Open Access Case Report

Immunohistochemical Analysis of Myofibroblasts Using α- SMA in Oral Submucous Fibrosis Turning into Malignancy- A Case Report and Review

Swapan Kumar Purkait, . Abhinandan, Nimisha Priya, Sriyanshi Singh, Sneha Singh

Journal of Pharmaceutical Research International, Page 192-198
DOI: 10.9734/jpri/2021/v33i52A33575

Oral submucous fibrosis is a premalignant condition, characterized by fibrosis in oral mucosa causing stiffness of mucosa and leading to reduced mouth opening. The malignant transformation of oral submucous fibrosis is very high among the rest of the premalignant conditions. Chronic chewing of arecanut causes production of myofibroblasts. These myofibroblasts plays an important role in neoangiogenesis as well as disintegration of the basement membrane at the tumor invasive front leading to carcinoma.  Here, we are doing an Immunohistochemical study using alpha SMA for proper microscopic visulizations of myofibroblastic activity in an OSF patient, encompassing the pathogenesis and malignant potentiality of the disease.

Open Access Systematic Review Article

Sarcomatoid Lesions of Head and Neck Region: A Diagnostic Dilemma

Dipankar Samaddar, Ananjan Chatterjee, . Abhinandan, Deepak Kumar, . Akriti

Journal of Pharmaceutical Research International, Page 283-293
DOI: 10.9734/jpri/2021/v33i52A33587

One challenging feature of head and neck pathology is that a dizzying array of sarcomatoid lesions occurs here ranging all the way from reactive to malignant and very aggressive. This makes accurate diagnosis critical. These lesions are quite diverse with great clinical and biological heterogeneity. Some are malignant while many others are benign or simply reactive in nature. For example; at mucosal sites, a well known lesion is spindle cell carcinoma (SpCC), which are overtly malignant, and the differential diagnosis then includes a number of different malignant spindle cell lesions. However, there are several benign or even non-neoplastic lesions that can sometimes be difficult to discern from SpCC, e.g. Nodular fasciitis, Proliferative myositis, Cellular schwannoma, Benign fibrous histiocytoma, Carcino sarcoma, Sarcomatoid melanoma. Fracture callus, etc.

Aim of Study: There is a diagnostic challenge to the oral pathologists to differentiate dizzying array of sarcoma like lesions from other similar microscopic simulates ranging all the way from reactive to malignant and very aggressive. This article aims to review the sarcomatoid lesions of the head and neck region with emphasis on differential diagnosis histologically and immunohistochemicaly.

Open Access Case Study

A 2 Years Girls with Nephroblastoma: A Case Report

Deeplata Mendhe, Achal Jiwane, Ranjana Sharma, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 62-65
DOI: 10.9734/jpri/2021/v33i52A33557

Introduction: Wilm's tumor, also known as nephroblastoma, is a common complication in children with renal cancer. It was responsible for 6% of all malignancies. It almost always affects children under the age of five. 90% of cases are diagnosed before the age of three, with the peak incidence occurring between the ages of two and five years. The case of a 2-year-old girl with Wilm's tumor is shown below. The majority of cases are unilateral, but 5% to 10% of the time both kidneys are affected.

Case Presentation: A 2-year-old girl was taken to the hospital with a chief complaint of a lump in the abdomen, fever, vomiting and fatigue, nausea, swelling, pain in the abdomen, weakness. On physical examination the patient has experienced in weakness the upper and lower limb, pain experiencing in the abdomen and presenting lumps in the abdomen S1 and S2 are heard in the cardiological system, and air entry is bilaterally equal in the respiratory system. Pupils are reflected light, tone, and a palpable smooth abdominal mass is frequently discovered by chance. The infant was never admitted to a neonatal intensive care unit (NICU). There had been no previous evidence of neonatal sepsis or jaundice. For a year, the girl was breastfed. The right side of the abdomen was where the first symptoms appeared. Small at first, but quickly grew larger and more asymmetrical.

Open Access Case Study

Case Report on: Tuberous Sclerosis

Ruchira Ankar, Archana Dhengare, Arti Raut, Seema Singh, Samruddhi Gujar

Journal of Pharmaceutical Research International, Page 140-147
DOI: 10.9734/jpri/2021/v33i52A33567

Introduction: Tuberous sclerosis is a rare hereditary disease that creates noncancerous tumours in the brain, kidneys, heart, liver, eyes, lungs, and skin. Seizures, intellectual incapacity, developmental delays, and behavioral issues are just a few of the warning symptoms. Like Skin problems, and lung and kidney problems. A hereditary mutation in one of two genes causes TSC.TSC1 and TSC2 are two distinct TSC types. The proteins hemartin and tuberin, which act as tumour suppressors and govern cell proliferation and differentiation, are produced by these genes. [1].

Background: Tuberous sclerosis complex (TSC) is a rare genetic disorder that affects 1 in every 6,000 to 1 in every 18,000 people. It's a life-threatening condition caused by the formation of benign tumors/lesions in several organs. Tumors can affect organ growth and/or function and are frequent in the brain, heart, skin, kidneys, and lungs. The number of organs affected, as well as the size of tumours inside each organ, varies greatly. As a result, the disease's symptoms are extremely variable and unexpected [2].

Case Presentation: A 35-year old female admitted to AVBRH on date 25/11/2021 with the chief complaint of fever chills, nausea, vomiting and itching and back skin over mouth and eye surrounding area since in 10 days.  

History of Present Illness: Tuberous sclerosis, also known as tuberous sclerosis complex, is a rare genetic disease that causes non-cancerous (benign) tumours in the brain, skin, kidneys, heart, eyes, and lungs. A 35-yearold female admitted to hospital on date 25/11/2020 with the chief complaint was fever chills, nausea, vomiting and itching and back skin over mouth and eye surrounding area since in 4month.

Interventions: The patient was treated the patient was started on Injection- Ceftriaxone, 1gm - Intravenous – BD- Antibiotic, Injection- Pan, 40mg – Intravenous- BD – Antacid, Injection- Livipril, 100mg – Intravenous- BD- Anticonvulsant, Injection- Paracetamol, 150mg – Intra muscular- SOS- Antipyretic.

Conclusion: During hospital stay with the chief complaint of patient are fever chills, nausea, vomiting and itching and back skin over mouth and eye surrounding area since in 10 days. Her situation was critical, therefore she was brought to AVBR Hospital and treatment was started right away.

Open Access Case Study

A Case of Mucinous Cystadenoma Carcinoma

Vaibhav G. Hatwar, Ranjana Sharma, Mayur Wanjari, Pratibha Wankhede, Sagar Alwadkar, Hina Rodge

Journal of Pharmaceutical Research International, Page 148-152
DOI: 10.9734/jpri/2021/v33i52A33568

Introduction: Mucinous Cystadenoma carcinoma is a type of tumor in the cyst adenocarcinoma grouping it can occur in the breast as well as the ovary. Tumors are normally multiocular with various smooth thin-walled cysts. Within the cyst is found an emergence or cellular debris.

Patient History: The female patient 63-year-old who was admitted to AVBRH on the date 21/05/2021 in the obstetric and gynae ward with a chief complaint of generalized weakness, loss of appetite, fever for 2 days 7 days ago, 2-3 fever spikes and burning micturition. All over investigation observed like blood and urine investigation, CT scan of the abdomen, histopathology then the final diagnosis is confirmed as mucinous Cystadenoma carcinoma.

Pharmacology: The patient was treated with antibacterial medicine, antibiotics, and diabetics, thyroxin stimulating drugs, etc. Management: Inj. Ceftriaxone 1gm 12 hourly, Inj.-piptaz 4.45 gm, 8 hourly, tab. Gimipride 0.5 mg with tab. Metformin 500 mg 12 hourly, tab. Thyrox 62.5 mcg, tab telmisartan 40 mg with tab. Chlorthalidone 12.512.5 mg 12 hourly, Inj.-pan 40 mg, 12 hourly, Inj.- Neomol 100 ml, and Tablet- nitrofurantoin 6 hourly.

Nursing Management: Monitor the vital sign, monitor nutritional status and monitor random blood sugar. Maintained bed rest of patient, managed the pain level of the patient. The patient was assessed for risk of bleeding.

