Open Access Short Research Article

Development of the Composition, Technology and Study of the Effectiveness of Drops for Oral Administration "Ascorbicdrop"

B. Uktamov, N. M. Rizaeva, D. S. Mirzakamalova, I. Sh. Sharipova

Journal of Pharmaceutical Research International, Page 310-316
DOI: 10.9734/jpri/2021/v33i56B33957

For normal life, many different substances are needed, among which vitamins play an important role. Everyone knows that the word "vitamin" comes from the Latin "vita" - life. This name is not accidental at all [1].

Vitamins are low molecular weight organic compounds, very small amounts of which are required for the implementation of various metabolic processes in the body. Most vitamins are indispensable because are not synthesized in the human body. In their natural state, they can be found in very small quantities in all foods of organic origin [1,2].

Insufficient intake of vitamins from food is a global problem, and not seasonal, as it is mistakenly believed. For a number of reasons, a modern person cannot get them in the right amount with food. Inadequate nutrition, physical inactivity lead to metabolic disorders in the body and increase the risk of developing serious diseases [3,4,5,6].

One of the main problems faced by drug manufacturers is sometimes a short shelf life. In order to preserve the pharmacological properties of drugs, they add preservatives to them or place them in a vacuum package. To date, the most effective way to solve this problem is to use a modified atmosphere with nitrogen.

The stability of solutions of easily oxidizable substances increases significantly if they are filled in an inert gas environment, for example, carbon dioxide, nitrogen or argon. This filling allows you to remove oxygen, this oxidizing agent that destroys unstable substances. The following factors influence the reduction of shelf life:

  • oxidative processes,
  • development of molds,
  • reproduction of microorganisms.

All oxidative processes in the packaging of a medicinal product occur under the influence of oxygen. As a result of this reaction, medications deteriorate. With the help of a pure nitrogen environment, it is possible to reduce the O2 content to a minimum level [7].

Open Access Minireview Article

Transfiguring Healthcare: Three-Dimensional Printing in Pharmaceutical Sciences; Trends during COVID-19: A Review

K. G. Siree, T. M. Amulya, T. M. Pramod Kumar, S. Sowmya, K. Divith, B. G. Ramu, M. P. Gowrav

Journal of Pharmaceutical Research International, Page 207-218
DOI: 10.9734/jpri/2021/v33i56B33946

Three-dimensional (3D) printing is a unique technique that allows for a high degree of customisation in pharmacy, dentistry and in designing of medical devices. 3D printing satiates the increasing exigency for consumer personalisation in these fields as custom-made medicines catering to the patients’ requirements are novel advancements in drug therapy. Current research in 3D printing indicates towards reproducing an organ in the form of a chip; paving the way for more studies and opportunities to perfecting the existing technique. In addition, we will also attempt to shed light on the impact of 3D printing in the COVID-19 pandemic.

Open Access Original Research Article

Seroprevalence of Anti-SARS-CoV-2 Antibodies in COVID-19 Patients in Hyderabad, Sindh

Shahzad Rasheed Qureshi, Nazakat Hussain Memon, Sadia Qamar Arain, Ghulam Shah Nizamani, Majid Ali Abbasi, Arshad Hussain Laghari, Ali Raza Rajput

Journal of Pharmaceutical Research International, Page 8-14
DOI: 10.9734/jpri/2021/v33i56B33921

Aim: The world is affected by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) pandemic. This virus has emerged as a human pathogen that can cause symptoms ranging from fever to Pneumonia, but it remains asymptomatic or mild. To better understand the virus's ongoing spread, identify those who have been infected, and track the immune response, accurate and robust immunological monitoring and SARS-CoV-2 detection assays are needed.

Methods: The estimation of serology tests to assess the presence of antibodies to SARS-CoV-2 in COVID- 19 patients at Asian Institute of Medical Sciences (AIMS) and Isra University & hospital. 1229 patients were selected including males and females with the age being 25 to 65 years living in the territories from 1st August to 30th November 2020. The anti-SARS-CoV-2 test was performed by an electrochemiluminescence immunoassay analyzer.

Results: Out of 1229 participants 206 (17%) were positive with COVID-19, and 1023 (83%) were negative. The results further revealed that a higher percentage of positive COVID-19 were detected in males in all age groups as compared to females, and most of them are affected at age of 46-65 years male 40 (24.69%) and female 14(17.5%).

Conclusion: The seroprevalence of SARS-COV-2 antibodies has increased in the old age population, which may aid in determining the true number of infected cases. Although the current study is based on a small sample of participants, the findings suggest a study with a larger population to implement stronger and targeted interventions.

Open Access Original Research Article

Exploring Knowledge, Attitude and Practice (KAP) Towards Vitamin D among Arts and Commerce Students in Vistas Chennai

M. Varaprasanna Rao, Mashhud Alam

Journal of Pharmaceutical Research International, Page 23-28
DOI: 10.9734/jpri/2021/v33i56B33923

Introduction: Vitamin D is an essential nutrient and a group of fat-soluble pro-hormones with multiple functions in the body including bone health, regulation of serum calcium and phosphate levels, as well as roles in immune function, cell proliferation, differentiation, and apoptosis. The two major biologically inert precursors of vitamin D are vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). Vitamin D3 is also formed when the skin is exposed to solar ultraviolet B and then converted to pre-vitamin D3 (Sunshine Vitamin). The severe vitamin D deficiency in adults and children’s causes softening of bones, muscle weakness and fractures.

Aim: The aim of the study is to explore knowledge, Attitude and Practice towards Vitamin D among Arts & Commerce students in Vels University Chennai.

Methods and Materials: The study was a prospective cross-sectional, carried out in the department of arts and commerce students in VISTAS Chennai. The questionnaire then underwent a series of validation process that included content, face validity and exploratory part. Item response theory (IRT) analysis was utilized for the validation of the knowledge domain. Exploratory factor Analysis (EFA) used for attitude and practice validation. Institutional Ethical Committee (VISTAS-SPS/IEC/VI/2020/05) approval was obtained before conducting the study. Self-online questionnaires link was sent via mail after registration. The questionnaire was divided based on Knowledge, Attitude and Practice with 5 questions each. Completed questionnaires were reviewed, entered into a database (SPSS) and analysed using descriptive and inferential statistics.

Results and Discussion: In our study, a total of 362 students were included where majority were males from first year commerce department around 18 to 19 years of age. Majority of the students had knowledge on vitamin D, attitude towards every day sun exposure and practice of using sun screens.

Conclusion: Our study concluded that the students’ knowledge on vitamin D is good. There was an inconsistent practices towards managing its deficiency. Despite widespread, concern about vitamin D, still attitude and practice towards Vitamin D is yet to known for young generations.

Open Access Original Research Article

Biological Activities of Withanolides from Datura innoxia

Ruby George, Priti Mathur

Journal of Pharmaceutical Research International, Page 43-54
DOI: 10.9734/jpri/2021/v33i56B33924

Aims: This study aimed to explore the therapeutic potential of Datura innoxia through the chemoinformatic and antibacterial evaluation of withanolides extracted from it.

Study Design: The pharmacokinetic and pharmacodynamic properties and drug-likeness of the withanolides—withametelinol A, withametelinol B, witharifeen, withametelin, dinoxin B, and daturalicin—of D. innoxia were analyzed using the SwissADME program. Schrodinger software was used to target and evaluate their antibacterial potentialities through docking studies. The penicillin-binding protein, DNA gyrase, efflux pump protein, and quorum sensing regulators of S. aureus and E. coli were selected as target proteins for assessing protein–ligand interactions. All observations were comparatively analyzed with the properties of withanolide A and withaferin A, the best-known withanolides. Most active dinoxin B withanolide (12500–100000 μg/ml) extracted from leaves of Datura innoxia; was subjected to antibacterial assay against methicillin-resistant S. aureus (MRSA) and multi-drug resistant(MDR) E. coli isolated from the urine samples of urinary tract infected patients.

