Open Access Case Report

A Case Report: A 37 Years-old Women with Takayasu Arteritis

Shakib H. Sheikh, Arti Raut, Savita Pohekar, Dipali Ghungrud, Swapna Morey

Journal of Pharmaceutical Research International, Page 56-60
DOI: 10.9734/jpri/2021/v33i53B33679

Background: A rarity of form of vasculitis, also known as TAK, induces inflammation in the walls of the major arteries in the body: the aorta and its main branches. The disease results from a body attack and inflammation of the walls of the arteries caused by the body's own immune system.

Case Presentation: A 37-years-old women had complaints of fever, giddiness, weakness of right upper limb and lower limb since1 day. After undergoing whole blood count, liver function examination, renal and MRI function checks, CT scan, angiography, etc. was studied. She was diagnosed with takayasu arteritis.  She had past medical history of neck pain and numbness since January 2020. For these complaints her family members referred her in private hospital. There is no significant history of surgery in present, lower segment caesarean section and piles operation was done previously. Physical findings were normal except the Glasgow Coma Scale score was 11 that is, patient  was semi-conscious, In General appearance patient activity was dull and weak due disease condition, Patient’s all routine investigations were normal except few like Total WBC count was increased (21,500cell /cm) due to increased infection, Granulocytes were increased  that is 75 % due to infection and autoimmune disease, ESR was increased  that is52mm/h. Angiography showed block in the right common carotid artery, MRI- showed Acute infract in left fronto  temporo parietal region involving insular par ventricular white matter,  absent flow in distal M1 segment of MCA.

Conclusion: The most frequently involved arteries and the angiographic trends in this Takayasu Arteritis study were subclavian arteries and carotid arteries. The difference between angiographic characteristics may lead to clinical differences. Operations and surgery should be carried out at various points in the course of the disease.

Open Access Case Study

Case Report on Squamous Cell Carcinoma of the Lip

Madhuri Shambharkar, Ragini Udan, Achita Swarkar, Jaya Khandar, Sheetal Sakharkar, Vaishali Tembhare

Journal of Pharmaceutical Research International, Page 182-188
DOI: 10.9734/jpri/2021/v33i53B33695

Introduction: Lip cancers are the most prevalent oral-maxillary malignancy. Lip cancer can be caused by a number of things, including smoking, exposure to ultraviolet (UV) rays, and drinking alcohol [1] In this article we report a case of lower lip squamous cell carcinoma in a 59 year old male patient who smoked heavily and had a history of direct sun exposure, and uv rays. His case report is important attributable to recurrent axillary metastases occurred after subsequent treatment.

Clinical Findings: The patient chief complaint is burning sensation on consumption of hot & spicy food since 3 months, apraxia, difficulty in mastication since 2 months approximately & nerve parenthesis in lower lip.

Diagnostic Evaluation: Hemoglobin (HB) -13.2gm,mch-27.9fl,mchc-33.3%, Total red blood cell (RBC) count-4.72million/cu.mm Rdw- 12.7%, Total white blood cell (WBC) count- 16500cu.mm, Monocytes -4%, Granulocytes- 85%, Lymphocytes -10%, Esonophils-2%, Basophilis-0%, Total platelet count-2.68 cu. mm.

Histopathology report: A multiple, irregular, reddish, brownish tissue pieces aggregating 1×1cm. selection from given tissue piece shows histopathological features are suggestive of well differentiated squamous cell carcinoma. Therapeutic Intervention:  post-chemo hydration, post-chemo drugs, BEP Chemotherapy (Bleomycin, Etoposide, Cisplatin).

Summary and Conclusions: The patient who was a 59 years old male was admitted to the oral surgery ward.  The patient was diagnosed as having  squamous cell carcinoma of the lip and he had complained of having burning sensation on consumption of hot & spicy food over the preceding 3 months,  apraxia and difficulty in mastication, over a period of about 2 months, and nerve paresthesia within his lower lip. He underwent mandibulectomy with excision of the tumour. Following radical mandibulectomy and adjuvant chemotherapy and radiotherapy, the patient has remained well with no evidence of metastasis at his 4 months follow-up based upon clinical assessment and radiology imaging which does illustrate that radical surgery, plus chemo-radiation for locally advanced squamous cell carcinoma has been shown to be associated with a good short-term outcome and after further follow-up assessments, the long-term outcome of radical surgery and adjuvant chemotherapy would be known.

Open Access Case Study

Non-Hodgkin’s Lymphoma: A Case Report

Aditya Patel, Samrudhi Gujar, Savita Pohekar, Ruchira Ankar, Arati Raut, Sheetal Sakharkar, Vaishali Tembhare, Pranali Wagh

Journal of Pharmaceutical Research International, Page 264-267
DOI: 10.9734/jpri/2021/v33i53B33705

Introduction: Hodgkin's and non-lymphomas Hodgkin's are malignant tumours of lymphoid tissue. Non-lymphomas Hodgkin's are a type of lymphoid tissue cancers that arise from T or B cells or their progenitors, and can be indolent or aggressive. B-cell lymphomas account for around 80% of all cases in the United States. Chronic lymphocytic leukaemia or small lymphocytic lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and primary cutaneous B-cell lymphoma are all examples of Non-Hodgkin's Lymphoma. Non-Lymphoma Hodgkin's is the sixth most prevalent malignancy in the United States, with incidence rates nearly doubling in the last 35 years. With each decade of life, the incidence rises; the median age upon diagnosis is 66. In India, the incidence rates in urban regions are many times higher than in rural areas, with the incidence being higher in metropolitan cities and among Indian immigrants, implying that urban lifestyles and economic advancement may boost cancer incidence. In 2010, NHL was projected to have caused roughly 0.36 million new cases and 0.19 million deaths.

Case Presentation: A male patient of Two and half years from Shiwangaon MO, was admitted to Paediatric Ward, AVBRH on 31st May, 2021 with a known case of Non-Hodgkin Lymphoma which was diagnosed itself at AVBRH on 31st May,2021. My patient was brought with a chief complain of swelling in the testicular region for 6 days. As narrated by the patient’s father, my patient was apparently alright 6 months back and then patient develop swelling in temporal region suddenly, associated with pain on touch, as the swelling develops more and uncomfortable, patient was brought immediately to AVBRH and was admitted in Paediatric Ward for further investigation.

Open Access Case Study

A Case Report on Tuberculous Meningitis

Shreya Kapgate, Ranjana Sharma, Deeplata Mendhe, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 274-278
DOI: 10.9734/jpri/2021/v33i53B33707

Introduction: The most common cause of tuberculous meningitis is a hematogenous spread of mycobacteria from the lungs. tuberculous meningitis is a fatal disease. Symptoms typically worsen over time, and there are three clinical stages to the disease (prodromal phase, phase of neurological symptoms and phase of paresis)

Case Presentation:  The chief complaint of a one-year-old boy was fever, irritability, vomiting, and Generalized Tonic-Clonic Seizure convulsions. The patient's pupils were found to be unequal on physical examination, prompting a repeat neuroimaging. It was done on MRI (magnetic resonance imaging) with T1 hyperintensity on T2 and restricted diffusion on DWI (diffusion-weighted imaging) he has not improved after taking treatment and the patient is on a ventilator as well, we nasogastric tube also. I was receiving treatment and will continue to do so until the end of my care.

Conclusion: In our environment, tuberculous meningitis that presents late is not uncommon. It arrived late at our medical facility. After a full recovery, the patient's comprehensive health care team collaborates to help him regain his previous level of independence and satisfaction. This report is intended to raise clinician awareness of tuberculous meningitis' unusual clinical presentation. Tuberculous meningitis is treated holistically with a focus on medical and nursing management.