Conclusion: The patient was admitted to the hospital with the chief complaint of generalized weakness, loss of appetite, fever for 2 days 7 days ago, 2-3 fever spikes and burning micturition.  and the patient was admitted to AVBR Hospital in the obstetric and gynae ward, immediate treatment was started by a health team member and all possible treatments were given and now the patient's condition is satisfactory.

Open Access Case Study

Case Report on Right Acoustic and Left Trigeminal Schwannoma, Hydrocephalus with Neurofibroma a Rare Case

Prerana Sakharwade, Khushbu Meshram, Shalini Lokhande, Pooja Kasturkar, Achita Sawarkar, Madhuri Naik, S. Avita Pohekar, Sheetal Sakharkar

Journal of Pharmaceutical Research International, Page 159-162
DOI: 10.9734/jpri/2021/v33i52A33570

A vestibular schwannoma or acoustic neurinoma, or acoustic neurilemoma is a slow growing benign tumor arises balance and hearing nerves in the inner ear. It is caused by overabundance of Schwann type of cell, which support and insulate nerve fibers, wrap onion skin around them. The nerves that control hearing and balance are impaired when vestibular schwannoma increases in size, resulting in hearing loss that is one-sided or asymmetric, tinnitus and loss of balance. When a tumor develops large enough, obstruct the facial nerve, resulting in numbness in the face. Vestibular schwannomas can also damage the facial nerve, resulting in facial weakness or paralysis on the tumor's side. If the tumor becomes large enough, it press against surrounding brain areas like the cerebellar and brainstem, posing a life-deteriorating hazard.(1) 17 years old male child was admitted in neuro ward with rare case of right acoustic and left trigeminal schwannoma, hydrocephalus with neurofibroma. In the present case, the treatment approach was mainly underwent in the form of right V.P.Shunt done and treated with antibiotics, antacids, anticonvulsants, analgesics, brain stimulants, protectants, multivitamins and other supportive treatment. Nurses have to play an important role to identify such type of symptoms and they should think critically, take action immediately to provide care to such type of patients.

Open Access Case Study

Case Report on Cirrhosis of Liver

Sheetal Sakharkar, Samrudhi Gujar, Vaishali Tembhare, Pranali Wagh, Jaya Khandar, Madhuri Shambharkar, Sonali Kolhekar, Khushbu Pande

Journal of Pharmaceutical Research International, Page 171-175
DOI: 10.9734/jpri/2021/v33i52A33572

Liver is the second largest organ in human body, more than 5,000 separate bodily functions .including helping blood to clot, cleansing the blood of toxins to converting food into nutrients to control hormone levels, fighting infections and illness, regenerating back after injury and metabolizing cholesterol, glucose, iron and controlling their levels. A 56- years old patient was admitted in AVBRH on date 9/12/2020 in ICU with the chief complaint of abdominal distension, breathlessness on exertion, pedal edema, fever since 8 days. After admitted in hospital all investigation was done including blood test, ECG, fluid cytology, peripheral smear, ultrasonography, etc. All investigation conducted and then final diagnosis confirmed as cirrhosis of liver. Patient was not having any history of communicable disease or any hereditary disease but he has history of hypertension and type II Diabetes mellitus for 12 years. Patient was COVID-19 negative and admitted in intensive care unit. Patient had been undergone with various investigations like physical examination, blood test, CSF fluid examination, ascitic fluid examination, fluid cytology, peripheral smear, ultrasonography, RT-PCR etc. Patient was treated with tab. farobact ER 300 mg BD, tab. Lasix 40 mg OD, tab. Udilive 300 mg BD, tab. Rifagut 300 mg BD, tab. Metformin 500 mg OD, tab. Amlo 5mg OD, syp. Duphalac 30ml HS. Monitor vital signs, maintain input output, Monitoring and managing potential complications like, bleeding and haemorrhage, hepatic encephalopathy, fluid volume excess, monitor laboratory tests as indicated, Identify and assess for pedal edema.

Conclusion: Cirrhosis of the liver is one of the final stages of liver disease. It is a serious condition, causing scarring and permanent damage to the liver. Life expectancy depends on the stage and type of cirrhosis of liver. Cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening. If liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

Open Access Case Study

Unintended Inhalational Organophosphate Poisoning Presenting as Angioedema: A Rare Case Report

Sanyukta Hepat, Abhijit Wadekar, Gaurav Jagtap, Vijay Kota, Anil Wanjari

Journal of Pharmaceutical Research International, Page 188-191
DOI: 10.9734/jpri/2021/v33i52A33574

Organophosphorus compounds are chemical agents in widespread use throughout the world, mainly in agriculture. In developing countries organophosphorus (OP) poisoning is a commonly encountered problem. Here we present a rare case of OP poisoning with angioedema as the presenting feature. Prompt treatment of these cases will help in reducing the morbidity and mortality.

Open Access Study Protocol

A Study Protocol on the Effectiveness of Post Mastectomy Exercises in Breast Cancer Patients on Reduction of Lymphedema and Improving Range of Motion among Patients Undergone Mastectomy

Amruta Kothe, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 71-75
DOI: 10.9734/jpri/2021/v33i52A33559

Background:  Breast cancer is the most commonly diagnosed type of cancer in the world and it is a major stressor in women's lives. Breast cancer cases are increasing in both rural and urban settings. Mastectomy is a procedure that removes the breast to prevent cancer cells from returning. Many complications can develop after a mastectomy but lymphedema and limited range of motion are the most prevalent. The present study aimed to assess the effectiveness of post mastectomy exercises in breast cancer patients on reduction of lymphedema and improving range of motion among patients undergone mastectomy.


  • To assess pre interventional level of lymphedema among patients undergone mastectomy.
  • To assess pre interventional range of motion among patients undergone mastectomy.
  • To evaluate the effectiveness of post mastectomy exercises in reducing lymphedema among patients undergone mastectomy
  • To evaluate the effectiveness of post mastectomy exercises in improving range of motion among patients undergone mastectomy.
  • To associate demographic variable with post mastectomy exercises.
  • To associate correlation of post mastectomy exercise with lymphedema and range of motion.

Methodology: A pre interventional one group pretest posttest design would be adopted to assess the effectiveness of post mastectomy exercises in breast cancer patients on reduction of lymphedema and improving range of motion among patients undergone mastectomy. In this study interventional analytical study will be used. Purposive sampling technique will be used to collect the data. The study will include 30 patients undergone mastectomy will be assessed by using American lymphology lymphedema scale and Elvaru STJ (Subtalar joint) range of motion and range of motion reliability tool with the help of inch tape and goniometer and then post mastectomy exercises will be teach by researcher as intervention.

Expected Results: The goal of this study is to see how effective post-mastectomy exercises are at reducing lymphedema and improving range of motion in breast cancer patients who had undergone mastectomy. Teaching post-mastectomy exercises can help the respondents reduce lymphedema and improve their range of motion.

Open Access Study Protocol

Protocol on: Evaluate the Effectiveness of Nursing Protocol on Knowledge and Practices Regarding Hemodialysis Care among Professional Staff

Swapna Morey, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 82-87
DOI: 10.9734/jpri/2021/v33i52A33561

Background: The prevalence rate of chronic kidney disease (CKD) ranges from 1 < percent to 13% and recently international society of nephrology reported In India, the prevalence rate of chronic kidney disease was 17 % in 2015.

Objective: 1. To assess the existing level of knowledge regarding hemodialysis care among professional staffs. 2. To assess the existing Practice regarding hemodialysis care among professional staffs. 3.To assess the effectiveness of nursing protocol on knowledge and practice regarding hemodialysis care among professional staffs. 4.To find out the correlation between knowledge and practice regarding hemodialysis care among professional staffs. 6.To associate the level of knowledge and practice regarding hemodialysis with selected demographic variable.

Methodology: It is Quasi experimental one group pre-posttest research design will be used in this research study conducted on the professional staff in the selected hospital of Wardha. Non-probability purposive sampling technique will be used to select samples for analysis. This research study included 60 professional staff of selected hospital of Wardha district.

Expected Results: Outcome includes To evaluate the nursing care for hemodialysis patients. Through, improve and evaluate the knowledge and performance of hemodialysis care among professional staff before and after the education and training interventions. To assess the existing practice of hemodialysis care and the generation of new evidence.

