Open Access Systematic Review Article

Patients with Multiple Illnesses

Abdulaziz Gari, Rayan Alghamdi, Yasir Aloufi, Saleem Alghamdi, Baraa Abukhudhayr, Turki Alzahrani, Ahmed Alzahrani, Mohannad Alghamdi, Ahmed Bakshwean, Abdulrazaq Alzahrani, Hassan Qadi, Ahmed Alghamdi, Moayad Alhothali

Journal of Pharmaceutical Research International, Page 89-96
DOI: 10.9734/jpri/2021/v33i54B33769

Approximately one-third of all individuals have multiple chronic conditions (MCCs) worldwide. Certain disorders tend to cluster together often, with correlations, such as depression and stroke, Alzheimer’s illness and infectious diseases such as HIV/AIDS and tuberculosis coupled and diabetes and cardiovascular diseases. The prevalence of MCC is highly variable according to the definition used and the number of conditions included in the study. In the United States, it was reported to be 23.1%. While other studies report MCC as high as 80% among elder population. The patient hardship encompasses a decline in standards of living, costly expenditures, adherence to multiple medications, incapacity to work, symptoms management, and a significant financial load on caregivers. This significant load from MCCs is expected to rise further. At the current time, the presence of more than one disease causes the patients to take multiple drugs, further prescribing may be indicated for the side effects of the used drugs. Furthermore, new conditions can be misdiagnosed and mistaken as side effects of the drugs the patients is taking. Strategies for treatments include establishing agreement on MCC taxonomy, putting more emphasis on MCC research, focusing on primary prevention to reduce morbidity, and shifting healthcare institutions and policies to a multiple-condition paradigm.

Open Access Systematic Review Article

Comparative Evaluation of Open Flap Debridement Therapy with Two Different Types of Platelet Concentrates, T-PRF and L-PRF as Adjuncts- A Systematic Review

Gowri Pendyala, Ekta Srivastava, Babita Pawar, Satish Manthena, Swati Pustake, Saurabh Joshi, Ameet Mani, Vidyasagar Mopagar

Journal of Pharmaceutical Research International, Page 263-271
DOI: 10.9734/jpri/2021/v33i54B33785

Conventional Periodontal therapy such as scaling and root planing and open flap debridement aims to halt the inflammation process and promotes repair of disease-related defects. Current regenerative procedures offers a limited potential toward attaining a complete periodontal restoration and none is considered a gold standard in the treatment of intrabony defects. This study was done to compare the efficiency of Titanium-Platelet Rich Fibrin and Leukocyte-Platelet Rich Fibrin as adjuncts to Open Flap Debridement  therapy to treat intra-bony periodontal defects. A search was conducted through PubMed and various other databases such as Cochrane, Google Scholar and EBSCO Host , under the key words, OFD , T-PRF,L-PRF, Clinical Outcomes, Comparison and  Randomised Contolled Trials. Six relevant articles were selected for analysis. Compared to non-platelet concentrates, L-PRFproves to be the better adjunct to open flap debridement therapy. When compared to T-PRF, however, L-PRF has comparatively inferior properties of bone defect resolution and fill.We can conclude that T-PRF has better properties, greater bone defect fill and defect resolution as compared to L-PRF.

Open Access Case Study

Fatal Fulminant Hepatic Failure in a Case of Zinc Phosphide Poisoning: A Case Report

Akhilesh Annadatha, Sourya Acharya, Dhruv Talwar, Sunil Kumar, Anuj Varma

Journal of Pharmaceutical Research International, Page 18-22
DOI: 10.9734/jpri/2021/v33i54B33760

Rodenticide is the term given for the compounds that are used in the killing of rats. The commonest compounds that are available as rodenticides are Aluminum phosphide, Zinc Phosphide, Yellow Phosphorus and Coumarins. Due to their easy availability in the general stores, these also have been used as a source of inflicting self-harm by the patients in order to commit suicide. Most of the patients escape the poisonous side effects with a mild course, but some cases progress to a state of Acute liver failure or fulminant liver failure. Due to the broad range of symptoms that can occur with the compounds, it is important to discuss the course of progression of symptoms from mild to severe in order to understand the treatment protocols to treat the patient appropriately. Some patients progress to such a severe form of symptoms that there is an urgent indication of liver transplantation. Here we report a case of rodenticide poisoning in a young female which started off with a mild course and ultimately progressed to fulminant liver failure leading to a fatal outcome.

Open Access Case Study

Advanced Physiotherapy of Supracondylar Femur Fracture with Implant In situ: A Case Report

Shraddha Kochar, Mitushi Deshmukh, Neha Chitale

Journal of Pharmaceutical Research International, Page 309-313
DOI: 10.9734/jpri/2021/v33i54B33791

Patient main concerns were restriction of movements of right knee and pus discharge from wound over right knee. In this case, the main clinical findings were a substantial loss in range of motion at right knee joints. There was also fixed flexion deformity seen over right knee. Diagnosis of the case was non united operated infected case of supracondylar femur fracture right side with implant in situ. In these types of circumstances, therapeutic approaches have been demonstrated to be useful. A 35-year-old male visited the orthopaedics who referred department of physiotherapy with complaints of restriction of movement of right knee and pus discharge from wound over right knee. Patient was examine in standing and supine position .On inspection, patient keeps right hip in flexion, knee in flexion patella pointing upwards and foot in equinus. According to the research, starting weight-bearing too soon can lead to failure of implant and mal-union. Supracondylar femoral fracture is a challenging condition to deal with and is associated with many secondary complications. An important role is played by physiotherapist in rehabilitation and supracondylar femur fracture management.

Open Access Study Protocol

Effectiveness of Body Mechanics Training (BMT) on the Management of Low Back Pain, Functional Disability and Physical Fatigue among Women Working in Health Profession: A Study Protocol

Nutan Prakash Makasare, Seema Singh

Journal of Pharmaceutical Research International, Page 58-64
DOI: 10.9734/jpri/2021/v33i54B33765

Background: The most prevalent musculoskeletal problem among healthcare workers is low back pain (LBP). It's a type of pain between the costal margins and the inferior gluteal folds, and a painful restriction of movement frequently accompanies it. In high-risk health care professionals such as nurses, the prevalence of LBP is higher (64.07%). Clients with chronic LBP had a high level of functional impairment and weariness.

Objectives: 1.To evaluate the effectiveness of Body Mechanics Training (BMT) on managing low back pain, functional disability, and physical fatigue among women working in the health profession on the 7th day and at the first, third, and sixth-month interval. 2.To identify the inter-relationship between LBP, functional disability, and physical fatigue.

Study Design: It is a two-arm trial, interventional hospital-based Study.

Place and Duration of The Study: This Study will be conducted in selected hospitals of Wardha district, Maharashtra, India. The duration of the Study will be six months.

Methodology: The participants will be 330 women in the nursing profession with nonspecific chronic LBP aged 21 to 50. With purposive sampling technique, participants will be allocated to 1 of 2 treatment groups: 1) Experimental Group will receive BMT including McKenzie and Yoga exercises, through a licensed physiotherapist and certified yoga trainer. 2) Control Group will receive written instructions regarding body mechanics in a booklet form and follow exercises at home. The experimental group will receive 24 sessions of 60 minutes (6 sessions per week over the first four weeks or a month) and then a supervised session once a week for the next five months. The outcome will be obtained during intervention on the 7th day and after completion at 1, 3, and 6 months. After therapy, the primary outcome will be pain intensity as determined by the Numeric Pain Rating Scale (NPRS). The secondary outcome, i.e. pain intensity, functional disability (measured with Modified Oswestry LBP Disability Questionnaire), and physical fatigue (measured with Chalder Fatigue Scale), will be measured after treatment.

Expected Results: LBP, functional disability, and physical fatigue will be reduced.

Limitations: Only Nursing personnel will be included in this Study.

Conclusion: This Study's results will contribute to developing BM Training Program for Nursing personnel to manage work-related nonspecific LBP.