Open Access Study Protocol

Title of Study/Article: Clinical Significance of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Predicting Postoperative Complications in Patients Undergoing Major Abdominal Surgery

Shyamal Shah, Darshana Tote

Journal of Pharmaceutical Research International, Page 258-263
DOI: 10.9734/jpri/2021/v33i53B33704

Background: Major abdominal surgeries are those that require more than 30 minutes, are conducted under general anaesthesia, and need at least a six-day stay in the hospital

Aim: To examine the clinical significance of pre-operative and postoperative NLR and PLR as separate morbidity parameters and the occurrence of surgical or non-operative complications in major abdominal operations.

Objectives: To determine the possible postoperative association of the importance of Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) with postoperative complication.

Methodology: This prospective study to find out the prediction postoperative complication after major abdominal surgery by nlr and plr values would be conducted in Acharya Vinobha Bhave Rural Hospital located in Central India in 30-50 participants between July 2019 to October 2021.

Results: Thefindings obtained during the course of the study would be analysed using SPSS software version 25.0 by the statistician.

Conclusion: The Nlr and Plr Ratio Is An Important Inflammatory Predictive Value In Assessing The Post-Operative Morbidity In Cases Of Major Abdominal Surgeries

Open Access Short Communication

Health Problems among Nurses Due to Flexible Working Conditions

Mayur B. Wanjari, Deeplata Mendhe, Pratibha Wankhede, Sampada Late

Journal of Pharmaceutical Research International, Page 234-237
DOI: 10.9734/jpri/2021/v33i53B33700

Sleepiness and sleeplessness are symptoms of shift work disorder (SWD), a sleep disorder caused by a person's work schedule. Understanding the mechanisms underlying shift work-related health concerns may be necessary when scheduling shifts, establishing employment routines, providing clinical care, and selecting employees. In today's workplace, stress has become the most influential element impacting individual efficacy and satisfaction. In this environment, occupational stress is becoming increasingly prevalent in the nursing profession. Nurses in today's healthcare system encounter several obstacles. These difficulties develop as a result of issues at the organizational, state, and national levels. It is critical for nurses to first recognize and comprehend every potential difficulty they may confront to deal with them effectively. Not only should they be recognized and understood, but methods to minimize them should also be sought.

Open Access Short Communication

A Short Note on Objective Structured Clinical Examination (OSCE)

Pauline Sharmila

Journal of Pharmaceutical Research International, Page 247-251
DOI: 10.9734/jpri/2021/v33i53B33702

Objective Structured Clinical Examination (OSCE) is a structured competency based examination popularly used in examining the Medical and Nursing students. The clinical competence is evaluated by a team of examiners through uniformly timed, multiple stations. OSCE as an evaluation tool is gaining importance and it is becoming very popularly used by examiners all over the world as it is standardised and multiple observations and skills can be assessed equally for all the students in a single preparation. OSCE with its advantages like objectivity, tailored stations, safety of the patients and provision of audit and recording of the entire process has made it the most needed assessment of the skill component in most of the professional programmes concerning medical and nursing students.

Open Access Minireview Article

Exploration of Phytochemistry and Ethnobotanical Uses of Cedrus deodara: A Review

. Nishtha, Parikshit Thakur

Journal of Pharmaceutical Research International, Page 149-152
DOI: 10.9734/jpri/2021/v33i53B33691

Cedrus deodara is one of the most useful tree species. Almost every part of the plant has good properties. Cedrus deodara has been an important tree due to its Ethnobotanical uses, Traditional uses, Phytochemistry and Pharmacology. From last decade, there has been a great progress in the medicinal perspectives of Deodara. Deodara has its utility in folklore medicines. Phytochemistry studies showed the presence of various useful compounds in the Deodara tree. Also, the oil of Cedrus deodara has a characteristic fragrance. C. deodara is also having traditional and ethnobotanical uses. Since Vedic period, various parts of this plant are being used for medicinal purposes.It is also believed that various respiratory diseases can be just cured by just sitting under this tree. In present, Deodara is seen as an important tree in point of view of research. It has its applications in Timber too [1]. This paper is focussed on the traditional and medicinal aspects of Cedrus deodara.

Open Access Minireview Article

Nursing Students and Online Learning During COVID-19 Pandemic: A Scoping Review

Rinu J. George, Jibin Kunjavara, L. Manoj Kumar, Shiny T. Sam

Journal of Pharmaceutical Research International, Page 268-273
DOI: 10.9734/jpri/2021/v33i53B33706

Aim: This scoping review paper aimed to overview the published research related to nursing students and online learning during the COVID-19 pandemic over the last year 2020-2021.

Methodology: Online Google Scholar Database was searched for articles related to nursing students and online learning during Covid 19 pandemic published between1st June 2020 to 1st June 2021.

Results: Initial search with key words “nursing students” found 20300 results, finally 39 articles were selected which meet the eligibility criteria. Majority of the authors (69.23 %) have an academic affiliation, only one single author (11.2 %) with clinical affiliation and those who had both academic and clinical were (28.19 %). Only (5.12 %) study applied any theory or conceptual frame work. The focuses of the studies selected were mainly (33.33 %) perception or attitude, (28.20 %) impact and satisfaction were as (20.52 %) focused on experiences and challenges faced. We could only find (5.12 %) studies those where funded. In the selection of research designs majority (46.15 %) adopted quantitative approach followed by (20.51 %) qualitative approaches and (10.25 %) mixed methods; others (23.07 %) included reports, editorials, reflective articles, opinions. About (94.8 %) studies were done without any collaboration with other disciplines only (5.12 %) studies were multidisciplinary.

Conclusion: Nursing teaching faculties swiftly responded to COVID-19 by conducting researches mainly adopting quantitative approaches. Nursing researches need more collaboration and funding.

Open Access Original Research Article

Frequency of Overweight Women and Ovarian Enlargement among Females Presented with Pelvic Pain Complains

Rukhsana Soomro, Zahida Parveen Brohi, Asma Jabeen, Afra Rehman, Mehreen Yousaf Rana

Journal of Pharmaceutical Research International, Page 1-4
DOI: 10.9734/jpri/2021/v33i53B33673

Objective: To determine the frequency of overweight females and ovarian enlargement among women presenting with pelvic pain complaints at rural Health facilities of district Tando Muhammad Khan.

Methodology: This descriptive study was conducted at physiology department of Sindh University with the collaboration of different rural health facilities of Tando Muhammad Khan, Sindh. All the females presented with pelvic pain and age more than 18 and up to 45 years were included. Body mass index (BMI) was assessed by the ratio of the individual's weight in kilograms divided by the height in meters squared (BMI = kg/m2). All the patients underwent ultrasound examination. Data collection was done by structured study proforma. Analysis of the data was done by the SPSS version 20.

Results: A total of 239 women with pelvic pain complaints were studied, their mean age was 32.79+4.31 years. Neoplastic ovarian lesions were seen amogn12.54% of the cases. Cystic ovarian lesions were among 30.54% of the females, 5.01% had ovarian mass and 21.33% females had mixed pathologies. BMI was normal among 62.76% cases, while 20.08% women were overweight, 03.34% were obese and 13.8%females were underweight.

Conclusion: Overweight females and ovarian enlargement were observed to be highly frequent among females presented with pelvic pain complaints. Cystic enlargement was observed to be the commonest cause of ovarian enlargement.