Results: In-silico studies revealed the therapeutical properties of various withanolides present in D. innoxia. In particular, the drug-likeness and antibacterial properties of withametelin and dinoxin B were significantly and remarkably high due to their binding affinity toward cell membrane proteins. Docking studies have shown that the efflux pump protein of E. coli and penicillin-binding proteins of S. aureus to be the ligand -interaction targets. A significant antibacterial assay revealed that the MRSA isolates were susceptible to dinoxin B, with a zone of inhibition of 21±0.5 mm to 24±0.5 mm, and the bacteria were susceptible at a concentration rate of ≤ 12.5 mg/ml.

Conclusion: It is crucial to bring awareness of the therapeutical importance of D. innoxia and to preserve this vital plant from being largely destroyed. As computational studies promote the effective selection of drug molecules, this research also helps to select the best compound for further clinical analysis.

Open Access Original Research Article

Evaluation of a Potential Association between Head Lice (Pediculus capitis) Infestation and Anemia among Female Primary School Students in Holy Makkah, Saudi Arabia

Khalil Mohamed, Amir Elmubarek Ali, Mohand Gafer, Muslimah Alsulami, Halah Tariq Albar, Mohamed Abdel-Fattaha

Journal of Pharmaceutical Research International, Page 62-68
DOI: 10.9734/jpri/2021/v33i56B33928

Aims: This study aimed to determine if there was an association between head lice infestation and anemia among female primary schools students.

Study Design: Case-control study.

Place and Duration of Study: Holy Makkah, Saudi Arabia between August 2020 and November 2020.

Methodology: We conducted a case-control study by comparing hemoglobin levels among study subjects with and without head lice infestation. Female students at 6 randomly selected primary schools were examined for the presence of head lice. Hemoglobin levels were obtained from each study subject; both those with and without head lice. Selected characteristics of study subjects were recorded and examined to determine associations between those factors and              anemia.

Results: A total of 82 subjects were included in the study; 44 subjects with head lice. The average (± standard deviation) age of subjects was 11 (± 2) (range: 6-11) years. We found a significant (p<0.028) association between the presence of head lice and hemoglobin level, the OR= 2.036 at 95% confidence interval 0.23 to 18.009. The mean of hemoglobin in subjects with lice was 13(±2) while the level in subjects without lice was 14.8(±2). Other factors significantly associated with the level of hemoglobin were being aged 10-11 years (p<0.05) and having a non-working mother (p<0.05).

Conclusion: In our study we found a significant association between head lice and level of hemoglobin among study subjects. Further studies are needed to determine the reason of this association in order to determine the appropriate management and prevention of this problem.

Open Access Original Research Article

Prevalence and Management of Hypertension along with its Complications - A Prospective Study

Aishwarya Dinakaran, R. E. M. Prema Chandrika, Mohd Mubashir Shareef, Mehraj Sultana, Quarratul Ain Khanam, P. Sailaja Rao

Journal of Pharmaceutical Research International, Page 76-83
DOI: 10.9734/jpri/2021/v33i56B33931

Aim: The main aim of the study was to estimate the prevalence of hypertension and correlate hypertension with the occurrence of its complications.

Study Design: The study was designed to detect the adverse outcomes of uncontrolled hypertension and review the treatment patterns in the management of hypertension along with the complications.

Place and Duration of the Study: This study was an observational study conducted for a period of six months from January to June 2020, at THUMBAY HOSPITAL NEW LIFE, in an inpatient department.

Methodology: Using a suitable designed data form, details of the patient were collected from patient demographics, prescription charts, laboratory data, medical records, doctor's and nursing notes.

Results: In this study, the prevalence of hypertension was found to be more in males (52.5%) than in females (47.5%). Among all age groups, individuals aged 50-59 yrs were highly affected. From the study, it was found that a greater number of patients fall in the category of stage-2 hypertension (38.75%) followed by hypertension crisis (28.75%), stage-1 hypertension (25%), and normal (7.5%). More patients with uncontrolled hypertension experienced cardiovascular complications (55%) when compared to cerebrovascular (27.5%) and renal (17.5%) complications. Chi Squared Test was used to analyse the significance of the study. P values < 0.0001 was considered as statistically significant.

Conclusion: It was concluded that the choice of antihypertensive drugs used in the management of hypertension were diuretics followed by Angiotensin receptor blockers (ARBs) and Calcium Channel blockers. The most commonly prescribed drugs in the study were Furosemide, Telmisartan, Amlodipine, Metoprolol, followed by clinidipine, carvedilol, metolazone, perindopril, cardiopril, and torsemide.

Open Access Original Research Article

Quality of Life and Patient Satisfaction after Endodontic Treatment Performed in Three Hospitals in Jeddah, kingdom of Saudi Arabia

Ragab Eid Saif Hassan, Abdulrahman waseem hamid alhamid, Abdullah Abdlilwahid Abdullah Alshuaybi, Abdulaziz Osama Asaad Hamadallah

Journal of Pharmaceutical Research International, Page 84-96
DOI: 10.9734/jpri/2021/v33i56B33932

Aims: To evaluate the quality of life of patients after endodontic treatment, and their satisfaction toward the endodontic treatment in Jeddah, Saudi Arabia.

Methodology: A cross sectional study, was conducted on 300 patients who underwent endodontic treatment from 6 months to a week ago. The study was performed using a self-administered questionnaire. The collected data were analyzed using statistical analysis software SPSS v.26.

Results: In the OHRQoL items, the total degree of the oral health-related quality of life assessment was medium with (M = 2.72 out of 5, RII = 54.4%, SD = 0.67), the most affected was "Feeling an excruciating pain in the mouth" with (M = 3.37 out of 5, RII = 67.4%, SD = 0.77), while the least was  " Feeling irritable with others because of the teeth or mouth" with (M = 2.32 out of 5, RII = 46.4%, SD = 1.35). The total degree of the personal satisfaction assessment was high with (M = 3.78 out of 5, RII = 75.6%, SD = 0.67). "Postoperative Pleasantness" was the most satisfied part with (M = 3.86 out of 5, RII = 77.3%, SD = 0.87).

Conclusion: This study showed a moderate level of OHRQoL among patients after the endodontic treatment, and a high level of satisfaction among patients toward the endodontic treatment.

Open Access Original Research Article

Prevalence of Iron Deficiency Anemia among Adolescent School Children of Manipur, India

L. S. Amarnath, Loushambam Samananda Singh, Ksh. Gomti Devi, R. K. Ranjit

Journal of Pharmaceutical Research International, Page 135-143
DOI: 10.9734/jpri/2021/v33i56B33935

Background: Iron deficiency anemia (IDA), one of the most common types of nutritional anemia worldwide is considered a major public health problem in developing countries. Prevalence in India remains alarmingly high. Population of Manipur, a small state in the north-eastern part of India, is different with distinct race, culture, socio-demographic pattern and dietary habits. Therefore, this cross-sectional study was conducted to determine the prevalence and risk factors of IDA among apparently healthy school children of Manipur, India.

Methods: Three hundred and seventy-nine blood samples (163 males and 216 females) were collected randomly from urban and rural school children in the age group of 13 to 19 years from Imphal west and Thoubal districts of Manipur respectively. Eligible participants were subjected to haemoglobin (Hb) estimation and serum ferritin (SF) assay. Moreover, a questionnaire was designed to collect demographics, food and drink habits, hygienic practices and socioeconomic status. BMI of the students were also recorded.

Results: The overall prevalence of IDA was 23.2% (n = 88), of whom 81.81% were females (n = 72) and 18.18% were males (n = 16). Prevalence of IDA among the males and females was higher in the rural compared to urban schools but not statistically significant. Correlation between BMI and Hb was significant (p < 0.05) but not with serum ferritin status. Students belonging to the middle income group had the highest prevalence of ferritin deficiency followed by the high income group and low income group respectively. Both the Hb and serum ferritin levels of students who do hand wash before meals were significantly higher than those who do not. Both hemoglobin and serum ferritin levels do not differ significantly among students who prefer home-made traditional food and junk food.

