Open Access Case Report

A Case Report: Post-Operative Physiotherapy Rehabilitation Program for a Patient with Tibial Osteosarcoma

Sapna Dhote, Dushyant Bawiskar, Pratik Phansopkar

Journal of Pharmaceutical Research International, Page 497-504
DOI: 10.9734/jpri/2021/v33i58A34143

Tumour or bone tumour can occur in any bone and called it as a Osteosarcoma. It is more prone in the long bones of the body especially at metaphyseal growth plate of the bone. Femur, Tibia and Humours are the most common bone for the osteosarcoma and in some research pelvis bone and skull or jaw bone also involved. There are many factors which cause the sarcoma might be due lack of physical activity. The Chondroblastoma as Giant Cell Tumour of the Humours of Epiphysial Chondromatous in nature. Proximal humerus and Knee are the most common and most affected bone by the Chondroblastomas at the level of epiphyses of the longer bone. 62% cases show the thinning of the Subchondral structure and 33% cases shows the collapse and chondral breach Mostly (90%) it is found in the age group of 5 to 25 years of age with the male and female ratio is of 2:1. Psychological and physical improvement is seen in the patient of sarcoma and enhances participation in the exercise with great enthusiasm and help in the reduction the impact of symptoms of diseases. Physical therapy exercise protocol starts from low to moderate intensity which involved resistance exercise, aerobic exercise and combination of both exercises.

Conclusion: Physiotherapy has been demonstrated to be useful in post-operative osteosarcoma patients in our case study. Physiotherapy assists the patient in de-stressing from both mental and physical stress. The goal of improving function through health-care management and goal-setting was met on schedule. Taking excellent care of yourself after surgery can help you avoid issues.

Open Access Case Study

Case Report: Budd Chiari Syndrome

Seema Singh, Sonali Wawre, Savita Poheka r, Aarti Raut, Samruddhi Gujar, Archana Dhengare

Journal of Pharmaceutical Research International, Page 8-12
DOI: 10.9734/jpri/2021/v33i58A34082

Budd-syndrome Chiari's is a rare condition is causes by obstruction to hepatic venous outflow. The female patient 25-year old who was admitted to Acharya Vinoba Bahave Rural Hospital on date 19/06/2019. 4 months ago, she noticed that her abdomen had become prominent. Her appetite became poor and she had vomiting bouts whenever she took food. A detailed clinical evaluation of the The syndrome of Budd-Chiari is based on a comprehensive history of of the patient, angiography is often used to assist in the diagnosis. The treatment also uses (MRI) and ultrasound technique. If the condition is detected early, treatment of Budd-Chiari syndrome is more effective. Large doses of corticosteroid, prednisone can also be recommended as heparin like anticoagulants can be efficient in the treatment of Budd-Chiari syndrome individuals. However, the condition typically has an acute onset and can become chronic later in life. The present case with right anticoagulant therapy, early diagnosis and successful treatment is reported.

Open Access Case Study

A Case Report on Schizophrenia with Autoimmune Encephalitis

Dharti Meshram, Sonali Wavare, Trupti Uke, Shabnam Sayyad

Journal of Pharmaceutical Research International, Page 20-24
DOI: 10.9734/jpri/2021/v33i58A34084

Schizophrenia is a severe mental illness with a high death rate and significant societal implications. Curative treatments are not available due to a lack of understanding of its etiopathogenesis. The mild encephalitis hypothesis of schizophrenia, established primarily by Karl Bechter and Norbert Müller, is one of the new research hypotheses. According to this theory, a significant subset of schizophrenia patients suffers from a mild but persistent form of encephalitis caused by a variety of etiology ranging from viral infections to traumas to autoimmune illnesses. This inflammatory method is believed to occur in the start or during the course of the disease.

The authors present case of a 65-year-old female got admitted in female psychiatric ward AVBR Hospital Sawangi Meghe, Wardha Maharashtra with chief complaint of forgetfulness, interest in environment decline, unable to communicate, poor performance at work, muttering to self, sleep disturbance, seeing people which are not seen other, fearfulness. all necessary investigation done, in mental status examination founded impairment in memory, disorientation cognitive function impairment, RBC count 3.82, WBC count 5300, Hb% 12, calcium 8.1, urea 26, creatinine 0.6, sodium 142, potassium 4.0. Alkaline phosphate 89. HIV, HBSAG non-reactive, A large number of white blood cells in the CSF An MRI that reveals evidence of brain inflammation. There was a slight increase in antinuclear antibody (1: 40 titer). Blood and CSF were positive for oligoclonal bands. The patient was received symptomatic treatment antianxiety, antipsychotic drug alleviates hallucinations and delusion. 

Disturbances of consciousness and orientation, catatonia, speech dysfunction, focal neurological signs, epileptic seizures/EEG abnormalities or autonomic dysfunction are warning signs in psychiatric patients which should always induce cerebrospinal fluid analysis with determination of antineuronal autoantibodies. Currently established immunotherapy strategies are summarised, taking into account international expert advice. Guided by clinical warning signs, our qualitative review enables rapid and reliable diagnosis of definite autoimmune encephalitis. This is of high relevance for the affected individuals, since early and sufficiently intense immunotherapy often leads to a good prognosis despite severe illness.

Open Access Case Study

Case Report of Typhoid Fever (Salmonella typhi)

Archana Dhengare, Savita Pohekar, Prerana Sakharwade, Sheetal Sakharkar, Samrudhi Gujhar, Vaishali Tembare, Ruchirra Ankar

Journal of Pharmaceutical Research International, Page 55-59
DOI: 10.9734/jpri/2021/v33i58A34089

Typhoid fever is a major health problem globally. Typhoid fever is an enteric fever characterized by systemic illness along with abdominal pain and fever in a "step-ladder" pattern. Typhoid fever is one of the major causes of mortality and morbidity in overcrowded and unhygienic areas though comprehensive research and public health interventions have decreased the occurrence. Patient is having sign symptoms as gastrointestinal symptoms, malaise, hepatomegaly, and high liver enzymes presented with a two-week fever. As a differential diagnosis, a Widal test  is done and two blood cultures were requested; both came out positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Treatment with ceftriaxone and metronidazole was stared prior to confirmation of the diagnosis, with a partial response; later, pharmacological therapy was altered based on ciprofloxacin susceptibility testing, with a satisfactory clinical response. We look at how to diagnose and treat enteric fever, with an importance to typhoid fever.

Symptoms or important clinical finding:- A 6 year old male was admitted in A.V.B.R.H on date 12/03/2021 with chief complaint of abdominal discomfort, malaise, problems such as  fever since 2 weeks, gastrointestinal symptoms, lethargy, hepatomegaly, and an increased liver enzyme.

Diagnosis therapeutic intervention and outcome: A case is diagnosed as Typhoid Fever. After physical examination and investigation, doctor was detected a case of 6 week.

Therapeutic intervention and outcome: Also provide a calcium supplements and iron supplements present case was stable but according to ultrasonography finding. Outcome- Good sanitation, improved water supply, and a suitable sewage waste matter system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever.

Nursing Perspective: Administration fluid replacement .i.e DNS and RL monitored vital signs per hourly. Maintained temperature chart 2 hourly strictly, maintained intake output chart properly. Tablet paracetamol, antibiotics given as per doctor’s order.

Conclusion: Good sanitation, improved water supply, and a suitable sewage waste matter  system, as well as the successful use of existing typhoid vaccinations, can all help to avoid typhoid fever.

Open Access Case Study

A Case Report on Acute Transient’s Psychotic Disorders

Sonali Wawre, Archana Dhengare, Pranali Wagh, Kanchan Bikade, Aarti Raut, Samruddhi Gujar

Journal of Pharmaceutical Research International, Page 111-116
DOI: 10.9734/jpri/2021/v33i58A34095

Background: Little is known about acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10.

Case Presentation: Acute transient psychotic disorder is a heterogeneous group of disorders characterised by the acute onset of psychotic symptoms such as delusion, hallucination and perceptual disturbances, and by the severe disruption of ordinary behaviour. Patient history: The Male patient 48 year old who was apparently admitted in AVBRH on date 08/05/2021 with chief complaint was Abnormal behaviour( taking clothes off in public ), irritability, aggressive, muttering and smiling to self from 10 days back. His parents once locked him in a room as they fear he might hurt him. He was taken to a faith healer in Pandarkawda twice by his parents. The Baba gave him some mysterious beats like bracelet to wear which eventually decreased his symptoms for 3 days but the symptoms persisted from the fourth day. This time, the Baba mixed a lemon juice, turmeric powder & kumkuma (a powder made from dried turmeric with a bit of slaked lime) and applied all over him eyes which severely inflamed & burnt his eyes. His eye injury elevated his psychotic symptoms which is why his parents took him to psychiatric OPD in AVBRH.

Past History: Patient was apparently asymptomatic 2 yrs back. He was married to a woman of his parent’s choice. His marriage life was stressful and unhealthy. He was underestimated by his wife due to his low qualification and health problem.

Clinical Finding: The patient has been undergone with various investigations like culture, blood tests, Physical examination and mental status examination symptomatically with antipsychotic agent and anticonvulsant such as Tab Olanzapine 10mg- HS, Tab Clonazepam 0.5mg – SOS.

Medical Management: Antibiotic eye drop homatropine and eye ointment ciprofloxacin.

Nursing Management: Administered fluid replacement i.e DNS and RL, eye care was done with betadine and Normal Saline solutions, eye care by administering eye drops and monitored all vital signs hourly.

Conclusion: Patient was admitted to hospital with the chief complaint of muttering to self, irritability and eye injury, blisters, pus discharge from eyes and his condition was very critical and patient was admitted in AVBR Hospital ,immediate treatment was started by health team member and all possible treatment were given and now the patient condition is satisfactory.

Open Access Case Study

A Case Report of Steven Johnson Syndrome

Archana Dhengare, Ranjana Sharma, Sonali Waware, Pranali Wagh

Journal of Pharmaceutical Research International, Page 132-139
DOI: 10.9734/jpri/2021/v33i58A34098

Introduction: In 1922, two doctors, Albert Mason Stevens and Frank Johnson, examined purulent conjunctivitis.”

Background: Stevens-Johnson syndrome was named after them as a result of their study. The incidence rate is 7 cases per million populations per year.

Case Presentation: Master Yash Ghudam was brought to AVBRH by his parents with chief complaints of fever since 5 days and erythematous lesions all over body since 3 days.

History of present illness: Patient was apparently alright 5 days back, and then he started having fever which was of high grade and was not associated with chills and rigor. Patient was treated on OPD basis and the symptoms of an unexplained disease in two young boys, aged 7 and 8, who had "an unusual, generalised eruption of continued fever, inflamed buccal mucosa, and extreme some antibiotic was given, but there was no relief, after 2 days there was ulcers formation inside the mouth for which some ointment and syrup becosule was started. But lesions were increasing. 3 days back the lesions first appeared on chest then got spread to legs and hands. For which patient was admitted in Chandrapur hospital from were the patient was referred to AVBRH for further management.

Interventions: The patient was treated the patient was started on intravenous and orally Cortecosteroids, Omnacortil 10mg, Antibiotics- Inj. Ceftriaxone1gm IV 12 hourly [100mg/kg/day], inj. Amikacin 150mg IV 12 hourly [15mg/kg/day], Syp. Mucaine gel 2tsp BD – swish and swallow), Syp. Cital  2.5ml TDS, Tab. Chymoral Forte  TDS, Inj. Pantop 20mg IV 24 hourly (1mg/kg/dose).

Pandya’s Formula: Syp. Gelusil 5ml, Syp. Benadryl 5ml, Syp. Omnacortil 5ml.  Skin allograft: It has been planned.

Conclusion: In this study, we mainly focus on medical management and outstanding nursing care helped prevent farther complication. Overall, the patient's reaction was positive, though recovery time from Steven johnson syndrome varies from person to person, taking weeks, months, or even years. However, only a small number of people completely recover, while some have long-term consequences. She took a long time to get back on her feet.

Open Access Case Study

Guillain Barre Syndrome: A Case Report and Literature Review

Ragini Joshi, Deeplata Mendhe, Mayur Wanjari

Journal of Pharmaceutical Research International, Page 158-161
DOI: 10.9734/jpri/2021/v33i58A34101

Introduction: The arrival of Guillain-Barre Syndrome is sudden. It’s a type of neuropathy caused by the immune system. Nutrition is very crucial. In impoverished countries, it is a disabling disease. Autoantibodies against diverse antigens can be seen in the outlying site. The occurrence links 0.4 to 1.7 million individuals per year.

Case Presentation: A 5-year-old boy was taken to the hospital with chief complaints of Weakness in bilateral upper and lower limbs, trouble in swallowing, inability to hold the neck, mouth-frothing, fever spikes. On physical examination, the patient has experienced weakness in bilateral upper and lower limbs, Bulbar weakness is present, pain experienced in both legs, the gag reflex is absent, In Cardiovascular System, S1 and S2 sound are present, In Respiratory System, Air entry is bilaterally equal, pupils are reflected light, tone, and power of upper and lower limbs are decreased, then treatment was started as soon as possible, he has not improved after receiving treatment, and the patient is on ventilator support, with treatment continuing until the end of my care.

Conclusion: In this study, we primarily focus on professional management, and outstanding nursing care may give the holistic care that Guillain Barre Syndrome requires while also effectively managing the challenging case. The comprehensive health care team collaborates to help the patient achieve their prior level of independence and satisfaction after a full recovery. 

Open Access Case Study

Mucormycosis in Post COVID-19 Patients: A Case Study

Amitendra Shembekar, Ninad Nagrale, Nandkishor Bankar

Journal of Pharmaceutical Research International, Page 233-239
DOI: 10.9734/jpri/2021/v33i58A34111

Introduction: Acute respiratory distress syndrome (ARDS) is a common complication of severe pneumonia virus, such as the flu and COVID-19, which requires critical treatment, including asthma support, corticosteroids, and other treatments to prevent acute respiratory tract inflammation. Although steroid treatment is limited to the treatment of viral pneumonia, it is usually a double-edged sword, leading to increased morbidity and mortality. Mucormycosis is a fungal emergency with a high tendency for contaguous spread and a poor prognosis if not detected and treated promptly. Mucormycosis is believed to be caused by uncontrolled diabetes mellitus (DM) and other immunosuppressive disorders, such as corticosteroid therapy.

Aim: To discuss causality factor of mucormycosis in COVID-19 infection.

Conclusion: COVID-19 is correlated with a high rate of secondary infections, both bacterial and fungal, most likely as a result of immune dysregulation. Furthermore, the widespread use of steroids and broad-spectrum antibiotics as part of the COVID-19 remedy can result in the production or exacerbation of pre-existing fungal diseases. Physicians should be mindful of the likelihood of invasive secondary fungal infections in patients with COVID-19 infection, especially in those that have pre-existing risk factors, and should be able to detect and treat these infections early in order to reducing mortality and morbidity.

Open Access Case Study

Ipsilateral Neck/Inter-Trochanteric and Mid-shaft Femoral Fractures Treated with Dual Construct Implants

Rahul Chaudhary, Nitin Samal, Sanjeev Chaudhary

Journal of Pharmaceutical Research International, Page 426-434
DOI: 10.9734/jpri/2021/v33i58A34134

Background: Various management protocols for ipsilateral neck/intertrochanteric and shaft fracture femur have been formulated, there have been many disagreements related to their ideal fixation plan. The aim of this study was to discuss the various type of fixation system available for such kind of complex injuries and the advantages of using dual construct fixation system.

Patient and Methods: In the present study we prospectively evaluated ipsilateral neck/intertrochanteric and shaft fracture femur in 7 cases managed from January 2018 to December 2020. All the patients were managed with dual constructs fixation system using dynamic hip screw (DHS) and locking plate. The outcome was evaluated using Friedman and Wyman scoring system.