Open Access Original Research Article

Role of Vitamin D in Reducing the Frequency of Asthma Attacks in Patients with Frequent Exacerbation of Asthma

Mubeen Ahmed Memon, Sheeba Faryal Ansari, Mumtaz Ali Lakho, Mukhtiar Hussain Jaffery, Syed Zulfiquar Ali Shah, Samar Raza

Journal of Pharmaceutical Research International, Page 11-16
DOI: 10.9734/jpri/2021/v33i53B33675

Introduction: Vitamin D deficiency is common among asthmatics with literature suggesting that its low levels in the body may trigger exacerbations and decrease the response to corticosteroid treatment. It has also shown to inhibit the production of cytokines, which in turn enhances the body’s response to corticosteroid treatment during an exacerbation. Therefore, maintenance of adequate levels of vitamin D in patients with asthma may reduce the risk of exacerbation and improve their general health. This study aims to explore the role of vitamin D supplementation in preventing asthma exacerbations.

Methods: This single blind parallel arm interventional study was conducted in the pulmonology ward in a tertiary care hospital from June 2018 to April 2020. Two hundred (n= 200) participants with a history of frequent acute exacerbation of asthma were enrolled in the study via consecutive convenient non-probability technique. Participants were divided into two groups; the placebo and the interventional group that received 200,000 IU of vitamin D capsule.

Results: Compared to day 0, mean episodes of exacerbation in the interventional group were significantly lower after 180 days (1.1 ± 0.4 vs. 0.61 ± 0.3; p-value <0.0001). Similarly, number of asthma attacks in past 7 days was significantly lower in intervention group after 180 days (4.4

± 2.7 vs. 3.1 ± 1.5; p-value 0.0001)

Conclusion: Vitamin D supplementation is a safe and cost-friendly approach to reducing asthma exacerbations. It may also help to improve the condition in severe asthmatics with low vitamin D levels.

Open Access Original Research Article

Maternal Morbidity in a Context of Social Vulnerability: The Case of the Province of Essaouira, Morocco

Abdelmounaim Manoussi, Abdellatif Baali, Hakima Amor, Nadia Ouzennou

Journal of Pharmaceutical Research International, Page 17-27
DOI: 10.9734/jpri/2021/v33i53B33676

Aims: The main aim of this study is to assess the prevalence of maternal morbidity                         among childbearing women and to determine the associated factors in a context of social vulnerability.

Study Design: This is a quantitative analytical cross-sectional study.

Place and Duration of Study: The study was conducted in 18 health centers in the province of Essaouira, Morocco from January 2020 to January 2021.

Methodology: We conducted a structured interview survey. Simple: We included 1184 married women aged 18 to 49.

Results: The prevalence of maternal morbidity was 64.8%. The main morbidities were sexually transmitted infections (50.1%) and anemia (45.8%). Multivariate analysis showed that frequency of postnatal visits, socioeconomic level, knowledge of pregnancy risks, and couple literacy, were statistically associated with maternal morbidity.

Conclusion: The use of postnatal care, the improvement of the socio-economic level of households, health education programs, and the fight against illiteracy are factors that would reduce maternal morbidity.

Open Access Original Research Article

Determination of a Cone-Beam Computed Tomography based Assessment of Mental Foramen Position

Bashir Ahmed, Manoj Kumar, . Bushra, Suneel Kumar Punjabi, Raj Kumar, Salman Shams

Journal of Pharmaceutical Research International, Page 28-33
DOI: 10.9734/jpri/2021/v33i53B33677

Objective: To assess the occurrence and location of the mental foramen in relation to gender and age by using cone-beam computed tomography.

Materials and Methods: A descriptive case series study was conducted at department of radiology at advance diagnostic care centre, Institute of Dentistry, Liaquat University of Medical & Health Sciences Hyderabad. One hundred and fifty patients of either gender, having age 18-40 years with retained permanent dentition and recommended for cone-beam computed tomography (CBCT) radiograph were selected by non-probability convenient sampling technique. Patients with history of bone disease, old trauma and not willing to participate were excluded. CBCT imaging of each patient will be performed and assessed for occurrence and location of the mental foramen.

Results: Out of 150 patients, male were 98 (65.3%) and female were 52 (34.7%) with mean age of 28.8 ± 6.9 (18-40) years. Position 4 was the most common right side horizontal position with 74(49.3%) patients followed by position 3 with 69(46.0%) patients, position 5 with 6(4.0%) patients and position 2 with 1(0.7%) patients. Similarly position 4 was the most common left side horizontal position with 75(50.0%) patients followed by position 3 with 70(46.7%) patients, and position 5 with 5(3.3%) patients. Position 1 was only choice either for right or left side vertical position in all patients i.e., 150 (100.0%).

Conclusion: It was concluded from the study that no significant difference was observed in occurrence and location of the mental foramen in relation to gender and age by using cone-beam computed tomography.

Open Access Original Research Article

Organization of Dental Care for Adults with Cardiac Arrhythmia against the Background of Anticoagulant Therapy

Maria Vitalievna Lomakina

Journal of Pharmaceutical Research International, Page 61-64
DOI: 10.9734/jpri/2021/v33i53B33680

The high prevalence of cardiovascular diseases among the adult population leads to the risk of disability and mortality of people of working age. At the same time, this group of patients also needs comprehensive dental management and consideration of pharmacotherapeutic features. The growing cost of dental services leads to a decrease in the availability of dental care, especially taking into account the age criteria of patients with heart rhythm disorders. According to opinion polls, less than 5% go to the dentist for preventive purposes. However, patients taking anticoagulant therapy are at high risk of developing complications during dental interventions, which means they require increased preventive control by the dental care organization system.

Purpose: to evaluate aspects of the organization of dental care for patients with a history of cardiac arrhythmia and taking anticoagulant therapy.

Methodology: a prospective study based on the data of the copy, based on the results of an objective examination conducted by dentists (n=105), as well as an anonymous questionnaire of patients with rhythm disorders (N= 100) about the subjective assessment of the oral cavity and their awareness of methods and tools of prevention.

Results: patients with cardiac arrhythmia taking anticoagulant therapy have an increased risk of bleeding as part of dental interventions. For the studied group of patients, an objective examination revealed a characteristic clinical picture of the oral cavity. The characteristics required for drawing up a personalized treatment plan for patients with cardiac arrhythmia were also identified. As part of the study, data on the degree of awareness of patients and their subjective assessment of the state of the oral cavity were obtained.

Conclusion: patients taking anticoagulant therapy require increased attention during an appointment with a dentist. It is important to identify all predictors of the development of complications, during the collection of anamnesis, to identify and level the low awareness of the patient about the methods and tools of prevention, as well as to conduct personalized oral care training.

Open Access Original Research Article

Assessment of Skeletal Discrepancies by Determining R Angle in Lateral Cephalograms in Navi Mumbai Population

Sushma Sonawane, Vaidehi Save, Vivek Soni, Sameer Narkhede, Karthick Shetty, Nitin Gadhiya, Rakesh Singh, Aparna Khamatkar, Veera Sawant

Journal of Pharmaceutical Research International, Page 65-77
DOI: 10.9734/jpri/2021/v33i53B33681

There is considerable interest in the area of orthodontics in malocclusions caused by vertical discrepancies because of their causes, diagnosis, treatment planning, and tendency to return after treatment. Hence, this study aimed to assess, evaluate and check reliability for vertical skeletal discrepancy by establishing a parameter ‘R angle’ in Navi Mumbai population. In this study, the lateral cephalometric radiographs of 135 orthodontic patients between the age group of 18-30 years of age were selected from the database of the Department of Orthodontics and Dentofacial Orthopaedics in D Y Patil University School of Dentistry, Navi Mumbai The study found that the R angle is clinically and statistically important when examining vertical skeletal discrepancies. So with the above results it is observed that R angle can be used to assess vertical skeletal discrepancy in Navi Mumbai population. Along with other parameters it can be important and valuable tool for orthodontist to determine skeletal discrepancies in vertical plane.