Conclusion: This study revealed that the majority of the students, especially females, have IDA that might become worse by malnutrition, lifestyle habits, and lack of awareness. Our results suggest that IDA can be prevented by providing proper knowledge on the healthful diet, improved lifestyle, and harmful effect of IDA to the students.

Open Access Original Research Article

Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients with Non-Insulin Dependent Diabetes Mellitus at Tertiary Care Hospitals in Karachi Pakistan

Syed Wajid Shah, Mirza Tasawer Baig, Syed Imran Ali, Qurratul ain Leghari, Aisha Jabeen, Uzma Shahid

Journal of Pharmaceutical Research International, Page 107-112
DOI: 10.9734/jpri/2021/v33i56B33936

Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic status but also effects the quality of life.

Objective: To study the prescribing pattern of Antihypertensive drugs in Hypertensive patients with Type 2 Diabetes Mellitus at Tertiary care hospitals in Karachi, Pakistan.

Methods: A cross sectional study was undertaken for six months in medicine outpatient department at tertiary care hospitals of Karachi. The study population was observed for the prescribed pattern of Antihypertensive medicines by assessing the 300 prescriptions of Hypertensive patients with Type 2 Diabetes Mellitus. Statistical analysis was performed using SPSS version 20. Data was presented as frequencies and percentages.

Results: The result revealed that the most commonly prescribed single antihypertensive drug was Enalapril 66 (22%) followed by Amlodipine 63(21%), Ramipril 57(19%), Diltiazem 33(11%), Lisinopril 21(7%) losartan k 6(2%), Nebivolol 6(2%), Bisoprolol 3(1%). Dual therapy included Ramipril and Nebivolol 1(0.33%) and Amlodipine+Valsartan 35 (11.67%), Amlodipine+Valsartan+HCTZ 9 (3%) were the antihypertensive drugs prescribed as fixed dose combinations.

Conclusion:  The present study shows Enalapril belonging to Angiotensin Converting Enzyme Inhibitor (ACEI) class was frequently used as single Antihypertensive agent and Amlodipine+Valsartan belonging Calcium Channel Blockers (CCBs) and Angiotensin Receptor Blockers (ARBs) was the most frequently prescribed fixed dose combination while managing Hypertension of Hypertensive patients with Type 2 Diabetes Mellitus.

Open Access Original Research Article

Molecular Docking Studies on Phenolic Constituents of Anethum graveolens L. Seed Extracts

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

Journal of Pharmaceutical Research International, Page 119-128
DOI: 10.9734/jpri/2021/v33i56B33939

Background: There are studies indicating that aqueous or hydroalcoholic dill extracts showed higher antioxidant activity compared to other fractions. Molecular docking studies would be relevant to get information on the mechanism of action of the phenolic constituents of Anethum graveolens seed extracts as bioactive compounds.

Methodology: In order to perform the docking studies of antioxidant activity of phenolic constituents of Anethum graveolens seed extracts, BIOVIA Discovery Studio and AutoDock Vina software were used.

Results: The orientation of flavonoids within Hck and CYP2C9 binding sites has been shown to be the main reason for their inhibitory potency.

Conclusion: Molecular docking studies indicate that the compounds identified interact with the target enzymes Hck and CYP2C9 at molecular level through their condensed ring systems and hydroxyl substituents and therefore support the antioxidant capacity of the studied phenolic compounds.

Open Access Original Research Article

Antibacterial Activity of CuO Nanoparticles Synthesized by Justicia adhatoda Leaf Extract

S. Alwin David, P. Subramanian

Journal of Pharmaceutical Research International, Page 160-170
DOI: 10.9734/jpri/2021/v33i56B33941

Aims: To determine the antibacterial activity of CuO nanoparticles (CuO NPs) synthesized by Justicia adhatoda leaf extract.

Study Design:  Synthesis, characterization and antibacterial activity determination of CuO NPs.

Place and Duration of Study: PG and Research Department of Chemistry, V.O.Chidambaram College, Tuticorin, Tamilnadu, India, between April 2019 and April 2020.

Methodology: CuO NPs were synthesised using Justicia adhatoda leaf extract. UV-Visible spectroscopy was used to characterize CuO NPs. The role of biomolecules in plant extract in the formation of the CuO NPs was identified using Fourier transform infrared spectroscopy. The particle size and lattice properties of CuO NPs were determined using XRD. The surface morphology of CuO NPs was studied using SEM. The presence of Cu and O in CuO NPs was confirmed using EDAX analysis. Bacterial antimicrobial activity was investigated.

Results: An absorbance band at 285 nm in the UV–visible spectrum clearly revealed the formation of CuO NPs. In the FTIR, CuO NPs had a distinct absorption peak at 608 cm-1, confirming metal–oxygen stretching in Cu-O nanostructures. The presence of crystalline CuO NPs was confirmed by XRD patterns, and they were found to be spherical in shape with a size range of 23.21–37.57 nm, as evidenced by FESEM. The biosynthesized CuO NPs exhibited a strong antibacterial activity against Staphylococcus epidermidis and Bacillus cereus bacteria.

Conclusion: Justicia adhatoda leaf extract mediated CuO NPs have shown significant antibacterial activity and they are considered potent antibacterial agents.

Open Access Original Research Article

Determination of Coagulation Profile among Children with Sickle Cell: Anemia in Steady-State and Crisis

Maysaa Ali Hassan Ali, Elharam Ibrahim Abdallah, Alaa Eltayeb Omer, Lienda Bashier Eltayeb

Journal of Pharmaceutical Research International, Page 179-185
DOI: 10.9734/jpri/2021/v33i56B33943

Background: Patients with Sickle Cell Disease (SCD) have been found to have an aberrant coagulation profile. One of the primary elements hypothesized to contribute to the vaso-occlusive crisis that characterizes sickle cell disease is coagulopathy (SCD)

Material and Methods: A total of 150 children were enrolled as follows, 50 children with Sickle Cell Anemia (SCA) in steady-state, 50 in crisis, and 50 with Hb AA genotype as control. 5 ml of Venous blood was collected. The platelets count was performed using Sysmex KX21N, the electrical impedance principle. The Mean Platelet Volume (MPV) is derived from the impedance platelet size distribution curve. STAGO PT31039352) semi-automated machine was used for estimation of PT, and APTT.

Result: children with SCA have significantly a prolonged PT, and APTT compared with children with normal hemoglobin genotype (P. value < 0.001) the mean of PT was (16.64, and 12.6) respectively, and APTT (41.45 and 37.94) consequently. A significant increase in platelet count between patients with SCA when compared with control (p. value 0.02), however a significant prolonged in APTT when compared to steady-state (P. value 0.005). MPV among children with crises when compared with steady-state revealed a significant result (p. value 0.006) the mean of MPV in steady-state = 6.79 while the mean of MPV in crisis = 7.09.

Conclusion: children with sickle cell anemia had a longer coagulation profile and marked variation in platelet count, which may increase the risk of thrombosis or bleeding.

Open Access Original Research Article

Prevalence of Xerostomia and Associated Systemic Risk Factors in Riyadh, Saudi Arabia: A Cross-sectional Study

Muhammad Mumtaz, Almuhanad Abdullah Alsuwaiket, Shammas Raza, Farhat Kazmi, Quratulain Shaikh, Afsheen Tabassum

Journal of Pharmaceutical Research International, Page 186-194
DOI: 10.9734/jpri/2021/v33i56B33944

Purpose: Xerostomia is a feeling of dry mouth and may result in poor oral hygiene, dental caries, mucosal lesions and burning mouth syndrome. Medication, systemic diseases and stress are common etiological factors of xerostomia. The present study investigated the prevalence of xerostomia and explored the possible risk factors associa­ted with this condition among Saudi population.

Methods: The present cross-sectional study was conducted on 418 participants visiting at Maxillofacial clinic, at secondary care hospital, Riyadh.  Demographic data and complete medical history were obtained from participants. All participants were requested to fill the Xerostomia-Inventory (XI) questionnaire. Comparisons between mean scores of XI-inventory and categorical variables like gender, comorbid conditions were made with students t-test or Wilcoxon test. Chi-square or Fischer’s Exact test were used for comparison between categorical variables like gender and responses to XI-items (No/Yes). P value of <0.05 was considered significant. All analysis was done on JMP-version-12.