Conclusion:  Conclusion will be drawn from the statistical analysis.

Open Access Study Protocol

A Study Protocol on: Evaluate the Awareness Program on Selected Vaccinations among Chronic Kidney Disease Patients

Deepali Ghungrud, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 98-104
DOI: 10.9734/jpri/2021/v33i52A33563

Background: “Chronic Kidney Disease” also known as a chronic renal failure, is one of the major health problems today. And infection is the second leading cause of morbidity and mortality in patients with chronic kidney disease, contributing around 30–36% of deaths among patients on dialysis. Overall, this condition is a threat to the life of the patients, hence to improve in the patient’s condition on dialysis and renal replacement therapy is a must. Here, early vaccination becomes must as primary treatment modalities to prevent the patients from communicable diseases like Hepatitis-B, Influenza, Pneumococcal diseases.

Aim: To evaluate the effectiveness of the awareness program on selected vaccinations among chronic kidney disease patients.

Methodology: Quasi experimental one group pre-test post-test research design will be used in this study and samples will be chronic kidney disease patients. Non probability purposive sampling technique will be used to select the samples. This research study included 100 chronic kidney disease patients of selected hospitals in Vidarbha region. Samples must select according to requirements for inclusion and exclusion criteria. For this study, Age between 18 to 65 years above, both male and female, Chronic kidney disease patients attending Nephrology and Medicine OPD/IPD and admitted patients in selected hospitals in Vidarbha region, able to read and write Marathi or Hindi, Willing to participate in study, available during data collection.

Expected Results:  1. To access this information for educating and change the attitude of patients regarding selected vaccination among chronic kidney disease patients. And understand the importance of vaccination before the onset of dialysis and renal transplantation.

Conclusion: Conclusion will be drawn from the statistical analysis.

Open Access Study Protocol

Application of Modified Lowa Model Evidence Based Practice on Trauma Care Nurses Regarding Head Injury

Lina Fating, Seema Singh, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 253-258
DOI: 10.9734/jpri/2021/v33i52A33581

Background: Head injuries are a regular occurrence in emergency departments around the world, with more than 2 million annual visits in North American EDs and more than 400 000 in the United Kingdom alone. Despite the fact that the mechanism of injury is consistent,, Head injuries are a regular occurrence in emergency departments around the world, with over 2 million visits in North American EDs and over 400 000 in the European Union alone. Regardless of how consistent the injury mechanism is.

Objectives: Holds data what nurses already know about the modified LOWA model. 2. Develop and test a protocol using a IOWA model that was adjusted. 3. Assess the updated LOWA model's effectiveness 4.To connect the knowledge score to demographic data.

Research Approach: Interventional approach Research design: - One group pre test and post test. Setting of the study: - The study will be conducted in AVBRH Hospital. Sample: - Staff Nurse Sample Size is 50Sampling Technique is Purposive sampling. Setting of the study is The study will be conducted in AVBRH Sample: - Staff Nurse Sampling Technique: - convenient sampling  Data Collection: - Field data Will be collected by the use of standardised questionnaires with three key sections: Section A (Standard standards), Section B (Socio-demographics and work history of staff) used the modified LOWA model and check list).

Expected Results: Oriented it toward the application of the LOWA model. Those characteristics are what evidence-based practise on trauma care nurses concerning head injury entails, but they may be able to address the issues that Traumatic Brain Injury Nursing faces. Adopting this paradigm into traumatic brain injury nursing units is worth a shot.With the assistance of a specific case, this article will discuss the clinical application of the Lowa Model in traumatic brain injury nursing care.

Conclusion: In the light of the study findings, this study shows that, the implementation of LOWA Model evidence based practice has a positive effect on nurse’s knowledge and practices regarding trauma care nurses regarding head injury. There was a significant improvement in the nurses ‘knowledge and practice regarding LOWA Model evidence-based practice implementation compared with that before it. There was positive significant correlation between nurses’ knowledge and their practice before and after program. Nurses’ knowledge and practice about LOWA Model improved after application of this program.

Open Access Short Communication

Prevention and Nursing Management for Central Line Associated Blood Stream Infection

Sheetal Sakharkar, Ranjana Sharma, Dinesh V. Mude, Pooja Kasturkar, Pratibha Wankhede, Kavita Gomase, Prerna Sakharwade, Kanchan Bokade

Journal of Pharmaceutical Research International, Page 32-38
DOI: 10.9734/jpri/2021/v33i52A33555

Central line associated blood stream infection (CLABSI), is a substantial contributor to in-hospital morbidity and death, as well as increased cost and length of stay in the intensive care unit (ICU). CLABSIs are one of the most deadly for each infection is expected to have a mortality rate of 12-25 percent. CLABSI prevention is important, and nurses play a vital role. Nurses are required to complete initial training as well as annual competence tests for central venous catheter protocol and other skills to ensure that they are delivering direct care to patients using the most up-to-date evidence-based practices.

Conclusion: CLABSI prevention bundles are the best method for implementing many interventions at once in addition to standardizing practice. Standard prevention bundles in addition to routine CLABSI education for staff are the most effective methods for preventing infection; it is inevitable that compliance with bundles will vary across healthcare institutions.

Open Access Short Communication

Ramifications of COVID-19 on Childhood Obesity: A Global Perspective

Sonali Kolhekar, . PreranaSakharwade, Khushbu Meshram, Madhuri Shambharkar, Jaya Khandar, Shalini Lokhande, Pooja Kasturkar, Kavita Gomase

Journal of Pharmaceutical Research International, Page 153-158
DOI: 10.9734/jpri/2021/v33i52A33569

The COVID-19 pandemic has had far-reaching ramifications that extend far beyond the Clinical Diseases. Children around the world have been impacted by the socioeconomic, psychological, and physiologic effects brought about by the emergence and response to this virus. This is especially true for children already suffering from obesity. They have been placed in an almost impossible situation due to the negative effects of living in relative isolation. Using logistic regression, the hazard factors for loss of life in young overweight COVID-19 patients were investigated. According to our data, obesity is linked to many health risks for teenage COVID-19 patients. They have a significant death rate, with worsening irritant responses, greater vascular damage, and elevated rates of lung consolidation. Younger children infected with COVID-19 who were hospitalized had a high proportion of comorbidities. Infants had less severe illness. Obese child were more likely to necessitate mechanical ventilation, as well as higher indicators of Inflammation at the time of admission. While in the hospital childhood obesity was linked to serious COVID-19 disease. Europe is no exception, three weeks have passed since Italy's mandatory countrywide lock-down began; lifestyle, diet, exercise, and sleep were collected and compared to data on children gathered in 2019. The additional weight accumulated during the lock-down may not be readily reversed, and if better practices are not re-established, it may contribute to obesity in adulthood. The United States similarly has reported increasing weight gain in youth aged 2-19 during the pandemic.

Open Access Original Research Article

To Assess the Psychological Impact (Stress and Anxiety) of Social Media on Quarantine People Related to COVID 19

Rucha Bante, Shiva Bawane, Pranay Bende, Nikhil Bhagat, Suhas Talwekar, Manjusha Mahakarkar

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i52A33552

Need of Study: The quarantine would impact day-to-day employees and companies with daily profits. Confining abnormally reduced social and physical contact with others whereas loss of habits is direct linked to distress, monotony, social isolation and disappointment. Hence the investigator plans to assess the effect of social media on the mental health of quarantined people related to covid-19.

Objectives: To assess the psychological impact (stress and anxiety level) on quarantine people.

Methodology: The study was based on an evaluative approach. The population was about all adults, above 18 – 60 years of age who were quarantined. The sampling technique used in the study was probability convenient sampling and the tool was PSS scale and GAD-7 checklist. The data gathering process began based on the objectives and the hypothesis the data were statistically analyzed with various tests such as descriptive statistics and inferential statistics.

Results: The majority 60% of the subjects had moderate levels of stress regarding social media on quarantine people due to covid-19 and 91% of subjects had mild anxiety regarding social media.

Conclusion: Research study concludes that clients of the community were suffered from stress and anxiety during the covid pandemic as per their occupation and lack of knowledge regarding stress and anxiety management brought resulted in increasing disturbance in performing a daily activity with an increase in the death rate due to overuse of social media.