Open Access Original Research Article

Antibacterial, Antifungal and Antihelminthic Properties of Ethanolic, Methanolic and Water Extracts of Pollen

Anita Rana

Journal of Pharmaceutical Research International, Page 78-88
DOI: 10.9734/jpri/2021/v33i53B33682

Microorganisms and helminthes can cause serious diseases in humans as well as in animals. The use of antimicrobial and antihelminthic drugs have created selective pressure and caused resistance to antibiotics used against them, thus it necessitates the use of honey bee’s derived natural products. One such bee derived product is pollen, collected by worker honey bees from the flowering plants and modify it by adding its salivary secretions. The present study embodies use of pollen as antimicrobial and antihelminthic substance. Among microorganisms 4 Gram (+ve) bacteria; (Bacillus subtilis, Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pneumoniae) and 3 Gram (-ve) bacteria; (Escherichia Coli, Pseudomonas aeruginosa, Salmonella enteric) and 2 yeasts (Candida albicans and Saccharomyces cerevisiae) were used and the methodology used disc diffusion assay and broth dilution method. The antihelminthic effect was observed among amphistomes via bioassay method under in vitro conditions. For observations three types of pollen extracts (ethanolic, methanolic and water extract) were prepared and positive controls used were; Ampicillin for antibacterial, Amphotericin B for antifungal and Albendazole for anti-helminthes. The antimicrobial activities were determined by measuring the zones of inhibition diameters in millimeters after 24 hours of incubation at optimum temperature for each microbe and also by broth dilution method. Results obtained showed that the water extract of pollen was found to be most effective against bacteria used in the present study where; Gram (+ve) bacteria were more susceptible as compared to the Gram (-ve) bacteria. It was also observed that among yeasts; Saccharomyces cerevisiae was more susceptible towards ethanolic extract of pollen while Candida albicans showed more inhibitions towards water extract of pollen. Results also demonstrated that none of the extracts of pollen was found to be effective against Helminthes (amphistomes) used in the present study.

Open Access Original Research Article

Antibacterial, Anti-inflammatory and Antioxidant Potential of Ethanol Extract of Ipomoea staphylina Roem. & Schult

G. Kokila, P. Jeevan

Journal of Pharmaceutical Research International, Page 97-106
DOI: 10.9734/jpri/2021/v33i53B33685

In the present study we evaluate the antibacterial, anti-inflammatory and antioxidant activity of medicinal plant Ipomoea staphylina Roem & Schult. Many bacteria are harmful to human beings and animals. Theses bacteria make diseases the host organisms. Many antibiotics are available in the marker for the treatment of bacterial diseases. However, antibiotics cause unwanted side effect. Thus, the study focused to evaluate ethanol extract of Ipomoea staphylina against bacterial pathogens. Antibacterial activity was evaluated by the method of well diffusion method. Antiinflamatory and antioxidant activity was evaluated by in vitro study method. Ethanol extract of Ipomoea staphylina showed antibacterial activity against different bacteria isolated from chicken at dose depended manner ie., higher dose of plant extract possessed maximum inhibition zone (21.67 ± 1.45 mm) (P<0.05) against selected bacteria. Moreover, plant ethanol extract possessed anti-inflammatory activity and antioxidant activity at dose dependent manner (P<0.05). Higher dose (100 μg/ml) of ethanol extract of Ipomoea staphylina showed maximum anti-inflammatory activity (68.38 %) and antioxidant activity (72%). From this result it is concluded that the medicinal plant Ipomoea staphylina Roem. & Schult. possessed antibacterial, anti-inflammatory and antioxidant activity. Further detailed study will be conducted for the new drug candidate discovery.

Open Access Original Research Article

New Insight of Methylenetetrahydrofolate Reductase (MTHFR) C677T Gene Polymorphisms, and Serum Electrolytes in Cardiac Syndrome X Patients

Nasir Abdelrafie Hamad, Lienda Bashier Eltayeb

Journal of Pharmaceutical Research International, Page 115-121
DOI: 10.9734/jpri/2021/v33i53B33687

Background: Cardiac Syndrome X (CSX) is a condition affecting the cardiovascular system with a significant degree of morbidity. Diagnosis and treatment are challenging when the cause is unclear. Subsequently, a molecular marker for screening of people with CSX is highly recommended. The present study evaluated the association between MTHFR C677T gene polymorphism among Sudanese patients with CSX.

Materials and Methods: A total of 100 subjects were enrolled. Venous blood sample was collected from each participant in Ethylene Diamine Tetracetic Acid (EDTA) containers. DNA was extracted from blood samples using guanidine chloride method and MTHFR mutation was detected by PCR-restriction fragment polymorphism (PCR-RFLP). Statistical package for social sciences (SPSS) was used to analyze data.

Results: Most patients 30(60%) were females, their age ranged between 30-60 with mean age 44.98±7.34 SD. MTHFR 677CT genotype frequency was statistically significant (P≤0.014), where 10(20%) had 677CT and 1(2%) had 677TT among patients group respectively compared to control individuals who had only 2(4%) 677CT. T alleles were significantly more frequent among our participant than C alleles. There is insignificant slightly decreased (2.4 ±2.8, and 2.5±3.2) in serum magnesium levels among patients compared to control respectively, as well as random blood glucose. Elevated mean levels of total cholesterol, and HDL among patients (182 ±18.1, and 49.7±7.1) vs (180 ±20.3, and 46.6 ±11.3) among control group, all findings were statistically non-significant. Slightly decrease in magnesium level (2.2 ±2.1, vs 2.9 ±0.8) among heterozygous CT genotypes compared to homozygous genotypes.

Conclusion: MTHFR C677T is linked to CSX in the Sudanese population, and serum magnesium level was slightly decreased among heterozygous MTHFR C677T. Furthermore, the mutation could be used as a disease molecular screening technique.

Open Access Original Research Article

Effect of Ayurvedic Interventions on Toxemia of Pregnancy (Preeclampsia) & Fetal Outcome- A Randomized Placebo-Controlled Trial

Renu Rathi, Geeta Sharma, C. H. S Sastry, Abhimanyu Kumar, Jitesh Verma, Bharat Rathi, Sumod Khedekar

Journal of Pharmaceutical Research International, Page 136-148
DOI: 10.9734/jpri/2021/v33i53B33690

Background: Toxemia of pregnancy also known as preeclampsia is a common clinical condition affecting 8-10% pregnancies worldwide. It has adverse outcome both for mother and fetus. The management options are mainly targeted to prevent adverse outcomes associated to                premature births, such as administration of antenatal corticosteroids and magnesium sulphate infusions.

Aim & Objectives: The main aim of the study was to evaluate efficacy of Ayurvedic interventions in management of toxemia and in prevention of premature delivery as well as fetal hazards due to pre-eclampsia.

Methods: It was an open ended, parallel group, randomized placebo controlled clinical trial with equal allocation in both the groups. Sample size was 15 in each group. Trial group was administered Gokshura Siddha Yavagu(Green gram gruel medicated with Tribulus terrestris Linn) and Dhatryavaleha (linctus prepared with Ayurveda medicines like Phyllanthus emblica L.)while control group was treated with similar looking placebo-linctus.

Results: Both ayurvedic parameters-Shotha(edema), Avil mutrata (Discolored urine) & clinical features of toxemia have shown excellent relief while control group patients either show poor or no relief when assessed by USG scan and needed further treatment with induction of labor.

Conclusion: This study concludes that Ayurvedic interventions in the form of Gokshura siddha Yavagu and Dhatri Avleha can provide significant symptomatic relief (p<0.0001) in toxemia of pregnancy and can also promote normal growth and development in fetus.