Results: The average surgical time was 120.4 min (range 98–143 minutes) with a blood loss ranging from 290-565 mL (average 460 mL). In 6 patients follow-up was undertaken between 10 and 22-months after surgery, with a mean follow-up time of 16.2 months. 1 patient lost follow-up at 3-month. The neck/IT fractures achieved union in 6 patients at the final follow-up. 3-6 months was the duration for bone union, with an average of 4.1 months. The mid-shaft femur fractures achieved solid union in 6 cases at the most recent follow-up. 3 to 11 months was the duration of union, with a mean of 5.1 months. 1 patient went into non-union 11 months after the surgery.  According to Friedman and Wyman scoring, 4 patients the functional outcome was good, in 2 patients the functional outcome was fair, and in 1 patient the functional outcome at the final follow-up was poor. The problems noted were surgical site infection in 1, Angulations (varus/valgus) of femoral neck in 1, non-union of neck femur fracture in 1, and avascular necrosis of femoral head in 1.

Conclusion: The management of ipsilateral neck/intertrochanteric and shaft fracture femur with dual construct implants dynamic hip screw for neck/IT fracture and locking plate for shaft femoral fractures yielded good union rates and good functional outcomes.

Open Access Case Study

A Case Report on Acute Necrotizing Pancreatitis and Nursing Management

Vaishnavi Shiwarkar, Arati Raut, Ruchira Ankar, Sheetal Sakharkar, Sonali Wawre

Journal of Pharmaceutical Research International, Page 449-455
DOI: 10.9734/jpri/2021/v33i58A34137

Introduction: Necrotizing pancreatitis (NP) is a health problem in which part of pancreas dies. This is because of inflammation or injury. If the dead tissue gets infected, it can cause serious issues. Pancreatitis is inflammation of the pancreas. During recurring attacks of pancreatitis, tissues within pancreas may die and later become infected. This condition is called as acute necrotizing pancreatitis.

Case Presentation: A 48 yr old male visited in AVBRH with the chief complaints of pain in epigastric region, recurrent vomiting, and abdominal distention since 7 days. Otherwise client was alright. After undergoing investigations such as complete blood count, liver function test, kidney function test, CT Scan (Computed tomography) and sonography etc. He was diagnosed with Acute Necrotizing Pancreatitis and was admitted to male medi- cine ward No.29. He had past medical history of pain in epigastric region, fever, abdominal distention, since 5days. For these complaints his family members referred him in “Get Life Hospital” at Amravati. He was treated with antibiotics, analgesic, After CT scan, Sonography it was found that there was Acute pan- creatitis. That’s why his family members admitted him at A.V.B.R Hospital for further treatment.

Conclusion: These results support nonsurgical management, including early antibiotic treatment, in patients with sterile pancreatic necrosis. Patients respond well to treatment.

Open Access Case Study

Three Distomolar in Single Patient: A Unique Case Report

Jaafari, Fatimah Rasheed M., Alanood Mansour Somili, Ghaliah Ahmed Rubaydi, Lujain Mahdi Hussin Masmali, Fareedi Mukram Ali

Journal of Pharmaceutical Research International, Page 585-588
DOI: 10.9734/jpri/2021/v33i58A34154

Supernumerary teeth are defined as those in addition to the normal series of deciduous or permanent dentition. Supernumerary teeth are more prevalent among males and in the permanent dentition. The exact etiology of supernumerary teeth is unknown, they may occur anywhere in the oral cavity. They may appear as a single tooth or multiple teeth, unilaterally or bilaterally, erupted or impacted in maxilla or both jaws.

Fourth molars, also called distomolars, are a variant in shape and number appearing as alterations during odontogenesis. They can be eumorphic or dismorphic, single or multiple, erupted or impacted, unilateral or bilateral, and can appear in both jaws. They are of unknown etiology, but there are several theories to justify these tooth alterations such as dental lamina duplication, its horizontal proliferation or its hyperactivity.

Hereby, we are presenting a unique case report of presence of three distomolars in a single patient at maxillary left side and mandibular right and left side.

Open Access Study Protocol

Protocol on Effect of Planned Teaching on Knowledge Regarding Menstrual Blood Banking among Nursing Students

Elizabeth Remsangzuali Ngente, Vaibhav Chaudhari, Nita Fodekar, Pranali Gathe, Samiksha Ghume, Shruti Jambhulkar, Kavita Gomase

Journal of Pharmaceutical Research International, Page 220-224
DOI: 10.9734/jpri/2021/v33i58A34109

Background: The student’s changing habits varies depending on their intellectual level. Transition concerns are also present among college students. You have issues with your parents and siblings due to shyness and aggression. They are having academic adjustment issues as a result of the new academic pattern, atmosphere, and faculties. Academic transition includes finding inspiration, taking actions to satisfy academic obligations, and dealing with academic frustration.

Aim: To evaluate the effectiveness of planned teaching on knowledge regarding Menstrual Blood Banking among nursing students.

Methods: The data gathering process began from 5th April 2021. The investigators visited selected nursing school in Sawangi (M) Wardha City and got the mandatory authorization from the concerned authorities. To ensure better coordination during data collection, the researchers introduced themselves and told them about the purpose of the study. The researchers contacted the final year nursing students of selected area and clarified the purposes of the study and described how it will be helpful for them. They investigated their will to take part in the study and attain permission from them. They will assess their knowledge regarding Menstrual Blood Banking among Nursing Students by using structured questionnaire and after that, they will give them planned teaching regarding Menstrual Blood Banking. Then, after the seventh day of planned teaching, they will assess their post-test knowledge score regarding Menstrual Blood Banking. The investigators acknowledged all the study samples as well as the authorities for their support. The conclusion will be drawn from the results and will be published in peer reviewed journal.

Materials and Methods: The information was gathered from nursing students at nursing colleges in Wardha district. The research method was quantitative, and the study design was pre-experimental, one group pre-test post-test. The research was conducted at Wardha district's selected nursing colleges. Students make up the population, and samples were taken from 64 nursing students. The data was collected using a self-administered questionnaire and a targeted sample strategy. The tools for data collection used was -socio demographic data (age, education, religion, course, year of study and residence of the students),self-administered questionnaire on Menstrual Blood Banking and lesson plan on Menstrual Blood Banking.

Expected Results: This study is planned to assess knowledge regarding Menstrual Blood Banking among nursing students. Hence, it is expected to identify the effectiveness of planned teaching regarding Menstrual Blood Banking. The conclusion will be drawn from the results and will be published in per review journal.

Open Access Study Protocol

Study on Work Safety for Employees in Radiology Department

Praful R. Dabhekar, Rupali Naik

Journal of Pharmaceutical Research International, Page 353-358
DOI: 10.9734/jpri/2021/v33i58A34126

Background: Working staff in the radiology department are exposed to harmful factors such as Radiation exposure, injuries; needle pricks while performing an investigation, leads to exposure to body fluids, muscle stress due to wearing heavy lead aprons, and while moving portable equipment for examinations. Strategies to prevent and reduce such harmful factors are guaranteed by taking regular inspections by radiation safety officers.  Safety supervision in radiology is important in shielding the patients, radiologists and healthcare staff. Observational safety audits and regular inspections in the radiology department for staff safety are the main and important parts of this study.

Objective: To assess and evaluate the current safety measures in Radiology Department and Scope of innovations and interventions in current working safety condition awareness. 

Methods: All employees working in radiology department satisfying the inclusion criteria are evaluated for the study. A survey carried out related to general working and routine procedures carried out in radiology department. Regular audits and inspection studies are covered in the study. The study consists of closed-ended questions regarding the profession and the knowledge of the basic safety measures in diagnostic and special scans in radiology department.                                   

Results: Employees in the radiology department are highly aware about work safety measures. There are regular safety audits and inspection studies are carried out by RSO and concerning departments. There is also scope for radiation workers to have introductory seminars on radiation safety before they start working with radiation.

Conclusion: Working in the radiology department has several types of safety risks, which can be barred or compact if manage suitably. Informally with these types of risks and their penalty, agreement with policy and strategy on work ecological safety, and expansion of a traditions that supports supervision, treatment, and on time conduct will go far toward civilizing overall employee security for all employees in the radiology department.

Open Access Study Protocol

Comparative Study of Combination of Oral Tranexamic Acid with Modified Kligman’s Formula Versus Oral Tranexamic Acid with Azelaic Acid 15% in the Treatment of Melasma

Riddhima Singh, Praveen Maheshwari

Journal of Pharmaceutical Research International, Page 412-418
DOI: 10.9734/jpri/2021/v33i58A34132

Background: Melasma refers to acquired hyper-pigmentary condition effecting skin. Owing to its multifactorial causation and chronicity, there is an increased need for new multimodality therapies to treat melasma more effectively and to prevent the side effects seen with the conventional modalities of treatment.

Objectives: Compare efficacy of combining oral Tranexamic Acid and Azelaic Acid 15% with that of Oral Tranexamic Acid (TA) and Modified Kligman’s Formula. Also, to record any adverse effects of combining these agents.

Methods: Patients having Melasma who will be coming to Dermatology OPD, AVBRH, Sawangi, Wardha, will be enrolled after considering the various inclusion and exclusion criteria. A detailed history will be asked, which will be followed by a cutaneous examination that includes the calculation of MASI (Melasma Area and Severity Index).

One Group (A) - participants will receive - Oral 500 mg Tranexamic acid OD plus Modified Kligman’s Formula (fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2%) cream one time at night only.

Second Group (B)- participants will receive -  Oral 500 mg Tranexamic Acid OD plus Azelaic Acid 15% gel once daily at night only.

Both groups will also receive Broad-spectrum sunscreen SPF-30 daily (3 hourly).

Patients will be called for regular follow up at 4 weeks and 8 weeks (for early results). Clinical photos will be clicked at every follow-up visit and MASI score shall be doocumented.

Expected Results: To analyze efficacy of combining Oral TA along with Azelaic Acid 15% and if it provides better results, we can avoid the undesirable side effects that are seen on prescribing the Modified Klingman’s Formula, in Melasma patients.

Conclusion: This study will help us in analyzing efficacy of combining Oral TA with Azelaic Acid 15%, therefore will provide a newer treatment modality with lesser side effects and maybe better results than the gold standard- Modified Klingman’s Formula.

Open Access Study Protocol

Anthropometric Analysis of Human Knee Joint in Indian Population

Ratnakar Ambade, Ankit Jaiswal

Journal of Pharmaceutical Research International, Page 478-484
DOI: 10.9734/jpri/2021/v33i58A34141

Background: It is well understood that distal femoral and proximal tibia scale is lower in case of the Asian than that of their western counterparts. Because of the Asian population's comparatively smaller structure and stature, many surgeons claim that imported implants may not be well fitted for Asian origin patients, mainly based on Western morphometry. It is very likely that an overweight section will be used in many Asian centres in most operations, resulting in low results of the procedure of the implant. For joint substitution of distal femur, careful positioning of fitted implants as well as balancing of underlying soft tissues is important. It is also important to use incredibly complex surgical procedures. To retain its usual functional motion spectrum, use of a suitable femoral part dimension is necessary. Furthermore, owing to a discrepancy between the size of the prosthesis and the bone, there could be a host of serious issues.

Objectives: To calculate the anthropometric distal femur parameter and determine the distal femur variations on the right and left side of the morph metric measurement and to evaluate dimension of current TKA as related to Indian population.

Methodology: This study included visiting the out patients Department of Orthopedics, at AVBRH in the age group 30-50 year during the period of June-2020 to April-2023 with sample size of 50 patients.

Detailed history and clinical review will be taken, including age, sex, socio-economic background, type of employment. In all patients involved in the study in Orthopedic OPD, thorough radiological assessment of all the knee joints will be performed. The radiological test and various anthropometrics will include knee joint Simple X-ray and CT-Scan.

Expected Results: We expect that from our results, anthropometric measurements of Indian population may differ from other literatures.

Open Access Opinion Article

Frequency of Metabolic Syndrome and its Associated Factors in Patients with Breast Carcinoma at Tertiary Care University Hospitals of Pakistan

Rabail Bashir Keerio, Sidra Abbas, Muhammad Abid Owais, Muhammad Iqbal, Syeda Saima Qamar Naqvi, Abdul Ghaffar Arain

Journal of Pharmaceutical Research International, Page 527-533
DOI: 10.9734/jpri/2021/v33i58A34148

Objective: To determine the frequency of metabolic syndrome and its associated factors in patients with biopsy proven breast cancer at tertiary care university hospitals of Karachi, Pakistan.

Methods: This cross sectional study was conducted at the hospitals affiliated with Dow university of health sciences & Baqai medical university from January 2018 to September 2019.A total of 114women between 30 to 50 years of age presented to the out patients clinics and underwent triple assessment including detailed history &examination, radiological assessment and fine needle aspiration cytology for confirmation of breast cancer were included in the study after taking written informed consent. Along with the routine baseline investigations blood sugar for hyperglycemia&blood sample for lipid profile was taken in fasting from Dow Lab. Blood pressure of the patients was also checked along with the weight, height and waist measurements. The SPSS version 19 was applied to the data for description and analysis.

Results: Mean age of the patients was 42.57 ±4.90 years. Stages of cancer showed that stage III was found in majority (n=50, 43.9%). Frequency of metabolic syndrome was observed in 44 (38.6%) of the patients. A significant association of metabolic syndrome with educational status (p-value <0.001), Hypertension (p-value <0.001), Central obesity (p-value <0.001), Fasting blood sugar levels (p-value <0.001), Triglyceride levels (p-value <0.001), High density lipoprotein levels (p-value <0.001), and different Stages of breast cancer (p-value 0.003) was observed.

Conclusion: This study show that a significant number of patients with breast cancer are suffering from metabolic syndrome which is also correlates with the educational status of the patients.

Open Access Short Communication

Outcome of COVID-19: Diabetes and Obesity

Rithika Gunta

Journal of Pharmaceutical Research International, Page 248-255
DOI: 10.9734/jpri/2021/v33i58A34113

Today the world is facing one of the biggest crisis, due to a new beta-corona virus emerged from Wuhan in China, on December 2019. WHO declared ‘acute respiratory syndrome COVID-19 (SARS Co-2)’as a pandemic on March 12, 2020. Corona viruses are enveloped positive single stranded RNA viruses, causing severe acute respiratory syndrome in the infected individuals. The risk of getting infected by covid-19 is similar in all the individuals across the nation. But the outcome of the infection varies from one individual to another, depending on the comorbidities present in them. The most vulnerable group of patients in respect to severity of outcome of the infection are the once with unbalanced heath conditions like age (>65 years), immune-compromised, hypertension, type 2 diabetes, increased insulin resistance, cardiovascular diseases, chronic kidney disease, chronic liver disease, vasculitis(vascular inflammation)and obesity. It is now a public knowledge that diabetes and obesity are a risk factor for any individual as these conditions can exacerbate the manifestations of COVID-19 infections thus increasing the severity of the condition, that may require hospitalization of the patient, later may even require intensive care unit or/and mechanical ventilation, with increased risk of mortality rates. In diabetic patients it is mainly due to failure in controlling the glucose levels and the risk of ketoacidosis. In patients with obesity lipid peroxidase creates reactive lipid aldehydes leading to poor prognosis.

Open Access Minireview Article

Role of Family Physician in Periodic Health Assessment Screening: A Review

Faisal Suliman Algaows, Bassam Mohammed Alowaydhah, Amani jadid Alsharari, Mohammad Saleh Al Samaani, Mutaz Ali Al Aydan, Afaf fahd M alselami, Tawfiq Hassan Alnasser, Hamoud Aoudah Al Dhabaan, Abdulrahman Zayed Alessa, Elham Mohammad Saleh Al-bediny, Thekra Hamoud Alshammari, Saja fayez almotadaris, Hassan Abdulkareem Alabbad, Mohammed Ali Almuanni, Rehab Jaffar Al-Dubaisi

Journal of Pharmaceutical Research International, Page 32-37
DOI: 10.9734/jpri/2021/v33i58A34086

A family physician is considered the first line of healthcare with patients. In the public sector, a medical officer is a generalist with no postgraduate training. The periodic health assessment has its roots at least as far back as the industrial revolution, employers paid for annual medical fitness examinations and tests to assess the state of their workers with intention of keeping their workforce healthy and safe. The technique is now included into the work of primary care physicians and is still practiced across multiple countries but it may be named with a different name such as Periodic health examination (PHE). The PHE allows for the implementation of evidence-based preventative measures, the education of patients on lifestyle issues, the updating of vaccines, and, most importantly, the detection of risk factors and diagnoses by updating the patient's cumulative profile. In low-risk individuals, however, treatment may not be essential every year. There’s serious question about the value of Periodic health assessment/examination. In this article we’ll be reviewing the PHE, its value and the role of family physician in it.