Open Access Study Protocol

Knowledge, Attitude, and Practice of Dental Implants among Dental Post Graduates and Practitioners in Wardha District, Maharashtra: A Cross Sectional Study

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

Journal of Pharmaceutical Research International, Page 119-123
DOI: 10.9734/jpri/2021/v33i54B33772

Background: Implant dentistry has become an important aspect of the treatment for patients who are partially or completely edentulous. Dental implants are a proven therapeutic option for replacing missing teeth, with positive long-term health outcomes. Dental implant performance is largely determined by the implant’s primary durability, which is affected by surgical procedure, bone quality and quantity, implant surface characteristics, implant geometry, and implant surface characteristics. Despite the advancements achieved in implant dentistry since its beginning, there exist several limitations in scientifically grounded information and proven clinical experience among dental professionals and postgraduates.  A study was conducted to assess and compare the knowledge, attitude and practice of dental implants among dental postgraduate students and dental practitioners (General and institutional in Wardha  district, Maharashtra and to identify the variations in their knowledge, attitude and practice with respect to dentist's factors (years of experience, implant training and their specialization). As a result, the actual picture was examined.


  • To assess the knowledge of dental implants among dental postgraduate students and dental practitioners
  • To assess the attitude of dental implants among dental postgraduate students and dental practitioners.
  • To assess the practice of dental implants among dental postgraduate students and dental practitioners.

Methodology: An online cross-sectional questionnaire survey will be done to examine responses to 20 selected questions pertaining knowledge, attitude, and practice of dental implants among dental postgraduates and practitioners in the Wardha district. The aspect of the results that will be examined. The questionnaire will be delivered to dental postgraduates and practitioners, and their replies, as well as the questionnaire's validation, will be recorded. In the cross-sectional study, a suitable sampling strategy was used based on the replies received following the survey. The results will be determined based on Knowledge, attitude, and practice of dental implants.

Survey Procedure: questions will be asked by online platform to dental health professionals with explanation of purpose of the study. The questions will be both open and close end type.

Expected Results: The expected result of the study will determine: Knowledge, attitude, and practice of dental implants among dental post graduates and practitioners in wardha district

Conclusion: Today is an era of evidence based dentistry. However, there is a substantial difference between the popularity of dental implants and the research that supports them. This research is an attempt to minimize that difference. Because this study will be done in an area where dentistry is in the air, with two large teaching dental hospitals and a large mass of dentists, it gives us a thorough realistic picture of where knowledge and practise of dental implants have reached in our field. As a result, the purpose of this study is to assess the need for a change in attitude and practise toward dental implants, as well as their evidence-based research on the subject.

Open Access Short Research Article

Cross Sectional Study on Hyponatremia

S. Rashmi, Santhi Silamban

Journal of Pharmaceutical Research International, Page 314-316
DOI: 10.9734/jpri/2021/v33i54B33793

Introduction: Sodium is the major extracellular cation, playing important role in maintaining homeostasis. Normal level of serum sodium is between 136-145 mmol/L. Hyponatremia (<136mmol/L) can present with nausea, vomiting, confusion, lethargy, disorientation.Severe hyponatremia (<125mmol/L) can present with seizures, coma or death.

Methods: Our study was a cross sectional, retrospective study including 100 subjects of hyponatremia.

Results: In our study, we analyzed the age-wise distribution, severity and various causes of hyponatremia in each grade of hyponatremia based on severity.

Conclusion: Drug-induced hyponatremia is a more prevalent and a preventable cause and can be avoided by proper monitoring of patients.

Open Access Short Communication

Association of Genetic Polymorphism of Tumor Necrosis Factor-α in the Development of Coronary Heart Disease in Elderly Patients

Bekkhan Saidmagomedovich Mezhidov, Khava Idrisovna Bekova, Aishat Alikovna Edieva, Khava Ismailovna Madalova, Victoria Alekseevna Malakhova, Zama Arbievna Uspaeva, Markha Sharipovna Tachaeva, Amina Magomedovna Tsinaeva, Alina Yurievna Maslova, Shamil Vakhaevich Khodisov

Journal of Pharmaceutical Research International, Page 81-88
DOI: 10.9734/jpri/2021/v33i54B33768

The research project outlines a new look at the concept of "inflammaging" and the role of the subclinical inflammatory process in various age-associated pathology, in particular coronary heart disease. Particular attention is paid to the tumor necrosis factor-α -cytokine, which plays an important role in the pathogenesis of chronic inflammatory processes and in the aging process. The increased content of tumor necrosis factor-α leads to the emergence and accumulation of various diseases, disability and mortality of elderly and senile people.

Tumor necrosis factor-α influences various risk factors for cardiovascular pathology. This substance aggravates various breakdowns in metabolism, primarily causing insulin resistance. Tumor necrosis factor-α is a key cytokine that stimulates bone resorption (osteoporosis) and sarcopenia. Currently available data prove the important role of tumor necrosis factor-α in various age-associated pathologies.

Open Access Original Research Article

Comparative Physiochemical Analysis of Kachi Ghani, Solvent Oil and refined Oil Extracted from Brassica nigra

Ruth Gill, Rajinder Kaur, Sukhminderjit Kaur

Journal of Pharmaceutical Research International, Page 1-10
DOI: 10.9734/jpri/2021/v33i54B33758

Brassica nigra or black mustard is traditionally used in various states of India from the ages. It is being commercially used in the form of kachi ghani, solvent oil (non-edible), and refined oil. Due to the antioxidant and antibacterial properties of kachi ghani mustard oil, it is considered to be of better quality. On the other hand, literatures also state that refined oil is better due to the purification processes. There is ambiguity regarding quality aspects of these three oil fractions. Therefore, the present study was planned for the comparative analysis the quality and physiochemical characterization of kachi ghani, solvent and refined oil. Commercially free fatty acids value, acid value, color, presence of argemone, pungency of oil and content of various monounsaturated fatty acids, saturated fatty acids and polyunsaturated fatty acids is determined to check quality of commercial grade edible oils. In consequence, it was observed that kachi ghani consists of less free fatty acids (0.37±0.02%), less acid value (0.74±0.04mg/g) and high pungency (0.279%) as compared to solvent and refined oil. Kachi ghani embrace more natural color (32.0 units) in comparison to solvent oil which was way darker and refined oil which was very light. The percentage of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids was spotted to be 6.44%, 64.360% and 28.64% respectively in kachi ghani oil.  The study shows that saturated fatty acids such as palmitic C-16, stearic C-18, behanic C-22 and lignoceric C-24 were present in kachi ghani. In solvent oil, palmitic C-16, stearic C-18, behanic C-22, and lignoceric C-24 were found whereas only palmitic acid was present in refined oil. High content of monounsaturated fatty acids were found in oil. Eicosenoic C-20:1, Oleic C-18:1, Eurcic C 22:1 and Nervonic C-24:1 unsaturated fatty acid was found in all the three fractions of oil.

Open Access Original Research Article

Granisetron Versus Ondansetron for Prevention of Post-operative Nausea and Vomiting (PONV) in Patients Undergoing Laparoscopic Cholecystectomy

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

Journal of Pharmaceutical Research International, Page 11-17
DOI: 10.9734/jpri/2021/v33i54B33759

Aim: To determine the efficacy of single dose Granisetron versus ondansetron in preventing PONV in patients undergoing elective laparoscopic cholecystectomy.

Methodology: A total of 100 patients were included in this study after the ethical approval of PUMHSW. Patients were randomly divided into two groups, in (Group G) 50 patients were given Granisetron and in (group O) 50 patients were given Ondansetron.  Every patient was evaluated for PONV at one hour, two hours, three hours, six hours, twelve hours and 24 hours post operatively.

Results: A sample of 100 patients with age between 20-60 years (mean age 43.72±5.67 years), were included in this study. Patients were received granisetron 1 mg I/V and other patients received ondansetron 4mg I/V before induction.

Conclusion: we concluded that there was no significant difference between efficacy of granisetron and ondansetron as the p-value is found to be ≤0.05.