Open Access Original Research Article

To Compare Mean Time Taken for Tracheal Intubation with Airtraq Versus Macintosh Laryngoscope in Elective Surgeries: A Randomised Clinical Trial

Kenza Nadeem, Naila Zahoor, Rabia Tabassum, Ziauddin Kashmiri, Muneeba Arshad, Tariq Hussain Mughal

Journal of Pharmaceutical Research International, Page 153-158
DOI: 10.9734/jpri/2021/v33i53B33692

Objective: To compare mean time taken for tracheal intubation with Airtraq versus Macintosh laryngoscope in elective surgeries.

Study Design: This is a Randomized control trial (RCT) study.

Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from June 2016 to November 2016.

Materials and Methods: A total of 60 patients divided 30 in each group randomly i.e. Macintosh laryngoscope Group A and Airtraq laryngoscope Group B who scheduled for elective surgery and fulfill the inclusion criteria. All patients were received intravenous glycopyrolate 0.2 mg, tramadol 2 mg/kg, and midazolam 0.03 mg/kg 10 minutes before induction of anesthesia. Induction was done with propofol 2-2.5 mg/kg, minimum 3 minutes were given to maximum effect of muscle relaxant. Time taken to intubate the trachea were noted in seconds and entered into the predesigned proforma.

Results: The analysis included data on all the patients between 18 to 50 years of age who scheduled for elective surgery during the study period after applying the exclusion criteria. Mean ± SD of age in group A were 36.85±8.47 years and in group B were 37.49±9.32 years. In Gender distribution of group A 11 (36%) were male and 19 (64%) were female and in group B the distribution of male and female were 8 (27%) and 22 (73%) respectively. By comparing both the groups for time taken in tracheal intubation in seconds Mean ± SD of group A was 35±7.8 and in group B was 21±4.2 and P value found to be highly significant i.e. (0.0001). 

Conclusion: It is to be concluded that Airtraq laryngoscope is more effective instrument than Macintosh Laryngoscope for use in routine airway management and duration of successful tracheal intubation was shorter in the Airtraq group.

Open Access Original Research Article

Formulation Development and Characterization of Darunavir and Ritonavir Sustained Release Tablets Using Quality by Design Approach

Dhaval Patel, Hitesh Patel, Hiren Chaudhary

Journal of Pharmaceutical Research International, Page 159-172
DOI: 10.9734/jpri/2021/v33i53B33693

Darunavir is a nonpeptidic inhibitor of protease and is primarily metabolized by cytochrome P450 3A (CYP3A) isoenzymes. It is usually coadministered with low-dose ritonavir (Darunavir/r). Ritonavir is an inhibitor of CYP3A isoenzymes and pharmacologically enhances Darunavir which leads to increased plasma concentrations of darunavir and allows for daily lower dose. Here, we have developed combination SR formulation of Darunavir and Ritonavir and evaluated. In vitro drug release of all formulations was carried out in dissolution medium 900ml of pH 3.0, 0.05 M Sodium Phosphate Buffer + 2% Tween 20 for 75 RPM USP II apparatus (paddle). The results shown that, all the formulations of matrix tablets shown the good release of drug from trialed formulations however all formulations were not releasing the drug in enough amount. In matrix tablets F6, the release of drug shows NLT 80%. So, the formulation F6 have been considered as suitable for the SR tablet of Darunavir and Ritonavir. Tablets were also evaluated though Quality by Design (QbD) method.

Open Access Original Research Article

Determination of Patient Characteristics and Role of Physician Intervention for Uncontrolled Hypertension: A Risk for Coronary Artery Disease

Waseem Raja Memon, Shahzad Memon, Dayaram Makwana, Abdul Rashid, Beenish Ghafar Memon, Nasrullah Aamer

Journal of Pharmaceutical Research International, Page 173-181
DOI: 10.9734/jpri/2021/v33i53B33694

Objective: Our research was designed to evaluate the association of uncontrolled hypertension with coronary artery disease and analyze the role of intervention in preventing CAD mortality ratio.

Methodology: This case controlled single-center study was conducted in department of Medicine, Peoples University of Medical and Health Sciences Nawabshah Pakistan from January 2020 to September 2021. In this study, BP screening was done among the adult population aged 50 years or over. All the recruited patients of coronary artery disease were divided into two main groups for a clinical trial; case (identified cases of uncontrolled hypertension) and the control group (without history of cardiovascular disorders and used medication for hypertension). For evaluating physician intervention, both groups were divided into two main groups for treatments; the standard Bp control (having <140 mm Hg SBP level) and the intensive blood pressure control (whose SPB <120 mm Hg). we used BP-lowering medication which adjusted the systolic blood pressure around 135–139 mm Hg in the standard group and less than 120 in intensive group.

Results: Overall the female prevalence was comparatively high (63.2%) than males (37%). No significant differences were found in the baseline characteristics of participants.  In 42% of cases, we found coronary artery calcification. Univariate logistic analysis of our study demonstrates the association of CAD with age, smoking, and BMI. We also found a positive association of CAD with higher CRP, and uncontrolled hypertension.

Conclusion: Our study observed a significant association between uncontrolled hypertension and coronary artery disease. The results of our study concluded that interventions in terms of BP control might be affected due to pre-existing cardiovascular diseases. However, intensive BP treatment would help to reduce the mortality ratio of CAD patients.

Open Access Original Research Article

Tertiary Care Orthopedic Hospital Experience to Find Effect of Dynamisation in Delayed Union Tibia Shaft Fracture

Syed Salman Adil, Imran Khan, Muhammad khan Pahore, Lachman Das Maheshwari, Madan Lal, Niaz Hussain Keerio, Syed Shahid Noor

Journal of Pharmaceutical Research International, Page 189-194
DOI: 10.9734/jpri/2021/v33i53B33696

Objective: Our study was designed to evaluate the effect of dynamisation in delayed union tibia shaft fractures.

Methodology: This prospective study was conducted at the Orthopedic Department, Shaheed Mohtarma Benazir Bhutto Medical College, from March 2020 to March 2021. During this timeframe total of 20 patients who underwent dynamisation for reamed intramedullary nailing were recruited. After two successive visits, those patients whose fracture failed to show progressive signs of callus formation underwent dynamisation. We removed the single static screw from the longer fracture segment to perform the dynamisation procedure. We inserted a poller screw slightly medial to the nail from anterior to posterior to provide additional stability to the proximal fragment. Statistical analysis was performed by using SPSS 23.0. For evaluating the success of dynamisation Chi-square test was used.

Results: The mean age of recruited patients was reported as 35.92 years ranging from 16 years to 63 years old. Out of these twenty cases, 17 were male (85%). The mean time duration of nailing was reported as 35.4 hours. Total fourteen patients were immediately treated with nailing within 20 hours of injury, while the rest six underwent delayed nailing. Total four cases of tibial fracture were turned out as failure because the patient failed to achieve union after dynamisation and underwent augmentation plating with bone grafting for the complete union.

Conclusion: Delayed dynamisation is a convenient and cost-effective technique to achieve union in femoral shaft fractures. Overall, our study reported an 80% success rate but failed to achieve early dynamisation in comminuted fractures.

Open Access Original Research Article

Formulation, Development, Evaluation and Solubility Enhancement of Lercanidipine Hydrochloride by Solid Dispersion Techniques

S. D. Mankar, Punit R. Rachh

Journal of Pharmaceutical Research International, Page 195-213
DOI: 10.9734/jpri/2021/v33i53B33697

Background: Solid dispersions (SDs) are the dispersion of hydrophobic drugs in an inert hydrophilic carrier. SDs are prepared to improve the dissolution properties and bioavailability of slightly water-soluble drug molecules by dispersing them into an inert hydrophilic carrier.

Aims and Objective: Evaluate the dissolution and solubility of Solid Dispersion of Lercanidipine Hydrochloride (LER).