Open Access Original Research Article

Feto-placental Changes in Pregnancy Induced Hypertension

Sonti Sulochana, Krishna Priya, . Sindhuja

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i58A34081

Aims: To study if there is any difference in the foetus and placenta of pregnant women who are normotensive and those of of hypertensive patients of different severity.

Study Design:  Prospective study.

Place and Duration of Study: Department of pathology, Saveetha institute of medical and technical sciences, between June 2017- June 2018.

Methodology: Pregnant women with hypertension attending obstetrics and gynecology department, Saveetha Medical College, Chennai was studied during the study period.

The study was conducted in accordance with the guidelines approved by the institutional review board of our Institution. The study population was divided into two groups namely normotensive and hypertensive patients. The hypertensive groups patients were further divided into two groups of mild (BP ≥140/90 mm Hg with proteinuria) and severe (BP ≥ 160/100 mm Hg with proteinuria). The placental specimens after expulsion were collected in 10% neutral buffered formalin solution. Informed consent was obtained in all patients and clinical data were obtained from the case notes. In the histopathology laboratory biopsy was taken from the insertion point of umbilical cord for light microscopy.

P-values less than 0.05 were considered statistically significant.

Data was entered in MS excel sheet and analysed using SPSS software version.

Results: The placental weight, birth weight of baby and APGAR score was decreased in PIH patients than normal pregnant women.

Conclusion: The diagnosis and treatment of PIH is very important to prevent complications in mother and baby.

Open Access Original Research Article

Effect of Box Breathing Technique on Lung Function Test

Ashfaaq Ahmed, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 25-31
DOI: 10.9734/jpri/2021/v33i58A34085

Background: Box breathing exercise is a technique of slow breathing rhythm also known as square breathing used universally. It increases the performance and concentration level, it also acts as a powerful stress relief. It is tested with a spirometer for the lung function test that measures the airflow of the upper and lower respiratory tract. This method builds up carbon dioxide in blood which calms down and regulates the ANS (Autonomic Nervous System), which enhances the cardio- inhibitory response of the vagus nerve that improves the mood. The main aim of the study was to analyze the effect of box breathing technique on lung function

Materials and Methods: The present study was carried out among the participants at the age of 18-25 years from Saveetha Dental College. A total of 30 participants were included in this study (15 males, 15 females). The experimental training procedures consisted of 2 sessions of box breathing day and night for a period of 30 days. Participants were informed of the procedures of the box breathing technique. RMS Helios spirometer was used to measure lung volumes and capacities. Statistics analysis was done using SPSS software, paired t test. P value of less than or equal to 0.05 was considered significant statistically.

Results: There was a significant increase among the participants FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume), FIVC (Forced Inspiratory Vital Capacity) parameters after 2 sessions on each day of box breathing technique for a period of 30 days. Other parameters increased to 10% but not significantly.

Conclusion: The present study illustrates the potential for box breathing practice to improve lung performance and reduce stress in healthy individuals. Despite the significant difference in FVC, FEV, FIVC levels supporting improved lung function, further investigation is needed to delineate mechanisms that underlie these benefits

Open Access Original Research Article

Multidrug Resistance among Gram Negative E. coli in Chicken Meat (Rafha-Saudi Arabia)

Akbar Ali, Vijay R. Chidrawar

Journal of Pharmaceutical Research International, Page 38-48
DOI: 10.9734/jpri/2021/v33i58A34087

Aims: Multidrug resistant (MDR) bacteria pose a major public health issuer globally. The genes for antibiotic resistance are transferred vertically in the form of genomic DNA and horizontally in the form of plasmids or transposons. Antibiotic are extensively used in animal farming to treat and prevent animal diseases, and at sub-therapeutic doses, they are used to promote animal growth. This extensive use of antibiotics is causing an increase in resistance among bacteria. More frequent, chicken meat available at retail shops is reported to be contaminated with a variety of drug resistant bacteria including E. Coli. The aim of the present study was to investigate antibiotic resistance in Escherichia coli strains isolated from chicken meat available in the local shops of Rafha, Saudi Arabia.

Place and Duration of Study: Department of basic health sciences, College of Pharmacy, Northern Border University, Rafha, Saudi Arabia, between February and October, 2019

Methodology: Eighty-six E. coli strains, isolated from chicken meat, were tested for their antibiotic resistance profile, using the disc diffusion method.   

Results: All the isolated E. coli strains were tested against 14 antibiotics. The maximum resistance was found against penicillin G (95%) followed by amoxicillin (85%), Cephalothin (81%), Erythromycin (72%), and Tetracycline (50%). Imipenem was the most effective agent of all with only 1% resistance followed by Cefepime with almost 6% resistance.

A high percentage of the isolates (57%,) were multidrug resistant as they were non—susceptible to at least one antimicrobial in ≥3 antimicrobial classes including amoxicillin, erythromycin and tetracycline.

Conclusion: The prevalence of MDR E. coli in retail chicken meat is very high and could pose a serious threat to public health.

Open Access Original Research Article

Correlation of HBA1c and Serum Cholesterol in Diabetic Patients

Mubeena Laghari, Faryal Adnan, Aneela Tehzeen, Zuha Talpur, Arsalan Ahmed, Shazia Murtaza

Journal of Pharmaceutical Research International, Page 49-54
DOI: 10.9734/jpri/2021/v33i58A34088

Aim: To determine the correlation of HBA1c and serum cholesterol in diabetic patients.

Methodology: This case control study was completed at the Biochemistry and Medicine Departments of Liaquat University Hospital Jamshoro from October 2015 to March 2016.Total number of study subject was 100 and they were divided into two groups. Group A (case group, n=50) comprises diagnosed T2DM subjects while group B (control group, n=50) consists of healthy normal subjects (HNS), healthy normal subjects with mean age 50±6.34 years. These subjects were assessed to find association of glycosylated hemoglobin with serum Cholesterol levels in Type-2 Diabetes mellitus patients. Those patients diagnosed asT2DM with age 30- 60years were included while those patients diagnosed as diabetic erectile dysfunction, diabetic nephropathy, diabetic renal failure, familial dyslipidemia, and hypercholesterolemia was excluded in this study. Blood specimens were collected from both groups aseptically then blood glucose, HbA1c, Blood cholesterol, were estimated. Written consent was taken by all subjects including in this study. Data was analyzed by SPSS version 21.0. P value ≤ 0.05 were considered significant. Results: The mean fasting blood sugar (FBS) of study participants of both groups was 162.74±25.42 mg/dL and 82.60±10.03 mg/dL respectively. The mean random blood sugar of both groups was 299.72±57.88 mg/dL and142.72±31.63 mg/dL respectively and mean glycosylated hemoglobin (HbA1C) of both groups was 8.40±1.27 and 5.75±0.24mg/dL respectively. The mean serum cholesterol values of DP and HNS were 7.05±1.02 and 5.74±1.45 mg/dl respectively. Conclusion: It was observed a positive correlation between HBA1c and serum cholesterol in type2 DM patients.

Open Access Original Research Article

A Computational Approach on the Anti-biofilm Effect of Ocimum sanctum Bio-compounds Against ptk of Acinetobacter baumannii

M. Kamalli, A. S. Smiline Girija, P. Sankar Ganesh, J. Vijayashree Priyadharsini

Journal of Pharmaceutical Research International, Page 91-103
DOI: 10.9734/jpri/2021/v33i58A34093

Introduction: Acinetobacter baumannii is a gram negative coccobacilli often considered as a nosocomial pathogen and as an opportunistic pathogen in immunocompromised patients. It is considered to be multi-drug resistant and a potent bacteria forming vital biofilms. Ptk which is protein tyrosine kinase is a protein coding gene involved with the synthesis of capsular polysaccharide. Ocimum sanctum is a perennial plant belonging to the Lamiaceae family. Tulsi and holy basil are the common names of this plant. In-silico docking approach method is much more convenient and cost effective to assess the bioactive properties of the natural drugs against any target ligands.

Aim: The aim of the study to assess the inhibitory effect of Ocimum sanctum bio-compounds against ptk of Acinetobacter baumannii using a computational approach.

Materials and Methods: Retrieval of the structure of ptk was followed by Ligand preparation and optimisation. Further drug likeliness was assessed using Molinspiration parameters, docking simulations and visualisation for the binding energy and hydrogen bonds.

Results: Among the bio compounds of O.sanctum, benzofuran is selected as an active inhibitory compound with -11.12 as its binding energy showing a high affinity.

Conclusion: The findings of the present study documents benzofuran as the promising candidate to design novel drugs from O.sanctum and to target the ptk of A.baumannii. However further experimental validation must be done to observe its efficacy and safety in the treatment of nosocomial infections caused by A.baumannii.

Open Access Original Research Article

Screening and in Silico Validation of Anti-Microbial Peptides Derived from Lysostaphin, Entero and Endolysin

Kirthick Kumaran A. S, Vijayashree Priyadharsini J., A. S. Smiline Girija, P. Sankar Ganesh

Journal of Pharmaceutical Research International, Page 104-110
DOI: 10.9734/jpri/2021/v33i58A34094

Introduction: Antimicrobial peptides (AMPs) are small molecules which are known to exert destructive effects upon pathogenic microorganisms. AMPs are designed from proteins obtained from various sources and tested under in vitro conditions to deduce their antimicrobial activity.

Materials and Methods: A few of the peptidoglycan hydrolases such as lysostaphin (AAB53783.1), enterolysin (AGG79281.1), and endolysin (YP_009901016.1) were selected for the study based on an extensive text mining process. The protein sequences of the proteins were retrieved from the NCBI (National Centre for Biotechnology Information) database in the FASTA format (https://www.ncbi.nlm.nih.gov/protein/).

Results and Discussion :In the antimicrobial protein lysostaphin, three antimicrobial peptide are been found, in which two is active and other is inactive, and one has antifungal property with a score of -0.15, and one having cell penetrating property, in which all are non toxic.

Conclusion: The present study predicts AMPs from lysostaphin, entero and endolysins. These peptides were found to possess antifungal, anti-biofilm properties. Most of the peptides predicted were found to be non-cell penetrating and non-toxic.

Open Access Original Research Article

Effect of Ocimum Sanctum Bio Compounds against csuE Gene Protein of Acinetobacter baumanii

Mukil Sunil, A. S. Smiline Girija, P. Sankar Ganesh, J. Vijayashree Priyadharshini

Journal of Pharmaceutical Research International, Page 117-125
DOI: 10.9734/jpri/2021/v33i58A34096

Background: Acinetobacter baumannii is a Gram-negative bacillus that is aerobic, pleomorphic and non-motile. Multi-drug resistance and biofilm formation contributes to the virulence and pathogenicity of the bacterium. Among many virulence factors, csuE is critical for initiation and assembly, showing much homology to type 1 and P pili. With much propensity of drug resistance, in recent years alternative medications have spurred renewed interest in targeting potent pathogens. Ocimum sanctum, also known as holy basil or tulsi possess various bio-active properties and can be used as alternative medicine to treat systemic ailments.

Aim: This study was aimed to analyze the drug-ligand interactions between csuE protein of A. baumannii and the bio-compounds from O.sanctum using in-silico docking analysis.

Material and Methods: csuE protein was retrieved and optimisation of protein was done. Ligands were selected and were assessed for drug likeness using molinspiration parameters. Further the compounds were subjected for docking analysis and the interacted molecules were visualized for binding energy and hydrogen bonds.

Results: Out of the 9 compounds of Ocimum sanctum, benzofuran showed good interaction with csuE protein of Acinetobacter baumannii with a least docking energy of -5.31Kcal/Mol.

Conclusion: The present study recommends benzofuran as the potent candidate for novel drug design to treat the infections caused by A.baumannii upon further evaluations for its safety and immunological response.

Open Access Original Research Article

Respiratory Responses to Short Term Sustained Isometric Muscle Contraction among Undergraduates

S. Nehal Safiya, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 126-131
DOI: 10.9734/jpri/2021/v33i58A34097

Aim: This study sets out to investigate whether a short-term isometric abdominal exercise can benefit adults with improvement in ventilatory functions.

Materials And Methods: The present study was performed in 20 adults from the student population of I-BDS students with no history of smoking and respiratory illness. The participants did a daily 20-minute static abdominal exercise over a period of three days. The lung function test was assessed using spirometry and the values of FVC, FEV1, FEV1/FVC, PEFR, FEF 25-75. Paired dependent t test was done to evaluate the anthropometric variables and changes in lung functions pre-exercise on day 1 and post-isometric exercise on day 3. 

Results: The study demonstrated a significant increase in the mean values of forced vital capacity and forced expiratory volume in one second. The FEV1/FVC ratio, PEFR, FEF 25-75% did not reveal significant changes.

Conclusion: The study concluded an innovative finding that ventilatory functions improved after short term isometric training.

Open Access Original Research Article

Distribution of Biofilm-associated Genes among Acinetobacter baumannii by in-silico PCR

A. Aldrin Joshua, A. S. Smiline Girija, P. Sankar Ganesh, J. Vijayashree Priyadharsini

Journal of Pharmaceutical Research International, Page 140-149
DOI: 10.9734/jpri/2021/v33i58A34099

Background: Acinetobacter baumannii is a coccobacillus that is Gram negative, non motile, non fermentative and oxidase negative. It is the most common and successful nosocomial pathogen recognised by WHO. This dreadful pathogen causes urinary tract infections, ventilator associated pneumonia (VAP), bacteremia, etc., These infections are most common in hospital wards especially Intensive Care Unit (ICU). The infections are due to biofilm formation by the virulent genes of A. baumannii, and the common biofilm-associated genes of A. baumannii were bap, csuE, fimH, epsA, bfmS, ptk, pgaB, ompA, blaPER-1. Among these, bap, epsA and ompA genes are highly prevalent among the clinical strains of A. baumannii.

Aim:  To detect the three vital biofilm-associated genes of A. baumannii by in-silico PCR analysis.

Materials and Methods: 19 isolates of A. baumannii were selected and 3 target genes, namely epsA, ompA and bap gene were used for the amplification process through in-silico PCR simulation tools. Evolutionary analysis was done for the ompA gene.

Results: The epsA gene was expressed in 10.52% of the total strains selected with the highest occurrence of ompA gene as 57.89%. bap gene was not observed from the study strains included. From evolutionary analysis based on ompA distributed strains, the Acinetobacter baumannii SDF and Acinetobacter baumannii BJAB0715 might be the parental strains where the evolution of strains would have started. Through successive generations, the Acinetobacter baumannii MDR-ZJ06 and Acinetobacter baumannii TYTH-1 had become the multidrug resistant strains present in the environment.

Conclusion: The findings of the study confirms the distribution of epsA and ompA genes among the 19 different strains of A. baumannii. The study suggests periodical monitoring of biofilm based virulence genes among the clinical strains and to curtail the A. baumannii infections.

Open Access Original Research Article

Evaluation of Various Stress Management Strategies among Chennai People - A Cross Sectional Study

A. N. K. Mitthun, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 150-157
DOI: 10.9734/jpri/2021/v33i58A34100

Background: Feeling stressed is a part of everyone's life. A feeling of emotional or physical tension is known as stress. Relaxation strategies play an important role in overcoming stress.

Objective: To evaluate the different stress patterns, their perceived stress and effects of different stress management strategies.

Methods: A cross sectional study was conducted through a convenience sampling method. The participants were administered with a self developed questionnaire consisting of 11 questions. The responses were collected using google forms. Descriptive statistics, frequency analysis and chi square test was used to analyse the data.