Open Access Original Research Article

A Study to Evaluate the Effectiveness of Structured Teaching Programme on Non Pharmacological Management of Pain During First Stage of Labour Among Student Nurses in Selected College of Nursing, Hoshangabad

M. A. Sheelamma, C. C. Linson

Journal of Pharmaceutical Research International, Page 23-31
DOI: 10.9734/jpri/2021/v33i54B33761

To Assess the knowledge on ‘‘non pharmacological” pain management during First stage of labour among nursing students in the terms of pre-test. Evaluate the effectiveness of structured teaching programme on pain management during First stage of labour by comparing pre-test score on post-test knowledge score. Find out the association between knowledge scores among nursing students and selected demographic variables. The research approach selected was quantitative in nature and research design was pre experimental with one group pre-test post-test design. Sampling was done using convenient sampling using 60 student Nurses. The study was conducted in St Joseph College of nursing, Hoshangabad. The tools used for generating necessary data were structured knowledge questionnaire on non-pharmacological management of pain. The data were analyzed using descriptive and inferential statistics. Majority of nursing students i.e. 36 (60%) have inadequate knowledge score, 24 (40%) had moderate knowledge score and none of them were having adequate knowledge. This study found that majority of nursing studentsi.e. 33 (55%) have gained adequate knowledge whereas 26 (43.3%) have gained moderate knowledge and 1 (1.6%) with inadequate knowledge after administration of structured teaching programme on nonpharmacological methods on reduction of labour pain. The findings of the present study shows that the mean post-test knowledge score (20.6) was apparently higher than the mean pre-test score (11.08). The difference between pre-interventional and post-interventional knowledge was 8.8. The statistical significance between pre and post-test knowledge is evident by‘t’ value of 14.02 at 0.05 level of significance. Hence, there is significant increase in the knowledge level of nursing studentsafter structured teaching programme. The structured teaching program was effective in enhancing the knowledge of the student nurses on non-pharmacological management of pain during first stage of labour.

Open Access Original Research Article

Knowledge Assessment of Stress Bone Fractures among Soldiers in Saudi Arabia

Abdulmalik B. Albaker, Youssef Taha, Mohammed Ahmed Bin Hadi Alkadi, Mohammed Majeed Alwaily, Meaad Saad Alosaimi, Sarah Abdurahman Alarfaj, Raad Mohammed Hamdi, Khames Alzahrani

Journal of Pharmaceutical Research International, Page 32-40
DOI: 10.9734/jpri/2021/v33i54B33762

Background: Stress fractures are well perceived in military preparing and athletes. Aside from knowledge of the frequency of these fractures and their impact on the economy and lost training hours, there are just a few studies in Saudi Arabia that show the real incidence of these              fractures. The precise incidence must be known in order to provide recommendations for future preventative initiatives. This study aims to assess the knowledge of stress fractures among Saudi soldiers.

Methodology: An observational cross-sectional study was conducted in medical centers; these centers are located in Saudi Arabia on male and female patients of all ages who are in Saudi military society to assess the knowledge of stress fractures among Saudi military society. Data collection was done by questionnaire that distributed between Saudi soldiers. Data was entered and analyzed using (SPSS) program, version 20 (IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.).

Results: Of all 1178 studied participants, 51.5% aged between 20- 30 years old. 91.7% were males. 47.5% of all participants had never heard of stress fractures before, 26.2% heard about it when joined military and 17.4% heard about it before joining the military field. 20.8% of all participants had stress fractures before, 10.4% were diagnosed through x-rays and medical history with the doctor, 4.6% were diagnosed through medical history only, and 2.4% diagnosed themselves. 85.3% of all participants agreed that stress fractures occur due to repetitive loading on the bones, 76.6% agreed that predominance of stress fractures of the lower extremities, over fractures of the upper extremities, 67.6% reported that stress fractures can be treated with painkillers, physiotherapy and reduce the risk and 78.6% agreed that stress fractures can be prevented by wearing appropriate footwear.

Conclusion: Participants and relatively good knowledge of stress fractures. Knowledge of stress fracture was significantly associated with years of experience of participants, military sector, and residence area in the kingdom.

Open Access Original Research Article

Awareness towards Disposal of Unused Medication in District Shaheed Benazirabad Sindh

Ghulam Abbas Kaloi, Imran Suheryani, Muhammad Ali Ghoto, Ubed-ur-Rehman Mughal, Razia Sultana, Rafia Tabassum, Yasmeen Qureshi, Jameela Jamali, Tooba Khan, Fozia Rustamani

Journal of Pharmaceutical Research International, Page 41-49
DOI: 10.9734/jpri/2021/v33i54B33763

Aims: The purpose of this study was to examine level of awareness about proper disposal of unused medicine. It is a growing problem. People directly dispose unused medicines into waste or flush into sink. Finally, these improperly disposed medicines mix with wastewater leach out into sea water, ground water, drinking water and effect human and other forms of life and develop microbial resistance and accidental poising and various societal repercussion. Confusion exists in people about proper disposal of unused medicine. Despite of already available guidelines people very rarely follow proper disposal methods. Particularly in developing countries situation is very alarming. It is well established fact that knowledge and level of awareness play pivotal role for practice of proper disposal methods.

Study Design: This study was a descriptive cross-sectional study.

Methodology: This study was conducted in Nawab Shah and its vicinities: Sakrand, Kaziahamed, Bachalpur, during September 2019 to May 2020. The number of participants were included in the study according Slovin's Formula. The simple random sampling method was used to select participants. The level of awareness about proper disposal of unused medicine of 400 participants was assessed through a well-designed questionnaire. The questionnaires were distributed to the participants at their homes with the help of volunteers. The descriptive statistics were analyzed through latest version of MS excel 2016.

Results: Out of 400, 320 (80%) of the participants admitted have no knowledge for proper disposal of unused medicines. 185 (46.25%) of the participants viewed throwing unused medicines into waste was correct. Whereas 176 (44%) of the participants believed improperly thrown medicines has no effect on environment.

Conclusion: The level of knowledge about proper disposal of unused medicine was found very low in study participants. It is suggested government should incorporate guidelines about the harmful effects of improper disposal of unused medicines in curriculum at primary level of education.

Open Access Original Research Article

Comparative assessment of Placental Weight and Fetal Outcome in Normal and Anaemic Mothers during Intranatal Period in Selected Hospitals in India

. Lalhriatpuii, Bali Thool

Journal of Pharmaceutical Research International, Page 72-80
DOI: 10.9734/jpri/2021/v33i54B33767

Background: Despite the fact that anaemia during pregnancy is the most prevalent and significant health problem in impoverished nations, anaemia has a negative impact on the placenta and fetal development. The placenta is a growing organ that provides nutrition, oxygen, and eliminates excretory wastes for the fetus while also acting as a protective barrier throughout pregnancy. If the placenta is compromised by anaemia, it has a negative impact on the foetus's growth.

Methods and Materials: Comparative descriptive research design was used, 60 subjects (30 normal mothers and 30 anaemic mothers) were allotted and in this study the purposive sampling technique was used to select the sample. The aim of the study was to compare the placental weight and fetal outcome in normal mothers and anaemic mothers. The objectives of the study were (i) To assess the placental weight in normal mothers and anaemic mothers. (ii)To assess the fetal outcome in normal mothers and anaemic mothers. (iii)To compare the placental weight and fetal outcome in normal and anaemic mothers.

Results: The result of the study shows that 93% normal mothers had average condition of placental weight, 2% normal mothers had good condition of placental weight while in anaemic mothers it was found that 30 percent had average condition of placental weight, 73.3% normal mothers had average condition of fetal outcome, 26.7% normal mothers had good condition of fetal outcome while in anaemic mothers it was found that 93.3% percent had average condition of fetal outcome, 06.7% had good condition of fetal outcome.

Conclusion: The study concludes that the comparison between placental weight and birth weight of babies shows significant difference with a positive relationship in both the groups. This means as the placental weight increases the birth weight also increases and vice-versa.