Open Access Original Research Article

Effect of Anticoagulants on the Survival Rate in Critically Ill COVID-19 Patients

H. M. Akshay, Gayatri Vaidya, Sarika M. Sheety, Chandan Dharmashekara, Bhargav Shreevatsa, Siddesh V. Siddalingegowda, Poojitha B. Sridhara Setty, Chandrashekar Srinivasa, Poojitha B. Sridhara Settee, Sharanagouda S. Patil, S. Bindya, Shiva Prasad Kollur, P. Ashwini, Chandan Shivamallu

Journal of Pharmaceutical Research International, Page 6-11
DOI: 10.9734/jpri/2021/v33i52A33550

Background: The World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19), as a pandemic in January 2020. The morbidity and mortality associated with the disease are enormous COVID-19, with a multi-systemic pathology, exhibits thrombosis as a common manifestation. Disseminated intravascular coagulation (DIC) and thrombotic lesions have been reported in >70% and >30% of patients, respectively, who have died due to the COVID-19 and therefore, heparin is included in the treatment of moderate to severe cases. This retrospective study was undertaken to check the effectiveness of prophylactic therapy with heparin at reducing mortality in critically ill COVID-19 patients.

Methodology: The study included retrospective data from case records of 169 critically ill COVID-19 patients with or without comorbidities and an anticoagulant regimen. The data were thoroughly studied for demographic profile, comorbidities, type and dosage of anticoagulants, length of intensive care unit stay, and mortality rates.

Results: The male to female ratio of the study subjects was 125/44 (76%/24%). Patients with comorbidities were critically ill as compared to those with none (140/29), and diabetes mellitus was the most common comorbidity, found in 99 patients. Mortality rate was significantly higher in patients who had not received any anticoagulant (p = 0.015) and in patients who had received unfractionated heparin (p =0.036) as compared to those who received low molecular weight heparin (LMWH).

Conclusion: The prophylactic administration of heparin improves the survival rate of the critically ill covid 19 patients is more when compared with the patients who do not receive heparin. LMWH is very effective in reducing thrombotic complications and mortality in critically ill COVID-19 patients.

Open Access Original Research Article

To Assess the Effectiveness of Video-assisted Teaching on Knowledge Regarding Male Breast Cancer among Adult Males

Shalaka Gadhave, Vaishali Gahane, Poonam Gajbhiye, Harsha Gandhare, Savita Pohekar

Journal of Pharmaceutical Research International, Page 12-25
DOI: 10.9734/jpri/2021/v33i52A33553

Introduction: As the healthcare programs focus on the relatively higher incidence, women have a fair level of awareness of breast cancer. Breast of male hence ignored in the community. Studies from India have shown that medical care is often taken in an advanced stage because of lack of awareness, and the aggressive nature of breast cancer in Indian men and seen at quite an early age. Video-assisted knowledge teachings about awareness of male breast cancer among adult males would improve their understanding and exploration of the perceptions and opinions of Indian male cancers.

Aim: To determine the effectiveness of video-assisted education on male breast cancer knowledge among adult males in the city of Wardha.

Methods and Materials: One group pretest and posttest design with a quantitative research approach has been used in this interventional study design. This study has been carried out in community set up. Sample size was100. Validated Pretested predesigned structured questionnaires were used. In Microsoft excel sheet, data collected was entered. SPSS-software was used to perform the statistical analysis. Frequencies and percentages for categorical variables have been presented.

Results: The pre-test findings show that 15(15%) of the adult males had a poor level of knowledge score,  50(50%) had average knowledge and 31(31%) of them had good knowledge and 4(4%) of them had found a very good level of knowledge. After video-assisted teaching in the post-test 3(3%) had a good knowledge score and 97(97%) had very good knowledge, thus it shows that after the post-test the knowledge score was increased. The Mean value of the pre-test is 9.32 and the post-test is 23.14 (p-value is 0.001), the calculated t-value is 35.47. Hence it indicates that Teaching aided with video was effective. The post-test score was significantly associated with population variables such as occupation and bad habits. The post-testing knowledge score with demographic variables such as age, religion, family type, education, marital status, dietary pattern, and area of residence was not significantly linked.

Conclusion: The study shows that the expected teaching on male breast cancer has helped adult males to gain a better understanding of the nature of the disease and to take measures to prevent male breast cancer.

Open Access Original Research Article

A Comparative Analysis of Intermittent and Continuous Phototherapy in Patients with Neonatal Jaundice

Shereen Mari, Shazia Memon, Muhammad Nadeem Chohan, Muhammad Touseef, Saroop Chand, Chetan Das

Journal of Pharmaceutical Research International, Page 26-31
DOI: 10.9734/jpri/2021/v33i52A33554

Aim: To compare the outcome of intermittent phototherapy versus continuous phototherapy in treatment of neonatal jaundice.

Study Design: Randomized clinical trial (RCT).

Place and Duration: This study was conducted at Department of pediatrics, neonatal ward, Liaquat university hospital Hyderabad/Jamshoro, from 8 January to 7 July 2020

Methodology: There were 222 neonate with jaundice, which were randomly allocated into two groups. One hundred and one neonates were in group “A” who received continuous phototherapy while 111 neonates were treated with intermittent phototherapy called group B. Phototherapy units were identical regarding their manufacture and radiance with 5 blue light tubes at a distance of 15-20 cm above neonate that produced the irradiance of 20µW/cm2/nm at 420-470 nm. Serum bilirubin levels were measured every 12 hourly after starting phototherapy up to 48 hours. SPSS version 22 was used for data analysis.

Results: The average age of the neonates was 2.23±1.45 days. In this study, the reduction of bilirubin level in both groups after 12, 24, 36, 48 hours of phototherapy and at the time of discharge was not different between groups.

Conclusion: Intermittent and continuous phototherapies were found to be equally effective. Because of its additional benefits, intermittent phototherapy can be adopted as a routine procedure instead of continuous phototherapy in neonatal care units, however, it needs to be confirmed by large scale RCTs.

Open Access Original Research Article

Phytochemical, Proximate, in-vitro Anti-malarial, Anti-inflammatory and Antimicrobial Screening of Leaf Extracts of Combretum platypterum (Welw) Hutch & Dalziel

C. E. Anarado, V. I. E. Ajiwe, O. F. Obumselu, C. J. O. Anarado, N. P. Okafor

Journal of Pharmaceutical Research International, Page 39-61
DOI: 10.9734/jpri/2021/v33i52A33556

Background: Combretum platypterum is used ethno-medically in the treatment  many diseases in Africa, such as; helminthiasis, sexually transmitted diseases, conjunctivitis, malaria, lumps, fever, eye problems, diarrhea, lower backache, coughs, swellings, as febrifuge, tonic, and to stop post-partum bleeding.

Aim: This work was aimed at investigating the phytochemical, proximate, anti malarial, anti inflammatory, anti bacterial and anti fungal activities of leaf extracts of Combretum platypterum.

Methods: Leaves of C. platypterum were cold extracted with methanol, ethyl acetate and n-hexane. The extracts were subjected to preliminary phytochemical analyses, proximate, anti malarial, anti inflammatory and antimicrobial tests.

Results: The results revealed that, alkaloids, terpenoids, flavonoids, cardiac glycosides, carbohydrates, resins and reducing sugars were found in all the extracts. It was also observed that the presence of the metabolites in each extract was in polarity-dependent manner. The percentage composition of carbohydrates was also the highest followed by the composition of proteins. The suppressions of the extracts against P. falciparum at half-maximal inhibitory concentration (IC50 mg/ml) were found to be higher than that of chloroquine at IC50 µg/ml. It was also found that methanol extract had the highest inhibition against Gram positive, Gram negative bacteria and C. albicans in a dose-dependent manner. K. pneumonia was resistant to the inhibition of the extracts. The anti inflammatory assays showed that methanol extracts at 500 mg/ml exhibited higher lipoxygenase Inhibition than diclofenac at 500 µg/ml. Ethyl acetate extract showed highest inhibition of heat-induced hemolysis, protein denaturation and proteinase among all the extracts.

