase Inhibitory Activities

F. O. Taiwo, C. A. Obafemi, E. M. Obuotor, I. J. Olawuni

Journal of Pharmaceutical Research International, Page 194-201
DOI: 10.9734/jpri/2021/v33i51B33539

Aims: To synthesize some phthalimides derivatives and evaluate the compounds for their possible biological properties.

Methods: The substituted phenylisoindoline-1,3-dione were synthesized from the reactions of N-phenyl phthalimide with different substituted aromatic aldehyde. The synthesized compounds were characterized using nuclear magnetic resonance spectroscopic analysis. The acetylcholinesterase and butyryl cholinesterase inhibitions were determined by Spectro photochemical analysis of acetylthiocholine and butyryl choline chloride.

Results: Compounds 6 (IC50 = 30±3 µg/mL) and 4 (IC50 = 141±60 µg/mL) were found to be the most active inhibitors against acetylcholinesterase, while compounds 4 (IC50 = 102±10 µg/mL), 5 (IC50 = 105 ± 20 µg/mL) and 2 (IC50 = 190 ± 10 µg/mL), were found to be most active inhibitor against butyryl cholinesterase.

Conclusion: The considerable acetylcholinesterase and butyryl cholinesterase inhibitory activities of the synthesized compounds makes them good candidates for the development of selective acetylcholinesterase and butyryl cholinesterase inhibitors.

Open Access Original Research Article

RP-HPLC Method Development and Validation for Cleaning Residue Determination of Tofacitinib Citrate in Tofacitinib Tablets

Thaticherla Kaleswararao, Duvvuri Suryakala

Journal of Pharmaceutical Research International, Page 262-276
DOI: 10.9734/jpri/2021/v33i51B33541

A novel, Specific, and precise RP-HPLC method was developed to determine the residue content of Tofacitinib citrate left on the surface of equipment used in the manufacturing process. The manufacturing equipment considered in assessment of cleaning has been verified and found the tools assembled to the equipment are made up of Stainless steel, Glass, Teflon and plastic. Hence, these surfaces of manufacturing equipment that come in contact with the drug product during manufacturing are considered for evaluation of the cleaning procedure. By developing and validating an analytical method for residue estimation, the manufacturing equipment can be evaluated for efficient cleaning and to release the manufacturing equipment for further intended use by minimizing the cross contaminations. The stationary phase suited for the well separation of components is CAPCELL PAK C18 150 x 4.6 mm, 3 μm; 0.4 % perchloric acid and acetonitrile in the ratio of 85:15 % v/v is the mobile phase pumped at a flow rate of 1.2 mL/min through the column at temperature of 40 ºC. Each run extended for 10 min as the Tofacitinib peak elutes at RT of 5.2 min. The method has been validated successfully for Specificity, Precision, Linearity, Accuracy, Ruggedness and Filter validation of both rinse and swab methods. The LOD, LOQ concentrations found to be 0.006, 0.019 µg/mL for swab method and 0.03 and 0.1 µg/mL for rinse method respectively. The correlation coefficient is 0.999 and method found linear from LOQ to 500% for swab method and LOQ to 200% for rinse method. Solution stability has been established to ensure the test solution get tested within the stable time (4 Days). Based on the filter validation data, it is concluded that PVDF filter is not suitable for cleaning sample analysis and 2 mL sample should be discarded when 0.45 µm Nylon filter is used for cleaning sample analysis.

Open Access Original Research Article

Enhanced Access to Testing & Diagnosis & Hepatitis C Burden; A Public Health Intervention

Shameem Bhatti, Bakhtiar Ahmed Bhanbro, Pardeep Kumar, Kanta Ahuja, Mansoor Qazi, Naseem Khatoon Bhatti

Journal of Pharmaceutical Research International, Page 277-282
DOI: 10.9734/jpri/2021/v33i51B33542

Objective: To gauge the effect of increasing access to care and streamlining testing and diagnosis on hepatitis C burden (incidence of disease, rate (%) of complications, adverse events and mortality) in a rural population.

Methodology: This quasi-experimental research was conducted at Taluka Gambat (Khairpur, Sindh, Pakistan) from August 2019 to January 2021. This public health intervention, comprised of establishing collection points, near healthcare centers in Gambat Taluka, that facilitated the sample collection, transport and testing of patient samples (for Hep C). The test results along with basic biodata, sociodemographic details, disease particulars, presenting signs and symptoms (and their duration), of consenting patients, were recorded onto a structured questionnaire and the data analyzed using SPSS. v. 21.0.