Results: The present study reported that the majority of respondents were stressed due to academic and personal reasons and among the various stress relaxation methods, respondents felt that music and yoga relieved them from stress.

Conclusion: The study concluded an innovative finding that music and yogic exercises when adopted provided a decent stress management strategy that suits the respondents.

Open Access Original Research Article

Comparative Study on the Efficacy of Commercially Available Chemical and Herbal Mouthwash against Oral Microorganisms

M. Infant Reshawn, N. P. Muralidharan

Journal of Pharmaceutical Research International, Page 162-169
DOI: 10.9734/jpri/2021/v33i58A34102

Aim: The present study was done to determine the activity of Naturally prepared  licorice mouthwash in comparison to chlorhexidine  mouthwash.        

Introduction: Maintenance of oral hygiene is very important in preventing the growth of  a sticky film of bacteria and food particles that accumulates on teeth and hence Mouthwashes are prescribed in dentistry for treatment of several oral conditions and for prevention against various microorganisms. Licorice  is  derived  from "liquiritiae” which is  shrub or herb  and  the  yellow  colour  of it is  due to the flavonoids content of  the plant, which  includes liquiritin, isoliquiritin and other compounds. Herbal Mouthwashes (mouth rinses) are solutions or liquids intended to reduce the microbial load in the oral cavity.

Materials and Methods: This study was conducted in Saveetha Dental Hospital, Chennai, Tamilnadu, India. The liquorice was extracted and formulated as mouth wash. Fig. 1 denotes the salivary samples were obtained from 20 volunteers (10 test group, 10 control group) and then, the participants were asked to  rinse their mouth with freshly prepared licorice mouthwash(test group),  chlorhexidine mouthwash (control group) and then paired saliva samples were obtained immediately after and before the mouthwash and finally the Colony forming units were recorded for pre and post usage of both the herbal and commercially available  mouthwash.

Results: Study showed that there was a mean reduction in the colony-forming units with herbal mouthwash and Chlorhexidine mouth washes. Herbal mouthwash showed reduction in colony forming growth after usage of herbal mouthwash.

Open Access Original Research Article

Digital Teaching Methodology among the Dental Students a Questionnaire Based Survey

N. Dharaneesh, A. Jothi Priya, R. Gayatri Devi

Journal of Pharmaceutical Research International, Page 170-178
DOI: 10.9734/jpri/2021/v33i58A34103

Background: The implementation of digital technologies in dental curricula has started globally and reached varying levels of penetration counting on local resources and demands. One of the biggest challenges in digital education is the need to continuously adapt and adjust to the developments in technology and apply these to dental practice in communicating with dental professionals, medical doctors, dental technicians, and insurance providers, dental students need to be prepared to manage digitized data, ensure patient safety, and understand the advantages and limitations of conventional and digital processes.

Aim: To create awareness about digital teaching methodology among the dental students.

Materials and Methods: A cross-sectional survey was conducted among the adolescent population with a sample size of 120. A self administered structured questionnaire was prepared based on digital teaching methodology and consisted of 13 questions. It was circulated to participants through an online platform (google form). The statistics were done using SPSS software, chi-square test was used to check the association and P value of 0.05 was said to be statistically significant.The pros of the survey is that the adolescents of different lifestyles and cultures were surveyed. Children and adults were excluded from the survey. Simple random sampling method was the sampling method used to minimise the sampling bias.

Results: The results showed that the dental students are aware about the digital teaching methodology.

Conclusion: The people are aware of the digital teaching methodology. But more awareness needs to be spread so that digital handling can be improvised in the near future.

Open Access Original Research Article

A Comparative Study of Low Versus Standard Intraperitoneal Pressures in Gynaecological Laparoscopic Surgery

Anup R. Patil, Deepika Dewani, Kalyani Mahajan, Neema Acharya, Arpita Jaiswal, Saunitra A. Inamdar, Sparsh Madaan

Journal of Pharmaceutical Research International, Page 179-185
DOI: 10.9734/jpri/2021/v33i58A34104

Background: Minimal access surgery in contrast to open surgery has quicker recovery during the postoperative period as well as reduced scores of pain. As a result of increased pressure in the abdominal cavity, laparoscopic surgery  has many implications over a range of organ systems as well as their functioning. Laparoscopic surgery due to increased intraabdominal pressure also has many implications on various organ systems and their functioning. To overcome the consequences of increased intrabdominal pressure, a number of trials have been formulated to compare low- versus standard-pressure pneumoperitoneum.

Aim: The aim of this study was to assess the effectivity of low intraperitoneal pressures v/s  standard intraperitoneal pressure during laparoscopic hysterectomies.

Study Design: Experimental study 

Materials and Methods: 40 cases with uncomplicated symptomatic benign uterine pathologies who were posted for laparoscopic hysterectomy were selected out of which 20-20 cases were randomized into low and standard pneumoperitoneum groups. 

Results: In patients in whom low pressure pneumoperitoneum is employed are better recovered in terms of pain than standard pressure pneumoperitoneum. This means hospital stay can be shortened in low pressure pneumoperitoneum groups which will be more economical and comfortable for patients.

Conclusion: Laparoscopic hysterectomy can be done at 10 mmhg with the benefits of :

  • Optimum visualization with low pressure
  • Reduction in post operative pain helping the patient for early ambulation so that patient will get back to routine work and normal life earlier, it is the main purpose of minimal invasive surgery.

Open Access Original Research Article

Knowledge and Awareness about Postpartum Distress among the Students of Saveetha Dental College

Jessly Daniel, A. Jothi Priya, R. Gayatri Devi

Journal of Pharmaceutical Research International, Page 186-195
DOI: 10.9734/jpri/2021/v33i58A34105

Introduction: Postpartum depression (PPD) is the most common psychiatric condition after childbirth.

PD has adverse long-term consequences for the mother, the infant’s development and the family environment symptoms-the core symptom of sadness or low mood, as well as fatigue/sleep disturbance and irritability. The aim of the study is to determine the Knowledge and awareness about postpartum distress among the students of saveetha dental college.

Materials & Methods: A cross-sectional survey was conducted among the study population with a sample size of 100. A self administered structured questionnaire was prepared and consisted of 15 questions. It was circulated to participants through an online platform (google form). The statistics were done using SPSS software, chi-square test was used to check the association and P value of 0.05 was said to be statistically significant.The pros of the survey is that the students of different lifestyles and cultures were surveyed . Children and adults were excluded from the survey.  Simple random sampling method was the sampling method used to minimise the sampling bias.

Results: Women during postpartum go through a lot of hormonal changes which lead to mood swings etc.They become very self conscious about their body .Mothers can also be depressed due to financial trouble, lactation etc.  Chi square test: p-value=2.98>  0.05 hence significant.

Conclusion: In summary, this study demonstrated an honest level of data and positive attitudes towards women with postpartum depression. However, negative beliefs, stigma, and misconceptions still prevailed among the relations.

Open Access Original Research Article

Livelihood Challenges and Mitigation Strategies Adopted During COVID-19 Lockdown Period

Lelith Daniel, Rajani Gupte, Manisha Gore, Samir Barve, Shirin Shikalgar, Revathi Pathak, Abhay Saraf

Journal of Pharmaceutical Research International, Page 196-205
DOI: 10.9734/jpri/2021/v33i58A34106

Over the past century, apart from COVID-19, human civilization has seen five other significant pandemics such as the H1N1 outbreak in 2009, Ebola outbreak in West Africa in 2014, and subsequent outbreak in Congo in 2019, Zika outbreak in 2016, etc. However, of all these outbreaks, perhaps the COVID-19 pandemic is unparalleled due to the global proportions that it has assumed. The severity of the epidemic can be seen in terms of the number of lives lost and the multi-dimensional impact that COVID-19 has had upon the economies of nations and lives of people. Beyond the physical sphere of human life, COVID-19 has also impacted human life's social, mental, and economic aspects.

This study was conducted to understand the livelihood challenges faced by the residents of 5 villages in Mulshi taluka during the lockdown period. In-depth interviews were conducted with three respondents from each village (15 respondents). The study drew upon the insights given by key opinion leaders in the towns such as Sarpanch and elected members of the gram panchayat, ASHA workers, ration shop owners etc. Identify the livelihood challenges faced by the people during the lockdown imposed due to COVID-19. Describe the strategies adopted by the people to overcome the challenges to livelihood faced by the people.

The residents of the village's studies faced various challenges related to agriculture such as lack of manpower to harvest produce, lack of transportation facilities to transport produce to markets, lack of storage facilities to store agricultural produce etc, loss of employment faced by daily wage laborers due to non-operational status of small businesses during the lockdown period and challenges due to reverse migration.

Open Access Original Research Article

Prediction of Accuracy in Emergency Health Records using Hybrid Machine Learning Model

G. S. Raghavendra, Shanthi Mahesh, M. V. P. Chandra Sekhara Rao

Journal of Pharmaceutical Research International, Page 206-212
DOI: 10.9734/jpri/2021/v33i58A34107

The quantity of digital information contained in electronic health records(EHR) has increased dramatically during the last ten years. Numerous researchers have discovered that these records may be used for a variety of other purposes as well, including applications in clinical informatics. Additionally, within the same time period, significant advancements in the area of deep learning have been made by the machine learning community. Using EHR data, we examine the existing research on applying deep learning to clinical activities. In this article we will discuss various deep learning techniques used for the classification of electronic health records along with proposing of Hybrid model for finding classification accuracy of various models.

Open Access Original Research Article

Estimation of Breath Holding Time (BHT) among Dental Students

Aashiq Mohamed, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 213-219
DOI: 10.9734/jpri/2021/v33i58A34108

Background: Breath holding time is the time taken by an individual to hold his/her breath as long as they can. During voluntary breath holding, tissues continue to utilize oxygen and liberate carbon dioxide. Therefore, during breath holding arterial pO2 falls and pCO2 rises. Normal Breath holding time (BHT) is 45-55 seconds which is estimated at 2014. The main aim of this study is to assess the breath holding time among healthy dental students.

Materials and Methods: A minimal number of sample sizes have been taken into account with regards to their BMI. The sample size was divided into two groups as gender comparison. Students were detail explained about the procedure and breath holding time has been measured. The statistical analysis was done by ANOVA test in SPSS Software-23 and an independent t-test was calculated.

Results: BHT was found to be significantly low among females compared to males. A statistically significant negative correlation was observed when BHT is correlated with gender because BHT differs in both the gender.

Conclusion: The present study revealed that breath holding time is less in females compared to males. Therefore, males are healthier than females.

Open Access Original Research Article

Estimation of Blood Pressure, Pulse Rate, Waist Circumference, BMI and BMR among PCOS Individuals

S. Rasveya, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 240-247
DOI: 10.9734/jpri/2021/v33i58A34112

Introduction: Polycystic ovarian syndrome (PCOS) is an endocrine disorder which will affect the female’s reproductive health, there are many risk factors found in the PCOS individuals such as irregular menstrual cycle, infertility, obesity, excess hair growth, hyperandrogenemia. The aim of the study is to estimate the blood pressure and pulse rate among PCOS individuals and to compare it with the normal subjects.

Materials and Methods: A group of 20 PCOS individuals and 20 normal individuals have been chosen from Saveetha dental college with age of 18-25 years whose blood pressure, pulse rate, waist circumference, BMI, BMR are measured, the blood pressure and pulse rate were measured with a automatic blood pressure monitoring machine and the waist circumference was measured with a inch tape from last rib and the iliac crest at its small parameter. The simple random sampling method is used to minimize the sampling bias. Data was collected and analyzed by an independent sample‘t’ test.

Results: When comparing with control healthy individuals, the systolic blood pressure (SBP) of PCOS individuals seem to be higher than the control subjects. The diastolic blood pressure (DBP) is also slightly higher for PCOS individuals. The pulse rate of normal individuals is higher than the PCOS individuals. The diastolic blood pressure had a significant value of about 0.002 which is less than 0.05 so it is significant

Conclusion: From this study it is evident that when PCOS is seen in women it not only affects the gynecological sphere it also affects the cardiovascular activity which may even have fatal outcomes. So it is mandatory for the PCOS subjects to have a proper diet, proper sleep, physical activity, and very importantly to have a stress free life.

Open Access Original Research Article

Knowledge, Attitude and Practice of Ischemic Heart Disease Patients towards Their Medication

T. V. Akshay, C. K. Shruthilaya, V. V. Rafiyath, K. S. Rajesh, K. Subrahmanyam, Raman Rajesh Kumar

Journal of Pharmaceutical Research International, Page 256-262
DOI: 10.9734/jpri/2021/v33i58A34114

Objective: Ischemic heart disease is mostly seen among all Cardiovascular diseases and is responsible for more than 80% of cardiovascular disease deaths. This study has been developed to design and to validate a Knowledge, attitude and practice (KAP) Questionnaire in order to assess the knowledge, attitude and practice of ischemic heart disease patients towards their medications.

Study Design: Prospective observational study

Methods: The study was conducted for duration of six months among 336 patients. The study subjects taken were above 18 years of age, who was diagnosed with Coronary Artery Disease by a Consultant Cardiologist in Cardiology Department. Practice questionnaires and all the details were explained by the investigator before filling the KAP forms. The data was tabulated and statistically analysed by SPSS software.

Results: 336 patients including both males and females were enrolled in the study. Majority of the patient were having good knowledge about the disease conditions that is 50% of the patients were aware about the ischemic heart disease. 326 (97%) of the 336 research participants were aware of the signs and symptoms of ischemic heart disease. Majority of the patient have an attitude towards the adverse conditions related to the disease i.e. 91.4% were aware of consulting a physician when they came across a side effect. 85.45% of the study subjects think that non-compliance to medication can lead to worsening of their condition. 98.2% of the study subjects are willing to take the treatment recommended by their doctor. Considering the practice, 81.5% the study subjects were ready to follow all the instructions given by the doctor.

Conclusion: Findings from this study provide a better understanding of “knowledge, attitude and practice” in Ischemic heart disease patients towards their medications. Estimating the knowledge, attitude and practices of the community has sufficiently provided crucial baseline information for the implementation of primary and secondary preventive programs.

Open Access Original Research Article

Evaluation of Nootropic Activity of Leaf Extract of Anacardium occidentale L.

Meghna Salian, Prasanna Shama Khandige

Journal of Pharmaceutical Research International, Page 270-278
DOI: 10.9734/jpri/2021/v33i58A34116

One of the plants that have been used for enthno medicinal purposes in traditional civilization is Anacardium occidentale L. of the family Anacardiaceae is native to Brazil also found in tropical countries such as Malaysia and India commonly known as cashew. The purpose of this study is to determine the in-vitro and in-vivo cognitive effects of an ethanolic leaf extract of the herb Anacardium occidentale on albino rats. Orally the ethanolic extract was administered in two doses (100 mg/kg and 400 mg/kg). The Elevated Plus maze and Y-maze showed statistically significant improvement in the memory process. The estimation of acetylcholinesterase enzyme in rats brain also shows improvement in the memory process by reducing acetylcholinesterase activity. Disorders related to cognition are one of the major health problems and increasing day by day especially affecting the elder individual. There is no proper medication for the impairment of memory. The study reveals that the ethanolic extract of the leaf of Anacardium occidentale has dose-dependent memory-enhancing performance. Synthetic drugs have a lot of side effects, whereas drugs belongs to natural substances have least side effect compared to synthetic one, which has gained a lots of importance. These studies need to be documented effectively. Research findings were contributed to meet the future needs in general healthcare, research, and conservation of endangered species and may give a lead to the discovery of newer drugs.