Results: Total 418-participants with mean age (41.1 ± 12.8 years) were included in the study in which 302-participants (72.2%) were female and 116-participants (27.8%) were male. Xerostomia’s prevalence was 24.7% and it was higher in males (34%) as compared to females (21%). A statistically-significant association was found between xerostomia and participant’s age (P < 0.0001). The participants with systemic illness showed a significantly higher mean Xerostomia Inventory (XI) score as compared to the healthy patients. In our study population common comorbid conditions were hypertension and diabetes.

Conclusion: The prevalence of xerostomia increases with increasing age and it has strong positive co-relation with chronic systemic diseases.

Open Access Original Research Article

Cytotoxic Effect of Ethanol Extract of Abrus precatorius Leaves on Raw 264.7 and SK-N-SH Cell lines

Krishnaprabha Naduchamy, Varadarajan Parthasarathy

Journal of Pharmaceutical Research International, Page 195-206
DOI: 10.9734/jpri/2021/v33i56B33945

Aim: This study was aimed to investigate the cytotoxic effect of ethanol extract of Abrus precatorius. leaves on Raw 264.7 and SK-N-SH cell lines.

Methodology: Soxhlet extraction was carried out using absolute alcohol and subsequently, the profiling of phytoconstituents of ethanol extract was performed by LC-MS analysis.

Results: The results showed that the presence of anthocyanin, phenolic acid, carboxylic acid, amino acid and monoester in ethanol extract of Abrus precatorius. The phytoconstituents such as picolinic acid, N-Acetyl-DL-tryptophan, 3-Hydroxybenzoic acid, kuromanin, aflatoxin G2, monobutyl Phthalate, laurolactam, 4-Dodecylbenzenesulfonic acid, 4-Methoxycinnamic acid, caffeic acid and octyl decyl phthalate were found  in ethanol extract. In addition to this, the cytotoxic effect of the ethanol extract was tested on Raw 264.7 and SK-N-SH cell lines using MTT assay. The cytotoxic study revealed that the ethanol extract of Abrus precatorius was non-toxic to Raw 264.7 cell, but it showed a toxic effect on human neuroblastoma cell line, SK-N-SH.

Conclusion: In this study, it was observed that the ethanol extract of Abrus precatorius was non-toxic to Raw 264.7 cell line, but it exhibited strong inhibition on the viability of SK-N-SH cell line.

Open Access Original Research Article

RP-HPLC Method Development and Validation for the Estimation of Lumefantrine in Bulk Drug

Ashish Sethiya, R. P. S. Rathore

Journal of Pharmaceutical Research International, Page 226-231
DOI: 10.9734/jpri/2021/v33i56B33948

Lumefantrine is an antimalarial agent used to treat acute uncomplicated malaria. It is administered in combination with artemether for improved efficacy. This combination therapy exerts its effects against the erythrocytic stages of Plasmodium spp. and may be used to treat infections caused by P. falciparum and unidentified Plasmodium species, including infections acquired in chloroquine-resistant areas. A reversed-phase high performance liquid chromatography (RP-HPLC) method was developed and validated for the estimation of lumefantrine in bulk drug. The separation was achieved on Thermo C18 analytical column (250 mm × 4.6 mm i.d., 5.0 μm) using 10mM KH2PO4: acetonitrile  (pH adjust 3.0 with OPA) in the ratio 20:80 v/v as mobile phase and at a flow rate of 1.0 ml/min. Detection was carried out using a UV detector at 240nm. The total chromatographic analysis time per sample was about 6.0 min with lumefantrine eluting at retention time of about 3.225 ± 0.001min. The method was validated for accuracy, precision, specificity, linearity and sensitivity. Validation studies demonstrated that this HPLC method is simple, specific, rapid, reliable and reproducible. The standard curve was linear over the concentration range of 5-25 μg/ml with r2 close to one (0.999). The limit of detection (LOD) and limit of quantitation (LOQ) obtained for lumefantrine were 0.25 μg/ml and 0.75μg/ml respectively. The high recovery and low relative standard deviation confirm the suitability of the proposed method for the determination of lumefantrine in bulk drugs.

Open Access Original Research Article

Analysis of Pain Manifestation and Its Management in Adults

Muhammad Shoaib, Rehan Zahoor, Waqas Latif

Journal of Pharmaceutical Research International, Page 239-243
DOI: 10.9734/jpri/2021/v33i56B33950

Introduction: Pain is link with significant disable due mobility, avoidance of activity, falls, depression and anxiety, sleep impairment, and isolation.

Objectives: The main objective of the study is to clinically analyse the pain manifestation and its management in adults.

Methods: This cross sectional clinical audit was done in Services hospital Lahore during January 2020 till June 2020. The data was collected from a large number of patients undergoing intermediate to major surgery and thus have high analgesic requirements. Medical folders that were not available or had missing notes were excluded. The folders were requested from the Medical Records Department and reviewed by four investigators.

Results: The data was collected from 169 patients. The mean age of the patients was 38 years. Pain was assessed in 85 of the 168 patients (51%) (62 of the 110 urogynaecology patients; 23 of the 58 orthopaedic patients) and reassessed in 55 of the 85 patients (65%) who had received an initial pain assessment. The ward doctor (intern, registrar or specialist) assessed pain in 67% of the 85 patients evaluated.

Conclusion: It is concluded that a significant proportion of the pain interventions appeared to be based on the professional knowledge of the practitioner and not supported by evidence-based guidelines of pain management.

Open Access Original Research Article

Frequency of Musculoskeletal Disorders and their Counter Measures Adopted by Final Year Students and Young Dentists: A Questionnaire Based Multicenter Study

Hina Mahmood, Murtaza Zaidi, Tayyaba Saleem, Muhammad Farhan Khan

Journal of Pharmaceutical Research International, Page 262-270
DOI: 10.9734/jpri/2021/v33i56B33952

Aim: Musculoskeletal disorders have significantly been related to poor ergonomics practice during clinics. There is limited data regarding the prevalence and reasons for work-related musculoskeletal disorders in young dentists. This study was conducted to find out the prevalence of musculoskeletal disorders in young dentists, identification of the perceived reasons for musculoskeletal disorders, and measures taken to manage them.

Study Design: Cross-sectional observational study.

Methods: A cross-sectional study was conducted on 408 house officers from ten dental institutes of twin cities and Karachi, Pakistan. The subjects were inquired through a validated questionnaire about the presence of muscular pain, affected body regions, frequency, intensity, nature of onset, aggravating factors, and average duration of the pain episodes. They were also asked about measures taken to counter musculoskeletal pain and their effectiveness.

Results: The overall prevalence of musculoskeletal disorders was n=231(56.6%) with n=172(39.2%) of participants reporting it to be work-related with a higher percentage of females n=138/172 (80.2%) The most affected body regions were the back n=101/172 (58.7%), shoulders n=91/172 (52.9%) and neck n=80/172(46.5%). Improper posture n=108(62.8%) followed by prolonged sitting n=88(51.2%) were the most common reasons perceived by the young dentists for their pain. Bed rest was adopted 93(54.1%) to alleviate pain followed by posture rectification 76(44.2%). Most n=134(77.9%) of them thought that these measures are helpful for the alleviation of pain.

Conclusion: The prevalence of work-related musculoskeletal disorders among young dentists is high. The back, shoulder, and neck areas were more frequently affected. A higher percentage of females suffered from MSD as compared to males. Bed rest was the most common measure adopted to alleviate the pain. Very few of them sought professional help for their musculoskeletal disorders.

