Open Access Case Report

Anaesthetic Management of Left Temporal Glioma Undergoing Awake Craniotomy

Roshan Nisal, Vasam Rajesh Kumar, Wankhade Prachi Pandit, Sanjot Ninave

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i59A34242

For an awake craniotomy, a 49 year old (ASA 2), 78 kg woman with type II DM was given regional anaesthesia (scalp block) with monitored anaesthesia care (MAC). She had a headache, which was primarily caused by a left temporal glioma. She was very apprehensive about having this procedure done while she was awake. Fentanyl and Dexmedetomidine infusions in combination with scalp block initially provided adequate operating conditions. Because the patient needed to be fully awake, alert and cooperative during the language and motor mapping, all sedation was turned off. Patient was cooperative and obeyed commands during motor and language mapping as well as during tumour excision. Patient underwent complete excision of tumour without any postoperative neurological deficit. The success of the awake craniotomy  is dependent on the patient cooperation, anaesthesiologist's experience, adequate intraoperative analgesia coverage, careful sedation titration, and meticulous planning.

Open Access Case Report

A Case Report on Malignant Rhabdoid Round Cell Tumor in Pelvis

T. Kumutha, Brighty Baby, M. S. Sasikala, T. Sivakumar, Subha Jayanthi, R. Saravanakumar

Journal of Pharmaceutical Research International, Page 425-428
DOI: 10.9734/jpri/2021/v33i59A34287

The malignant neoplasm is called as malignant rhabdoid tumor or renal tumor. The Malignant tumor had the highest rate of proliferation. Tiny, round, and generally undifferentiated cells make up malignant small round cell tumours. A round cell tumor is a group of malignant tumors composed of relatively small and undifferentiated cells with an increased nuclear - cytoplasmic ratio. Soft tissue malignant tumours of the abdomen and pelvis are a rare but serious kind of cancer. Examples of these tumours include Ewing's sarcoma, peripheral neuroectodermal tumour, rhabdomyosarcoma, synovial sarcoma, non-lymphoma, Hodgkin's retinoblastoma, neuroblastoma, and hepatoblastoma. Mast cell tumour, histiocytoma, lymphoma, plasmacytoma, and transmissible venereal tumours are some of the different types of round cell tumours. Melanomas are the cytologic "great impostor," as they might look on cytology as round cell tumours despite being classed as mesenchymal cancers. Rhabdoid tumours have long been thought to be extremely malignant and have a bad prognosis. Children with this form of tumour have a six to eleven-month median survival duration. They're also less common. In 5% of small round cell tumor patients, can be curable, and it is best achieved by combining systemic chemotherapy with thorough cytoreductive surgery. Here we report a 9-year-old female child who was diagnosed with a malignant rhabdoid round cell tumor in the pelvis. She has undergone excision of pelvic floor tumor andfurther managed with Chemotherapy.

Open Access Case Report

Rare Presentation of Gall Bladder Adenomyomatosis

M. Ishwarya, R. Anantharamakrishnan, K. Senthil Kumar, K. Pranay

Journal of Pharmaceutical Research International, Page 510-512
DOI: 10.9734/jpri/2021/v33i59A34298

Introduction: Adenomyomatosis is a benign alterations of gall bladder wall that can be found in 9% of patients. We present a case of gall bladder adenomyomatosis of young male presented with right upper quadrant pain.

Case Report: A 22 year old male admitted with a history of pain over right upper quadrant for 8 months. The patient’s physical examination revealed tenderness over the right hypochondrium region. Contrast enhanced computed tomography showed - gall bladder wall appeared diffusely thickened with multiple small cystic areas noted.

Conclusion: Symptomatic gall bladder adenomyomatosis is an indicator for cholecystectomy, which results in complete disappearance of symptoms. Asymptomatic cases are not an indication for surgery, but the radiological diagnosis must be beyond any doubt. If there is a any diagnostic doubt about the possibility of gall bladder cancer, a cholecystectomy is justified.