Open Access Original Research Article

A Functional and Radiological Outcome Analysis of Hip Forage Procedure, done for Early Stages(Ficat and Arlet Grade 1 and 2A) of Avascular Necrosis of Head of Femur

Shubham Padmawar, Dr. Suhas Landge, Prateek Upadhyay, Mitali Madhusmita

Journal of Pharmaceutical Research International, Page 97-105
DOI: 10.9734/jpri/2021/v33i54B33770

Background: Avascular necrosis of the femoral head is a severe disease and causes osteoarthritis of the hip joint in young adults. Early diagnosis leads to better prognosis and therapeutic success.

Aim: To study pain, radiological outcome & functional outcome post hip forage procedure in patients of avascular necrosis of head of femur (Ficat and Arlet grade 1 and grade 2A).

Study Design: This was a prospective observational study.

Place and Duration of Study: Conducted in the Department of Orthopaedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Nerul, Navi Mumbai over a period of 2 years from 2015 to 2017

Methodology: We included 50 patients (39 males, 11 females) with Avascular necrosis of unilateral or bilateral head of femur (Grade 1 and Grade 2A), clinical, radiological and functional(with the help of Harris hip score) examination was done at 6 months and 12 months follow up post operatively. 

Results: Out of the 50 patients, pre-peratively, 60% reported moderate pain, 20% mild pain and 20% severe pain. At follow-up, 36% patients reported slight pain, 26% mild pain, 26% moderate pain, 8% marked pain, and no pain was reported by 4% patients. Pre-operatively, no limp was seen in 34% patients, while 66% patient had a limp. At follow-up, 70% patient had a limp and no limp in 30% patients. Before surgery, support (cane use) was required by 6% patients, while at follow-up, support was noted by 12% patients. Preoperative mean Harris Hip Score was 63.6, while that at follow-up it was 74.74. Radiological worsening of the disease occurred only in 38% of the patients which suggests that disease progression was delayed in most patients(62%). 2% patients had a complication of foot drop.

Conclusion: Avascular necrosis of femoral head is more common in young males. Core decompression by multiple drilling and/or core decompression with fibular strut grafting are equally effective in pre collapse stages (stage 1 and stage 2A) with better functional and radiological outcomes and hence these procedures can play a vital role in delaying the disease progression.

Open Access Original Research Article

Tocotrienol-rich Fraction Modulated Genes Responsible for Inflammation in Lipopolysaccharide-stimulated RAW 264.7 Macrophages

Sitti Rahma Abd Hafid, Maliya Azilah Mohammad Aini, Nabiha Iran, Irmaliayana Norisam, Khairul Adzfa Radzun, Ammu Kutty Radhakrishnan

Journal of Pharmaceutical Research International, Page 106-118
DOI: 10.9734/jpri/2021/v33i54B33771

Background: Inflammation plays a vital role in the pathogenesis of chronic non-communicable diseases (NCDs), the leading health issue worldwide. An earlier study reported that tocotrienol-rich fraction (TRF) showed better anti-inflammation effects in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages.

Aim: This study aimed to investigate the anti-inflammatory effects of tocotrienol-rich fraction at the molecular level by looking at the genes that were differentially regulated and pathways affected in LPS-stimulated macrophages exposed to TRF using the microarray approach.

Methods: A microarray study was carried out in LPS-stimulated RAW 264.7 macrophages. Total ribonucleic acid (RNA) was extracted from the RAW 264.7 cells treated with TRF (10µg/mL), alpha-tocopherol (10 µg/mL) or LPS (10 ng/mL). Untreated cells served as control. Enrichment analyses, such as Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG), were conducted for genes listed in the differentially expressed genes (DEGs). 

Results: The microarray analysis showed that the expression of five genes [Hamp, Interleukin-1a (IL-1a), IL-b, C-X-C motif chemokine ligand 2 (CXCL2) and colony-stimulating factor 3 (CSF3)] and one gene (SLC1A4), an amino acid transporter, was modulated (fold change 2, P< 0.05) in the TRF-treated cells. With a more stringent analysis (fold change 3, P < 0.05), only one gene (CSF3) was downregulated in the TRF-treated in RAW 264.7 cells. Analysis using the GO and KEGG pathways revealed interactions between pro-inflammatory agents such as tumor necrosis factor-alpha (TNFα) and nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-B), as well as signaling pathways of interleukin (IL)-1 and IL-17.

Conclusion: TRF modulated the expression of genes responsible for acute and chronic inflammation that were part of the lipoxygenase (LOX) and cyclooxygenase (COX) inflammatory pathways. Further investigation on the effects of TRF in different cell lines and in vivo studies should be conducted in the future.

Open Access Original Research Article

Anti-inflammatory Activity of Herbal Tablet of Phyllanthus emblica on Carrageenan-induced Paw Edema in Wistar Rats

Amulyaratna Behera, Himansu Bhusan Samal, Dinesh Kumar Sharma, Satish Kanhar, Atul Kadam, Prachi Khamkar, Suchismeeta Behera

Journal of Pharmaceutical Research International, Page 155-167
DOI: 10.9734/jpri/2021/v33i54B33776

Aim: In the current investigation, tablet dosage form of hydroalcohol extract of leaves of P. emblica was developed and evaluated foranti-inflammatory activities.

Methodology: Hydroalcohol extract of leaves of P. Emblica (HPE) was prepared and formulated tablet dosage form. The mechanical properties e.g. hardness, friability, disintegration, and dissolution of tablet were evaluated. Anti-inflammatory activities of HPE (150 mg/kg) and HPE (650 mg) tablets were performed in carrageenan induced hind paw edema in wistar rats.

Results: The anti-inflammatory activity was found to be significant in carrageenan inducedpaw edema. HPE (150 mg/kg) and HPE tablets (650 mg) were significantly (p < 0.05) reduced the carrageenan induced paw edemaby 66.41% and 69.43% respectively as compared to                carragenan control. The % inhibition of standard drug (dichlorofenac sodium) was recorded to be 70.18% after 5 h.

Conclusion: The study standardised the development of HPE tablet and its anti-inflammatory effect.

Open Access Original Research Article

Phenolic Constituents of Anethum graveolens Seed Extracts: Chemical Profile and Antioxidant Effect Studies

Sanda Rodica Bota, Oana Delia Stanasel, Cristian Felix Blidar, Georgeta Serban

Journal of Pharmaceutical Research International, Page 168-179
DOI: 10.9734/jpri/2021/v33i54B33777

The Aim of the Research: Anethum graveolens (dill) is a common herb used in traditional Romanian cuisine, as well as in phytotherapy. Dill seeds have been reported to be rich in antioxidants. As interest in food additives of natural origin has increased in recent years, the purpose of this paper was to study the composition and antioxidant potential of Romanian dill seeds.

Methodology: In this study, the total phenolics contents, the phenolic profile, and the antioxidant properties of the methanolic and hydromethanolic extracts of Romanian dill seeds were investigated. Folin-Ciocalteu assay, DPPH spectrophotometrically method and reverse-phase high-performance liquid chromatography RP-HPLC, respectively were applied.

Results: The highest content of total phenolics was found in acidified methanol samples (46.5 - 46.8 mg GAE/g dry seeds). RP-HPLC analysis highlights important content of quercetin, kaempferol, caffeic acid, sinapic acid, gallic acid, vanillic acid, (±) - catechin and umbelliferone. Antioxidant activity, measured via DPPH free radical scavenging ability, showed very high values (93.5 - 95.6% for the crude extracts and 67.5 - 93.2% for extracts at a concentration of 0.25 mg/mL). Methanolic extract exhibited the best IC50 value (88.7 ± 0.01 μg/mL).

Conclusion: All experiments proved the antioxidant activity of dill seed extracts.