Open Access Original Research Article

Nephroprotective Activity of Ethanolic Extract of Carissa carandas Leaves against Gentamicin-Induced Acute Kidney Injury in Wistar Albino Rats

V. V. Rajesham, Hima Sowmya Kandoti, Mitta Raghavendra, P. Roshan Ali, T. Rama Rao

Journal of Pharmaceutical Research International, Page 279-286
DOI: 10.9734/jpri/2021/v33i58A34117

The present study was aimed to evaluate the nephroprotective activity of ethanolic extract of Carissa carandas Linn. Leaves (EECC) in Gentamicin-induced nephrotoxicity in Wistar albino rats. The renal damage was induced by Gentamicin (80mg/kg body weight, i.p.). Nephroprotective activity was investigated by the administration of EECC at two different doses (100 and 200mg/kg body weight, p.o) for 28 days and by assessing serum parameters, renal oxidative stress markers and histopathological studies. Gentamicin-treated animals showed an increase in serum creatinine, uric acid, urea, and malondialdehyde (MDA) levels and decrease in total protein, reduced glutathione (GSH), and catalase(CAT) compared to normal control animals, which indicates severe nephrotoxicity. Histopathological studies of kidney Gentamicin-treated animals showed extensive acute tubular necrosis and peri-tubular inflammation. Administration of EECC showed a significant improvement (p<0.05) in biochemical and oxidative stress markers compared to the disease group. EECC treated groups showed better histological appearance when compared to the disease group. Ethanolic extract of Carissa carandas Linn. Leaves showed significant nephroprotective activity against gentamicin-induced acute kidney injury.

Open Access Original Research Article

Level of Awareness and Knowledge of Folic Acid Intake among Women in the Reproductive Age in ARAR Region, Saudi Arabia

Abdulrahman Mazki Alanazi, Abdullah Juayf Alanazi, Yasir Wadi Alanazi, Muhammad Sari Alanazi, Ghada Rezk, Sabry Mohamed Hammad

Journal of Pharmaceutical Research International, Page 287-297
DOI: 10.9734/jpri/2021/v33i58A34118

Background: Folic acid reduces the risk of neural tube defects. As approximately 50% of pregnancies are unintended, women of reproductive age should be aware of the importance of folic acid. This study aims to assess the level of awareness and knowledge among childbearing female on the importance of preconception folic acid supplementation in preventing neural tube defects (NTDs) in Arar city.

Methodology: A population-based cross-sectional study was conducted in Arar city, Norther Saudi Arabia on included Saudi women in reproductive age. A pre-designed online questionnaire was used for data collection. Data was entered and analyzed using statistical package for Social Sciences Program, version 20 (SPSS Inc., Chicago, Illinois, USA). The results were displayed as counts, percentages. Appropriate statistical tests will be used for comparisons. P ≤ 0.05 is considered significant.

Results: The sample consisted of 428 women in reproductive age, 60.1% aged between 30 to 40 years, 39% aged between 20 to 30 years and only 0.9% aged between 18 to 20 years old. 91.8% were married. 85% of participants reported that their doctor prescribed folic pills for them before. 95.1% think that women should take folic acid pills in pregnancy while 75.2% think that it is necessary to take folic pills pre-pregnancy. 85.3% had taken folic acid pills in previous pregnancy. 31.3% think that it should be stopped after pregnancy. 84.6% think that folate deficiency causes fetal abnormalities. Only 8.4% of studied women reported attending seminar or lecture on folic acid importance.

Conclusion: The results of the current study affirmed good knowledge of folic acid supplementation usage during pregnancy among women in Arar, KSA. There was a significant association between knowledge of folic acid taking importance during pregnancy with marital status, number of children, and educational level of participants.

Open Access Original Research Article

A Comparative Study of Anti-inflammatory Activity of Tecoma stans, Acalypha indica and Abutilon indicum Plant Leaf Extract

Priyanka Sivasubramanian, R. Gayatri Devi, J. Selvaraj, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 298-306
DOI: 10.9734/jpri/2021/v33i58A34119

Introduction: Inflammation is said to be the response of the body to an injury. It is a body defence reaction to reduce or eliminate the spread of injurious agents. It is essential that steps should be taken to introduce new medicinal plants and to develop cheaper, effective and safe analgesic and anti-inflammatory drugs. The main aim of this study is to assess the potential anti-inflammatory activity of Tecoma stans, Acalypha indica and Abutilon indicum plant is being studied.

Materials and Methods: Protease inhibition assay was done by Bovine serum albumin was added to plant samples with increase in concentrations as per the standard methods. In this study, Aspirin was used as a standard anti-inflammatory drug.The data were analyzed statistically by a one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test to see the statistical significance among the groups. The results with p<0.05 level were considered to be statistically significant.

Results: In this study, it was observed that the plant leaf extract of Tecoma stans, Acalypha indica and Abutilon indicus contain anti-inflammatory activity. The protein denaturation inhibitory activity of leaf extract of Tecoma stans, Acalypha indica and Abutilon indicum, plant extract was represented graphically. Tecoma stans, was observed to contain the anti inflammatory activity.

Conclusion: This study revealed that Tecoma stans, Acalypha indica and Abutilon indicum are important medicinal plants with diverse pharmacological spectrum and contain anti-inflammatory properties. Hence, this research has been taken to collect and compile the pharmacological uses of these plant extracts which will be useful to the society to venture into a field of alternative systems of medicine.

Open Access Original Research Article

To Impact of Vit-D in Pulmonary Tuberculosis Patients Receiving DOTS

Gangaram Bhadarge, Saurabh Hadke, Neha Bhatt, Meghali Kaple

Journal of Pharmaceutical Research International, Page 331-335
DOI: 10.9734/jpri/2021/v33i58A34123

Introduction: Vitamin D, also known as calciferol, is a fat-soluble vitamin that helps regulate bone metabolism and calcium homeostasis in humans. Vitamin D from the skin and right is passed on by the liver to 25-hydroxyvitamin D (25 (OH) D, which is used to assess a patient's vitamin D status. The enzyme 25-hydroxyvitamin D-1hydroxylase converts 25 (OH) D into 1, 25-dihydroxy vitamin D (1,25 (OH) 2 D) in the kidneys. Vitamin D is essential for good health. Turning the immune system to the host (MTB). Cathelicidin, an anti-bacterial peptide that prevents mycobacterium from replicating macrophages, shown to be stimulated by vitamin D. In cases of tuberculosis, high levels of serum vitamin D and hypocalcaemia. Enhanced macrophages may be blamed for high calcitriol levels in granulomas. Low levels of vitamin D, on the other hand, linked and tuberculosis (PTB) in several studies conducted worldwide.

Aim: Study of Vit-D In Pulmonary Tuberculosis Patients Receiving treatment.

Materials and Methods: This study included 40 newly diagnosed PTB patients of both sex with the age group of 18-60. The patients were comprised before and after the DOTS therapy. Time period of this study were from September 2020 to Арril 2021 а nоn-rаndоmised соntrоlled trial.

Results: The weight of patients before DOTS was decreased as compare to the weight after DOTS. The level of vitamin D significantly raised in newly diagnosed PTB patients while the vitamin D level was decreased after DOTS therapy.

Conclusion: Decreased level of vit-D in the blood can be linked to an increased risk of tuberculosis. As a result, serum Vit-D levels in TB patients can be necessary to control, as Vit-D deficiency may develop without symptoms and intensify once TB therapy starts.

Open Access Original Research Article

Oxidative Effects in Streptozotocin-induced Male and Female Mice: The Effect of Garlic Oil and Melatonin

Abeer Al-Rashedi, Banan Al-Johari, Rahaf Al-Abbasi, Raghdh Sindi, Rawan Bin Hameed, Sulafah Al-Saadi, Sara Al-Awam, Mawada Bukhari, Rahaf Al-Talhi, Yosra Al-Hindi

Journal of Pharmaceutical Research International, Page 336-343
DOI: 10.9734/jpri/2021/v33i58A34124

Background: Recent studies have revealed that a hyperglycemia-induced overproduction of superoxide can be the first event in the activation of all pathways involved in the pathogenesis of complications of diabetes. Supplementation of garlic was found to decrease diabetes-induced oxidative stress complications. Studies shown also that melatonin attenuates diabetes‐induced oxidative stress in diabetic induced rabbits and rats.

Objective: In this present study, oxidative stress in diabetic model and the effect of garlic oil or melatonin treatment were examined in both genders' male and females' mice.

Methods: 96 mice were randomly divided into 5 groups including control (C), diabetic (D), melatonin 10 mg/kg (D+M), garlic extract 100 mg/kg (D+G) and combined melatonin and garlic (D+M+G). All treatments were given orally daily for 16 weeks after induction of hyperglycemia by streptozocin (STZ). Fasting blood glucose and antioxidant levels were estimated.

Results: Streptozotocin induced diabetic mice, showed a significant increase of plasma glucose, lipid peroxide and uric acid. Accordingly, significant decreases in the levels of antioxidants ceruloplasmin were found in the plasma of diabetic mice. Treatment of diabetic mice with garlic oil or melatonin for 16 weeks significantly increased plasma levels of ceruloplasmin activities. Lipid peroxides, uric acid, blood glucose was decreased significantly after treatment with garlic oil or melatonin.

Conclusion: The results suggest that garlic oil or melatonin may effectively normalize the impaired antioxidants status in streptozotocin induced diabetes in both males and females mice.

Open Access Original Research Article

Telemedicine during COVID-19 Pandemic in Saudi Arabia: Oral and Maxillofacial Surgeons’ Knowledge and Implementation

Manal Abdalla Eltahir, Amjad Ebrahim Alshommemri, Rayan Suliman Alyahya

Journal of Pharmaceutical Research International, Page 344-352
DOI: 10.9734/jpri/2021/v33i58A34125

Telemedicine can significantly improve health care delivery for patients with limited access to medical services. Innovative uses of this kind of technology in the provision of healthcare is increasing with the emergence of the virus causing the disease COVID-19, there is an urgency to expand the use of technology to help people who need routine care. This study aimed to assess oral and maxillofacial surgeons' knowledge of telemedicine and its applications, and incorporation of telemedicine into their clinical practice during the COVID-19 pandemic.

Methodology: This is a cross section, Questionnaire based study conducted among oral and maxillofacial surgeons in Saudi Arabia from November 2020 to January 2021. The study sample included 200 oral and maxillofacial surgeons from different regions in Saudi Arabia which has been calculated depend on reality of the Saudi health workforce during the next ten years 2018-2027 book and the total number of OMS and oral surgeons who was registered was approximately 300. The self-administered questionnaire (which was constructed after extensive reviewing of the literature in the same context) was distributed among the selected surgeons using online platform; the components of that questionnaire were: socio demographic characteristics, knowledge of telemedicine technology, using of telemedicine before and during COVID-19 and security of telemedicine technology. A Scoring Criteria used to indicate the knowledge of OMS and oral surgeons towards the use of telemedicine technology. All statistical analyses were performed using SPSS version 21.

Results: A total of 69 OM surgeons were responded, of which 52.2% were females. The knowledge of the surgeons regarding telemedicine was moderate among 43.5% (mean: 11.6; SD: 4.12, out of 20 points). Surgeons who were working in the private clinic (F=2.982; p=0.027), those who had heard of telemedicine (t=4.987; p<0.001) and those who implemented telemedicine at a current workplace before COVID-19 (t=3.873; p<0.001) had significantly better knowledge score than the rest.

Conclusion: Although there was an increased implementation of telemedicine use during the covid-19 pandemic, the oral and maxillofacial surgeon’s knowledge about it seems to be low.

Open Access Original Research Article

Prevalence of Incidental Radiopacities in Panoramic Radiographs

Hashmath Ara, Chandrasekaran Krithika, Chitathoor Sridhar

Journal of Pharmaceutical Research International, Page 435-441
DOI: 10.9734/jpri/2021/v33i58A34135

Routine panoramic radiographs often reveal hidden lesions other than those related to the patient's chief complaint [1]. The study aims to determine the prevalence of incidental radiopacities in panoramic views. There are several conditions where calcifications can occur in soft tissue, including major and minor salivary glands, lymph nodes, and blood vessels, such as sialolith, phlebolith, exostosis, dystrophic calcifications, etc. [2]. Interpretation of panoramic radiograph should consider the possibilities of soft tissue calcification super-imposed in bone. Three hundred and sixty (360) panoramic radiographs are included in the study. The prevalence and distribution of radiopacities were documented along with the probable diagnosis. In addition, statistical analysis was done by SPSS software to evaluate the age and gender-related distribution of radiopacities in panoramic radiographs.

Open Access Original Research Article

Study of Haematological and Biochemical Parameters of COVID-19 Patients in ICU and in Ward

Nandkishor Bankar, Gangaram L. Bhadarge, Neha Bhatt, Rakesh Kumar Jha

Journal of Pharmaceutical Research International, Page 442-448
DOI: 10.9734/jpri/2021/v33i58A34136

Introduction: Covid-19 is 65 nm to 125 nm in diameter and contains single-stranded RNA as nuclei content. Covid-19's global scale transmission, frequent occurrence, large number of deaths, infection and mortality among care providers, and multiplicative impact in vulnerable or sensitive groups are all major causes of concern. The clinical presentations of coronavirus disease are diverse, ranging from asymptomatic carriers to manifestations of respiratory collapse requiring mechanical ventilation and ICU support, as well as multi-organ and systemic symptoms such as sepsis, septic shock, and multiple organ dysfunction syndromes (MODS).

Aim: Comparison of Haematological and Biochemical Parameters of Covid-19 Patients in ICU and in Ward.

Materials and Methods: 25 patients were ICU and 25 patients were ward. Patients went directly to the Observed Treatment in the Dept. of Medicine and Dept. of Respiratory.

Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Centre.

Results: Serum urea and creatinine significantly raised in ICU patients as compare to ward patients while sodium, potassium and chloride were insignificantly increased in ICU patients.

Table 1 shows the D-dimer was also increased in ICU patients (3.45±2.76) as compare to the ward patients (1.49±2.13). D-Dimer is significantly increased in ICU patients (P=0.0071). As we can see in above table the level of Pro-BNP were highly significantly raised in ICU patients as compare to the ward patients (P = 0.0001). While level of Trop T insignificantly increased in ICU patients (P=0.8732).

Conclusion: Several indicators, such as elevated leukocyte and CRP, LDH, and deranged urea/creatinine, were identified to be most likely correlated factors with disease incidence and mortality in our study. So are lower bicarbonate levels. However, acute liver and kidney injury are more common in COVID-19 patients.

Open Access Original Research Article

Understanding Patients Experiences Living with Diabetes Mellitus: A Qualitative Study, Gujarat, India

Angel Christian, Kailash Nagar

Journal of Pharmaceutical Research International, Page 464-471
DOI: 10.9734/jpri/2021/v33i58A34139

Introduction: Diabetes mellitus is leading health problem in India. India is experiencing the burden of communicable disease as well as non-communicable disease. It is believed due to unhealthy life style and faulty food habits. The International Diabetes Federation estimated that 72.9 million adults in India were living with diabetes in last four years. The study overviews the different factors like personal, familial, social, and financial affecting the life style and management of the disease.  Thus, diabetes mellitus affects all the dimensions of health of an individual. The aims of the study to assess quality of life and experiences faced by the patients who are suffering from diabetes mellitus and how the progressive stage of the diseases altered the all the dimensions.

Objectives:

  1. To explore the lived in experiences of diabetes mellitus patients.
  2. To explore the various dimensions of the lived in experiences of diabetes mellitus patients.

Materials and Methods: A qualitative, exploratory and descriptive design was used to explore and describe the experiences lived by participants suffering from diabetes in the selected areas of Kheda district Gujarat. The investigator used the phenomenological approach of the qualitative paradigm. The study conducted among 10 samples who are suffering from Diabetes Mellitus more than 07 years, sampling technique used was non-probability. Semi structured interview questions were used to conduct the detail history from the participants, where investigator has attain at least 6 to 8 sitting, (duration 30-45 Min.) with each participants. The investigator used local language for the interview and recorded in mobile, later all the recorded session has been verbatim according to the themes and sub-themes.

Results: The study resulted in the extraction of six themes, which reflect the experiences of the study participants. The themes are: 1) lived time; 2) lived body; 3) lived relationship; 4) lived economical; 5) lived vocational and 6) lived spiritual. It was found that diabetes still causes participants to suffer from fear, depression and anxiety along with they hate to have modification in dietary pattern in which they cannot have sweets and sweet products. Although emotional support was provided by the family members and friends. Participant’s absence from work in their early diagnosis was due to both their health conditions and emotional embarrassment. There are evidences that diabetes has psychological damage to patient’s life and so they feel more anxious and fatigue.