Conclusion: The therapeutic use of the leaves of C. platypterum against malaria and swelling was confirmed by the activities of the extracts against inflammation and P. falciparum. It is also necessary that the bioactive compounds responsible for these activities be isolated.

Open Access Original Research Article

The Outpatient Prescribing of Topical Betamethasone in Al-Kharj

Nehad J. Ahmed, Menshawy A. Menshawy, Mohd. Faiyaz Khan

Journal of Pharmaceutical Research International, Page 66-70
DOI: 10.9734/jpri/2021/v33i52A33558

Aim: The present study aimed to describe the prescribing pattern of topical betamethasone in the outpatient setting in Alkharj.

Methodology: This retrospective study that included collecting data from the electronic prescriptions in a public hospital in Alkharj in 2018.

Results: During the study period from Jan to Dec 2018 only 46 patients received topical betamethasone. Most of the patients were female (63.04%). About 71.74% of the prescribed betamethasone was in ointment form and 28.26% in lotion form. Most of the prescribers were residents (97.83%). Most of the prescriptions were written by dermatology department (58.70%).

Conclusion: The use of topical betamethasone was uncommon and this could be due to the availability of other topical corticosteroids and other alternatives. It is important to increase the knowledge of health care workers and the patients regarding the use of topical corticosteroids.

Open Access Original Research Article

Nutritional Agonists of PPAR-γ: An Immunomodulatory Approach to Control Cytokine Storm in Covid19 Patients

Nadeem Siddiqui, Shaik Mohammad Anjum, Sreeja Nannapaneni, Sri Sarvani Vemuri, Bhavana Potluri, Sreedhar Bodiga, Vijaya Lakshmi Bodiga, Suryanarayana Veeravilli

Journal of Pharmaceutical Research International, Page 88-97
DOI: 10.9734/jpri/2021/v33i52A33562

Recent examinations express that multi organ failure is seen in Corona virus infected patients with different pathway. It has been shown in contemplates that increased levels of cytokines like IL-1B and INF gamma were observed. It is called as cytokine storm with higher convergences of CCL2 and CXCL10. The cytokine storm is trailed by our immune system attacking own body which thus may cause numerous organ abnormalities and conclusive outcome being death. There is currently no specific treatment for viral illness, and this methodology is an optional path for focusing on specific qualities that may diminish cytokine storm. In such manner Peroxisome Proliferators Activated Receptors (PPARs) have a place with group of transcription factors which are known to manage the inflammatory mechanisms in body. This immunomodulatory approach is intended to focus PPAR-gamma ligands and their molecular docking studies. The activation or increased expression levels of PPAR gamma because of chosen agonists may reduce the cytokine storm in the covid patients. Thus, this is one such fascinating way to deal with neutralization of the cytokines exorbitantly elevated by use of substances like pomegranate, lemon grass and so on to activate PPARs reliably.

Open Access Original Research Article

Phytochemical and Antimicrobial Screening of Leaf and Tuber Extracts of Tephrosia calophylla Bedd

B. Kavitha

Journal of Pharmaceutical Research International, Page 105-114
DOI: 10.9734/jpri/2021/v33i52A33564

Tephrosia calophylla, (Fabaceae) a perennial woody under shrub endemic to south India. It is one of 13 rare or threatened Tephrosia species. Commonly it is known as Adavivempali. The various species of Tephrosia is ascribed to have many medicinal and therapeutic uses. The importance of this study was to preliminary screening of different phytochemical constituents for the detection of various secondary metabolites and evaluation of antibacterial, antifungal activity and Minimum Inhibitory Concentration of the different crude extracts of tuber and leaf. Tuber and leaf both yielded more number of secondary metabolites like alkaloids, phenols, flavonoids tannins, saponins and glycosides with high quantity when compared with the leaf, consisting low quantities of phyto-constituents as steroids and in tuber consisting only tannins. Antibacterial activity of T. calophylla tuber and leaf aqueous and alcohol extracts at 10 mg/well are showing more effective activity on Bacillus subtilis (MTCC-441), Escherichia coli (MTCC-443), Pseudomonas aeruginosa (MTCC-741), Klebsealla neumoniae, Proteus vulgaris strains than the control drug Ampicillin 10 mg/well with 30.25-15.00 mm zone of inhibition. The minimum inhibitory concentration (MIC) with leaf and tuber extracts was 0.312 to 2.50 mg/ml compared to that of the 10 mg of Ampicillin. Antifungal screening of aqueous leaf extract was more effective on Candida albicans with 19.25 mm inhibition zone than Aspergillus niger at 10 mg/well compared to Nystatin the control drug at 10 mg/well with 10.2 to 12.1 mm of zone of inhibition. Fungal MIC on both organisms with leaf and tuber extracts ranges from 0.612 mg to 3 mg compared to 10 mg of Nystatin.

Open Access Original Research Article

Interpolymer Complex of Chitosan and Eudragit L-100: Preparation, Characterization and Drug Release Behavior

Shrikant Bute, Saurabh Gupta, Kamlesh Wadher, Nikita Naidu, Milind Umekar

Journal of Pharmaceutical Research International, Page 115-127
DOI: 10.9734/jpri/2021/v33i52A33565

Aims: The aim of the present investigation was to prepare interpolymer complex between Chitosan and Eudragit L100, and to evaluate its performance as a matrix for controlled release of drugs, using Diclofenac sodium as a model.

Methodology: Interpolymer complex were prepared by combining different % chitosan solutions with different % Eudragit L100 solutions in different ratios. The formation of interpolyelectrolyte complexes (IPEC) between carbopol and Chitosan was investigated, using turbidimetry and viscosity measurement. The structure of the prepared IPEC was investigated using FTIR spectroscopy and DSC. A Rotary compression press was used to formulate matrix tablets of diclofenac sodium using polymers in physical mixture and IPECs.The amount of Diclofenac Sodium released in the dissolution medium was determined spectrophotometrically at 276 nm.

Results: The results of the present investigation confirmed the formation of an interpolyelectrolyte complex between Chitosan and Eudragit L 100. The release of the model drug Diclofenac sodium was significantly controlled from tablets made up of the IPEC as compared with polymers alone and in combination. Release profiles were represented by a mathematical model, which indicates that the prepared system releases drug in a zero-order manner by changing the ratio of the IPEC in the tablets.

Conclusion: Controlled release drug delivery systems designed to manipulate the drug release to achieve specific clinical objectives that are unattainable with conventional dosage forms.

Open Access Original Research Article

Green Synthesis of Copper Oxide Nanoparticles Using Coix lacryma jobi Leaves Extract and Screening of its Potential Anticancer Activities

Ksh. Sangeeta Devi, Atom Rajiv Singh, D. Velmurugan, M. Damayanti Devi, Deepak Singh Lourembam, N. Rajen Singh

Journal of Pharmaceutical Research International, Page 128-139
DOI: 10.9734/jpri/2021/v33i52A33566

Background: Copper oxide nanoparticles(CuO NPs) have been powerful evidence in several in vitro studies such as cytotoxicity and antimicrobial compared with other metal oxide. Here, we have synthesized green CuO NPs using Coix lacryma jobi leaves extracts.

Place and Duration of Study: Department of Chemistry  Manipur University, Manipur, India and Regional Institute of Medical Sciences, Imphal, India between February 2019 to March 2021.

Methodology: Green CuO NPs nanoparticles were synthesized from Copper chloride dihydrate (CuCl2.2H2O) using Coix lacryma jobi leaves extract, and the synthesized green CuO NPs were characterized using Field Emission Scanning Electron Microscopy (FESEM) - Energy Dispersive Spectroscopy, IR Spectroscopy, UV-Visible Spectroscopy, Powder X-Ray diffraction Spectroscopy and HR-TEM where FESEM-EDS determined the purity of CuO NPs.

Results: No other impurities present were observed in EDS, and the PXRD spectra show the crystallite size of CuO NPs with respect to the (002) plane is found to be 25.2 nm, and the presence of CuO NPs at adsorption spectrum with a distinct peak at 282 nm was determined by  UV-Visible spectroscopy and the homogenous morphology and crystalline nature of the CuO NPs were determined from TEM micrograph and SAED pattern. In applications, the substantial anticancer activity of green CuO NPs (synthesized using Coix lacryma jobi leaves extract) was proved on human cervical and lung cancer cell lines with IC50 values of 31.88 μg/ml and 15.61 μg/ml, respectively.