Materials and Methods: To study the effect of polymer, dissolution and solubility studies were carried out. Solid state characterizations of prepared solid dispersions were performed by differential scanning calorimetry (DSC).Drug- carrier interactions were studied by FT-IR spectroscopy, whereas X-ray diffraction of powder was done to demonstrate the crystal structure of the dispersions.

Results: The prepared solid dispersion exhibited 94% drug release at 30 minutes which is higher than both LER pure and LER MKT. Better dissolution characteristic of solid dispersion was confirmed by 9.86 min MDT and 63.12% DE30 which is higher than that of LER MKT (13.64 MDT, 46.92 % DE30) Solid state characterization revealed that enhancement of dissolution is the result of conversion of crystalline form of LER to less crystalline and/or amorphous form.

Conclusion: Solid dispersion of LER can successfully be prepared with the PEG6000 in the ratio of 1:6 using solvent evaporation technique. It is a successful and easy approach for the increase in onset of action of drug after administration and facilitates treatment of cardiovascular diseases.

Open Access Original Research Article

Determination of Terpenoid Profile in Dry Cannabis Flowers and Extracts Obtained from Different Cannabis Varietes

Tijana Serafimovska, Marija Darkovska Serafimovska, Marija Mitevska, Sasho Stefanovski, Zlatko Keskovski, Gjoshe Stefkov, Trajan Balkanov, Jasmina Tonic Ribarska

Journal of Pharmaceutical Research International, Page 214-228
DOI: 10.9734/jpri/2021/v33i53B33698

Aim: The aim of this study was to determine the terpenoid profile in dried cannabis flowers obtained from different varieties of cannabis plant and in cannabis extracts in order to investigate quantity of terpenes lost during extraction and purification process.

Methods: GC/MS method for determination of terpenes was verified. The concentration of terpenes was determined in dry flowers as raw material and in decarboxylated and distillated cannabis extracts, using the same GC/MS analytical method. The extraction was performed using 96% ethanol as a solvent.

Results: The obtained results indicate that dry cannabis flowers from different cannabis plant can be distinguished only by their terpenoid profile. The use of standardized cannabis-based extracts can be confirmed by determination of terpenoid profile. The purification process of the cannabis extracts removes terpenes. The percentage of major terpen beta-Myrcene decreased from 68% in dry flower to 15% in decarboxylated and, 1.9% in distillated cannabis oil after purification. The percentage of second major terpene alpha-Pinene decreased from 15% in dry flower to 5% in decarboxylated and, 0.7% in distillated cannabis oil after purification.

Conclusion: Terpenes act synergistically with cannabinoids. Following the monograph for quality testing of cannabis extracts in the German Pharmacopoeia, the purification process is necessary to achieve a final concentration of cannabinoids (Tetrahydrocannabinol) of more than 95% in the final active pharmaceutical ingredient. The purification process removes terpenes that have proven synergistically pharmacological effects with cannabinoids.

Open Access Original Research Article

Comparative Intraocular Pressure Study among Diabetic and Non-Diabetic Patients

Asadullah Jatoi, Noman Ahmed Shaikh, Mona Liza Mahesar

Journal of Pharmaceutical Research International, Page 229-233
DOI: 10.9734/jpri/2021/v33i53B33699

Background: Diabetes mellitus is one of the major health issues in the world. Its microvascular complications contribute to ocular complications including increased intraocular pressure (IOP) which is a risk factor of glaucoma. Identification of factors responsible for glaucoma is a mainstay in the early detection and prevention of blindness.

Aim and Objectives: The objective of the study was to compare IOP among diabetic and non-diabetic patients and to assess the correlation between age and IOP.

Materials and Methods: The cross-sectional study was performed on 104 participants. Patients were divided into two groups based on diabetes (case, n = 52) and non-diabetes (control, n = 52). The detailed history and routine clinical investigations were performed. Three consecutive readings of IOP of the left and right eye were recorded separately using Goldmann applanation tonometer. Wilcox sign-rank test and Spearman-correlation test was used to find the difference between the IOP and correlation between age and IOP, respectively.

Results: A significantly higher IOP was observed in diabetic patients than non-diabetic patients. (0.0001). There was no sex difference in IOP was observed in diabetic and non-diabetic patients. Age of the patient was not correlated with IOP (r = –0.02197219, P = 0.824).

Conclusion: Diabetic patients are prone to higher IOP; therefore, diabetic patients should be regularly assessed for IOP for diagnosis glaucoma.

Open Access Original Research Article

Efficacy of Submucosal Dexamethasone Injection on Postoperative Adverse Outcomes Following Third Molar Surgery

Arfat Bashir, Samreen Naz, Marium Khalil, Mehmil Aslam, Fida Hussain, Fizza Abidi

Journal of Pharmaceutical Research International, Page 238-246
DOI: 10.9734/jpri/2021/v33i53B33701

Introduction: The most common dento-alveolar procedure is surgical removal of an impacted third molar, which is associated with post-operative pain, swelling, and trismus.

Objective: To determine the effect of submucosal dexamethasone injection on the post-operative outcomes in third molar surgeries.

Materials and Methods: It was a descriptive study conducted in Department of Oral & Maxillofacial Surgery, Liaquat College of Medicine & Dentistry, Karachi between November 7, 2019 to May 6, 2020. All patients who fulfilled the inclusion criteria and visited to LCMD, Karachi were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, all the patients (n=65) received 4mg submucosal dexamethasone injection. The duration of surgery was recorded with postoperative outcomes in terms of pain, trismus and swelling were measured on 3rd and 7th day. All the collected data were entered into the proforma and used electronically for research purpose.

Results:  The mean SD of age was 25.9 ± 7.2 years. Right side surgery was documented in 39 (60%) patients, while left side surgery was documented in 26 (40%) patients. On the third and seventh day, the mean SD of VAS pain score was (5.9 ± 3.2), (3.8 ± 4.4), swelling was (2.5 ± 1.1), (0.9 ± 0.6) mm, and trismus was (16.9 ± 9.7), (11.8 ± 9.1) mm, respectively.

Conclusion:  It is to be concluded that a significant difference in outcomes was observed between the third and seventh post-operative days in patients who had submucosal dexamethasone injections in third molar surgeries.

Open Access Original Research Article

Frequency of Thrombocytopenia in Neonates Following Phototherapy in Neonatology Unit of Tertiary Care Hospital

Hina Naqvi, Shazia Memon, Mushtaque Ali Shah, Muhammad Nadeem Chohan, Numra Shaikh, Fiza Shah

Journal of Pharmaceutical Research International, Page 252-257
DOI: 10.9734/jpri/2021/v33i53B33703

Aim: To determine the frequency of thrombocytopenia and its severity in relation to level of indirect hyperbilirubinemia in neonates following phototherapy at tertiary care hospital.

Study Design: Descriptive study

Place and duration:  This study was conducted at Paediatric department (neonatal ward), Liaquat University Hospital, Hyderabad, from 1st August 2020 till 31st Jan 2021

Methodology: All neonates who fulfilled the inclusion criteria presented at pediatric department (neonatal ward), Liaquat University Hospital Hyderabad were included in the study. After written consent, brief history was taken from the mother or family member and complete blood count (CBC) was sent to check the baseline platelet count along with total serum bilirubin, it was repeated after 48 hours of phototherapy.

Results: Out of 231 neonates 70 (30.3%) developed thrombocytopenia after phototherapy. In our study 117 neonates (50.6%) were males & 114 neonates (49.4%) were females with the mean age of 5.9307+1.6640 days. The thrombocytopenia was seen in 70 neonates (30.3%) and type of severity was mild, moderate & severe in 52(22.5%), 13(5.6%) & 5(2.2%) respectively.

Conclusion: There was a decline in mean platelet count after phototherapy but it was not statistically significant. The treating doctor should also keep in mind, other causes of thrombocytopenia when the patient is receiving phototherapy.