Open Access Original Research Article

Heavy Metal, Aflatoxin, Pesticide Residue, Microbial Analysis of Siddha Polyherbal Formulation Veppampoo mathirai

S. M. Chitra, N. Anbu

Journal of Pharmaceutical Research International, Page 180-186
DOI: 10.9734/jpri/2021/v33i54B33778

Aim: The polyherbal siddha formulation veppampoo Mathirai is effective in regulating blood pressure but its safety is not known. The heavy metal, aflatoxins, pesticide residue, microbial count have not been evaluated so far. The current study evaluated the above parameters. The present study was aimed to evaluate the safety parameters (heavy metal, aflatoxin, pesticide residue and microbial profile) of Veppampoo Mathirai.

Materials and Methods: According to AYUSH [Ayurveda, yoga, unani, siddha, naturopathy] Pharmacopoeial laboratory for Indian medicine (PLIM) guidelines, the formulation was evaluated for its safety parameters at Noble research solutions, kolathur, Chennai, accredited with ISO 9001: 2015.Atomic Absorption Spectrometer (AAS) was used for testing heavy metals and aflatoxins were tested using Thin layer chromatography(TLC). The Pesticide residues content was estimated by GC/MS while microbial count by pour plate method.

Results: The study revealed presence of heavy metals mercury, arsenic, lead and cadmium within the recommended limit as per AYUSH Pharmacopoeial Laboratory for Indian Medicine Guidelines whereas presence of Aflatoxin, pesticide residues and microbes were absent in the sample which showed the formulation Veppampoo Mathirai (VPM) was free from toxicity.

Conclusion: VPM showed heavy metal content below the permissible limit as per PLIM guidelines of AYUSH. Aflatoxins and pesticide residue were not detected while the microbes and specific pathogens were absent in the current batch of VPM. Hence, the present study ensures the formulation was safe for therapeutic use.

Open Access Original Research Article

The Prevalence of Dental Anxiety among Dental Patients in Qassim Region

Faisal S. Alharbi, Mazen Abdurrhman Alhodaithy, Mohammed Farhan

Journal of Pharmaceutical Research International, Page 187-194
DOI: 10.9734/jpri/2021/v33i54B33779

Objective: This study aimed to assess the prevalence of dental anxiety among patients visiting dental clinics in Al-Qassim region of Kingdom of Saudi Arabia.

Methods: The 377 participants were selected from three major cities of Al-Qassim region - Buridah, Onizah, and Alrass. A self-administered questionnaire based on Modified Dental Anxiety Scale (MDAS) was used to gather the responses of the participants. The questionnaires were handed to respondents during their regular visits to the dental clinics.

Results: The findings of the study revealed that 18% of the sample population suffer from severe dental anxiety. The analysis showed that feelings associated with anesthetic injection are the most-anxiety provoking factor while the next day visit is the least anxiety-provoking item. The findings show that female participants (M = 3.1, p = .001) significantly manifest more dental anxiety than their male counterparts (M = 2.8, p = .001). The younger participants demonstrate higher dental anxiety than other age groups.

Conclusion: The dental anxiety exists in the sample population. Gender and age are associated with varying MDAS scores.

Open Access Original Research Article

Bio-analytical Approach for Stability Studies of Bendroflumethiazide Materials

B. Veeraswami, V. M. K. Naveen

Journal of Pharmaceutical Research International, Page 195-203
DOI: 10.9734/jpri/2021/v33i54B33780

In this paper a comprehensive study of stability related, and evidence based best practices of Bio-analytical stability on Bendroflumethiazide drug samples are studied. The proposed approach is very significant and essential for the drugs development process address the specify the acceptancy, purity, efficacy, prediction of strength and quality of the drugs. The stability study constituents several methods like Bench-Top, Auto-sampler, Freeze-Thaw, Dry-extract, Wet-extract, Short-term, long-Term stability studies at relative intervals results the complete stability information about the drug under the proposed and validated method. There ported out comes of this methos shows this drug have good stability according to ICH guidelines.

Open Access Original Research Article

Amelioration of Cell Phone and Wi Fi induced Pancreatic Damage and Hyperglycemia (Diabetes Mellitus) with Pomegranate and Vit E in Rats

Hadiya Sibghatullah, Sibghatullah Muhammad Ali Sangi, Elsamoual Ibrahim Ahmedani, Ali Alqahtani, Abdulhakim Bawadekji, Sreeharsha Nagaraja

Journal of Pharmaceutical Research International, Page 204-215
DOI: 10.9734/jpri/2021/v33i54B33781

Background: Type 2 Diabetes Mellitus has become a global concern. To date numerous studies have been conducted but little literature is available to explain the effects of mobile phone radiation on pancreas, where from Insulin is secreted. In Some studies, effects of ionizing radiation have been examined and established the relationship between cell phone exposure and cell damage.

Objectives: Objectives of study were to observe the effects of mobile phones, connected with WiFi on the pancreas.

Methods: 40 male Wistar Albino rats were exposed tomobile phones connected with Wi-Fi for eight weeks.

Results: The histopathological examination of the rat pancreas revealed that, exposure of rats to cell phones and Wi-Fi causes significant damage to the rat pancreas.

Conclusion: The ionizing radiation emitted from cell phones and WiFi causes increase in oxidative stress leading to inflammation and pancreatic cell death that may affect glucose homeostasis.

Open Access Original Research Article

Ginsenoside Re, Produces Multi-targeted Potent Antidiabetic Effects Via Estrogen Receptor Signaling Pathway in Rat, an Alternative Multi-Targeted Therapeutic for Type 2 Diabetes

Jingxian Gao, Xianli Meng, Bayin Zabu, Yi Zhang, Siqinbilig Wu, Huhe Muren, Ni Ha, Qinnuan Sun, Tang Jisi, Changxi Bai

Journal of Pharmaceutical Research International, Page 216-236
DOI: 10.9734/jpri/2021/v33i54B33782

Aims: To identify more effective ginsenoside for type 2 diabetes (T2D) and clarify whether the ginsenoside characterizing estrogenic multi-targeted antidiabetic effects.

Study Design: Identifying more effective ginsenoside through preclinical evaluation of antidiabetic effects of representative ginsenosides with T2D rat model, and further test pharmacological mechanism underlying the potent antidiabetic effects of the ginsenoside in the same model.

Place and Duration of Study: Key laboratory for Pharmacy, Inner Mongolia Medical University, March 2018 to November 2020.

Methodology: Used a total of 240 female adult rats. Rat model of T2D induced by high-fat diet fed and streptozotocin. Five tapes of representative ginsenosides (Rb1, Rd, Rg3, Re, Rg1) administrated at low (20 mg/kg daily) and high (40 mg/ kg daily) doses to T2D rats with orally for 4 weeks. Detect testing indexes with biochemical, histological, Quantitative Real-Time PCR, and western blots analysis.

Results: Ginsenoside Re (Re), very significantly lowered blood glucose (P<0.01), lipids (P<0.001), free fatty acid (P<0.001), and glucagon (P<0.01) levels, markedly improved impaired insulin sensitivity (P<0.01), ameliorated oxidative stress (P<0.01) and inflammation (P<0.01) in T2D rats, exhibited potent antidiabetic effects. Moreover, Re, phosphorylate serine/threonine kinase (Akt) (P<0.01) and endothelial nitric oxide synthase (eNOS) (P<0.01), up regulates B-cell lymphoma-2 (P<0.01) and insulin gene expression (P<0.01), down regulates glucagon gene expression(P<0.01), reverse impaired glucagon-like peptide 1 (P<0.01); exhibits multi-targeted effects; these effects of Re were inhibited by estrogen receptor (ER) inhibitor (ICI-182,780) (P<0.01). Functionally, the antidiabetic effects of Re were sequentially inhibited by inhibitor of ER, Akt, and eNOS, respectively (P<0.01).

Conclusion: These findings, revealed a novel pharmacological property of Re that characterized in multi-targeted potent antidiabetic effects mediated by ER/Akt/eNOS/NO signaling pathway, provide the first evidence for the potential use of Re, as a multi-targeted therapeutic for T2D, particularly, a novel candidate for replacement of estrogen therapy and NO therapy in diabetes.