Open Access Original Research Article

GC-MS Analysis and Antimicrobial Assessment of Syzygium cumini (L.) Skeels Seed Ethanol Extract

S. Mabel Parimala, A. Antilin Salomi

Journal of Pharmaceutical Research International, Page 271-283
DOI: 10.9734/jpri/2021/v33i56B33953

People use plants to treat infections, and this has led to search of antimicrobials from medicinal plants. In this work, we evaluated the ethanol extract of Syzygium cumini seeds for their antibacterial and antifungal activities. Extraction was performed by maceration method using ethanol. The antimicrobial efficacy of the extract was assessed by agar well diffusion method against ten bacterial species, Bacillus cereus, Bacillus subtilis, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Serratia marcescens, Staphylococcus aureus and Streptococcus mutans, and five fungal species, Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Candida albicans and Mucor sp. Minimum inhibitory concentrations (MICs) of the extract were determined by resazurin microtiter plate assay.  Phytochemicals in the extract was identified by gas chromatography mass spectrometry (GC-MS) information.  In agar well diffusion method, Gram-negative bacteria such as P. aeruginosa and S. marcescens, Gram-positive bacteria such as B. subtilis and E. faecalis and fungi A. fumigatus were more susceptible showing larger zones of inhibition.  In resazurin method, low MICs were recorded for bacteria, B. cereus (<7.8 µg) and P. aeruginosa (15.6 µg) and fungi, A. fumigatus (31.2 µg).  Fifteen compounds were identified by GC-MS profiling of the extract.  The antimicrobial activity of the extract can be rightly related to the secondary metabolites in the ethanol extract of Syzygium cumini seeds.

Open Access Original Research Article

Relaxation Effect of Extract Ethanol Curcuma Longa on Isolated Guine Pig Trachea

Hidayati Yanita, Chrismis Novalinda Ginting, Linda Chiuman, Sahna Ferdinand

Journal of Pharmaceutical Research International, Page 284-289
DOI: 10.9734/jpri/2021/v33i56B33954

Aims: Asthma is a chronic obstructive pulmonary disease which is a world health problem that is not only infected in developed countries but also in developing countries. According to the National Asthma Education and Prevention Program (NAEPP), asthma can be defined as a chronic inflammatory disorder that occurs in the airways, which involves inflammatory cells. curcumin reduces allergic airway inflammation in mice through inhibition of a specific pathway aimed at investigating the anti-inflammatory effect of curcumin in acute allergic asthma and its underlying mechanisms in mice.

Study Design: This study is experimental study.

Methodology: The experimental animals were divided into 2 groups, each group consisting of 4 animals. Group 1 gave theophline as a positive control group and group 2 was given extracts with concentrations (1 mg / ml, 2 mg / ml, 3 mg / ml, 4 mg / ml, 5 mg / ml, 6 mg / ml, 7 mg / ml and 8 mg / ml). These animals are acclimatized for 1 (one) week with the aim of homogenizing their food and life with the same conditions so that they are considered eligible for research.

Results: The ethanol extract of curcuma longa has no different ability from atropine sulfate 1 x 10-6 M in reducing the smooth muscle contraction of isolated guinea pig tracheal induced by acetylcholine, the strength of acetylcholine without incubation contraction compared to acetylcholine with EETH incubation showed statistically different results (p<0.05).

Conclusion: The mechanism of the relaxing effect of curcuma longa on isolated mouse smooth muscle is mediated through inhibition of the PDE enzyme.

Open Access Original Research Article

Stability of Insulin on Polycaprolactone Nanoparticles as a Function of Surface Properties

Nader I. Namazi

Journal of Pharmaceutical Research International, Page 296-309
DOI: 10.9734/jpri/2021/v33i56B33956

The purpose of this research was to formulate insulin-loaded polycaprolactone (PCL) nanoparticles and evaluate structural stability of the protein using fluorescence spectroscopy. The size and morphology of the nanoparticles were characterized using dynamic light scattering (DLS) and scanning electron microscopy (SEM). Fluorescence emission data revealed that insulin is most stable with multilayer adsorption at pH close to its isoelectric point (IEP). The obtained particle size ranged from 130-140 nm+22 (SD). The loading amount of insulin onto the PCL nanoparticles was low at pH 7.4 and relatively high at pH 5.3. The adsorption phenomenon of protein onto hydrophobic nanoparticles provides a promising noninvasive carrier system for insulin.

Open Access Original Research Article

Prednisolone Loaded Tamarind Gum Microspheres for Colonic Delivery

Harish K. Kunjwani, Dinesh M. Sakarkar

Journal of Pharmaceutical Research International, Page 324-332
DOI: 10.9734/jpri/2021/v33i56B33959

The aim of this work was to formulate a novel multiparticulate system having pH sensitive property and specific enzyme biodegradability for colon specific drug delivery of Prednisolone (PD). Natural polysaccharide, Tamarind gum is used for microsphere preparation and Eudratit S- 100 for coating to provide pH controlled drug release. The formulation aims at minimal degradation and optimum delivery of the drug with relatively higher local concentration, which may provide more effective therapy for inflammatory bowel disease including Crohn disease and ulcerative colitis. Tamarind gum microspheres were prepared by emulsion dehydration technique using polymer in ratio of 1:1 to 1: 9. These microspheres were coated with Eudragit S-100 by oil in oil solvent evaporation method using core: coat ration (5:1). Tamarind gum microspheres and Eudragit coated tamarind gum microspheres were evaluated for surface morphology, particle size and size distribution, percentage drug entrapment, surface accumulation studies, in vitro drug release in simulated gastrointestinal fluids. The effect of various formulation variables were studied the prepared microspheres were spherical in shape in the size range of 64 µm to 113 µm, the encapsulation efficiency was in range of 30-72% depending upon the concentration of gum. The drug release was about 14-20% in first four hours of study gradually rises in 5th hour and 85% drug release occurs in 10-12% hr thus showing desirable drug release in the colonic simulated environment. PD tamarind gum microspheres are thought to have the potential to maintain drug concentration within target ranges for a long time, decreasing the side effects caused by concentration fluctuation, ensuring the efficiency of treatment and improving patient compliance by reducing dosing frequency. The animal study done using acetic acid induced colitis model on rats also suggest the anti inflammatory activity of the formulation.

Open Access Review Article

Overview on Pediatric Myelodysplastic Syndrome: A Review

Ahmed AbdelSamie Fadl, Hussam Yahya Abdullah Alghamdi, Baraah Atef Madani Ashgan, Nuha Saad H. Alasmari, Sultan Salman Alwahbi, Bayan Anwar Alkhamis, Sultan Meshal Almutairi, Quds Hussain Albeladi, Ghadeer Abdullah Alotaibi, Rawan Obaid Alotaibi, Reema Mohammed Bamousa, Jana Fahad Alzamami

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i56B33920

Myelodysplastic syndrome (MDS) is a set of clonal bone marrow diseases in children that are characterised by peripheral cytopenia, dysplastic alterations in the bone marrow, and inefficient hematopoiesis. MDS is uncommon in children, with just 1-4 occurrences per million children afflicted. Adults, particularly the elderly, are more susceptible to the disease. Some hereditary disorders, such as Fanconi's anaemia, Shwachman's, and Down's syndromes, are known to predispose children to developing MDS. JCML and monosomy 7 syndrome are the two most frequent paediatric MDS types, both of which affect children in their early years. Approximately 20% of juvenile myelodysplastic syndrome (MDS) cases are discovered by chance during normal laboratory testing or during the course of a suspected hereditary bone marrow failure (IBMF). Differentiating MDS with low blast numbers from aplastic anaemia (AA) and MDS with excess blasts from AML are the two key diagnostic issues in this condition. Bone marrow transplantation and stem cell transplantation is the treatment of choice in most cases. In this article we discuss the disease epidemiology, diagnosis, and treatment.