Conclusion: The study attempted to explore the lived in experiences of Diabetes Mellitus Patients and it was found that DM has affected all the dimensions of health especially in physical, psychological and economical dimensions. 1) In Physical dimension the patients were having common complaints of giddiness, weakness and headache which was leading them to certain problems. 2) In psychological dimension the patients were having more anxiety, fear regarding the disease and long term treatment along with depression. 3) In economical dimension some patients were having good family income so there were no issues related to expenses on diet and medication 4) In social dimension all the participants were having good relation with their everyone. 5) In vocational dimension all were having difficulty at work place to concentrate in their work but after starting the treatment their health was improved so later they continued their work properly. 6) In spiritual dimension only two participants were not having belief in God rest all were having faith in God and prayed daily.

Open Access Original Research Article

Prevalence of Computer Vision Syndrome in School Going Children During COVID Era

Shruti Sanghavi, Ankur Sanghavi, Chetan Saoji, Sonal Muley, Sachin Daigwane

Journal of Pharmaceutical Research International, Page 472-477
DOI: 10.9734/jpri/2021/v33i58A34140

Background: Prolonged use of electronic devices poses a significant risk of Computer vision syndrome (CVS). Computer Vision syndrome is emerging as the next unexpected epidemic of the COVID era. Almost all children attending regular online schools are suffering from mild to severe Computer vision syndrome. Besides health problems, CVS also results in concentrate difficulties in studies and decrease a child’s performance. Awareness regarding CVS is increasing among folks of all ages since it has hit not just school going children but their parents as well who are pursuing work from home.

Materials and Methods: From March 2020 to March 2021, a multidisciplinary study was conducted to look at the increase in CVS and related factors among school-age children in School of Scholars, Nagpur taking online classes. The randomized controlled trial was used to select 600-school aged children between the ages of 8 and 17, and data was collected using a systematic questionnaire completed by the children's parents.

Results: CVS was found in 345 (57.5%) of the 600 children studied, which is very concerning. With proportions of 83.50 percent, 66.33 percent, and 62.17 percent, respectively, the most common reported signs of CVS were eyestrain, eye inflammation, and eye pain. CVS are linked to daily screen use and pre-existing eye disorder.

Conclusion: To deter CVS, it is critical to reduce screen time, improve parent and child understanding of safety precautions, and receive management support. To protect a child's overall well-being, we encourage policymakers and parents to restrict e-learning, since it will never be a suitable replacement for conventional classroom instruction.

Open Access Original Research Article

Stem Cells from Human Exfoliated Deciduous Teeth Differentiation and Characterization in to Islet like Pancreatic Cell Lineages – An Ex-vivo and In-vitro Study

Jaiganesh Inbanathan, Chandrasekaran Krithika, K. Ponnazhagan, Srividhya Srinivasan, P. Manodh, M. R. Sanjana

Journal of Pharmaceutical Research International, Page 485-496
DOI: 10.9734/jpri/2021/v33i58A34142

Background and Objectives: Stem cells from human exfoliated deciduous teeth (SHEDs) have been demonstrated as a novel population of adult stem cells capable of multi-differentiation potential.

Methods: Study samples comprise of 30 extracted exfoliating primary teeth collected from children aged 6 to 14 years. After attaining the required cell passage, flowcytometric analysis and trilineage differentiation was done to characterize SHEDs. Further SHEDs were differentiated into Islet like cell aggregates (ICAs) using Serum free media A,B&C. Differentiated ICAs were characterized by RT-PCR, immunocytochemistry, DTZ stain and insulin assay.

Results: Flowcytometric analysis of SHEDs showed expression of positive markers CD73, CD90 while no expression of negative markers CD34, CD45 and HLA-DR. Isolated SHEDs had the potential to differentiate into tri-lineages and ICAs. RT-PCR analysis of derived ICAs showed up-regulated expression of GAPDH, insulin, Glut2, PDX1 and PAX6. Immunofluorescence analysis gave expression of Ngn3, Isl-1, C-peptide, Glut2 and PDX1. DTZ stained positive on derived ICAs.Insulin secretion of SHED derived ICAs were measured 26 ± 6 MIU/L at basal glucose level, 128±3 MIU/L and 240 ±9 MIU/L at stimulated glucose level which gave a statistically significant difference in mean value of insulin secreted in different concentration of glucose (p<0.001). The net insulin secretion value of SHED derived ICAs at different glucose concentration was less when compared with Min 6 cells used as positive control.

Interpretation and Conclusion: Stem cells from Human Exfoliated Deciduous teeth are mesenchymal stem cells which has the unique potential to differentiate into islet like cell aggregates and serve as a promising source of insulin which under standardized protocols and experimentations can be used for stem cell based therapy for insulin dependent diabetes mellitus.

Open Access Original Research Article

Study of TNF-α, IL-6 and Insulin Resistance in Type 2 Diabetes Mellitus at Vidharbha Region

Ankita Kondhalkar, Rajan Barokar, Prajakta Warjukar, Roshan Kumar Jha

Journal of Pharmaceutical Research International, Page 534-539
DOI: 10.9734/jpri/2021/v33i58A34149

Background: DM is a metabolic condition caused by deficiencies in insulin synthesis, insulin action, or both. It is characterised by chronic hyperglycemia and glycosuria, as well as abnormalities in carbohydrate, fat, and protein metabolism. Diabetes and its complications are believed to be caused by a variety of causes. Genetics, diet, sedentary lifestyle, perinatal causes, age, and obesity are among them.  The relationship and interaction of various risk factors with disease severity is still unknown, so the aim of the proposed study was to determine the possible relationship between biochemical markers glycosylated haemoglobin, lipid profile, insulin resistance, and immunological markers TNF- and IL-6, in order to suggest appropriate measures to reduce the country's diabetes burden.

Materials and Methods: A total of 300 people were chosen for the study after visiting Shalinitai Meghe hospital in Nagpur for a health check-up. The three groups were contained in this area.

Results: Both biochemical and immunological parameters rose in managed diabetic patients and significantly increased in uncontrolled diabetic patients, according to the report, but values did not differ between groups 1.

Conclusion: Low-grade inflammation and inflammatory mediator upregulation have been suggested to play a role in T2DM etiology. TNF- and IL-6 have a positive connection with T2DM and insulin sensitivity, according to our data. These can be used as T2DM biomarkers in the early stages of the disease. To help doctors monitor and treat T2DM successfully, more research on a larger spectrum of pro and anti-inflammatory cytokines (mediators) in conjunction with other biochemical, immunoassay, and hematological markers is needed.

Open Access Original Research Article

The Effect of Obesity, Hypertension and Diabetes on Health-related Quality of Life among the Elderly in Saudi Arabia's Eastern Province

Othman Al Mulhim, Salman Abdulrahman Alhumud

Journal of Pharmaceutical Research International, Page 540-556
DOI: 10.9734/jpri/2021/v33i58A34150

Aims: This study explores the cumulative effects of cardiovascular risk factors on the health-related quality of life (HRQL) among the elderly.

Study Design: Our study comprises a cross-sectional design.

Place and Duration of Study: The Nov 2021 population-based research represents the Saudi Eastern Province population aged 60 years and above.

Methodology: Information was collected through home-based personal interviews using a structured questionnaire on the participants' health. The participants provided informed verbal consent. On each scale of the SF-36 questionnaire, multiple linear regression examined the relationships between obesity, hypertension, diabetes and HRQL after adjusting for sociodemographic data and lifestyle factors.

Results: Diabetes and hypertension registered the worst HRQL among males on all the scales (‒53.8 to ‒22.0 points according to the scale) in the two-factor cluster and male clusters except social functioning and role-emotional. Obesity and diabetes registered the worst HRQL on all the scales (–24.4 to –40.4 points according to the scale) in the two-factor female cluster except physical functioning, bodily pain and general health, and on all scales in female clusters except physical functioning, bodily pain, general health, social functioning and role-emotional.

Conclusion: Our study shows that obesity, hypertension and diabetes (as separate factors and in combination) negatively affect HRQL.

Open Access Original Research Article

Oral Submucous Fibrosis – A Clinicopathological Correlation

R. Sudarshan

Journal of Pharmaceutical Research International, Page 589-594
DOI: 10.9734/jpri/2021/v33i58A34155

Objective: Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder of the oral mucosa and collagen metabolic disorder caused by betel nut use. Diagnosis of this condition can be made clinically, but ascertaining its malignant transformation histopathology is mandatory. So, the correlation between the clinical and histopathology was conducted.

Materials and Methods: The correlation study was conducted on 20 OSMF patients. Clinical diagnosis with histopathological confirmation was based on the standard approach. Study structure included gender, duration, frequency, and quid placement correlated with clinical and histopathological staging.

Results: The current study has included most of the subjects being males and was below 25 years. Habit duration, frequency, and quid placement were correlated with clinical and histopathological staging and were directly related. Six subjects of (30%) Group 1 cases associated with 3 (42.9%) in the histologically early stage of the disease. Further, 14 (70%) cases in Group 2 clinical staging correlated with 8 (88.9%) cases in moderately advanced histological staging.

Conclusion: The clinical and histopathological correlation was not obtained in the present study. The negative p-value could be because of certain factors like biopsy site selection and decreased study subjects. However, factors like frequency and quid keeping had a positive histopathological correlation.

Open Access Original Research Article

A Study to Assess the Effectiveness of Planned Teaching Programme on the Knowledge Regarding Management of Pre-Eclampsia among Antenatal Mothers

Mahesh K. Chaudhari, Shiwani P. Dandade, Saurabh D. Borkar, Shivani K. Borkar, Archana Teltumbde

Journal of Pharmaceutical Research International, Page 595-603
DOI: 10.9734/jpri/2021/v33i58A34156

Background of the Study: Pre-eclampsia is a multisystem disorder with an unknown aetiology that appears as hypertension of 140/90 mm hg or higher with proteinuria after the 20th week in a previously normotensive and non-proteinuric woman. Pre-eclampsia is unique among hypertension illnesses in terms of the effects it has on maternal and newborn health. It is a leading cause of maternal and neonatal mortality and morbidity around the world.

Objectives of the Study: 1. To assess the existing knowledge regarding pre-eclampsia among antenatal mothers. 2. To evaluate the effectiveness of planned teaching on knowledge regarding pre-eclampsia among antenatal mothers. 3. To find out the association between knowledge score with selected Demographic variables.

Materials and Methods: 100 samples were taken from selected Hospital Wardha by Non probability sampling technique. Research design descriptive survey was used. Statistical compare ANOVA and t-test formula used.

Results: In pre test Antenatal mothers have 65% fair knowledge regarding pre-eclampsia , and mean knowledge score was 2.02%. In post-test of Antenatal mothers have 52% Excellent knowledge and mean knowledge score was 0.97 % regarding management of pre-eclampsia.

Conclusion: It is concluded that In Pre – test level of knowledge score fair was 65 % and mean knowledge score was 2.02 % And In Post - test level of knowledge score excellent was 52 % andmean knowledge score was 0.97 %. Study conclude that their is lack of knowledge of Pre-eclampsia among antenatal mothers. After the completion of the study it is revealed that the planned teaching program was effective in gaining the knowledge regarding management of pre-eclampsia among antenatal mothers. It can improve their health status and prevent from sideeffect.

Open Access Original Research Article

Knowledge, Attitude and Practice of Dental Practitioners towards Screening for Oral Pre-Cancer and Cancer

J. Manju, Chandrasekaran Krithika

Journal of Pharmaceutical Research International, Page 604-611
DOI: 10.9734/jpri/2021/v33i58A34157

One of the global health issues is Oral cancer, which has an increased death rate. Awareness of oral cancer screening is important for oral health care professionals for early detection and improving the patients' survival rate. Attitude towards oral cancer awareness and knowledge of oral cancer screening are the key factors that impact oral cancer awareness success.

Materials and Methods: To assess the knowledge, attitude, and practice of dental practitioners and dental students towards screening for oral pre-cancer and cancer. This study included dental practitioners working in various academic institutions and private practitioners in Chennai. Participants were asked to fill in age, gender, designation, and experience. A structured questionnaire consisting of 10 questions, each having four options, was administered to the participants. The data collected was 100 responses analyzed by statistical package for the social science (spss inc., version 16 for, Chicago, IL, USA). Simple descriptive statistics were used to describe the distribution of data collected. T-test and ANOVA were employed to assess the statistically significant difference in the KAP scores between different groups.

Results: The response rate for the present study was 100%. 37% of general dental practitioners reported that they routinely do a thorough oral examination for all the patients,52% agree that they are adequately trained to examine patients for oral pre-cancer and cancer screening,8% of them reported that they never do toluidine blue staining for patients with oral lesion. Majority(57) of them agree that they would recommend biopsy for suspected cases of oral cancer. Only 9% of the participants were aware of the time required for intraoral screening examination. 31% of them were aware of the risk of malignant transformation in a white lesion. 73% of the participants were aware of the occurrence of oral cancer in non - tobacco users was rare. 53% of agree that thorough intraoral examination for oral cancer will reduce oral cancer mortality and morbidity.

Open Access Original Research Article

Assessment of Proximal Radio-median Cubital/Radio-Cephalic Arterio-venous Fistula

Jawed Akther, Y. R. Lamture, Varsha P. Gajbhiye, Ranjit Ambad, Aditya V. Ghunage

Journal of Pharmaceutical Research International, Page 612-619
DOI: 10.9734/jpri/2021/v33i58A34158

The present study aims to conducted the Assessment of Proximal radio-median cubital/radio-cephalic Arterio-venous Fistula. Arterio-venous Fistula is life line for long-term hemodialysis for end stage renal disease patients. The order of preference as per National Kidney Foundation/ Kidney Disease Out Come Quality Initiative (KDOQI) is distal Radio Cephalic fistula is considered as gold standard followed by elbow Brachio Cephalic Fistula, transposed Brachio-Basilic Fistula, forearm arterio-venous graft. This is a cross sectional-prospective interventional study, 05/2017 to 04/2019, JNMC, Wardha, MH, with sample size of 66 cases. Out of 66 cases 25 % patients had diabetes mellitus, 48% cases were suffering from chronic glomerulonephritis, 15 % cases were suffering hypertension, 6 % cases had COPD and another 6 % cases had some cardiovascular disease. About 54 % cases had previous access failure. In our study the mean flow volume for AV fistula in proximal forearm was 485± 291 ml/minon postoperative day1, 695 ± 298 on postoperative day 7 and 755± 347 ml/min. Overall postoperative complications in 12% cases was reported in our case study though Yilmiz et al reported postoperative complications in 15% cases.

Open Access Original Research Article

Novel UV Spectrophotometer Methods for Quantitative Estimation of Empagliflozin (EMPA) and Linagliptin (Lina) Using Mixed Hydrotropy Solubilization

Udai Bhan Singh Rathore, Pradeep Kumar Goyal

Journal of Pharmaceutical Research International, Page 620-627
DOI: 10.9734/jpri/2021/v33i58A34159

Simple, precise accurate, novel  and safe UV-Spectrophotometric simultaneous equation method developed for the simultaneous estimation of poorly water-soluble drugs Empagliflozin (EMPA) and Linagliptin (LINA) in tablet dosage form using 2M ammonium acetate: 2M sodium citrate and (50:50% W/W) as mixed hydrotropic solution and validated as per ICH guidelines. This Method involves solving of simultaneous equations based on measurement of absorbance at two wavelengths 270 nm and 294 nm (λmax of EMPA and LINA) in hydrotropic solutions. Ammonium acetate and sodium citrate solution did not show any absorbance above 240 nm and thus no interference in the estimation of drugs was seen. EMPA and LINA follow Beers law in the concentration range of 10-50mg/ml and 5-25mg/ml (r2 = 0.999). % Recovery for both the drugs was in the range of 98.50 to99.23 % indicating excellent accuracy. The methods were precise, with a relative standard deviation of less than 2% for both drugs. The developed methods were validated according to ICH guidelines and values of accuracy, precision and other statistical analysis were found to be in good accordance with the prescribed values. Thus, method can be used for routine monitoring of drugs in industry for the assay of bulk drugs and commercial formulation.