Open Access Original Research Article

'Silymarin' a Potential Treatment Targeting Hepatic Fibrosis of Schistosomiasis

Maimonah Alghanmi, Aziza Alrafiah

Journal of Pharmaceutical Research International, Page 237-255
DOI: 10.9734/jpri/2021/v33i54B33783

Background: Despite all treatment and control efforts, schistosomiasis still thrives in humanity. It is endemic in 78 countries that are anchored by poverty and diseases. Until now, the broad-spectrum praziquantel (PZQ) drug is the only effective treatment of choice. However, reports documented some side effects for PZQ like haemorrhage in lung tissues, resistance, and inefficacy to treat fibrotic tissues. Therefore, alternative drugs that help in reducing the undesired effects of schistosomiasis are required. This study examined the efficacy of Silymarin in interfering with the fibrogenesis process using a mouse model. Silymarin is a herbal extract known to have flavonoids and polyphenols that help in reducing the inflammatory reaction, stimulating hepatocyte regeneration, and inhibiting the fibrogenesis process.

Methods: A total of thirty adult tBALB/c male mice were divided into negative, chronically infected control and treated groups. All were killed after 18 weeks from the initial infection. Different histopathological investigations and liver function tests were carried out to detect the difference between the groups.

Results: Administration of Silymarin exhibited a significant improvement in all associated histopathology with a considerable decline in the area percentage of collagen fibers. It restored the elevated level of serum ALT as well.

Conclusion: Silymarin as a treatment for chronic hepatopathies will only be successful if started during the acute phase of the disease.

Open Access Original Research Article

Isolation and Characterization of Quercetin from Bambusa arundinacea

Akanksha Awasthi, Divya Juyal, Mamta F. Singh, Saurabh Sharma

Journal of Pharmaceutical Research International, Page 256-262
DOI: 10.9734/jpri/2021/v33i54B33784

Flavonoids are natural antioxidants that are formed from plants and found in meals such as fruits and vegetables. They have the capacity to bind to free radicals. Because of its abundant prevalence in foods, Quercetin, which belongs to the flavonol subclass of flavonoids, has gotten a lot of attention. Quercetin is also found in Bambusa arundinacea. The plant was obtained and authenticated. Further the isolation procedure was done and was analyzed via TLC, FT-IR, and UV, 1 H NMR, Mass and XRD Analysis. The results obtained from the above parameters showed the resemblance with standard quercetin. Thus it was concluded for the presence of quercetin from Bambusa arundinacea.

Open Access Original Research Article

Community Members and Dentist Perceptions for Oral Treatment Seeking Behavior in an Underprivileged Area: A Qualitative Study

Sarah Moideen, Farzeen Tanwir, Saima Mazhar, Natasha Zaidi, Chander Kumar, Arsalan Khalid

Journal of Pharmaceutical Research International, Page 282-288
DOI: 10.9734/jpri/2021/v33i54B33787

Background: Antibiotic resistance affects generations. It is a major health issue. Resistance to antibiotics is on the rise globally. The absence of proper regulatory mechanism and free access to pharmaceutical agents have led to self-medication and inappropriate therapeutic and

prophylactic prescription.

Methods: Qualitative in-depth research was conducted using focus group discussions (FGDs) for data collection. The study was conducted in an underprivileged colony in Karachi, Pakistan. Community members and Dentist were part of the focus group discussion.

Results: There were two major themes that emerged from the analysis. ‘Knowledge associated with common oral diseases and their consequences’ and ‘Home remedies and treatment seeking behavior’. The focus group discussions showed that the perceptions of community members and dentists was based on bad oral hygiene, lack of awareness of oral disease outcome and barriers in pursuing treatment by dentist There was a lack of Government healthcare facilities and poor professional attitudes and futile law enforcement regarding medicine dispensing and disposal.

Conclusion: The value of this study is to understand the perceptions and determinants of health seeking behavior and recognize the reasons for use and misuse of antibiotics. There is a great need for Government intervention and inexpensive treatment for the masses.

Open Access Original Research Article

Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

Obaid Ul Haseeb, Haris Rashid, Afrin Ahmed, Mir Arsalan Ali, Shakil Alam, Santosh Kumar Sidhwani, Fatima Zehra Khan

Journal of Pharmaceutical Research International, Page 296-302
DOI: 10.9734/jpri/2021/v33i54B33789

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique.

Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant.

Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002.

Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

Open Access Original Research Article

Prescription Audit and Dispensing Errors in the Outpatient Pharmacy of Tertiary Care Multispecialty Teaching Hospital

T. Irsath Ahamed, K. Vaishnavi, R. R. Harini, Likhita Yalavarthi, Jagadeesan M.

Journal of Pharmaceutical Research International, Page 303-308
DOI: 10.9734/jpri/2021/v33i54B33790

Background: Although errors occurring during the process of dispensing may affect the goal of the treatment, they also can be the significant cause of morbidity and mortality. There are only few published evidences which focuses on the errors of dispensing that occurs in the pharmacy.             This study focuses on identifying the dispensing errors, impact of brand substitution on cost and DDIs.

Objective: To identify the dispensing errors, impact of brand substitution on cost and DDIs.

Methodology: Prospective observational study conducted over a period of eight weeks in outpatient hospital pharmacy of tertiary care multispecialty teaching hospital, Tamil Nadu. Prescriptions and medication bills and dispensed medicines are collected from the hospital pharmacy to obtain data required for the study. Prescription containing only medical devices were excluded from the study.

Results: Out of 1010 prescriptions, dispensing errors were present in 419 (41.48%) prescriptions which consist of 557 errors. The errors include dispensing multi-pills to make the required dose is 3.77%,tablet splitting is 0.8%, incorrect strength is 1.07%, omission error due to unavailability is 31.4%,dispensing drugs with brands other than prescribed brands is 63.7%. Prescriptions which had more than three drugs were analyzed for drug-drug interactions (n=389). DDIs were present in 156(40.1%) prescriptions which had a total of 281 interactions.

Conclusion: The brand substitution and omission errors are the major causes of dispensing errors. Brand substitution is not always recommended as it may have some adverse effects because of salt and excipients variation. Pharmacists are in the position to identify and reduce DDIs by discussing with the physicians.

Open Access Original Research Article

The Outpatient Prescribing Pattern of Olopatadine in Al Saih

Nehad J. Ahmed, Gamal A. Gabr, Abeer A. El-Sherbiny

Journal of Pharmaceutical Research International, Page 317-320
DOI: 10.9734/jpri/2021/v33i54B33794

Aim: This study was conducted to demonstrate the prescribing pattern of olopatadine eye drops in Al Saih.

Methodology: This is a retrospective study includes evaluating outpatient prescribing of olopatadine eye drops from 1st of January 2018 to 30th of June 2018 in a public hospital in Alkharj.

Results: More than half of the patients who used olopatadine eye drops were females (56.00%). The age of 28.00% of them was between 50 and 59 and the age of 26.67% of them was between 40 to 49 years. More than half of the patients received olopatadine eye drops for 1 month (54.67%). Most of the prescriptions were written by ophthalmology department (96.00%).

Conclusion: Olopatadine eye drops prescribing was infrequent in Al Saih due to the availability of other alternatives. Further studies are needed to investigate the prescribing of olopatadine eye drops and its alternatives by the outpatient settings.

Open Access Original Research Article

In-silico ADME and Docking-based Virtual Screening Study Aiming at the Sigma-Covalent Inhibition of SARS-CoV-2 RdRp

G. Koteswara Reddy, V. Nikhil Reddy, S. Phavethra, A. Bhavani, A. J. Vineeth, A. V. V. Satish Reddy

Journal of Pharmaceutical Research International, Page 321-336
DOI: 10.9734/jpri/2021/v33i54B33795

The objectives of the study were to examine the virtual screening of the compounds and sigma-covalent inhibition of SARS-CoV-2 RdRp (RNA-Dependent RNA-Polymerase), which is conserved and is an essential enzyme for RNA transcription and replication of this virus. In this study, we collected around 1225 similar compounds of Penciclovir and Acyclovir inhibitors from PubChem and predicted ADME (Adsorption, Distribution, Metabolism and Excretion) molecular descriptors using Swiss-ADME server. Virtually screened 24/1225 compounds based on drug-likeliness five rules (Lipinski, Ghose, Veber, Egan, and Muegge) and lead-likeliness properties. Further 10/24 compounds screened, based on high binding affinity and RMSD<3.5Å against RdRp structure using PyRx docking software. Furthermore, the molecular interactions of 10 compounds studied using Discovery studio software and finally screened five PubChem compounds 57201841, 135408972, 54552823, 135409422 and 467850, based on bioactivity score using Molinsipiration cheminformatics software. All these five compounds showed up anti-SARS CoV-2 activity, though further in-vitro studies are required.