Open Access Review Article

Overview on Renovascular Hypertension: Review Article

Mohammed Salah Hussein, Almutairi, Samia Nouh, Azam Mohammed Alnamy, Alsulami, Roaya Ayed, Zainab Ali Alshaikh, Abdulaziz Homoud A. Alrethaia, Lamia Abdulaziz Aljeraisy, Thekra Zaidan albalawi, Ethar Abdulrahman H. Almohseny, Fatimah Turki AlGhamdi, Alrayuf Mohammad Alothri, Alotaibi, Turki Abdulelah R, Ali Aziz Al-sayed

Journal of Pharmaceutical Research International, Page 15-22
DOI: 10.9734/jpri/2021/v33i56B33922

Renovascular hypertension (RVH) is a prevalent cause of secondary hypertension that frequently develops to resistant hypertension. It is characterised as systemic hypertension that develops as a result of a restricted blood supply to the kidneys. Patients cannot be recognized clinically from those with essential hypertension; therefore, diagnosis requires arteriography, however urography and isotope renography may hint to the diagnosis. Atherosclerotic renal artery stenosis (ARAS) and fibromuscular dysplasia are the two most prevalent causes of RVH. The ultimate objective of controlling RVH, like with other kinds of hypertension, is to minimize the morbidity and mortality associated with high blood pressure The widespread use of effective antihypertensive medication treatment, statins, and other strategies to control vascular disease has resulted in remarkable improvements. In this review we will be looking at etiology, pathogenesis and treatment or RVH.

Open Access Review Article

Imagining of Acute Respiratory Distress Syndrome: A Review

Hossam A. El-Kenawy, Abdullah Thamer Aldarsouny, Nouf Mohammed Alaqel, Noor Anwar S. Alkhamis, Fatimah Fayez J Aldawood, Yazeed Abdulaziz Alhazzani, Nawaf Fahad Alnufaie, Sara Abdullah S Aledaili, Waleed Abdullah Alkhalifah, Amal Mohammed Alharbi, Abdulaziz Ayed Alshammari, Lena Mohammednoor Hariri

Journal of Pharmaceutical Research International, Page 55-61
DOI: 10.9734/jpri/2021/v33i56B33926

Acute respiratory distress syndrome (ARDS) is a life-threatening disorder marked by low oxygen levels and rigid or non-compliant lungs. In the absence of any indication of cardiogenic pulmonary edema, ARDS is defined as an acute disease that begins within 7 days of the triggering event and is marked by bilateral lung infiltrates and severe progressive hypoxemia. ARDS has a significant death rate, and there are few effective treatment options for this life-threatening illness. The management of these severely ill patients in the intensive care unit relies heavily on imaging. Chest radiography, bedside lung ultrasonography, and computed tomography scans can all help with patient care and prognostic variables identification. However, imaging results are not always specific, and other diagnosis should be considered.

Open Access Review Article

Overview on Gastrointestinal Stromal Tumor; A Review

Hashem Bark Awadh Abood, Amani Nasser D. Albalawi, Haifa Obedullah AlEnazi, Mousa Mutlaq Almuhanna, Norah Othman Busaad, Rafa Ghazi Ali Jarad, Mahdi Saleh Alkhamis, Shahad Majed Alsharif, Mutaz Abdulrahman S. Alahdal, Deena Ahmed S. Alqahtani, Abdulmajeed Ramzy Alhakamy, Sulaiman Abdullah Alraqibah

Journal of Pharmaceutical Research International, Page 29-36
DOI: 10.9734/jpri/2021/v33i56B33925

GISTs (gastrointestinal stromal tumours) are benign tumours that most usually affect the gastrointestinal (GI) system. GISTs can strike at any age, however they are most typically diagnosed in later life, with a median diagnostic age in the 60s. Abdominal ultrasound, CT scan, magnetic resonance imaging (MRI), and positron emission transverse tomography (PET) can all be used to detect GISTs (PET).CT enterography is the most effective method for determining the location of these tumors. Histopathology and immunochemistry are used to diagnose GISTs. Surgical excision remains the therapy of choice for gastrointestinal stromal tumours more than 2 cm that are readily resectable. Due to the possibility of resistance to standard treatment, mutational analysis should be undertaken when considering adjuvant and neoadjuvant  therapy. In this review we’ll be looking at the disease etiology, epidemiology, diagnosis and management.

Open Access Review Article

Post-traumatic Stress Disorder Following COVID-19 Pandemic: A Review

Heba A. Fouad, M. Alanazey, Mohammed Amer, K. Alruwaili, Anfal Farhan, M. Alanazi, Fahad Inad, A. Bamousa, Ahmed Khalid, H. Alsraij, Abdulkarim Ibrahim, M. Qadri, Almuhannad Ali, M. Alhamad, Suhail Abdulrazzak, A. Al-Sharief, Mazen Saud, Y. Kariri, Reem Mohammed, M. Qoqandi, Abdullah Abdulhalim, H. Alharbi, Tariq Mishal

Journal of Pharmaceutical Research International, Page 37-42
DOI: 10.9734/jpri/2021/v33i56B33929

COVID-19 pandemic has an impact on the quality of life (QoL) of the young people by affecting their psychological stress and suspicion of diagnosis with post-traumatic stress disorder PTSD. In response to this global health crisis, quarantine and lock down measures were implemented by international and government health organizations to contain the rapid spread of the virus. Such a period of health crisis has significant repercussions on human health and welling, accompanied by psychological distress and related symptoms such as stress, panic and anxiety in the general population specifically students. Therefore, this study aimed to study association between COVID-19 pandemic and lock down with post-traumatic stress disorder.

Open Access Review Article

Etiology, Assessment and Management of WDHA (Watery Diarrhea, Hypokalemia, and Achlorhydria) and VIPoma

Mohammed Salah Hussein, RIdha A. Bdulmohsen Al Shaqaqiq, Khaled Mubarak Aldhuaina, Azhar Abdullah Al-qattan, Salwah Mohammed Qaysi, Abdulrahman Mubarak Almutairi, Turki Bjad Bensgayan, Nada Essa Al Essa, Fahad Mohammed Albaqami, Fawaz Abduljabbar ALDoohan, Afnan Abdullah Obeed aljohani, Yousef Naif Alobaywi

Journal of Pharmaceutical Research International, Page 69-75
DOI: 10.9734/jpri/2021/v33i56B33930

The syndrome of watery diarrhoea, hypokalemia, and achlorhydria (WDHA syndrome) is an uncommon disorder marked by severe, watery diarrhoea caused by non–beta pancreatic islet cell oversecretion of vasoactive intestinal peptide (VIP). The onset of the disease is gradual, and diagnosis is often months or years later. Long-term dehydration, electrolyte and acid-base abnormalities, and chronic renal failure are all linked to morbidity. Pancreatic endocrine tumours are extremely rare, with less than 10 incidences per million people. VIPomas are uncommon tumours that affect between 0.05 and 2.0 percent of people. The most prevalent symptom is diarrhoea, which affects at least 89 percent of patients. VIPoma is treated with a combination of medicine and surgery The goal of first medical treatment is to reduce symptoms and restore fluids and electrolytes as quickly as possible

Open Access Review Article

Diagnosis and Management of Fractured Teeth; Review Article

Ashwag Siddik Noorsaeed, Mohammed Abdullah AlMuhanna, Lujain Hussain Aljurbua, Salihah Abdulaziz Alturki, Nojoud Omar Balubaid, Zahrah Mohammed Alfaraj, Nouran khalid Wahbi Albishi, Ali Maitham Alnahwi, Ali Abdullah Alsalem, Ahmed Mohammedali Alsumur, Mohammed Abdullah Alsalem, Osamah Ibrahim bin Hussain, Sara Shawqi Algheryafi

Journal of Pharmaceutical Research International, Page 129-134
DOI: 10.9734/jpri/2021/v33i56B33933

Traumatic damage to the teeth and oral tissues are the most common causes of tooth fracture. Because of their location in the oral cavity, front teeth in the upper jaw are the most commonly fractured. Sports, car accidents, and physical violence are the most prevalent causes. Cracked teeth are often diagnosed by visually inspecting the tooth (preferably utilizing microscopes). The size and form of the fracture plane are not always determined by looking at the crack line. One factor that contributes to the difficulty of effectively making an endodontic diagnosis is the inability to visualize the depth of the fracture through a clinical exam alone. Transillumination, microscopes and dyes are a useful tool for finding and diagnosis of the crack, treatment of the crack depends on the type, extend of the crack as well as the condition of the patient. In this review we’ll be looking at the diagnosis, etiology and management of fractured teeth.