Open Access Case Report

A Rare Case of Adult Medulloblastoma Associated with Multiple Sclerosis: Case Report and Literature Review

Assem S. Alrumeh, Waleed A. Alkhalifah, Abdulrahman Y. Alturki, Zubair Syed, Wafa Al shakweer

Journal of Pharmaceutical Research International, Page 670-678
DOI: 10.9734/jpri/2021/v33i59A34318

Medulloblastomas are the most common primary malignant brain tumors in childhood. They are responsible for around 20–40% of all brain tumors in children. They rarely occur in adulthood, but here they only make up less than 1% of all brain tumors. The standard therapy consists of an operation in combination with radiation and chemotherapy, which are individually determined for the patient. In this article, we discuss a case of 47 years old female patient diagnosed with primary progressive multiple sclerosis since 1 year. After 3 months of the diagnosis, she deteriorated and became unable to walk. MRI showed a large patchy enhancing midline cerebellar mass with evolving hydrocephalus. Tumor expressed positive reaction with synaptophysin immunohistochemical stain rendering medulloblastoma diagnosis.

Open Access Case Report

Rehabilitation of a Patient with Wedge Compression with Paraplegia: A Case Report

Mayuri K. Wanjari, Rebecca Timothy, Suchitra Menon, Rakesh Krishna Kovela, Mohammad Irshad Qureshi, Ragini Dadgal, Snehal Samal

Journal of Pharmaceutical Research International, Page 853-857
DOI: 10.9734/jpri/2021/v33i59A34339

Background: Despite the most significant efforts of many experts to provide natural therapeutic therapies, spinal cord injury (SCI) is a traumatic event with limited functional recovery. After a spinal cord injury, paraplegia can develop. Damage to the ligaments, vertebrae, or discs of the spinal column causes this. Paraplegia is the loss of muscle function in the lower half of the body, including both legs. Leg paralysis, in this case in which affects all parts of the pelvic organs, legs, and torso. This is partly owing to the complex character of SCI, which involves a great deal of disarray and malfunction as a result of the initial injury. Secondary degeneration is caused by neurotoxicity, vascular malfunction, neuroinflammation, apoptosis, and demyelination.

Presentation of Case: 34year old male patient with wedge compression was diagnosed on x-ray after a fall from the tree.

Discussion: The requirements for regeneration, rehabilitation, and neuroprotection appear to necessitate a diverse set of therapeutic approaches that can be used at different stages of the post-injury response.

Conclusion: We'll focus on one strategy, in particular, physical training/exercise, which looks to have a wide range of applications and benefits for those with a chronic or acute SCI.

Open Access Systematic Review Article

Prevention of the Development of Chronic Diseases in the Era of the COVID-19 Pandemic: A Systematic Review

Elena Andreevna Stepanenko, Liana Aslanbekovna Isaeva, Alena Igorevna Sokolova, Irina Vladimirovna Vinogradova, Alexander Vladimirovich Labuznov, Olga Valeryevna Ignatyeva

Journal of Pharmaceutical Research International, Page 836-841
DOI: 10.9734/jpri/2021/v33i59A34336

The article discusses the features of the prevention of chronic diseases in the era of the COVID-19 pandemic. It is known that patients suffering from various chronic diseases have weakened immunity, and this forces doctors to attribute such patients to the risk group, whose participants are most susceptible to the severe course of coronavirus disease.

In light of all the above, the main task of medical workers today is to prevent the development of chronic diseases as such, and therefore the prevention of chronic diseases in general is a priority for medicine today. An attempt to preserve the health of the nation and prevent the mortality rate from increasing is the main task of doctors, secondary and junior medical personnel. That is why preventive work among the population, especially the older age group, should be carried out actively and systematically today.

Open Access Case Study

Case Report On: Complete Heart Block

Archana Dhengare, Ruchira Ankar, Ranjana Sharma, Sheetal Sakharkar, Arati Raut, Sonali Wavare

Journal of Pharmaceutical Research International, Page 82-87
DOI: 10.9734/jpri/2021/v33i59A34251

When the electrical signal normally does not travel from the atria, the upper chambers of the heart, to the ventricles, or lower chambers, full heart block occurs. During surgery, the atrio ventricular (AV) node is weakened and complete heart block can result. Often, complete heart block occurs naturally without surgery [1].

Patient History: Heart block is an irregular heart rhythm where the heart (bradycardia) beats too slowly. In this condition, between the upper chamber (atria) and the lower chamber (ventricles), the electrical signals that tell the heart to contract are partially or completely blocked. Present history- The patient 71-year old male who was admitted to hospital on date 25/11/2019 with the chief complaint was severe chest pain, breathlessness, excessive palpitation, vertigo, and sweating since in 4 months.