Open Access Original Research Article

Evaluation of Diuretic activity of Fractional Extracts of Ajuga remota Benth (Lamiaceae) in Albino mice

Desalegn Chilo, N. J. Raju

Journal of Pharmaceutical Research International, Page 341-353
DOI: 10.9734/jpri/2021/v33i54B33797

The present study was evaluated the in vivo diuretic activity of fractional extracts of A. remota in albino mice. The dried aqueous crude extracts were subjected to soxhlet extraction by n-butanol, methanol and water solvents. The mice were randomly divided into eleven groups with 8 mice in each. All fractions were administered orally at doses of 250, 500 and 1000 mg/kg to adult male mice, and the positive and negative controls were treated with furosemide (10 mg/kg, p.o) and the vehicle distilled water (2 ml/100 gm of body weight) respectively. The diuretic effect of the extracts was evaluated by measuring urine volume, urinary electrolytes and urinary pH. The result indicates that aqueous and methanolic fractions at 1000 mg/kg dose produced significant (p<0.001) increase in urine output and electrolyte excretion (p<0.001) when compared to control. Additionally, potassium sparing activity (27%, p<0.05) and high natriuretic index (2.7-3.03) were produced by the n-butanol fraction relatively even if it showed minimal effect on urine output. Therefore, from the present study it may be concluded that the compounds present in methanolic and aqueous fraction are responsible for diuretic activity. This finding together with previous results on the aqueous crude extracts provides a quantitative basis for developing a new diuretic medicine from A. remota plant.

Open Access Original Research Article

To Assess the Effectiveness of Selected Breathing Exercises among Chronic Obstructive Pulmonary Disease Patients

Archana Dhengare, Savita Pohekar

Journal of Pharmaceutical Research International, Page 354-361
DOI: 10.9734/jpri/2021/v33i54B33798

Mortality rate of chronic obstructive pulmonary disease (COPD) is more than 3 million people every year, making it 3rd largest cause of death in the world. It has been estimated that by the year 2030. chronic obstructive pulmonary disease will become the third biggest cause of death. chronic obstructive pulmonary disease (COPD) is a progressive irreversible airway disease characterized by emphysema and chronic bronchitis, resulting in breathlessness, cough and sputum as the disease progresses, subjects with COPD experience increasing deterioration of their health-related quality of life (HRQOL), with greater impairment in their ability to work and declining participation in social and physical activities. Hence practicing pursed lip breathing exercise in their daily routine will improve their breathing pattern and quality of life.


  1. To assess the breathing pattern of chronic obstructive pulmonary disease patient.
  2. To assess the effectiveness of selected breathing exercises among the chronic obstructive pulmonary disease patients.
  3. To associate the effectiveness of selected breathing exercises among chronic obstructive pulmonary disease patient with their demographic variables.

Materials and Methods: The research approach used for the study was interventional evaluatory approach. The study was conducted in respiratory unit at Wardha City Maharashtra, India, using one group pre test post test design without control group. Non probability purposive sampling technique was used for selecting 60 COPD patients. On the first day pre test assessment of breathing pattern with the help of borg rating scale and provided pursed lip breathing exercise for 20 minutes, 2 times in a day and it was continued for 15 days followed by post test on the 15th day. The data collected, tabulated and analysed in terms of objectives of study using descriptive and inferential statistics.

Results: The mean post test score. The overall comparison of selected breathing exercise among COPD patients at rest pre test score was higher 3.48 with SD of ±1.25 when compare with at rest post test score which was 0.91 with SD of ±0.85.The statistical Student’s paired t test implies that the difference in the selected breathing exercise among COPD patients was found to be 18.98 which is statistically significant at 0.05% level of significance. Also the overall comparison of selected breathing exercise among COPD patients during activity pre test score was higher 7.95 with SD of ±1.50 when compared with during activity post test score which was 2.76 with SD of ±1.02. The statistical Student’s paired t test implies that the difference in the selected breathing exercise among COPD patients was found to be 18.98 which is statistically significant at 0.05% level of significance. Hence it is statistically interpreted that effectiveness of selected breathing exercises among COPD patients at rest and during activity in post test was effective. The tabulated values was much higher than the calculated’ values at 5% level of significance, also the calculated ‘p-value which was much higher than the acceptable level of significance i.e. ‘p’=0.05. Hence the association of effectiveness of selected breathing exercises is statistically not associated with demographic variables.

Conclusion: According to the results of this study, patients with Chronic Obstructive Pulmonary disease patients who practiced pursed lip breathing exercise 20 minutes, 2 times a day for 15 days had improvement of the breathing pattern which was statistically proved. Hence pursed lip breathing exercise was cost effective, non invasive, and highly feasible. Hence the researcher concluded that pursed lip breathing exercise can be practice as an effective intervention on improving breathing pattern among chronic obstructive pulmonary disease patients.

Open Access Review Article

Overview on the Causes and Updated Management of Impetigo

Abdullah Rahil Alotaibi, Rahaf Mohammad Alshahrani, Ahad Awadh Alanazi, Marwah khalil I Almalki, Saleh Asaad Alsaadoon, Ahood Ahmad Ali Mahjari, Duaa Abdullah Alahmadi

Journal of Pharmaceutical Research International, Page 50-57
DOI: 10.9734/jpri/2021/v33i54B33764

Impetigo is the most common bacterial skin infection in children between the ages of 2 and 5. There are two main types: non-vesicular (70% of cases) and bullous (30% of cases). Non-bullous impetigo or impetigo is caused by Staphylococcus aureus or Streptococcus pyogenes and is characterized by honey-colored skin on the face and limbs. Impetigo primarily affects the skin or is a secondary infection with insect bites, eczema, or herpes lesions. Bullous impetigo caused only by S. aureus causes large, relaxed blisters and is more likely to affect the interstitial area. Both types usually resolve within a few weeks without scarring, and complications are rare, the most serious of which is streptococcal glomerulonephritis. Treatment includes topical antibiotics such as mupirocin, retapamulin, and fusidic acid. Oral antibiotic therapy can be used for impetigo with large blisters, or when topical therapy is not practical. Amoxicillin / clavulanate, dicloxacillin, cephalexin, clindamycin, doxicillin, minocycline, trimetoprim / sulfamethoxazole, and macrolides are optional, but penicillin is not.

Open Access Review Article

Diagnosis and Management of Surgical Site Infections: Narrative Review

Abdulrahman Zaki Mutyi Alsharari, Wadad Mtharad A. Alruwaili, Hanan Essam M. Saba, Nujud Menwer R. Alanazi, Afkar Bader M. Alkhaldi, Mariyah Mohammed M. Alruwaili, Maryam Bakr H. Alhumud, Lubna Abdulrazaq Z. Alfaleh, Farah Faisal R. Bakri, Shaima Naif M. Alsharari, Ahmed Musleh H. Alhajouj

Journal of Pharmaceutical Research International, Page 65-71
DOI: 10.9734/jpri/2021/v33i54B33766

Infection of the wound after surgery is a regular occurrence. Wound infection is a complicated process that involves a molecular interplay between numerous biological processes. Wound infections are associated with a high rate of morbidity and mortality. Surgical site infections are a common surgical complication that affects approximately 3%-6% of all surgical procedures according to different studies. Surgical site infections (SSIs) cause negative consequences in patients, such as prolonged hospitalization and mortality. Each incision causes wound contamination, however there are established techniques to reduce the incidence of SSI. Improved adherence to evidence-based preventative strategies such as adequate antibiotic prophylaxis, in particular, can help to reduce the rate of SSI. The sort of procedure used determines the correct diagnosis of SSI. Early detection, on the other hand, is critical for good management of all surgical operations. Consistent antibiotic therapy, wound drainage, and, if necessary, vigorous wound debridement are all part of the treatment for SSI. Following that, wound management is determined by the location and nature of the infection.  