Open Access Original Research Article

The Effectiveness of Muscle Energy Technique in Patients with Adhesive Capsulitis

Farjad Afzal, Akhtar Rasul, Muhammad Shahid Javed, Muhammad Mustafa Qamar, Bushra Mushtaq, Muhammad Fahad Kayani, Sehar Afreen, Sidra Ali Naqvi, Muhammad Arif

Journal of Pharmaceutical Research International, Page 279-283
DOI: 10.9734/jpri/2021/v33i53B33708

Objective: The objective of study was to find the effectiveness of muscle energy techniques (METs) in patients with adhesive capsulitis.

Methodology: Study was conducted in population of Sargodha seeking physiotherapy treatment for adhesive capsulitis in physiotherapy rehabilitation departments and centers. Study was randomized, controlled and multicenter. 50 patients were selected by inclusion and exclusion criteria and were divided into two groups by lottery method of randomization. Group I obtained muscle energy technique. Group II was controlled that obtained conventional treatment in the form of heat and range of motion exercises. Duration of study was 06 month. Interventions were carried out for two weeks (total 10 sessions). A baseline measurement was taken on shoulder pain and disability index (SPADI). A post intervention measurement was taken on same outcome measurements tools and was compared by independent t test.

Results: The pre intervention measurements on Shoulder Pain Disability Index were 61.11 in control and 61.18 in METs group. The post intervention measurements on Shoulder Pain Disability Index were 49.33in control and 27.69 in METs group.

Conclusion: This study concluded that METs techniques are effective in treatment of adhesive capsulitis to decrease the pain and disability in comparison to control groups.

Open Access Original Research Article

CECT in Pulmonary Thrombolism

Shaha Pramod, Ragi Skanda, Bhoite Amol, Tamboli Asif, Gautama Amol

Journal of Pharmaceutical Research International, Page 284-293
DOI: 10.9734/jpri/2021/v33i53B33709

Introduction: Pulmonary embolism (PE) is the third most common acute heart disease after myocardial infarction and stroke and is a major public health problem. PE is a disease that has high morbidity and mortality, yet it is challenging to obtain a diagnosis.

Objective: The study aims to assess the role of MDCT-PA in the diagnosis of pulmonary embolism, and it's associated conditions in suspected cases of pulmonary embolism.

Materials and Methods: The study was conducted in the department of radiology in KRISHNA INSTITUTE OF MEDICAL SCIENCES DEEMED TO BE UNIVERSITY situated in KARAD equipped with a 16 slice MDCT scanner (EMOTION) manufactured by Siemens.

Results: Through the study period of one and half year and have met the inclusion criteria, a total of 90 consecutive patients who presented with suspicion of PE were referred for MDCT-PA in the department of radio-diagnosis, Krishna Hospital, Karad. A review of all the cases was done, and the results were presented in the form of tables.

Conclusion: Multidetector computed tomography pulmonary angiography can be used to confidently diagnose pulmonary embolism in which it is not contraindicated. MDCT-PA is the investigation of choice because it is a rapid, non-invasive study, highly sensitive and specific.

Open Access Original Research Article

Assessment of Knowledge and Practices on Effective Hand Hygiene among Rural and Urban Population of South India: A Web Based Cross Sectional Survey

S. M. G. Ishrar, C. Nagavalli, V. Vikas Reddy, G. Navya

Journal of Pharmaceutical Research International, Page 294-302
DOI: 10.9734/jpri/2021/v33i53B33710

Aims: The study aims to assess the level of awareness regarding Hand hygiene among the population in urban and rural areas of South India.

Study Design: A web based cross sectional survey.

Place and Duration of Study: An online study was conducted among public of South India for a period of 6 months.

Methodology: The data was collected through online mode by providing google link to fill questionnaire form through various social media platforms. The questionnaire consists of demographic details, knowledge and practice related questions. SPSS was used to interpret data and chi-square test, independent T test, backward multiple regression analysis was done.

Results: From the collected data a total of 1178 responses were collected (urban:726, rural:452). From independent T test the knowledge mean score of HH was: 10.07±2.136 for urban population and 9.79±2.138 for rural population. By this urban population has more knowledge than rural population. From backward multiple regression analysis of Knowledge score, the findings shown that the urban male residents with 2 members household residing in Tamilnadu have preferably more knowledge than others when compared with demographic details. From the independent T test the HH practice mean score was 11.25±1.991 for urban residents and 10.77±2.280 for rural residents. From the Backward multiple regression analysis of Practice score, the findings shown that most parsimonious combination of region (rural, urban), age group (10-30 years, 30-60 years and >60 years), gender(female, male), state and UT (Andhra Pradesh, Karnataka, Tamilnadu, Kerala, Telangana, Andaman and nicobar, Puducherry, Lakshadweep), household (2, 3, 4, >4 members), education level (10 and below 10, intermediate, UG, PG, Ph. D) in predicting the practice score.

Conclusion: The study results concluded that urban residents have preferably more knowledge than rural residents. Creative campaigns and awareness programs should be conducted to attain persistent improvement in HH practices.

Open Access Review Article

The Role of Ultrasound in Diagnosis of Acute Appendicitis: A Review Article

Rania Mohammed Ahmed

Journal of Pharmaceutical Research International, Page 5-10
DOI: 10.9734/jpri/2021/v33i53B33674

Acute appendicitis (AA) is a frequent abdominal infection that affects 7% of people at some time in their lives. As a result, any delay in diagnosis might lead to complications such as perforation and abscesses in the incision. Ultrasound (U/S) plays an essential role in the diagnosis and management of acute appendicitis, which improves patient outcomes. Recent technological advances have brought profound changes to diagnostic ultrasound imaging. Acute appendicitis is a frequent abdominal condition that affects many people at their lives acute appendicitis is a difficult diagnosis based on clinical and laboratory data.

Abnormal US findings during appendiceal scan indicate a greater chance of having recurrent appendicitis, US scan play an important role in the pre-surgical evaluation and planning of patients with appendicitis.

In this review, different US techniques and their applications in diagnosis of appendicitis and early and accurate diagnosis are discussed.

Open Access Review Article

Phytochemicals against COVID -19, Pharmacological Perspectives: A Systematic Review

Ahmed S. Ali, Ekram A. Saied, Sharifa M. Theeban, Mazen M. Humayran, Assmaa Ahmed Shaker, Abdelbagi Alfadil, Mohammed S. Almuhayawi

Journal of Pharmaceutical Research International, Page 34-55
DOI: 10.9734/jpri/2021/v33i53B33678

Background: Many publications discussed the potential role of medicinal plants in the management of COVID-19. However, clinical studies of the efficacy and safety of specified phytochemical(s) are limited.

Objectives: To explore the pharmacological profile of specified compounds against COVID-19

Method: Systematic literature search of academic databases to explore specified phytochemicals for the management of COVID-19 using appropriate search terms. Rayyan software was used to organize 786 citations of which. 236 articles were included in this review.

Results: Initially 70 compounds were identified to have a potential role in the management of COVID-19. In this review, 18 compounds were selected for further search

Conclusion: In vitro anti-SARS-CoV-2activity has been demonstrated for a variety of natural compounds. However, preclinical research for most phytochemicals is scarce, and only a few compounds have been evaluated in clinical trials against COVID-19. A comprehensive pharmacological profile of these phytochemicals is urgently needed.