Open Access Review Article

Causes and Management of Acute Pyelonephritis

Mohammed Salah Hussein, Jawaher Abdullah Almukalaf, Saad Mohammed Alalyani, Rayan Mofareh Alharbi, Wejdan Ibrahim Alzahrani, Duaa Salah Aldhubiani, Adel Ali Khubrani, Ziad Mofareh Alharbi, Leena Saqer Alotaibi, Zainab Mohamed Alradhi, Ghoson ghonem Alharbi, Rumyyan Abdulaziz Rumyyan Alrumyyan

Journal of Pharmaceutical Research International, Page 13-19
DOI: 10.9734/jpri/2021/v33i58A34083

Acute pyelonephritis is a bacterial infection that causes kidney inflammation. Pyelonephritis is a kidney infection that develops as a result of an ascending urinary tract infection that travels from the bladder to the kidneys. Acute pyelonephritis affects over 250,000 people each year, resulting in more than 100,000 hospitalizations. Infection with Escherichia coli is the most prevalent cause. Fever, vomiting, abdomen or loin discomfort, and fatigue are all symptoms of acute pyelonephritis, however Fever is the most clinically useful symptom. Escherichia coli is the causative agent in more than 80% of instances of acute pyelonephritis. Staphylococcus saprophyticus, and enterococci are among the other etiologic factors. While Infections caused by Klebsiella, Enterobacter, Clostridium, or Candida are more common in diabetic patients. Acute pyelonephritis can be treated as an outpatient or as an inpatient procedure. Outpatient treatment is available for healthy, young, non-pregnant women with uncomplicated pyelonephritis. The choice of first-line oral antibiotics depends on local antibiotic resistance characteristics, although trimethoprim alone or in combination with sulphamethoxazole, cephalexin, or amoxicillin-clavulanic acid. In this article we will be looking the causes and management of acute pyelonephritis.

Open Access Review Article

Suicide and Suicidal Tendency in Primary Care Setting; Review Article

Faisal Suliman Algaows, Sarah Salman Alhussain, Joud Bandar Damanhori, Alzahrani Amjad Ahmed H., Alghamdi, Ahmed Hamed A, Alshardan, Ali Mesfer, Shahad Emad Aldakhil, Salwa Mohammed Majrashi, Alanazi, Shahad Hussain, Alzahrani, Majed Khidhran M., Naif Abdullah Sultan Albaqami

Journal of Pharmaceutical Research International, Page 60-73
DOI: 10.9734/jpri/2021/v33i58A34090

Suicide is critical public health problem that primary care physicians potentially can help address given that concerned patients frequently visit them in the weeks and months preceding the successful suicide. This article contemplates issues placing the patient at high risk for successful suicide and clinical valuation techniques available to the primary care physician. Patients identified as being at risk of attractive suicidal or those who have a equal of suicidal ideation or behavior judged apposite for management in the primary care setting should be monitored for risk at regular intervals. It is extremely significant to learn about and try to contextualize the patients' emotions that triggered the present crisis. Nurses can make sure that they have a thorough understanding of the present acuity, and all of the precipitating factors, and can exactly and collaboratively communicate with the caregivers and other involved medical teams.

Open Access Review Article

The awareness of Cervical Cancer Screening among Appalachian Women: Review Article

Faisal Suliman Algaows, Yara Saeed Jazzar, Mohammed Hassan Almalki, Shahad Bandar Almeqbel, Raghad Abdulrahman Almughazzawi, Maitham Jaber Abdullah Aljaber, Reem Yahya Mousali, Mohammed Falah Alharbi, Abdullah Mohammed Alshahrani, Issa Mohammad Alkhonain, Fahad Obaidallah B. Alharbi

Journal of Pharmaceutical Research International, Page 74-82
DOI: 10.9734/jpri/2021/v33i58A34091

There is a long tradition of negative experiences with cancer among Appalachian women that manifests as avoidance behaviors in seeking screening and follow up because of fear of a cancer diagnosis. The avoidance is usually seen as ‘passive refusal,’ but also occurs in an active form as refusal to obtain services even when offered. This problem is compounded by poverty, which influences many parts of life and is associated with lack of transportation, child care, and exclusive reliance on public health departments and other safety net health care providers to seek cancer screening. Pap tests have reduced the annual incidence cervical cancers.

The study aims to overview cervical cancer methods and recommendations among women in reproductive age.

Open Access Review Article

Artificial Intelligence in Diagnosis of Oral Potentially Malignant Lesions- Need of the Hour

Abhilasha Chapade, Kumar Gaurav Chhabra, Amit Reche, Priyanka Paul Madhu

Journal of Pharmaceutical Research International, Page 83-90
DOI: 10.9734/jpri/2021/v33i58A34092

Artificial intelligence (AI) is a technological breakthrough that is rapidly progressing and has captivated the minds of researchers all over the world. AI can be used to make a diagnosis of oral cavity lesions, detect and identify suspicious changed oral mucosa undergoing premalignant and malignant transformations. The purpose of this review is to give a comprehensive summary of developing optical imaging technologies, innovative artificial intelligence-based techniques. The concepts of image-based techniques for identifying oral cancer are defined in terms of clinical requirements and features. Although artificial intelligence (AI) is beginning to have a significant impact on increasing diagnosis accuracy in a variety of fields of medicine, there has been limited research on oral cancer to date. These results suggest that combining artificial intelligence with imaging can improve oral cancer outcomes, applications ranging from very low-cost oral cancer screening with Smartphone-based probes to algorithm-guided identification premalignant lesion heterogeneity and margins using optical coherence tomography. Oral cancer outcomes can be improved by combining imaging and artificial intelligence technologies for better detection and diagnosis.

Open Access Review Article

Birth Control: A Review of Pharmacological and Non-pharmacological Modalities, Associated Pros and Cons, and Their Effectiveness

Maryam Fairag, Malak ALGhamdi, Abdulaziz Baghlaf, Bader Alallah, Turki Alharbi, Shakr Alwani, Ahmed Alshareef, Raad Alharbi, Omar Alsaedi, Abdulaziz Almehmadi, Norah Alamri, Sarah Aljumah, Malak Almutairi

Journal of Pharmaceutical Research International, Page 225-232
DOI: 10.9734/jpri/2021/v33i58A34110

Introduction: Family planning importance is increasing progressively and is regarded as an essential part in every couple’s life. Family planning has a lot of benefits for the whole family as it provides a better control over the period between each pregnancy leading to a better balance over the personal, financial, and societal life. There are multiple birth control methods, from which couples can choose from with the assistance of their physicians since each method has its own advantages and disadvantages. Furthermore, some contraceptive methods may be more suited for a certain couple or situation than another one. This review of current methods aims to shed the lights on the various contraception options along with their advantages and disadvantages to aid providers in taking care of their patients.

Methodology: A thorough search was carried out on PubMed using the most suitable keywords representing the aim of the present study. A total of 120 were found and based on whether they are suited to achieve the aim of the study, 28 were selected.

Discussion: There is a great variety of birth control methods, and each has its associated advantages and disadvantages. Barrier contraceptive methods, most common of which are male condoms, are extremely popular in Western countries. Combined hormonal contraception methods which are available in the form of pills, patches, and rings. Progestin only contraception either in the form of a pill, injection or an implant is the most commonly used type among breastfeeding women. Furthermore, intrauterine devices are another effective contraceptive method which may be copper-based or hormonal-based.

Conclusion: Contraception is an integral part of family planning, which can be achieved through a variety of methods. Each birth control method has its own pros and cons that should be explained to the couple clearly, so they can choose the method that is most suited for them.

Open Access Review Article

Clinical Manifestation of COVID-19 in General Age Group: A Review

Shringarika Prakash

Journal of Pharmaceutical Research International, Page 263-269
DOI: 10.9734/jpri/2021/v33i58A34115

Background: COVID-19 is the disease caused by SARS-COV-2 or novel coronavirus. It is extremely contagious and has capability to produce severe clinical outcomes.

Summary: Clinical manifestations of coronavirus disease 2019 or COVID-19 is different for different age groups. The general trend is that the chance of contraction and severe clinical outcome after infection increases with increase in age. The vulnerable section which is going through their immunosuppressive state must be cautious as they need to be protected more than any age group of the population.

Conclusion: More study needs to be done to find out the vulnerable groups and nuances attached between COVID-19 and clinical manifestation in them.

Open Access Review Article

Metronidazole-induced Metallic Taste: A Systematic Review and Meta-Analysis

Hani Raka Karrar, Mahmoud Ismail Nouh, Rehab Salah Aldin Alhendi, Yousef Ismail Nouh, Mawadah Ismaeel Nooh, Ramlah Abdulfattah Almansour, Yahya Hasan Alayafi, Baidaa Talal Alharthy, Sarah Khalid Albarrak, Hanin Ali Alshame

Journal of Pharmaceutical Research International, Page 307-317
DOI: 10.9734/jpri/2021/v33i58A34120

Aims: This study aimed to estimate the incidence rate of metallic taste side effects in a patient who received metronidazole versus tinidazole and link it to the safety profile for metronidazole.

Study Design: Systematic Review and Meta-Analysis.

Place and Duration of Study: This study where written and revised in the pharmaceutical care department at general network for healthcare providers Hospital, Jeddah, Saudi Arabia. between Mar 2021 and Dec 2021.

Methodology: Literature searches were conducted in the following databases: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Statistical analysis was performed using Review Manager (RevMan) Version 5.4 software.

Results: Our meta-analysis of randomized controlled trials studies confirm that there is a slight increase in the rate of metallic taste adverse effects. Around one-fifth of patients who were treated with tinidazole had developed an incidence rate (5.1%) higher than the patient who treated with metronidazole. Our data shows that the incidence rate of metallic taste adverse effects in patients who received metronidazole was 15.5% (58/373) while the incidence rate in patients who received tinidazole was 20.6% (104/505). But the overall rate of metallic taste adverse effects was not statistically significantly different (RR, 1.07; 95% CI, 0.45 to 2.55; P = 0.87). also, there was statistical heterogeneity in the included studies (I2 = 75%).

Conclusion: In our meta-analysis, the incidence rate of metronidazole-associated metallic taste adverse effects was slightly lower than the incidence rate of tinidazole-associated metallic taste adverse effects. It is not statistically significant as the result shows but still shifting the patient to metronidazole instead of tinidazole may decrease the incidence rate of metallic taste by (5.1%) and give good coverage for the microbial than tinidazole.

Open Access Review Article

Telehealth for COVID-19 Pandemic

Pratik Agrawal

Journal of Pharmaceutical Research International, Page 318-324
DOI: 10.9734/jpri/2021/v33i58A34121

The COVID-19 epidemic has caused huge strain on health infrastructure. In this pandemic, burden on healthcare workforce is rising, as there was need to give treatment, observing, and subsequent follow-ups during the epidemic. Consequently, the Covid-19 pandemic has profoundly affected healthcare. Clinical focuses are presently reacting to CORONA VIRUS 19 through fast appropriation of advanced devices and advances, for example, Tele health and effective consideration which allude to the conveyance of medical care directing computerized or a ways off utilizing Information and Communications Technology (ICT) for therapy of One still living. Tele health was required to convey opportune consideration while limiting openness to secure clinical professionals and One still living. In like manner, a quick writing audit was led, and 35 examination contemplates distributed from 2019 to May 2020 were utilized to give hypothetical and functional proof on the hugeness of utilizing Tele health and effective consideration for far off treatment of One still living during the CORONA VIRUS 19epidemic. This article gives down to earth manage dependent on the best way to utilize Tele health and effective consideration during the CORONA VIRUS 19 epidemic. This investigation gives suggestion on the possibilities of combining effective consideration arrangements soon towards adding to incorporate advanced innovations into medical services.

Materials and Methods: The material required for the review was taken from the databases of PubMed, Web of science,the from the website of World Health Organization and the patients data of SMHRC and DMMC Wanadongari Nagpur.

Open Access Review Article

Causes and Management of Recurrent Pregnancy Loss, a Review

Mazen Bishrah, Alabdullah, Walaa Abdulhadi, Alserehi, Fatimah Omar M., Alanood Khalid Alansari, Ghada Abdulhai Alhindi, Melebary, Talal Basheer, Amani Nabil Yamani, Almojel, Shaden Abdulmohsin A., Saad Aied Saeed Abohasel, Abutaleb, Atheer Ahmed H., Banan Ali Ahmed Mahdi, Salam Atif Sait, Lamya essa Alotaibi, Tagwa hassan mabrouk Mustafa

Journal of Pharmaceutical Research International, Page 325-330
DOI: 10.9734/jpri/2021/v33i58A34122

Recurrent Pregnancy Loss (RPL) is defined as two or more consecutive failed clinical pregnancies verified by ultrasound or histopathology. It is an important reproductive health issue, affecting 2%–5% of women. Up to one half of all cases of RPL have no identifiable cause. Etiology of the RPL is linked to several genetic, environmental, endocrinal, and anatomic factors which all will be discussed in this article. Treatment of RPL depends on the underlying cause behind it, and thus diagnosis and identifying of such factors plays major role into treating it. Lifestyle changes also is encouraged. Stress, smoking, drinking cessation, and weight loss can be all helpful. In this article we’ll be looking at RPL causes, and management.

Open Access Review Article

Identification, Prevention and Treatment of Drug Toxicity in the Primary Care Settings

Abrar Abdulfattah Al Yamani, Faisal Musaad Alhoshan, Ali Salem Alhamidah, Ghada Saleh Albalawi, Saeed Abdullah Almalki, Asrar Abdalh Alanazi, Abdullah Mohammed Alassiri, Abdulaziz Saud Alasmari, Aqeelh Mohammed Albaharna, Anwaar Saud Aloufi, Arwa Abdulmajid Hussain

Journal of Pharmaceutical Research International, Page 359-364
DOI: 10.9734/jpri/2021/v33i58A34127

Studies from global countries indicate that poisoning is a common etiology for morbidities and associated mortality. Most of the cases did not require medical intervention as they were treated at home. However, around one-fourth required management at a healthcare facility. In addition to the healthcare burdens, evidence indicates that these events also have significant economic burdens on the affected patients and healthcare facilities. The present literature review provided evidence regarding the proper ways to identify patients presenting with suspected medication poisoning and the recommended management approaches. Obtaining a complete history from the patient should be the first step that can lead to diagnostic clues. Then, a thorough examination should be provided, followed by relevant imaging and laboratory studies to confirm the diagnosis. Management might be supportive in many cases, and an antidote can enhance the treatment process. Approaches should also be conducted to achieve decontamination and enhance the elimination of the affected patients.

Open Access Review Article

Pharmacognostical Profile of Gymnema sylvestre and its Anti-Hyperglycemic Activity

Sorabh Sehajpal, Rohit Saraswat, Neetu Verma

Journal of Pharmaceutical Research International, Page 365-376
DOI: 10.9734/jpri/2021/v33i58A34128

In this paper explored the pharmacognostical profile of gymnema sylvestre and its anti-hyperglycemic activity has been documented well with references. The importance of the species in Ayurveda has been highlighted. The bioactive components like gymnema sylvestre has a variety of secondary metabolites, including oleanane, gymnemic acid, gymnemasides (A-F), gymnemic acid (IXVIII) homologue, gymnemic acid A1 and its derivatives, triterpenoidsaponin, al has been clearly includedin the review kaloid (Conduritol-A), polypeptide (Gurmarin), and gymnemasaponins. This study has provided the groundwork for developing a pharmacognostical profile of medicinal plant growers and collectors. The goal of this review study is to provide a regional profile of the indigenous knowledge system for medicinal plant usage and cultural behaviors related to healing. This study aids in the identification of novel ethnomedicinal plant species in the study region, which may lead to the development of new medicines. The plant toxicity test results indicated that it may be used as an alternative to diabetes therapy with no or little adverse effects. This study confirms the conventional use of indigenous plant-derived natural medicine for treating diabetes mellitus. The study also highlighted the efficacy of "Ayurveda" which is an ancient tradition, used in some parts of India. This ancient concept should be carefully evaluated in the light of modern medical science and can be utilized partially if found suitable. I hope that this kind of research will be useful to future researchers as per their needs.