Results:  A total of 492 individuals were studied. The mean age of the sample was 32.5± 6.9 years with an age range of 18 to 65 years. Pre-Intervention (establishment of collection units) records showcased a lower frequency of cases being reported, which jumped to more than three-fold following provision of greater access to testing and diagnosis. The number of cases presenting with Hep C complications though, steadily declined (from 66.7% to 12.1% - p: < 0.05), and the mortality rate took a significant dive (33.3% to 0% - p: < 0.05). The incidence of diagnosed cases presenting with adverse outcomes (liver cirrhosis, liver failure and hepatic carcinoma) fell sharply, from 33% to 6.1% - p: < 0.05.

Conclusion: Enhanced access to care and streamlining testing and diagnosis, overtime reduced the disease burden associated with Hepatitis C, by identifying patients with the disease early before the disease progresses and leads to adverse events.

Open Access Original Research Article

Impact of Probiotic (Saccharomyces Boulardii) Administration in Prevention and Management of Chronic Diarrhea

Muhammad Ilyas Siddiqui, Rizwana Qureshi, Mumtaz Ali Bharo, Shahbat E Maryam Syed, Aatir H. Rajput, Khalil Ahmed Kazi

Journal of Pharmaceutical Research International, Page 289-293
DOI: 10.9734/jpri/2021/v33i51B33544

Background: Diarrheal disease is the second leading cause of death in children under five years old, and is responsible for killing around 525 000 children every year. Though many treatment modalities exist, chronic diarrheal conditions demand a safer alternative modality (with lesser side effects) and thus, role of probiotics in prevention and management of chronic diarrhea merits exploration.

Objective: To study the impact of probiotic (Saccharomyces Boulardii) in prevention and management of chronic diarrhea.

Methodology: This experimental study comprised of a sample of 178 (chosen via non-probability, consecutive sampling) children aged 2 months to 12 years, presenting to the study setting with chronic diarrhea (from November 05, 2019, to May 04, 2020) to the Dept. of Pediatrics at Liaquat University Hospital, Hyderabad. After taking written consent, data was recorded onto a structured questionnaire containing inquiries about the socio-demographic details, diarrheal disease history, medication history and eventual treatment outcome. The study population was divided into 2 equal groups (S. Boulardii group & Control Group) of 89 each. The active treatment period was 5 days. All study participants were examined on day 0 (inclusion day) and followed up on day 3 and day 6 during active treatment phase and in the following month thereafter for observation. The data obtained was analyzed through SPSS version 20.

Results: The mean age of the sample stood at 6.5 (SD ± 1.5) years. Baseline characteristics such as mean age and the average frequency of stools were comparable in S. boulardii and control group at the time of inclusion in the trial. By day 3 it reduced to 2.8 and 4.4 stools per day respectively and by day 6 it reduced to 1.4 (S. boulardii Group) and 3.7 (control group). The duration of diarrhea was 3.2 days in S. boulardii group whereas it was 5.2 day in control group (P = 0.001). In the following month, S. boulardii group had a significantly lower frequency of 0.46 episodes as compared to 1.28 episodes in control group.

Conclusion: After careful consideration, it can be concluded that average frequency of stools is significantly reduced and brought down to normal in the S. boulardii group as compared to the control group The drug was well accepted and tolerated. There were no reports of the side effects during treatment period.

Open Access Original Research Article

Effect of Stretching and Strengthening Protocol on Forward Flexed Posture in Post-Menopausal Women

Sharvari Sahasrabuddhe, Sandeep B. Shinde, Pradnya P. Ghadage

Journal of Pharmaceutical Research International, Page 306-314
DOI: 10.9734/jpri/2021/v33i51B33547

Background: Forward flexed posture is one of the most common structural change which occurs during menopause due to osteoporosis. Stretching and strengthening of cervical and thoracic spine muscles helps to alter the postural changes and maintain COG. This study thus, aims to see the effectiveness of the structured exercise protocol in post-menopausal women.

Aims and Objective: To study the effectiveness of supervised and non-supervised stretching and strengthening protocol in post-menopausal women with forward posture.

Materials and Methods: A total 40post-menopausal women with forward head posture were selected on the basis of selection criteria. They were randomly allocated in two groups A) Supervised Group= 20, B) Unsupervised Group=20 each. Forward flexed posture was assessed using Occiput to Wall Test and Craniovertebral Angle. Treatment was explained to both the groups. The pre and post measurements of the participants were recorded.