Open Access Review Article

Challenges Faced by Healthcare Professionals During the COVID-19 Pandemic: A Review

Pratibha Wankhede, Mayur Wanjari, Sampada Late, Hina Rodge

Journal of Pharmaceutical Research International, Page 89-92
DOI: 10.9734/jpri/2021/v33i53B33683

Introduction: On March 11, 2020, the WHO formally declared the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks a pandemic by publishing public health guidelines to guide pandemic response. Serious illnesses may necessitate hospitalization and ventilatory assistance. The pandemic of coronavirus disease 2019 (COVID-19) has posed new concerns for healthcare workers around the world. However, in many developing nations, including India, information is scarce concerning these issues. Healthcare facilities are one-of-a-kind and difficult to understand. The Indian healthcare system consists of both governmental and private healthcare facilities. Healthcare practitioners face a variety of obstacles daily. The unexpected appearance of COVID-19 created a new threat to an already overburdened healthcare system. The pandemic altered the healthcare dilemma by introducing new employment and societal obstacles to healthcare workers. The goal of this review research is to uncover the causes of the workplace and societal issues that healthcare workers encounter.

Open Access Review Article

Orchids as Valuable Folklore Medicine: A Review

. Sushma, Reenaand Diksha

Journal of Pharmaceutical Research International, Page 93-96
DOI: 10.9734/jpri/2021/v33i53B33684

The impetus of writing this paper is to review various medicinal orchid species growing in different parts of India. The family orchidaceae is one of the diverse groups among angiosperms which includes different types of orchid species. This paper is written to review the medicinal and therapeutic importance and use of different orchid species for treatment of various types of diseases. Orchids are herbaceous plants which are mentioned in ancient ayurvedic system of medicine because of their therapeutic properties. Most of the medicinal orchid species are epiphytic and terrestrial in habitat.

Open Access Review Article

A Review on Eucalyptus Globulus – An Authentic Herb

Shailja Sharma, . Sushma, . Nishtha

Journal of Pharmaceutical Research International, Page 107-114
DOI: 10.9734/jpri/2021/v33i53B33686

In the ancient time Eucalyptus globulus used for the various purpose. It is a tall and an evergreen tree that can grow up to the height of 70m and its diameter is about 4 to7ft. which was first found on the island of Tasmania in 1792 which associate to the Myrtaceae family which is commonly called as Tasmanian Blue Gum, southern blue gum or blue gum are the different names of eucalyptus globulus grow in the various parts of India. The particular species of Eucalyptus globulus have been used for various purposes. It had been found that eucalyptus is a rich source of phytochemical constituent and also possesses medicinal use. The different part of the eucalyptus is very nutritionally and highly valuable therapeutically property because of the presence of some specific chemical composition as its essential oil contain esters, carboxylic acids, aldehyde etc. phytochemical analysis of this tree has revealed that their leaf oil contain 1.8 cineole, cryptophone etc., essential oil had been extracted from its buds. The aim of this review paper is compiling all the information about eucalyptus such as anti-inflammatory, analgesic, anti-nociceptive antimicrobial, anti-fungal, anti-viral and anti-oxidant agent of the nature.

Open Access Review Article

Intercropping Systems in Wheat (Triticum sativum L.) for Insect Pests and Disease Management – A Review

Gurparteek Kaur, Garima Gupta, Kritika Hooda

Journal of Pharmaceutical Research International, Page 122-129
DOI: 10.9734/jpri/2021/v33i53B33688

Cereal crop wheat, Triticum sativum L., is an important food and feed crop that is grown all over the world. There is a complementary relationship between legumes and cereals for nitrogen resources, it was found that intercropped legumes acquire a higher amount of atmospheric nitrogen in comparison to legumes grown as an individual crop. Furthermore, both wheat and pulse intercropping give benefits in terms of minimizing pests and diseases. Intercropping not only restricts onset of pest species but also crop combinations conserves beneficial insects that can preserve the damaging pest population below the threshold level. In the current study, numerous instances were provided that show successful control of various insect pests when wheat was intercropped with mustard, Linseed, barley, mung bean, canola, and other crops. Wheat intercropping with other crops can be used as part of an integrated pest management strategy to reduce pest incidence while also increasing the number of beneficial organisms.

Open Access Review Article

Effects of Covid-19 on Patients with Cardiovascular Diseases: A Systematic Review

Naveen Sharma, Priyanka Joshi, Pawan Kumar Gupta, Parjanya Kumar Shukla, . Archna

Journal of Pharmaceutical Research International, Page 130-135
DOI: 10.9734/jpri/2021/v33i53B33689

Aim of Object: During the COVID-19 pandemic, the entire world is experiencing a mortality situation; most people are battling against the corona virus, but some individuals have already suffered from cardiovascular problems.

For improved patient care, adequate information and comprehension of the relationship between cardiovascular disorders and COVID-19 is required. The dominant clinical manifestations of the corona virus infection are on the respiratory system. In this instance, the acute cardiac injury is the most often reported cardiac abnormality, in which the degree of cardiac output is increased, troponin levels rise, and mostly it is found in about 8% to 12% of patients. The involvement of viral cardiomyocytes and systemic inflammation is the most prevalent mechanism for cardiac damage. The corona virus attaches itself and enters through angiotensin converting enzyme-II.

Discussion and Conclusion: Recent articles on COVID-19 have revealed nothing regarding these individuals' cardiac vascular manifestations. This is a critical component of all that has a big influence on COVID-19 patients' cardiovascular systems. To fully comprehend the method and effects, more study is required.

Open Access Review Article

Development of Scientifically-based Approaches to the Design of Food Products for Herodietic Purposes

A. A. Varivoda, N. V. Kenijz, M. V. Dadueva, D. K. Davidyan, M. Z. Pshikhopova, I. S. Kirichenko, N. Y. Basova

Journal of Pharmaceutical Research International, Page 303-310
DOI: 10.9734/jpri/2021/v33i53B33711

The study conducted a detailed analysis and provides data on the demographic situation in the world, as well as in the Russian Federation, concluded that the trend of rapid aging. Nutrition refers to the most important factors of the influence of the external environment on the state of health, working capacity and life expectancy of a person. For this reason, every person needs high-quality and specialized nutrition that will fill all the needs of the body in nutrients, namely proteins, lipids, carbohydrates, vitamins and mineral elements. This scientific article analyzes and systematizes approaches to ensuring the nutritional needs of people of older age groups and recommends ratios in the composition of diets according to gender and age characteristics. The standards of energy and nutritional requirements for various groups of the population are analyzed. The problems associated with the development of the production of products for the elderly are investigated and promising directions of their production are established. It is determined that the most social problem for the elderly is providing the body with biologically and physiologically valuable substances, in particular macro - and microelements, vitamins, essential amino acids, the presence and ratio of which has a significant impact on the processes of metabolism and assimilation by the body.

Open Access Review Article

Herbal Approaches for Alzheimer Disease: A Review

. Yoggeta, Deepika Bhatia, Manisha bhatti

Journal of Pharmaceutical Research International, Page 311-324
DOI: 10.9734/jpri/2021/v33i53B33712

"Plague of the Twenty-First Century," or “Alzheimer disease” is anneuro-degenerative disease that influenced the world's elderly population. The prevalence of Alzheimer's disease is expected to increase to one hundred thirty-five million by 2050, with no treatment(s) currently available to cure or monitor the disease's progression. The current treatment(s) have lesscapability to manage symptoms or delay disease development, and they can cause serious side effects. The cost of overall treatment is high for both the patients and their caregivers or family members. As an example, there is an serious requirement to find safer alternative treatments for better management of Alzheimer's disease. The various Indian herbal medicines such as Centella asiatica,Celastruspaniculatus Curcuma longa, Clitoriaternatea,Bacopa monnieri, Withania somnifera, has been reviewed in this article. Eclipta alba, Desmodiumgangeticum, Evolvulusalsinoides, Moringa oleifera, and Convolvulus pluricaulis are among the plants that have shown promising effect in the treatment related to cognitive disability.