Open Access Original Research Article

Knowledge, Attitudes, and Practices towards COVID-19 Pandemic among Residents of the Jharkhand State, India: An Online Survey

Arpita Rai, . Nishant, Anshul Kumar, D. K. Singh, Nitin Madan Kulkarni, Shailesh Kumar Chaurasia, L. R. Pathak

Journal of Pharmaceutical Research International, Page 176-187
DOI: 10.9734/jpri/2021/v33i52A33573

Background: People's adherence to control measures is imperative in the fight against COVID-19. The present study was done to evaluate knowledge, attitudes, and practices towards COVID-19 among residents of Jharkhand and to assist the government in deciding further course of action during the COVID-19 outbreak.

Methods: This study was an online cross-sectional survey. The link to the questionnaire was displayed on the official website of Rajendra Institute of Medical Sciences, Ranchi, National Health Mission, Jharkhand, official website of all districts under Jharkhand state administration, Integrated Disease Surveillance Programme and Information & Public Relations department. Participation of residents in the survey was extensively propagated using mass media mainly local television networks, radio channels and newspapers.

Results: A total of 4683 responses were received from all districts of Jharkhand. The majority of the participants were young adults (47.5%) and the number of male participants was more than the females (81.4%). The mean correct knowledge score for participants of this study was 10.73+2.2 (maximum attainable score was 14) while the mean practice score for the participants was 4.5+0.69 (maximum attainable score was 5). The knowledge score of the participants was significantly associated with their age, education status and economic class (p<0.0001). The participants largely held an optimistic attitude and healthy practices towards COVID-19. Conclusion: Participants had a positive attitude but were also logically worried and uncertain about the near future. Adequate knowledge of participants was visible in their practices. There was however a gap across age groups, gender, literacy and income levels which should be addressed in future campaigns.

Open Access Original Research Article

Gender-Related Differences of Cardiac Troponin-I Levels in Patients with Acute Myocardial Infarction at Time of Acute Chest Pain

Mahir Abdulkadhum Khudhair Alzughaibi, Ammar Waheeb Obeiad, Nassar Abdalaema Abdalhadi Mera, Mohammed Sadeq Hamzah Al-Ruwaiee

Journal of Pharmaceutical Research International, Page 199-205
DOI: 10.9734/jpri/2021/v33i52A33576

Background: Cardiac Troponins-I (CTNI) are myoregulatory polypeptides that control the actin-myosin interface, considered specific to cardiomyocytes. Age and sex variances in the extent of CTNI levels have arisen a recent debatable emphasis. Existing revisions do not display a reliable clinical power of sex-specific CTNI 99th centiles, which actually might mirror procedural aspects. Nevertheless, from a biochemical viewpoint, the trends of sex-specific CTNI 99th centiles seem sensible for the ruling-in of acute myocardial infarction AMI. Vulnerable females may be missed when applying the male sex-specific threshold.

This study aimed to determine whether gender differences in CTNI exist in patients with AMI presented with chest pain.

Methodology: The study was a cross-sectional, single-center, included 236-patients with AMI diagnosis by cardiologists at Merjan teaching hospital during the period from April to July 2020 from patients attending the hospital for cardiac consultation complaining of acute chest pain suggestive of AMI. Blood analysis had initiated at the time of admission included serum creatinine, blood urea, R/FBS, WBCs, PCV, and serum CTNI. A p-value below 0.05 specifies statistical significance. All statistical bioanalyses had performed by IBM-SPSS, version-25 for Windows.

Results: The mean age of participants was 67.5 years, the men were dominant 76.2%. The incidence of DM and hypertension were significantly high and 24.5% of the patients were current smokers. Biochemical serum analysis revealed mean creatinine, urea, sugar, and STI values were 79.8±4.2 mmol/l, 15.9±1.7 mmol/l, 10.9±0.9 mmol/l, and 7.9±0.6 ng/ml separately. Both hypertension and smoking were significantly (p-0.001) more among males compared to the females, which is not the case for the prevalence of DM. The males were heavier significantly than females (p-0.001). Almost, there was no impact of gender on most of the other study variables other than serum TNI levels, which were significantly higher among the males (p-0.001).

Conclusion: In patients with AMI presented with acute chest pain, the routine of CTNI in the diagnosis of AMI is based on the patient's gender. The application of gender-dependent cutoff levels for CTNI analyses appears to be highly suggested.

Open Access Original Research Article

Adverse Effect of Social Media Addiction on Life Effectiveness of Adolescents: An Approach towards Mental Health and Mood Modifications

Ahuja Rashi, Kumar Rita, Phogat Poonam

Journal of Pharmaceutical Research International, Page 206-220
DOI: 10.9734/jpri/2021/v33i52A33577

Objective: The prime intent of this study was to determine the adverse effect of social media addiction on adolescent’s life effectiveness, studying in grade 8th to 12th in Delhi NCR, India.

Materials and Methods: The psychometric properties of the Bergen social media Addiction Scale and Life Effectiveness Questionnaire by James Neill were evaluated, additionally examining the factor structure utilizing the Partial least squares-based Structural Equation Modeling (SEM) amongst n = 968 adolescents. The hypothesized inverse relationship between the two scales is tested using the person correlation examination.

Results: Adolescence’s life effectiveness, dimensions of time management, self-confidence, emotional control, and achievement motivation were significantly adversely (negatively) related to Facebook Addiction.

Implications: The over-use of social media will trigger failure in education and social relationships, health and well-being concerns, provoking life disruption. The reasonable usage of online media requires ethos, attention, and awareness on how to utilize them effectively. We can propel students by bringing issues to light.

Open Access Original Research Article

Human Patellar Bone Dust has Osteogenic Potential: An in vitro Study

Mariam Adeel Roghay, Nuzhat Hassan, Shumaila Usman, Syed Nudrat Nawaid Shah, Kevin Joseph Jerome Borges, Kanwal Haneef

Journal of Pharmaceutical Research International, Page 246-252
DOI: 10.9734/jpri/2021/v33i52A33580

Aims: To substantiate the osteogenic differentiation of human Umbilical cord Mesenchymal Stem Cells (hUMSCs) under the influence of Bone Dust (BD) by detecting expression of genes RUNX2 and IBSP in the differentiated cells.

Study Design: In vitro study.

Place and Duration of Study: MDRL Cell Culture Lab Ziauddin University and Dr.Zafar H.Zaidi Institute of Proteomics, University of Karachi, between July 2020 and July 2021.

Methodology: We designed an innovative experiment to differentiate hUMSCs into osteoblasts under the influence of BD, without using any conventional differentiating medium. The hUMSCs were isolated from umbilical cord and cultured in a 6-well plate with 3μm inserts, in which BD was lodged, preventing direct contact of BD with hUMSCs. The plates with hUMSCs and BD-filled inserts were incubated at 37°C for 14 days after which RNA extraction, cDNA synthesis and qPCR for two genes was performed. Expression of Runt-related transcription factor-2(RUNX2) and Integrin-binding Sialoprotein (IBSP) were quantified.

Results: Results revealed an increased expression of the late osteogenic marker IBSP(p=0.01) signifying that the hUMSCs had undergone differentiation into mature osteoblasts.

Conclusion: This novel experiment identifies BD as a new source for osteogenic differentiation of hUMSCs in in vitro experiments.

Open Access Original Research Article

Clinical Profile of Acute Coronary Syndrome

Azeem Ahamed, N. Deepthi

Journal of Pharmaceutical Research International, Page 259-262
DOI: 10.9734/jpri/2021/v33i52A33582

Background: In the developing world, coronary artery disease (CAD) is considered to be a leading source of illness and ultimately death. Indians are nowadays linked to a more dangerous variant of coronary artery disease (CAD) with a lower age of onset and is more common in men.

Aim: To analyse the clinical profile of patients with ACS syndrome for the purpose of drawing predominance in demography, metabolic disorders and tobacco use.

Materials and Methods: We enrolled 50 patients with characteristic ECG alterations and clinical history who were admitted to the emergency department between January and August 2021 in a prospective research at Saveetha Medical College and Hospital. Every patient had a predetermined Performa filled out, which included a full clinical history and investigation procedures. The clinical history disclosed details regarding the patient's age, gender, and risk factors.