Conclusion: The patient was admitted in the hospital with the chief complaint  of severe chest pain, breathlessness, excessive palpitation, vertigo and sweating since 4 months and his condition was very critical and the patient was admitted in AVBR Hospital and immediate treatment was started.

Open Access Case Study

Effect of Muscle Energy Technique in Patient with Chronic Neck Pain- A Case Report

Deepak Jain, Deepali Patil, Pratik Phansopkar

Journal of Pharmaceutical Research International, Page 124-129
DOI: 10.9734/jpri/2021/v33i59A34256

Introduction: Chronic neck pain might lead to a change in muscle tissue fibres. Neck discomfort is a serious and prevalent sickness. It is common in the general population, and it frequently results in severe impairment. These alterations have an impact on the cervical spine's capacity to govern 3-D movement efficiently. A range of manual therapy approaches are available to assist relieve pain and impairment while also cervical spine range of motion enhancement and everyday mobility. More evidence for Muscle Energy Technique (MET) in treating such a condition was found. This case report describes muscular energy technique's effect on a patient who has been suffering from neck pain for a long time.

Case Presentation: At the previous three months, a 27-year-old female accountant in a hospital with extended periods of sitting while working on a computer presented to our facility with neck pain. Increase in pain with looking up.

Discussion: The therapy was well embraced through this patient to muscle energy technique resulting in a high degree of flexibility in the cervical spine, reduce pain and improves flexibility and strength.

Conclusion: Physiotherapy has a significant effect Pain, strength, and range of motion are all factors to consider. The findings of this case study indicate that a specific muscle energy technique It's possible that a routine will help to alleviate the problem of neck pain, improves strength and functional ability.

Open Access Case Study

Rehabilitation Strategies in Management of Complex Case of Cervical Burst Fracture- A Case Report

Rishika H. Gabada, Pooja Kasatwar, Chaitanya A. Kulkarni

Journal of Pharmaceutical Research International, Page 205-208
DOI: 10.9734/jpri/2021/v33i59A34265

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed. They typically occur from severe trauma, such as a motor vehicle accident or a fall from a height. With a great deal of force vertically onto the spine, a vertebra may be crushed .If it is only crushed in the front part of the spine, it becomes wedge shaped and is called a compression fracture. However, if the vertebral body is crushed in all directions it is called a burst fracture. Burst fractures cause severe pain. The diagnosis of a burst fracture is usually made by x-rays and a CT scan. Occasionally, an MRI scan may be ordered as well, in order to assess the amount of soft tissue trauma, bleeding or ligament disruption. The review of the CT scan and x-rays allows the treating physician to make a determination as to the level of the fracture, whether it is a compression fracture, burst fracture or fracture dislocation. A spinal compression fracture also may be caused by trauma to the spine. Events that may cause trauma to the spine can include: A car accident, a hard fall or a fall from a height of more than 15 feet, landing on the feet, and a blow to the head. Any fall from a standing height that results in a spinal compression fracture or any other fracture most likely indicates weak bones due to osteoporosis. The physical exam should be performed to document both spinal deformity, that is, angulation of the spine or tenderness of the spine at the level of fracture, as well as, a neurologic exam. Neurologic exam should include testing of the muscle strength, sensation, and reflexes of the lower extremities, as well as, testing of bowel and bladder sphincter control. A 36 year old man was brought to the hospital as he had a fall from electric pole approximately 20 feet height. He had sustaining injury to the neck. Surgery was done as patient was diagnosed with C6 burst fracture with fracture dislocation of C5-C7. Therapeutic Interventions includes exercises, strengthening exercises, cervical fracture fixation, and traction.

Open Access Case Study

Case Report on Cerebral Venous Sinus Thrombosis

Gaurav Mujbaile, Vaishali Tembare

Journal of Pharmaceutical Research International, Page 419-424
DOI: 10.9734/jpri/2021/v33i59A34286

Introduction: Cerebral venous sinus Thrombosis is the unusual cause of a stroke affecting both reproductively old and genetically or thrombotic risk factors (CVST). The superior sagittal sinus and the cross sinus are two most common places for thrombus formation. A 26-year-old Man was taken to the Acharya Vinoba Bhave Rural Hospital with a new-onset complex-partial convulsion with secondary generalization, headache, and emesis seven days before presentation. Later on he experienced headache which was acute in onset and continuous in nature which was associated with fever. Patient had 1 episode of seizers lasting for 3-4 mints. Which was associated with fall on ground. He complained about weakness in left upper limb.