Open Access Review Article

Pattern of Antibiotic Prescription for Orofacial Infections among Dentists: A Narrative Review of Literature

Suhael Ahmed, Nada Mohamed Abdelfattah Aly Elkholy, Amna Alghamdi, Sarah Aedh Alshehri, Khalid M Alanazi, Omar K. Alanazi, Shaya Farhan Aldossary, Nafeesa Tabassum, Abdulrahman Al Saffan, Noha Abdullah Alenezi

Journal of Pharmaceutical Research International, Page 97-106
DOI: 10.9734/jpri/2021/v33i56B33934

Bacterial infections are common in dental and oral clinical practice. It is been estimated that about 10% of total antibiotic prescriptions are related to dental infections. Combination of amoxicillin-clavulanate and plain amoxycillin is the most commonly used drug by dentists across the world. Three general considerations were recognized in this literature review—Empirical antibiotic prescription by dentists without a culture test; concomitant prescription of antibiotics with non-steroidal anti-inflammatory drugs which may ultimately affect the bioavailability of the former drug; and the increased antimicrobial resistance amongst oral pathogens. Since decades, antibiotics have been prescribed for the treatment of odontogenic infections and non-odontogenic oral infections, and for focal infections and sepsis prophylaxis. Renal failure, liver failure, and pregnancy are situations that require special attention when considering an antibiotic prescription. This review attempted to contribute to the rational use and abuse of antibiotics while focusing on the general characteristics of these drugs.

Open Access Review Article

Causes and Management of Neck Pain in Primary Care, Review Article

Faisal Suliman Algaows, Nader Marzouq AlOtaibi, Salma Mousa Hakami, Omar Abdrabalrasoul Alkhabaz, Bandar Owaidh ALJohani, Maha Abdulkader Azzeem, Asma Ghassan Sadeq, Abdula Abdulrahman A. Alfuraih, Abdullah Mohammed T. Albin Alshaikh, Hajr Ibrahim S. Almarie, Mustafa Mohammed Beyari, Mohammed Ali S. Alkhuwaysah

Journal of Pharmaceutical Research International, Page 144-152
DOI: 10.9734/jpri/2021/v33i56B33937

Neck pain is a prevalent ailment that affects many people around the world. Neck pain is linked to a high level of disability and is usually regarded as a serious public health issue. Pain between the superior nuchal line and the spinous process of the first thoracic vertebra is referred to as neck pain. The pain in the neck might refer to the head, trunk, and upper limbs in some cases. This article seeks to offer a summary of the existing evidence on the prevalence, costs, diagnosis, prognosis, risk factors, prevention, and management of neck pain patients.

Open Access Review Article

High-altitude Pulmonary Edema in Emergency Department: A Review

Hisham Mohammed Sonbul, Abdu Saleh Alwadani, Bader Aziz Alharbi, D. Almaymuni, Saleh Mohammed, Abdulrazaq Abdulmohsen Alkhalaf, Hajer Ali Alkreedees, Darin Ahmednoor Alkhars, Mohammed Ali Allift, Alyazeed Ali Alyami, Abdullah Ali Alshehri, Fahad Saeed Alshahrani, Afnan Obaid Ahmad Aljefri, Fahad M. Altowairqi

Journal of Pharmaceutical Research International, Page 113-118
DOI: 10.9734/jpri/2021/v33i56B33938

High altitude pulmonary Edema (HAPE) is a severe form of high-altitude disease that, if left untreated, can result in death in up to half of those who are affected. Lowlanders who rapidly go to elevations more than 2500-3000 m are more likely to develop high altitude pulmonary Edema (HAPE). Individual sensitivity owing to a low hypoxic ventilatory response (HVR), quick pace of climb, male sex, usage of sleep medicine, high salt consumption, chilly ambient temperature, and intense physical effort are all risk factors. HAPE may be totally and quickly reversed if caught early and correctly treated. Slow climb is the most effective technique of prevention. A fall of at least 1000 meters, is the best and most certain treatment choice in HAPE. Supplemental oxygen, portable hyperbaric chambers, and pulmonary vasodilator medications (nifedipine and phosphodiesterase-5 inhibitors) may be beneficial. In this article we’ll be looking at the disease etiology, epidemiology, diagnosis and management.

Open Access Review Article

Surgical Management of Acute Sphenoid Sinusitis: A Review

Hashem Bark Awadh Abood, Talal Habib Alshammari, Majed Mubarak AlMutairi, Abdulaziz Abdulrazaq Alkhaldi, Othman Saleh Alessa, Hussain Ali Almutairi, Abdelkhalig Rhamtalla Mohammed Elkheder, Majed Mahmoud K. Alenzi, Fatimah Essa Ageeli, Yousuf Loai F. Ramadan, Mohammed Saleh Almaslouk, Dnya Saleh Affat Alanaziy, Mohammad Ali Hassan Zarei

Journal of Pharmaceutical Research International, Page 153-159
DOI: 10.9734/jpri/2021/v33i56B33940

Sphenoidal sinusitis is usually described as acute inflammation of the sphenoid sinuses - either one or both - (the two large cavities just behind the nose and between the eyes). The disease is relatively uncommon—comparatively, chronic sphenoid sinusitis is more common—and may be limited to the sphenoid sinus or, more commonly, may involve multiple sinuses or pansinusitis.  Acute sphenoid sinusitis can lead to symptoms such as headaches, nausea, and even complications in the orbit. For low vision, early diagnosis and treatment is essential to preserve vision and life. This study aims Learn about surgical approaches to the treatment of acute sinusitis

Open Access Review Article

Overview on Neurological Manifestations of Thyroid Disease

Mohammed Salah Hussein, Faisal Mohammed Alyahya, Husam Fouad K. Barradah, Adeeb Abdullah Almuhanaa, B. Alzhrani, Olayan Mohammed, Abeer Dhaifallah Alanazi, Norah Talal Almutairi, Riam Saleh Alkhamis, Taif Nasser Aljaber, Albishi, Haya Saaed, Ahmed Dhaifallah Alghamdi, Hussain Ali Al Baqir

Journal of Pharmaceutical Research International, Page 171-178
DOI: 10.9734/jpri/2021/v33i56B33942

Hypothyroidism and hyperthyroidism are both prevalent medical conditions that are frequently accompanied with neurologic and neuromuscular dysfunction. Triiodothyronine (T3) and thyroxine (T4) hormones are produced by the thyroid gland and play a crucial role in tissue formation and metabolism. Both of these hormones have a variety of impacts on the brain and neuromuscular system. Specially in children, because brain development can be effected by any disturbances in Thyroidal hormones level. And thus, conditions like Allan-Herndon-Dudley Syndrome & Benign Hereditary Chorea is considered genetic thyroidal diseases both will be discussed in this review. hypothyroidism can have serious consequences for neuropsychiatric function. The pathophysiological processes underlying the neurological symptoms of hypothyroidism and hyperthyroidism are likely to be multifactorial, in this review we will be looking at multiple neurological as well as psychiatric manifestations related to thyroidal hormones disorders.

Methods: We used the phrases "hypothyroidism," "hyperthyroidism," "neurological problems," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy" in a PubMed search, google scholar and google search engines. Case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials were among the papers examined. Classification of thyroidal dysfunction has been made depending on the thyroidal hormones level. The neurological consequences of congenital hypothyroidism were examined, as well as the clinical aspects of hypothyroidism and hyperthyroidism-related neuromuscular disorders, as well as other autoimmune illnesses. Hashimoto encephalopathy's evidence and pathophysiological issues were also examined.

Conclusion: Thyroid is critical organ due to role of its thyroidal hormones, both hypothyroidism and hyperthyroidism induce some serious neurological and phycological disorders, some of which is genetic, hypothyroidism can impact the development of child and thus regular thyroidal hormones testing is recommended in children who demonstrates any signs of neurological psychiatric  or cognitive disease.