Results: On analysis, results were conclusive of male predominance probably accentuated by tobacco use, alcohol consumption and other metabolic disorders.

Conclusion: With prevalence of risk factors on rise, younger individuals are also affected. Proper risk factor management will help in preventing Acute coronary syndrome.

Open Access Original Research Article

Cemented Bipolar Hemiarthroplasty for Fracture Neck of Femur and Unstable Intertrochanteric Fractures - Prospective and Retrospective Study

P. Sharajdeen

Journal of Pharmaceutical Research International, Page 263-266
DOI: 10.9734/jpri/2021/v33i52A33583

Hip fractures in elderly patients are becoming a major social problem from various perspectives, including the progressive aging of global societies. The elderly have a high risk of hip fracture, even with minor injuries because of osteoporosis, while early surgical treatment may be difficult due to comorbidities and medication. In this study, significant risk factors were identified. Patients over age 70 had three times the mortality of younger patients. Greater than three pre-existing medical conditions is associated with a 25 percent mortality rate, more than twice that of healthier patients. Surgery performed on the first day of admission and beyond the fifth day was associated with a 34 percent mortality rate. Those patients operated in during days 2 through 5 had a 5.8 percent mortality rate. There was no failures related to inadequate stem or mechanical loosening. The tendency to dislocation can be clinically identifiable by major discrepancy in length, there was no failures related to inadequate stem or mechanical loosening. The tendency to dislocation can be clinically identifiable by major discrepancy in length and only 1 patient had shortening of about 2 cms post operatively which was slightly better than that of James et al (11%).

Open Access Original Research Article

A Study to Assess the Knowledge of Elderly on Laughter Therapy in Selected Areas of Madhya Pradesh

Bincy Jacob, C. C. Linson

Journal of Pharmaceutical Research International, Page 267-275
DOI: 10.9734/jpri/2021/v33i52A33584

The purpose of this study was to examine the elderly's understanding about laughing therapy in Madhya Pradesh's designated locations. The sample of 30 older persons was chosen using a non-probability handy sampling approach. The older people's knowledge was assessed using a structured questionnaire. According to the data, the majority of older individuals have an average level of knowledge about laughing therapy, while 40% of samples have a bad level of information, 10% have a high level of knowledge, and none have an exceptional level of knowledge. The elderly must be educated on the benefits of laughing therapy in everyday life.

Open Access Original Research Article

Technical Quality of Endodontic Treatment Performed by Underperforming Undergraduate Dental Students

Abeer A. Mokeem Saleh, Hadeel Y. Edrees

Journal of Pharmaceutical Research International, Page 276-282
DOI: 10.9734/jpri/2021/v33i52A33586

Objectives: This study aimed to evaluate the technical quality of root canal treatment performed by fifth-year underperforming students, in the extra sessions of the 2018–2019 academic year.

Methods: Periapical radiographs of teeth endodontically treated by underperforming undergraduate students at King Abdulaziz University Faculty of Dentistry, were collected. The quality of obturation was evaluated radiographically in relation to the length of obturation to root apex, homogeneity and density of obturation, root canal tapering, and incidence of mishaps (such as perforation, ledge, missed canal, separated instruments). The data were subjected to descriptive analysis.

Results: The periapical radiographs of 70 treated teeth showed acceptable length, filling density and root canal taper in 96 (80%),50 (41.7%) and 66 (55%) root canals, respectively. Only four teeth were subjected to mishaps.

Conclusion: Under the circumstances of this study, the quality of endodontic treatment performed by underperforming students at the extra session was low. More studies are needed to address the student underperformance source and hence amend the quality of root canal filling. 

Open Access Original Research Article

Effectiveness of Physical Workout on Psychological Wellbeing among Students in Selected University of Health Sciences Mangaluru

Christy Babu, Syed Imran

Journal of Pharmaceutical Research International, Page 294-302
DOI: 10.9734/jpri/2021/v33i52A33588

Background of Study: Student period is the most memorable period of one's life time, it includes both happy moments and stressors to cope with, here researcher try to identify the stress level and psychological well being of student be and to identify the affect of physical workout on the psychological well being.

Methods: A quantitative research approach and quasi experimental pre test post test control group design was adopted for the study. Fifty subjects were selected bypurposive sampling technique. The subjects were assigned either to experimental group (n=25) or control group (n=25). The psychological wellbeing was measured using Ryff’s scale of psychological wellbeing.

Results: The study showed that the students have various stress and the physical workout is effective in improving psychological well being, This shows there is no association between psychological wellbeing and selected demographic variables of the students.

Conclusion: concluded that physical workout is effective in improving psychological wellbeing among students.

Open Access Original Research Article

Stress and Financial Burden Faced by Dentists Amidst COVID 19 Pandemic

Amruta Popatrao Patil, Dilip Magdum, Santosh Jadhav, Abhijeet Jadhav, Prakash Vhatkar, Pratibha Gopal Kavle

Journal of Pharmaceutical Research International, Page 303-310
DOI: 10.9734/jpri/2021/v33i52A33589

Introduction: The Covid-19 pandemic, initiated in Wuhan, China, had devastating effects on the dental industry world-wide. The mode of transmission of SARS Cov-2, causative agent of Covid-19, was through aerosol and saliva contamination putting dentists at high risk of contracting Covid-19. The measures taken to contain the spread of virus had financial repercussion on the dental industry. The survey was conducted to understand the mental health of dentists amidst Covid-19 pandemic.

Aim: To analyse the concerns and anxiety faced by dental surgeons regarding vaccination and the psychological and socio-economic impact Covid-19 pandemic had on dental setups.

Methods: A cross-sectional study was conducted for a period of 3 months. A sample size of 300 dentists belonging to age group of 25years to 45years was analysed. The dentists included in the sample practiced in Maharashtra, India. A questionnaire was formulated in Google forms and circulated through social media platform. The result was analysed and demonstrated in pie-charts.

Results: The survey analysed that majority of dentists were apprehensive to carry out dental procedures. Along with the risk of contracting and being a source of transmission of Covid-19, dentists had huge financial burden of clinic rents, EMI loan pending bills, the cost of preventive kits and reduced patient flow.

Conclusion: The survey was successful in analysing the monetary and safety concerns faced by dentists amidst Covid-19 pandemic. The survey also pointed out the mental stress dentists had to overcome to practice dental procedures.

Open Access Original Research Article

Experimental Study of the Effect of Serum Hydrogen Sulfide on the Course of the Inflammatory Process in the Vaginal Wall

Dmytro Grebeniuk, Natalia Voloshchuk, Oleksandr Nazarchuk, Nataliia Dzis, Illia Taran, Elina Slyvka, Andriy Hryhorenko, Mykola Melnychenko, Pavlo Gormash, Natalia Hodovan

Journal of Pharmaceutical Research International, Page 311-323
DOI: 10.9734/jpri/2021/v33i52A33590

Introduction: Various pathological conditions are characterized by the influence of hydrogen sulfide level on the course of the pathological process. This study examines the effect of serum hydrogen sulfide levels on the inflammatory process in the vaginal wall of rats.

Aims: To evaluate the effect of excess and deficiency of serum hydrogen sulfide on the course of the inflammatory process in the vaginal wall of rats.

Methodology: The study was performed on 125 female Wistar rats under 1 year of age and weighing 160.0 to 200.0 grams. All animals were divided into 7 groups: control (intact rats) and 6 experimental groups with different H2S levels and different treatment approaches of inflammation in the vaginal wall. The level of serum hydrogen sulfide was studied and the levels of TNF-α and IL-1β in the tissue homogenate of the vaginal wall were determined. In all experimental groups, the study was performed in dynamics - 10 min, 4, 8 and 24h after simulation of inflammation.

Results: The dynamics of local levels of TNF-α and IL-1β in all groups had a similar trend and was characterized by the rapid development of the inflammatory process from its simulation to 4 hours of study, followed by gradual attenuation of inflammation and almost complete normalization of the studied indicators for 24 hours. Preliminary serial introduction of sodium hydrosulfide, as a donor of hydrogen sulfide, allowed to reduce the degree of manifestation of the inflammatory process and to achieve faster normalization of the studied parameters. At the same time, the artificially created deficiency of serum hydrogen sulfide (previous serial administration of propargylglycine) prolonged the duration and increased the studied indicators of inflammation in the vaginal wall.