The patient was then transferred to our care institution for definitive management. On arrival, the patient’s neurological examination was done and he reported a severe headache. MRI imaging performed at our institution. The patient was followed clinically, and no posttreatment imaging studies were performed. Following a 3-day hospital stay, the patient reported a significant reduction in headache severity and was discharged home.

Open Access Case Study

Ultrasound-guided Hydrodissection of Sural Nerve for Foot Pain

Jeshnu Prakash Tople, Deepjit Bhuyan

Journal of Pharmaceutical Research International, Page 513-518
DOI: 10.9734/jpri/2021/v33i59A34299

Background: Sural nerve entrapment is an impor­tant but infrequent cause of pain. The sural nerve provides sensation to the posterolateral aspect of the leg, lateral foot and fifth toe. Sural nerve entrapment can be challenging to treat and can cause significant limitation. We present a case of sural nerve entrapment resistant to conservative management that was effectively treated by percutaneous ultrasound guided hydrodissection of the sural nerve.

Case Report: A 57 year old male came with complaints of pain and tingling sensation on both lower limbs with 50% decrease in sensation to touch (right > left) in lateral aspect of both foot. The patient had tried several conservative modalities with no success. We performed percutaneous ultrasound guided hydrodissection of the sural nerve and the patient reported complete improvement in his pain.

Conclusion: Percutaneous ultrasound guided hydrodissection of the sural nerve, is a safe and effective treatment for patients with sural nerve entrapment that does not respond to conservative therapy. However, studies are needed to elucidate its effectiveness and safety profile.

Open Access Case Study

Case Report: Management and Outcomes of COVID-19 in a Patient with Cirrhosis of Liver

Seema M. Kolhe

Journal of Pharmaceutical Research International, Page 547-551
DOI: 10.9734/jpri/2021/v33i59A34304

Introduction: The outbreak of coronavirus disease 2019 (COVID-19) has recently become a major problem affecting thousands of individuals around the world. It is understood that a significant proportion of patients infected with COVID-19 have disturbed liver function tests. This is a case report of a patient with liver cirrhosis and COVID-19.

Presenting Complaints and Investigations: A 39 year old female patient was admitted in AVBRH on 06/02/2021 with chief complaint of distension of abdomen, breathlessness, shortness of breath, reduced urine output over last 3 months. She had skin lesions over the hand, foot, abdomen and back with itching since 4 months. Physical examination, blood investigations and abdominal ultrasound showed cirrhosis of liver with gross ascites seen clinically. She had mild splenomegaly and gall bladder was enlarged. Laboratory tests showed elevated total bilirubin level. In peripheral blood examination, RBC count was low (3.66m/cu mm), Haemoglobin level was 8.2 gm/dl, Platelets count was low (1.19 lakh per cu. mm). WBC count was 3600 cu mm. Doctor diagnosed this as the case of cirrhosis of liver with pemphigus vulgaris with COVID-19.

Past History: 6 months ago, patient was admitted in Aarogyadham hospital Yawatmal with chief complaint of abdominal pain, loss of appetites, fever. On ultrasonography, she had splenomegaly for which she took the treatment.

The Main Diagnosis, Therapeutic Intervention and Outcomes: This case was diagnosed as a case of COVID-19 with Cirrhosis of liver. Interferon alpha 2b solution was given for 10 days to help improve the immunity. Tab. Ursoldiolis (ursodeoxycholic acid) was used to dissolve gallstones.

Conclusion: Good clinical assessment, appropriate care, good nursing care by trained nurses and appropriate treatment can save lives even in complicated COVID-19 infected cases.