Open Access Review Article

Effects of Kinesio-Taping in Lateral Epicondylitis: A Narrative Review

Aloysius Rodrigues, Saumya Srivastava

Journal of Pharmaceutical Research International, Page 219-225
DOI: 10.9734/jpri/2021/v33i56B33947

Aim: The objective of this narrative review was to assess the effects of Kinesio-Taping in Lateral Epicondylitis.

Methods: A comprehensive search of already published relevant articles only from medical databases like Google Scholar, PubMed and ScienceDirect was carried out for obtaining the same from the year 2014-2019.

Background: Lateral epicondylitis is a familiar musculoskeletal disorder that primarily affects the extensors of the wrist. Kinesio-taping (KT) is a newer generation taping technique that aid's the body’s healing process whilst supporting and giving stability to the muscles and joints without hindering the range of motion of the body.

Conclusion: The current review recognises the need for Kinesio-Taping in individuals with Lateral Epicondylitis as it has shown to enhance the functionality of the wrists and reduce pain.

Limitations:  More in-depth studies are to be conducted to find out the mechanism behind Kinesio-Taping.

Open Access Review Article

Prakaradi Yogas: The Traditional Immunomodulators

Priya Kumari, Sudhir Kumar Pani, Swapnil CR., Aboli patil

Journal of Pharmaceutical Research International, Page 232-238
DOI: 10.9734/jpri/2021/v33i56B33949

It’s a well-known fact that Prevention is better than cure. As children are the basic building block of future generation Its the need of situation and mandatory for all to take care of their health in this current pandemic situation. Childhood is considered as the most susceptible age for infection. So following the proper safety measures during pandemic Arogya can also be achieved by good physical and mental health with the use of different(Ayurveda formulations well explained about Prakaradi yogas in Arogya raksha kalpa Druma one of the classical Ayurveda paediatric book for children .Prakaradi yogas  aims at achieving basis of life immunity through various herbal formulations. Immunomodulators are the herbal drugs that augment or improve the immune response and immunity is always a prime concern in childhood. In Arogya Raksha Kalpadrum it’s been explained well that herbal formulations can enhance immunity when taken accordingly from birth up to attainment of 12 years of age. Use of Immuno-modulatory measures starting from Jatamatravastha up to 12 years of age can fulfill the desired health and longevity. Tackles the expected dosha vaishamya, and stabilizes Agni when taken at right time.This article highlights the role of different Prakkaradi Yoga in children for healthy growth and development of child to improve the longevity and quality of life.

Open Access Review Article

Applications and Biological Functions of Exosomes: A Comprehensive Review

N. Kowsalya, S. Meenakshi, M. P. Gowrav, D. V. Gowda, K. Divith

Journal of Pharmaceutical Research International, Page 244-261
DOI: 10.9734/jpri/2021/v33i56B33951

Exosomes are also known as extracellular vesicles (EVs) which is bounded by a membrane mostly seen in eukaryotic cells secreted within the endosomal compartment along with some of the selected composition of RNA, proteins, lipids and DNA. They are capable of transferring signals among cells therefore it is used as a mediator for cell-to-cell communication. Exosomes helps in the excretion of cellular waste from the body. Exosomes possess various widespread activity in many of the biological functions such as transferring the biomolecules like enzymes, proteins, ribonucleic acid, lipids and also in the regulation of various pathological and physiological process in various diseases. Exosomes are released in to the in vitro growth medium with the help of cultured cells. They are said to be identified in coined matrix and tissue matrix. They are also identified in some of the biological fluids such as cerebrospinal fluid, urine, blood. Exosomes are considered as promising biomarkers in identification and treatment of many diseases as they contribute a lot in the diagnosis of various therapies. The efficacy and stability of imaging probes and therapeutics are enhanced by its biocompatible nature. Exosomes play a major role because of their use in the field of clinical application. It is important to understand the molecular mechanism behind their function and transport in order to explore more about exosomes. Here we discuss about the review and advancement done in the field of exosomes along with their biomedical applications, isolation techniques and biological functions.

Open Access Review Article

Effectiveness of Helmet Therapy in Infants with Positional Skull Deformity: A Literature Review

Nischitha U. Shetty, P. Shilna Rani, K. U. Dhanesh Kumar

Journal of Pharmaceutical Research International, Page 290-295
DOI: 10.9734/jpri/2021/v33i56B33955

Background: Positional skull deformity usually manifests during first six months of life due to various factors like premature births or multiple births, improper positioning of infant’s head as the head of an infant is softer than the older children’s head, thus leading to either positional brachycephaly or positional plagiocephaly. Early helmet therapy intervention may improve the shape of the skull by reducing the risk of secondary cosmetic and nervous system complications.

Aim: To study the effectiveness of helmet therapy in infants with positional skull deformity.

Methods: The data source for this literature review is done by studying and reviewing articles through various data like Pub Med, Google Scholar, science direct, Elsevier and medicine Cochrane library.

Conclusion: Helmet therapy is contemplated to be effective in the treatment of mild-moderate-severe positional skull deformity than repositioning therapy by improving the structure of the misshaped skull, as well as the use of helmet therapy is reviewed not to hinder the head circumference growth in infants.

Open Access Review Article

Surgical Management of Lymphatic Leakage

Hashem Bark Awadh Abood, Atheer Hamad Alatawi, Abdulaziz Ali ALMohammed, Mutasim Hassan Alhasani, Saleh Amir Almutairi, Abdulrahman Nasser Abohaimid, Ziyad Fahad Althobaiti, Asmaa Mamoun Kremli, Rahaf Hamed M. Alrayiqi, Abdulkareem Mamoon Abdullah, Mashael Sultan AlSadoon, Zainab Ali Alhassar, Muath Mohammed AlMuqhim

Journal of Pharmaceutical Research International, Page 317-323
DOI: 10.9734/jpri/2021/v33i56B33958

Lymphatics are found in almost every organ in the body, and they produce a variety of waste products that must be eliminated. lymphatic leakage is a typical occurrence. It can cause immunodeficiency as well as nutritional issues. Furthermore, it has a significant morbidity and death rate, depending on the existence of an underlying illness. Lymphatic leakage can be congenital, traumatic, or cancerous, and occurs when the lymphatic system is disrupted. It might take the following forms: Chylothorax, Lymphatic Fistula, Chylous Ascites. treatment of lymph leaks includes: reduction of lymphatic flow through physiological or pharmacological manipulation; replacement of fluid and electrolytes, as well as interventional procedure and/or direct surgical closure. In this review we’ll be discussing lymphatic system anatomy, its leakage and its management.

Open Access Review Article

Diagnostic Criteria and Lipid Screening of Dyslipidemia in Children

Ashraf Saeed Ali Mehder, Hussam Sbitan Alenazi, Saeed Awad Alqahtani, Nouf Khalid Hammad, Sultan Yousef Alenezi, Sad A. Alajmy, Kawakib Mohammed Alotaibi, Amnah Essa Abu Lahsah, Ahmed Mohammed Saleh Alshak, Amal Ibrahim Alsayed, Rawan Abdullah Alzahrani

Journal of Pharmaceutical Research International, Page 333-339
DOI: 10.9734/jpri/2021/v33i56B33960

Obesity is associated with significant morbidities and life-threatening conditions. Evidence shows that obesity in the pediatric population has increased by ten folds recently. This has been attributed to the remarkable recent alternations in socioeconomic factors and the overall increase in the incidence of obesity among the different populations. The pathogenesis of atherosclerosis and cardiovascular diseases is usually initiated in childhood. Previous studies indicates that early identification and proper treatment of dyslipidemia in the pediatric population can significantly reduce the risk of developing cardiovascular diseases and associated morbidities. Therefore, it is vital to screen children's lipid profiles to identify dyslipidemia and apply better interventions. This can significantly reduce the risk of premature cardiovascular diseases and accelerated atherosclerosis. The present study aims to identify the diagnostic criteria and various lipid screening approaches proposed in the literature to identify dyslipidemia in children. Two main approaches for screening dyslipidemia in children were reported. These include universal and selective screening approaches. While the latter is recommended to identify high-risk children, universal screening is also recommended to identify children missed by targeted screening (usually treated by pharmacological modalities).