Results: Statistical analysis was performed using the unpaired t test. Occiput to wall test and craniovertebral angle were used as the outcome measures for determining the effect of stretching and strengthening on forward neck posture. Comparing the pre-intervention and post-intervention values of occiput to wall test, a significant difference was seen following administration of protocol (p<0.0001). For craniovertebral angle, a significant difference was seen between pre-intervention and post-intervention values (p<0.0001). Also, it was seen that there was a significantly higher difference in the values of craniovertebral angle and occiput to wall test values in the supervised groups as compared to the unsupervised group.

Conclusion: The current study demonstrated the effect of stretching and strengthening exercise in improving postural kyphosis in post-menopausal women. In addition, all variables of interest showed statistically significant post-treatment improvements in supervised group than unsupervised group.

Open Access Original Research Article

Assess the Effectiveness of Self-instructional Module on Knowledge Regarding Cultural Beliefs of Dietary Habits among Postnatal Women

Kalyani Ambule, Bali Thool, Manjusha Mahakarkar, Shalini Moon, Archana Teltumade

Journal of Pharmaceutical Research International, Page 315-320
DOI: 10.9734/jpri/2021/v33i51B33548

Background: The study of cultural factors in nutrition emerged as a distinct focus of research only recently, with the formation of the National Research Council's Committee on Food Habits in 1941. The impact of culture on nutrition has primarily been studied in the realm of "food habits," which is the second of two distinct spheres comprehended by nutrition science. The first is concerned with determining nutritional requirements and dietary standards and includes biochemistry and physiology.

Objective of the study: This study aims to assess the effects of self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women. 1. To assess the existing knowledge regarding cultural beliefs of dietary habits among postnatal women 2. To assess the effectiveness of self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women 3. To associate knowledge regarding cultural beliefs of dietary habits among postnatal women with demographic variables.

Material and methods: Evaluatory research approach is used to assess the effectiveness of self-instructional module on through the difference between the pre-test and post-test knowledge score. In this study a total number of 60 postnatal women who fulfil the inclusion criteria were selected. A structured questionnaire developed for assessing the knowledge of postnatal women.

Result: According to the findings, 13.33% of postnatal women had an average level of knowledge, 55% had a good level of knowledge, and 31.67% had an excellent level of knowledge. Conclusion: According to findings of the study, there is an improvement in knowledge of postnatal women. Statistically, the self-instructional module on knowledge regarding cultural beliefs of dietary habits among postnatal women was proved to be effective.

Open Access Original Research Article

Impact of Socio–Economic, Health and Patient Related Factors on Medication Adherence in Patients with Hypertension and Type II Diabetes

Meraboina Prasad, Venugopalan Santhosh Kumar

Journal of Pharmaceutical Research International, Page 327-338
DOI: 10.9734/jpri/2021/v33i51B35575

Background: Adherence to therapies is a primary determinant for treatment success in chronic diseases. Despite increased awareness, poor adherence to treatments for chronic diseases still remains a global problem. Failure to adherence, seriously affects the patient and the health care system.

Aim: The main purpose of this study was to evaluate the level of drug adherence in patients with hypertension and type II diabetes. A prospective cross sectional study was carried out in tertiary care hospitals of Khammam region, Telangana with a size of 2880 patients. A structured questionnaire has been designed using MMAS 8 scale to determine the compliance level and the socioeconomic status of the objects was analyzed by Kuppuswamy scale. 

Results: In our study, the following results were reported, age (P <0.001), gender (P <0.001, OR = 1.954), residence (P <0.0001, OR = 3.102), level of education (P <0.0001), profession (p <0.0001), net monthly income (P <0.001), socio economic class (P <0.001), medication Costs (P <0.001 OR = 0.2346), Health Literacy (P <0.001, OR =0.2051), Social support (P <0.001, OR =3.549, 95% CI=2.701 to 4.649). Frequency of Visits (P <0.001, OR =0.09421), No of medications (P <0.001, OR =0.2506), Complexity (P <0.001, OR =0.1862), Self-Monitoring (P <0.001, OR = 0.1011), felt worse (p<0.0001,OR=0.1591).

Conclusion: Our results showed that demographic variables, socio economic factors, health care factors had direct influence on medication adherence. Illiterates, lower-economy patients have not followed the recommendations of health care providers who insist on the need to increase drug adherence in primary care. Our findings call for the need to design new interventions on multidimensional factors likely to interfere with this study, such as patient knowledge and information to improve compliance.