Open Access Review Article

A Review of Lactoferrin Inflammatory Role in Type 2 Diabetes Mellitus with Neutrophil Dysfunction

Amani Y. Alhalwani

Journal of Pharmaceutical Research International, Page 377-390
DOI: 10.9734/jpri/2021/v33i58A34129

Lactoferrin (LF) is a protein that plays important roles in many diseases including diabetes mellitus (DM). DM is one of the most challenging health concerns of the 21st century. At least 30% of the diabetic population is undiagnosed at any one time, so effective and early diagnosis is of critical concern. Several of the body’s chemicals, such as enzymes, electrolytes, and proteins, have been used as biomarkers in the diagnosis of diabetic diseases. Detection of LF is considered an important sign of type 2 diabetes (T2DM), due to its activity as an anti-inflammatory agent and in the down-regulation of pro-inflammation. LF is produced by glandular epithelial cells and neutrophils, and a decrease in its concentration is linked with the dysfunction of neutrophils in many diseases. Neutrophils are the first line of defence against pathogens that invade the human body during inflammation. Therefore, the health of neutrophils can be employed as a biomarker in the diagnosis of diseases such as diabetes. A decrease in LF concentrations in T2DM could result in increased levels of inflammatory markers that are associated with the inflammation activity. Increased understanding of the link between LF concentration and development of T2DM should improve early diagnosis and treatment outcomes.

LF is identified through use of various techniques such as immunoassay, proteomics, and spectrometry. The aim of this review is to summarise each pathway and some of the most relevant LF biomarkers that may be used to monitor the development or progression of diabetes and its complications, and the link between levels of LF and neutrophil dysfunction in T2DM. Moreover, the objective of this review is to show the most common LF analysis that may be useful in the clinical diagnosis of T2DM and discuss to what extent this analysis method can be a tool for prognostic and diagnostic work.

Open Access Review Article

Role of Public Awareness Ensuring the Sustainability of Arsenic Mitigation

Sovan Kumar Singha, Deb Prasad Sikdar

Journal of Pharmaceutical Research International, Page 391-404
DOI: 10.9734/jpri/2021/v33i58A34130

Arsenic poisoning is the largest mass poisoning in history. It causes numerous toxic effects to human health which ultimately leads to cancer or Alzheimer’s disease. Nearly 300 million people over 180 countries worldwide are suffering from the arsenic contaminated groundwater more than WHO directed limit. Despite of its potential fatal toxicities, there is no effective treatment for arsenicosis. Cost-effective arsenic removal technology is also a matter of considerable research. This study aimed to summarize the individual and social issues related to arsenic problem and the remedies suggested by different authors to cope with the adverse effects of arsenic. Reported studies emphasized that only mass awareness and mass education can stop the spreading of this disaster. This study will be helpful for future research on the awareness on arsenic contamination and studies on assessing behavior in different context. Policymakers may find it as helpful resource since it describes the problem from grass-roots level. Researchers’ of pharmaceuticals and medicines may be inspired to perform their research in this field.

Open Access Review Article

Overview on Malocclusion after Maxillofacial Trauma and Its Management

Ashwag Siddik Noorsaeed, Reham Salem Alzahrani, Lujain Hussain Aljurbua, Mohammed Fouad Sheayria, Siefuddin Abdulaziz Bokhari, Faisal Eisa Althaqafi, M. Alsunaydan, Sarah Fahad, Saba Abdulelah M. Lanqa

Journal of Pharmaceutical Research International, Page 405-411
DOI: 10.9734/jpri/2021/v33i58A34131

Malocclusion is one of the most common and often difficult-to-manage complications associated with post-traumatic maxillofacial injury. Maxillofacial injury is considered an important health problem worldwide. Such injuries most often have significant financial consequences and result in deformity of facial aesthetics, loss of function, and increased incidence of other health problems. Many common treatment approaches are extraction of teeth, occlusal adjustments, functional therapy, or a combination of these. An appropriate treatment plan should typically involve orthodontic treatment because it can prevent multi-segment upper jaw operations and stabilize the arches by coordinating and aligning them. The most common and important form of post traumatic malocclusion is malocclusion secondary to condylar fractures. Patient may complain of an open bite with functional disturbances, facial asymmetry. There is also improper alignment of teeth, frequent biting of the inner cheeks or tongue, discomfort when chewing or biting. Management approach of secondary malocclusion after maxillofacial trauma should include prosthetic treatment, orthodontic treatment, and implant-supported rehabilitation.

Open Access Review Article

Lower Respiratory Tract Infections in Primary Care, Review Article

Faisal Suliman Algaows, Bader Abdulwahab N. Alamer, Mohammed Abdulhafith R. Alotaibi, Zahra Nasser A. Aljubran, Bassam Zaal Hammad Alshammary, Nawaf Abdullah A. Alfaifi, Nasser Abdullah Aldawsari, Ahmed maashi helal Alanazi, Abdullah Mohammed Alwadai, Ahmed Ali M. Alayyafi, A. Alzarga Ibrahim Mohammad

Journal of Pharmaceutical Research International, Page 419-425
DOI: 10.9734/jpri/2021/v33i58A34133

Any infectious illness of the upper or lower respiratory tract is classified as a respiratory tract infection (RTI). Acute bronchitis, bronchiolitis, pneumonia, and tracheitis are examples of lower respiratory tract infections (LRTIs). The most prevalent cause of death from lower respiratory infections is pneumococcal pneumonia. Pneumonia is a major cause of death globally. new advances in pneumonia diagnosis and treatment have been made, identification of new pathogens as well as the development of newer therapeutic agents like fluoroquinolones, macrolides, streptogramins, oxazolidinones, and –actam antibiotics. Despite these advancements, respiratory tract infections continue to be a challenge in both the diagnostic and therapeutic domains. Because detecting and treating pneumonia may be difficult, a number of professional organizations have created treatment recommendations. In this review we’ll be looking at LRTIs and pneumonia epidemiology, etiology, diagnosis and treatment.

Open Access Review Article

COVID-19: The Pandemic Situation in the Context of India

Daksh Hardaswani

Journal of Pharmaceutical Research International, Page 456-463
DOI: 10.9734/jpri/2021/v33i58A34138

The novel corona virus disease (COVID-19) is a pandemic due to the global health crisis it has created in the world and greatest challenges that it has introduced in this 21ST century. COVID-19 is the the 5th pandemic which was first reported in Wuhan, China and gradually spread into the other parts of the world. This virus is a spillover of an animal virus and then also adapted the ability of transferring human to human. The virus is highly contagious due to rapid spread and constantly evolves in the human population.  COVID-19 pandemic is a lot more than just a health emergency, but it is also socio-economic because people are losing jobs and income. The COVID-19 disease affects physical and mental health due to isolation. Moreover, more and more countries are affecting the cases of COVID-19 which are rising very rapidly day by day.

Therefore, every country needs to several actions which accelerates their safety health, balance between the protection of health, prevent economic and social disruption due to this pandemic. In the spirit of the solidarity, we all need to be contributing our self to protect this situation. However, every country is equally responsible for determining the measures to prevent or decrease the viral transmission. Government authorizes also trying to act for reduce disease’s trajectory and they focus on develop the vaccination and therapeutic drugs. 

Aim: To find causes, symptoms, awareness, Prevention, and treatment of COVID-19.

Conclusion: The world is going by the critical situation and that is COVID-19 pandemic which is originated due to corona virus. Shortness of breath, fever and dry cough are most common symptoms of the novel corona virus. COVID-19 is highly contagious, so we must keep safe distance from other people and wear a mast hand wash our hands frequently. As it were together can we overcome the interwoven wellbeing and social and financial impacts of the widespread and anticipate its acceleration into an extended compassionate and nourishment security catastrophe, with the potential misfortune of as of now accomplished advancement picks up. 

Open Access Review Article

Otorhinolaryngological Manifestations in COVID-19: Review of Recent Evidence

Ameen Z. Alherabi, Bassam T. Alharthi, Jeehad M. Felemban, Hareth H. Alharthi, Mohammed T. Alrefai

Journal of Pharmaceutical Research International, Page 505-510
DOI: 10.9734/jpri/2021/v33i58A34144

Objectives: In this review we provide an updated concise review about the most common Otorhinolaryngological symptoms in COVID-19 patients.

Methods: A searched strategy designed on published literature in different large medical databases and journals using various keywords to get the recent described manifestations.

Results: 25 included studies that focused on ENT symptoms and involved the confirmed cases only. 6276 patients were accounted for the results which showed that the most prevalent ENT manifestation were cough in 3498 (56%) patients, headache in 2013 (32%) patients, sore throat in 1966 (31%) patients, anosmia in 1340 (21%) patients, loss of taste in 914 (15%) patients, and rhinorrhea in 196 (3%) patients.

Conclusion: Cough was the commonest symptoms which should raise the suspicion to do COVID-19 swab especially if associated with smell and taste disorder.

Open Access Review Article

How to Cope with Anxiety Due to the COVID-19 Pandemic?

Lavanya Vijay Doiphode, Pradip Jain, Swarupa Chakole

Journal of Pharmaceutical Research International, Page 511-514
DOI: 10.9734/jpri/2021/v33i58A34145

Background: The COVID-19 pandemic has had a major effect on our daily lives. It has not only changed our daily routines and practices but also our behaviour to various situations. Social distancing which is necessary to break chain of spread of COVID-19 pandemic is creating a feeling of loneliness and anxiety moreover daily reports and statistics of deaths and people tested positive are creating a sense of fear in the population. A sense of discomfort and fear created due COVID-19 and the inability to cope with the situation is COVID anxiety. People already suffering from depression and anxiety may be more vulnerable to COVID anxiety. Vaccination which was the need of hour is available now but there are many myths and misconceptions related to vaccination in general population.

Conclusion: During these uncertain times people are facing all kinds of emotions including grief, fear, sadness, worry, anxiety and having a positive outlook and attitude is very important during these times we cannot succumb to the pressure we need to fight back and emerge stronger and set an example for the future generations.

Open Access Review Article

Implication of Buteyko Breathing Technique in Asthmatic Population: A Literature Review

Saloni Patil, P. Shilna Rani, K. U. Dhanesh Kumar

Journal of Pharmaceutical Research International, Page 515-521
DOI: 10.9734/jpri/2021/v33i58A34146

Background: Complementary and experimental medicine is gaining interest in the treatment of asthma around the world. This study summarizes the literature on complementary and alternative medicine approaches that use breathing retraining, i.e Buteyko breathing technique (BBT) as a primary component.

Aim: The aim of this research is to provide background for BBT, analyse the available evidence for its efficacy and evaluate the physiological framework behind it.

Methods: The analysis of literature is carried out by studying papers from electronic databases such as Cochrane, Medline, Embase, AMED, PEDro, Google Scholar, Elsevier, APTA, Campbell, Web of Science, and Research Gate.

Conclusion: Individual studies using BBT consistently showed a reduction in asthma medication use. In either of the BBT experiments, no significant difference in lung ability was found. BBT detractors argue that drug reduction can be due to the physicians' influence, which is difficult to determine. Longer follow-up is needed to show that the improvement in asthma treatment as measured by drug usage is sustained over a clinically appropriate time span.

Open Access Review Article

COVID-19: Source, Symptoms, Screening, Prevention and Treatment

Nikita Suda, Rakesh Kumar Jha, Supriya Meshram

Journal of Pharmaceutical Research International, Page 522-526
DOI: 10.9734/jpri/2021/v33i58A34147

Background: COVID-19 is an infectious disease caused by the newly acquired SARS-COV2 virus. The disease is rapidly changing, as well as our understanding of the emerging virus. Not knowing what it was at the beginning of the year 2020, scientists have been able to classify, track, classify, and establish diagnostic tests. Severe illness may strike the elderly and those with chronic illnesses, such as heart disease, diabetes, or cancer.

Conclusion: Over the past four decades, the emergence of new infectious, global threats has reshaped national and international thinking and the level of public health responses needed to combat these threats. All countries are at risk of new diseases, according to International Health Regulations.

Open Access Review Article

Physiology of Seed Dormancy and Germination-A Review

Cherry Nalwa, Meenakshi Seth

Journal of Pharmaceutical Research International, Page 557-562
DOI: 10.9734/jpri/2021/v33i58A34151

Seed dormancy is considered as an inherent property which outlines the environmental conditions in which the seed is accomplished to evolve. To better understand seed dormancy mechanisms, a series of rigorous studies examining seed metabolism in relation to gibberellin and abscisic acid have been organised. Abscisic acid is a hormone involved in the formation of primary dormancy, whereas gibberellins are a hormone involved in the induction of germination. During changes in dormancy certain variations in sensitivity can be observed. In the higher plants as the dormancy is present across all climatic regions differing responses in the environment has resulted due to adaptation. As a result of this variance, incubation is timed to avoid adverse weather conditions in order to promote reproductive growth and plant establishment. All molecular mechanisms emphasizing kernel latency initiation, conservation and improvement play a large part in the evolution and adaptation of these seeds and plants and their importance is indescribable. Together genetic and environmental factors are liable for triggering seed dormancy. For the induction of seed dormancy and besides its release the balance between the intensity of ABA plus GA remain in charge. There is a triphasic pattern of germination including imbibition i.e rapid uptake of water, enzyme activation and initiation of embryo growth resulting in the radicle protrusion. The dormancy state is regulated not only by the seed maturation environment, but it also changes over time after shedding in a way that is determined by the ambient environment.

Open Access Review Article

A New Genetic Insight for Orphan Renal Disorder, Fabry: A Review

Pragati Karemore, Dinesh Kumar, Anil Kumar

Journal of Pharmaceutical Research International, Page 563-576
DOI: 10.9734/jpri/2021/v33i58A34152

Fabry is the rare X-linked genetic disorder caused due to mutation in Alpha –Galactosidase encoding GLA gene mutation in chromosome number 22. It has wide diversification in prevalence due to clinical heterozygosity. There are some potential biomarkers for the evaluation of normal or altered genes responsible for Fabry. Advances in the research of biomarkers over the years have made significant development for several clinical indicators, viz.  urine-derived cells, oxidative stress, DNA methylation, etc. At present days the recommended therapies for the disease are Enzyme Replacement Therapy (ERT), Chaperone therapy (CT), and mRNA-based therapy, besides, some second-generation therapies which are still under clinical trials.

Open Access Review Article

Management Strategies for Oral Submucous Fibrosis- An Update

R. Sudarshan

Journal of Pharmaceutical Research International, Page 577-584
DOI: 10.9734/jpri/2021/v33i58A34153

There are plentiful management trials in Oral Submucous Fibrosis (OSMF), such as drugs, herbs, and Chinese medicines, but none proved to be entirely successful. So in this review, there are different management strategies tried in the management of OSMF, mechanism of action, and the dosage regimen.

Open Access Review Article

A Review on Myths and Facts about COVID-19

Areeba Abid Sheikh, Pradip Jain, Praful Patel

Journal of Pharmaceutical Research International, Page 628-632
DOI: 10.9734/jpri/2021/v33i58A34160

Background: Myth is widely held but false idea or a belief. It is usually backed by religious, traditional , customs and rituals which tries to manipulate public mindset. Since the spread of Covid-19 Pandemic, myths are being believed by people .In this review article I am providing information about Myths and its actual facts about COVID-19 which are essential to be known so as to stop the spread of Myths by some set of people for own gains or either due to lack of Scientific Information It takes too long to debunk a myth by presenting facts.

Conclusion: Myths have been believed by common people at large whenever a new disease or virus is identified. These Myths have potential to spread more vigorously than the virus itself Myths can have detrimental effects on various aspects of physical, mental and social health. These myths should be curbed by providing evidence based information which can stop its spread. Therefore strict possible measures as discussed above should be taken by respective authorities.