Conclusions: The course and intensity of the inflammatory process in the vaginal wall of rats are directly dependent on the background level of serum hydrogen sulfide.

Open Access Original Research Article

Title: Clinical Profile of Persistent Pulmonary Hypertension in Neonates with Role of Sildenafil in its Outcome: Rural India NICU Experience

Sunil Pathak, Deepika Bhil, Sakshi Prabodh, Manish Rasania, Saurabh Kumar, Shailesh Jain

Journal of Pharmaceutical Research International, Page 324-336
DOI: 10.9734/jpri/2021/v33i52A33591

Background: Persistent pulmonary hypertension of newborn (PPHN) result from failure of normal fall in pulmonary vascular resistance at or shortly after birth. It is associated with high mortality and morbidity.

Objectives: To estimate incidence, risk factors; and outcome within limited resources – conventional ventilation, sildenafil, dobutamine and milrinone therapy.

Methods: This prospective study was carried out on cases of PPHN admitted between March 2017 to August 2018. PPHN was suspected clinically, and then confirmed by echocardiography.

Results: Out of 2811 inborn live births 12 (0.43%) developed PPHN. Out of total 942 NICU admissions, PPHN was diagnosed in 40(4.2%). 32 (80%) were full term, 6 (15%) were late preterm and 2(5%) were post term neonates. 25(62.5%) were male. Major etiological factors were asphyxia 19(47.5%), EOS (early onset sepsis) 18(45%) and MAS (meconium aspiration syndrome)  12(30%). 20(50%) responded to oral sildenafil and dobutamine therapy, 6 more responded with addition of milrinone. The overall survival rate was 26(65%) and poor outcome in 14 (35%) in our study. Median duration of respiratory support was 1.5(1 – 6) days in those with poor outcome and 6(4 – 7) in those survived. Duration of hospital stay was 1.5(1 – 6) days in poor outcome and 17(13 – 22) in those survived.

Conclusions: Asphyxia, EOS and MAS are common causes of PPHN. Severity of respiratory distress on admission is correlated with mortality rather than etiological factors. Conventional ventilation, dobutamine, sildenafil and milrinone therapy are mainstay of treatment of PPHN cases in resource limited settings, and helps to reduce mortality to some extent. 

Open Access Review Article

Reliability of Sit to Stand Test in Fall Identification in Knee Osteoarthritis- A Literature Review

Anju Jose, Nityal Kumar Alagingi

Journal of Pharmaceutical Research International, Page 76-81
DOI: 10.9734/jpri/2021/v33i52A33560

Osteoarthritis is the second most prevalent degenerative illness as well as the most frequent joint condition in India. It is one of the most common degenerative disorder of the articular cartilage and surface of weightbearing joints causing disability in elderly patients. Gait, stair-climbing, unipedal stance, and the sitting-to-standing (STS) task have all been shown to be altered in research. Most of the research article had proved that sit to stand test, we can use to physiotherapy department to identify the risk of fall in knee OA patients. Most of the patients had severe knee pain and reduced lower limb muscle strength so, during the test patient may take a long time to complete the test and there is a loss of balance. Due to pain and reduced endurance and loss of balance, the patient may not be capable of completing the test. So, the test is reliable to determine the risk of a fall in knee OA patient.

Open Access Review Article

Applications of Silver Diamine Fluoride in Dentistry

Sayali Deshpande, Amit Reche, Priyanka Paul Madhu, Kumar Gaurav Chhabra, Sunaina Mutyalwar

Journal of Pharmaceutical Research International, Page 163-170
DOI: 10.9734/jpri/2021/v33i52A33571

Various studies published in the literature around the world indicate a significant prevalence of early childhood caries (ECC). Treatment of early childhood caries (ECC) using silver diamine fluoride (SDF) has become a viable alternative, particularly for young and anxious children, because traditional restorative treatments is unlikely to combat this prevalent condition. Arrested caries is identified by the hardening of teeth and it changes its color from dark brown to black. More restorative treatments can be performed if necessary. Traditional ECC restorative treatments are not always inexpensive or feasible, as they involve patient cooperation to achieve a satisfactory result. Japan was the first country to promote silver diamine fluoride in 1960. SDF has been used to prevent the spread of caries in various Asian nations, including Japan and China. It was enacted as a fluoride to treat sensitive teeth in the United States by Food and Drug Administration ( FDA). For young children or individuals with specific needs, it is painless and simple to use .The fluoride in SDF stimulates remineralization while the silver ions act as an antimicrobial agent when applied to carious lesions and stop cariogenic biofilms from growing. SDF also prevents future degradation of the dentin's collagen. With a 38 percent use rate, SDF has been utilized in a number of nations. According to a review, SDF is a harmless, economical caries control agent with a wide utilisation in dentistry, and it may meet the WHO Millennium Development Goal (MDG) as well as the United States Institute of Medicine's criteria. The applications of SDF in dental treatment are discussed in this article.

Open Access Review Article

The Utility of Zinc Augmentation in Diabetes - A Narrative Review

Chidiebere V. Ugwueze, Ekenechukwu E. Young, Chidimma B. Nwatu, Belonwu M. Onyenekwe, Chinweuba M. Abonyi, Chidiebele M. Ezeude, Bede I. Nnolim, Basil C. Ezeokpo, Chioma Unachukwu

Journal of Pharmaceutical Research International, Page 221-233
DOI: 10.9734/jpri/2021/v33i52A33578

Diabetes mellitus has sadly become a pandemic, with chronic and debilitating complications which by far are more pronounced in the developing countries of the world. Despite the availability of a wide array of anti-diabetic drugs (both oral and parenteral medications), micro-vascular and macro-vascular diabetes complications are still common. Owing to this sad reality, the place of micronutrients augmentation has come to the frontline of research in diabetes management. Zinc is one of the well-known micro-elements with diverse functions in various physiologic processes in humans. The authors reviewed the role of zinc augmentation in subjects with diabetes generally, both those with complications of diabetes and those without complications. Emphasis was also laid on the modulatory actions of zinc on various diabetes-related processes which include: its anti-oxidant effect; improvement of insulin secretion/sensitivity; increased amylin action; inhibition of gluconeogenesis and atherosclerosis. The impact of zinc supplementation on fasting plasma glucose, glycated haemoglobin and lipid indices were also detailed, while a brief overview of the pharmacology and pharmacokinetics of zinc was also undertaken.

Open Access Review Article

Roles of Tumor Necrosis Factor-α and Tumor Necrosis Factor-α Receptor 2 in Inflammation-Related Diseases

Nazakat Hussain Memon, Maaz Khan, Muhammad Raza Memon, Abdul Hameed Lanjwani, Farhatullah Kandhro, Arshad Hussain Laghari, Sadia Qamar Arain

Journal of Pharmaceutical Research International, Page 234-245
DOI: 10.9734/jpri/2021/v33i52A33579

The aim of the present review is to provide basic knowledge about the role of tumour necrosis factor-α 1 and tumor necrosis factor-α receptor 2 in neuro-inflammation diseases. We performed an open-ended, English restricted search of PubMed, Embase, PsychINFO, Web of Science, Scopus, and the Cochrane Library for available literature from 24Feb. 2018–12 May 2021, using terms related to neuroinflammation, tumour necrosis factor-α, tumour necrosis factor II (TNFR-II), TNF-α and related diseases, TNFR-II and inflammation-related diseases, their relationships, and polymorphism. The main outcomes assessed were the presence of plaques and tangles, behaviour and cognition, reduction in brain tissue mass, and synaptic function the majority of studies were documented a beneficial effect in other areas, including the presence of plaques and tangles and synaptic function. The human studies were showed that TNF-αI was beneficial to Alzheimer's disease patients, with one being a small pilot study and the latter being an observational study, with a high risk of bias. It is concluded that the functions and mechanisms of TNF-α and TNFR-II in inflammation-related diseases will provide new viewpoints and theories in the development and treatment of these diseases. They play important roles in the pathogenesis of diseases induced by or related to inflammatory cytokines and signaling pathways.