Open Access Review Article

The Role of Microbiome in Cancer Cell Stimulation and Therapy

Shahira Hassoubah

Journal of Pharmaceutical Research International, Page 97-115
DOI: 10.9734/jpri/2021/v33i51B33520

In recent times, the microbiome has been increasingly recognized as having a hand in various disease states that include cancer as a part. Our commensal and symbiotic microbiota, in addition to pathogens with oncogenesis features, have tumor-suppressive characteristics. Our nutrition and other environmental influences can modulate some microbial species representatives within our digestive system and other systems. The microbiota has recently shown a two-way link to cancer immunotherapy for both the prognosis and the therapeutic aspects. Preclinical results indicated that microbiota modification could be transformed into a novel technique to improve cancer therapy's effectiveness. This article aimed to review recent development in our understanding of the microbiome and its relationship to cancer cells and discuss how the microbiome stimulates cancer and its clinical and therapeutic applications. Such information was selected and extracted from the PubMed, Web of Science, and Google Scholar databases for published data from 2000 to 2020 using relevant keywords containing a combination of terms, including the microbiome, cancer, immune response, immune response, and microbiota. Finally, we concluded that studying the human microbiome is necessary because it provides a thorough understanding of humans' interaction and their indigenous microbiota. The microbiome provides useful insight into future research studies to optimize these species to fight life-threatening diseases such as cancer and has rendered the microbiome a successful cancer treatment strategy.

Open Access Review Article

Risk of Postoperative Sensitivity and Pulpal Complications in Respect of: Amount of Reduction, Temporization, Cement Type

Namdeo Prabhu, Amjad Abdulrahman S. Albulayhid, Abdulaziz Abdolah Y. Althari, Talal Eid Q. Alruwaili

Journal of Pharmaceutical Research International, Page 246-252
DOI: 10.9734/jpri/2021/v33i51B33531

Fixed partial dentures (FPDs) made of metal ceramic are a popular treatment option for missing teeth. Studies have shown that posterior abutments of FPDs had a higher pulp survival rate than anterior abutments. Postoperative sensitivity following the cementation of a fixed prosthesis is a frequent symptom, especially when the abutments include important pulp. Dentinal hypersensitivity affects between 4 and 74 percent of people. Females are found to have a somewhat greater DH incidence than males. While DH can affect individuals of any age, there have been several theories on what causes abutment sensitivity after tooth preparation and cementation. In this review we included some of it. Also, we discussed methods of management of postoperative sensitivity and Management of fractured abutment screw.

Open Access Review Article

Post Anesthesia Care in Intensive Care Unit: A Review

Tamer M. Kadry, Ali Adnan Al Khamis, Khalil Abdrabalnabi M. Ahmed, Ahmed Mohammed Al Hammad, A. Sakabomi, Duoaa Mohammad, Arwa Sultan D. Alnemari, Shaima Fouad M. Aldoughan, Shouq Ali Alshehri, Sarah Abdulfattah Alsufi, Abdulrahman Mohammed A. Nasser, Mohamed Abdulhameed Aziz, Ahmed Saad Alromaihi, Alnashri Saud Ali, E. Alhazmi, Essa Ibrahim

Journal of Pharmaceutical Research International, Page 253-261
DOI: 10.9734/jpri/2021/v33i51B33540

The notion of inpatient treatment is possibly as ancient as medicine itself. It would have been sensible to place patients in such facilities such that those who were sicker were more visible to receive better care from the personnel. The first Intensive Care Units (ICUs) were established in Europe and around the world in the 1950, today intensive care units (ICUs) are a common sight in hospitals throughout the world. The PACU is designed to make some processes easier in order to provide better postoperative care. Invasive and noninvasive breathing, goal-directed hemodynamic control, invasive monitoring, and pain management are just a few of the options that can be provided. PACU helps reducing postoperative morbidity and consequently the duration of stay of patients.The costs of both establishing and operating a PACU are undeniable. however, by reducing postoperative morbidity and consequently the duration of stay of patients, overall expenses should be reduced. But with that being said many developing countries do not have the same luxury as developed ones when it come to having enough ICUs. That with other problems such as the differences in level of training and number of staff operating such units determine the overall result of health care process. In this article we will be discussingthe importance of PACU and various factors that affect it.