This study aims to: Diagnosis and Management of Surgical Site Infections. In this review we will be looking at surgical site infections epidemiology, etiology, diagnosis and management.

Open Access Review Article

Health Benefits, Utilization and Characterization of Rhododendron arboreum (Ericaceae)

. Nitika, Shubham Kumar, Jasdeep Singh

Journal of Pharmaceutical Research International, Page 124-133
DOI: 10.9734/jpri/2021/v33i54B33773

Rhododendron arboreum is a small tree, mostly found in the mountain areas with pale pink or deep pink flowers, widely spread throughout the world. It is a member of the Ericaceae family, and it is well-known for its lovely flowers. R. arboreum species is distributed widely among the 80°N and 20°S latitudes and is designated as ‘State flower’ of Himachal Pradesh (India) and ‘National flower’ of Nepal. Due to its many inherent phytochemical properties, it is used as a treatment for various diseases such as bacterial infection, diarrhoea, and headache, infamy, and fungal infections. The people living in the mountainous area historically use the flowers of this plant to make variety of products viz.  juice, squash, jelly, syrup, pickle, honey. R. arboreum have several important polyphenolic and bioactive compounds such as saponins, flavonoids and steroids. This review highlights Rhododendron's nutritional properties, potential properties and medicinal properties and various products developed, which boost livelihoods of the rural tribal community for sustainable growth and treatment of various diseases.

Open Access Review Article

Nanotechnology in Periodontics Revisited: A Review

Pallavi Sitaram Kamble, Akshada Ashish Gandhi, Priyanka Vhanmane, Shashank Vijapure

Journal of Pharmaceutical Research International, Page 134-143
DOI: 10.9734/jpri/2021/v33i54B33774

Nanotechnology is the study of materials, devices, and systems that display features that are distinct from those found in larger systems. It is no surprise that medical and dental researchers have taken notice of this rapid advancement in technology, which has piqued their curiosity about how it may be used to cure and prevent disease. It is a relatively new science that deals with the manipulation of matter at the molecular level, including the manipulation of individual molecules and their relationships. High-level control of position and chemical characteristics are the primary goals of this method. Nanotechnology has become one of the most promising and significant areas of scientific research as a result, thanks to an increased interest in interpreting matter's property at this dimension. Nanotechnology has been used in dentistry to produce new materials and procedures for diagnosing, preventing, treating, and regenerating periodontal disease, which is the subject of this article. Cargoes and materials such polymeric nanoparticles, non-porous nanogels, nanotube scaffold matrices, and nanofibers have shown promise effectiveness, and their functions in disease treatment are of significant interest. The purpose of this review paper is to offer thorough recent updates on the numerous nanotechnology-based methods to periodontal disease treatment.

Open Access Review Article

Perioperative Use of Vedolizumab in Crohn’s Disease Patients and Surgical Outcomes

Mohammed Alfawaz

Journal of Pharmaceutical Research International, Page 144-154
DOI: 10.9734/jpri/2021/v33i54B33775

Despite advancement in managing Crohn’s disease (CD), a considerable proportion of cases still need surgical intervention, which is an essential means in therapy algorithms. Other drugs of the biologics are recently available, while most CD cases having operations have previously received a drug of this class. This class of agents has a direct association with higher postoperative complication rates, which raises a lot of controversies. In this review summarize the essential data concerning the vedolizumab effect on CD’s postoperative results. The previous data did not demonstrate a cause-effect absolute connection between the increased postoperative morbidities and vedolizumab. Many routing factors unquestionably affect CD’s postoperative outcomes and complications, like malnutrition, unsuitable abdominal settings, and steroids’ previous use. Using vedolizumab perioperatively seems safe. Nevertheless, a definitive relationship from the available data is controversial. Personalized, multidisciplinary evaluations and decisions should be made for each case independently, adjusting the surgical plan regarding the involved risk factors.

Open Access Review Article

Circadian Dysregulation: A Mainstream Mess of the Present World

Pankaj Mehta, Gurpreet Kaur, Neelam Thakur, Navneet Kaur

Journal of Pharmaceutical Research International, Page 272-281
DOI: 10.9734/jpri/2021/v33i54B33786

The physiological systems of humans and other organisms are periodic in nature. One such system is a circadian rhythm, a biological internal clock that is endogenous and entrainable. The circadian rhythm regulates essential functions such as the sleep/wake cycle, hormones, feeding behaviour, metabolism and cell division as well. Due to shift work or jet lag or even irregular sleep, diet, etc., circadian rhythm disorders are one of the most common problems in this century. It is a major factor that can trigger various diseases like depression, lung tumorigenesis, cancer, anxiety, depression and many more. The purpose of this review is to discuss circadian dysregulation and its potential long-term effects in cancer including lung tumor and mental illness including depression, anxiety. Loss of autonomous cells containing Bmal1 and Per2 (the core components of circadian rhythm) will increase growth and metabolism imbalance and increase in c-Myc levels. To treat circadian rhythm disorders, zeitgebers (external cues) should be used to entrain or synchronize the circadian rhythm and sleep phase chronotherapy can also be used.

Open Access Review Article

Child Birth and its Effect on Functional Status of Women: A Review

T. R. Rejisha, Madhu Malleshappa, Ali Irani, Sruthy Johny, Jessy Grace

Journal of Pharmaceutical Research International, Page 289-295
DOI: 10.9734/jpri/2021/v33i54B33788

Though highly satisfying motherhood comes with its own challenges. Often underestimated, the effect of child birth on maternal function is a huge and can invariably effect not only the individual but the society in general. Yet there seems to be an attitude of “its all part and parcel of motherhood” when it comes to the functional status of mothers. To improve the functional status of women one needs to quantify it and a scale for Indian mothers are not in existence yet. No matter the mode of delivery , the maternal function is compromised, its said that the physiological healing is complete at 6 weeks post delivery but the researchers are not able to come to terms regarding time needed to achieve the pre pregnancy functional status or in many cases if it ever returns. Hence the gravity of situation is dare and needs acknowledgment not only from the health care professionals but from the society in general. In this article, we are examining the different modes of delivery and its subsequent effect on physical functions of women.

Open Access Review Article

A Review on Impact of Anthropogenic Sulphur Dioxide Pollution on Health and Environment

Pankaj Mehta, Jennifer Ngangbam, Neelam Thakur, Navneet Kaur

Journal of Pharmaceutical Research International, Page 337-340
DOI: 10.9734/jpri/2021/v33i54B33796

The explosive global change in the emissions of Sulphur dioxide (SO2) over the decades have brought about tremendous effects in the regional as well as global scale in the composition and quality of air that we breathe. The global SO2 emission peaked in the 1970s, decreased until 2000 and has risen to peak again mainly as the result of increased globalization in developing countries. The global estimation is surprisingly low but the regional output of SO2 is high. The main hotspots being in East Asia Countries. The Sulphur aerosols not only impacts the animals’ health, but those of the ecosystems at large. SO2 contributes to global warming, ozone depletion, acid rain, smog etc. that has brought disastrous environmental conditions. WHO recommends a maximum exposure of not more than 0.5 ppm for around 24 hours’ span. SO2 reacts with other gases to form sulphate particles, constituent of particulate matters i.e. PM 2.5 concentrations, the exposure to which causes skin, respiratory, reproductive failures and cardiovascular ailments. This study, as such, is meant to bring into light the sources of SO2 and its harmful effects on health and environment at large. Air pollution is a major issue with adverse effects prevailing over the globe at present.