Open Access Case Study

A Rare Case of Dengue Fever with Abducens Nerve Palsy

Pon Divya Bharathi, P. Manimekalai, M. C. Vinatha, Pujari Lokchaitanya, Nandhyala Durga Venkata Sainadh

Journal of Pharmaceutical Research International, Page 623-625
DOI: 10.9734/jpri/2021/v33i59A34312

Dengue fever is one of the most common vector borne disease which is a viral infection transmitted by aedes mosquito. Most common in the tropical countries. Neurological manifestations are not commonly seen in dengue, it can present as encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a very exceptional manifestation. A 48-year-old Indian male was diagnosed with dengue, complicated with isolated unilateral sixth cranial nerve palsy. The patient was managed conservatively. Patient made a fast and full ocular recovery following treatment with methyl prednisolone. Hence, dengue can present with a cranial nerve palsy and the recovery process can be hasten with the use of corticosteroids.

Open Access Case Study

An Interesting Case of Melioidosis

J. Vijay, R. Vedamanickam, K. Saranya Devi

Journal of Pharmaceutical Research International, Page 634-637
DOI: 10.9734/jpri/2021/v33i59A34314

Melioidosis also termed as Whitmore’s disease is an infectious disease which is caused by bacterium Burkholderia pseudomallei.Southeast Asia and northern Australia are endemic to this diseases which is predominantly transmitted in tropical climates.The coarse of disease involves multiple system involvement most common being lungs and it is mistaken as tuberculosis in many times.the other system involved are musculoskeletal and abscess over internal organs in spleen ,liver.This is a case report of 20 year old male presented with history of fever, swelling over multiple sites of the body, reddish discharge from the swelling, with history of planting trees in the past. Routine investigation showed leucocytosis and multiple abscess in liver and spleen .Blood culture showed positive for burkholderia pseudomallei .started treatment with meropenam and linezolid for 2 weeks and patient resolved from symptoms completely and discharged. Here we discuss about an clinical coarse and treatment response to bacteria burkholderia pseudomallei.

Open Access Case Study

A Case Report On: Incomplete Abortion with Chronic Hypertension

. Vaishnavi, Kavita Gomase, Vaishali Taksande

Journal of Pharmaceutical Research International, Page 664-669
DOI: 10.9734/jpri/2021/v33i59A34317

Introduction: Abortion is a distressing experience that affects the mother in a variety of ways by influencing on emotional status that can finally result in psychological disorders such as depression [1].  An incomplete abortion occurs when the products of conception are lost in the first 20 weeks of pregnancy. Moderate to severe vaginal bleeding, as well as lower abdomen and/or pelvic pain, are common symptoms of incomplete abortion [2]. Substantial evidence indicates that women with a history of spontaneous abortion have a greater risk of non-communicable diseases, including hypertension, cardiovascular diseases, and type 2 diabetes [3]. In low and middle-income nations, abortion is one of the most common causes of maternal death [4]. In general, incomplete abortions are unavoidable, with chromosomal abnormalities accounting for 50% of all occurrences. Age, maternal disorders (diabetes, hypertension, renal disease, thyroid issue, polycystic ovarian syndrome, lupus, thrombophilia), under or overweight, aberrant uterus, teratogen exposure (drug, alcohol, caffeine, radiation), and infections are all changeable etiologies and risk factors (human immunodeficiency virus, sexually transmitted infections, Listeria monocytogenes) [2].

Case Presentation: A 30-year-old woman's case study with 15 weeks pregnant admitted in the obstetric and gynecological unit on the date 11 June 2021 with complaints of amenorrhea since 4 months, bleeding per vaginam, passage of clots, blurring of vision, pain in abdomen, breathlessness and her blood pressure was noted as 140/100mm of Hg. Interventions: Generally, the patient with abortion and raised blood pressure is hospitalized and care is provided in the obstetric and gynecological unit or ward. The goals during this phase are saving a life of mother, maintaining and restoring hemodynamic  stability and preventing the spread of infection or correcting the complication.

Outcomes: During the period of five days treatment, the client was having raised blood pressure but significantly the client’s health was improved with further treatment and management .After a hospital stay of five days the markable progress was seen further before returning to the  home. Discussion: Although the patient reacted well to treatment, more interventions and health education could be used in the future to help the patient  to achieve the better health results.

Open Access Case Study

Positive Outcomes of Goal Directed Cardiac Rehabilitation for a Patient Undergone Rheumatic Heart Disease Undergone Mitral Valve Replacement: A Case Study

Grisha Ratnani, Rashmi Walke, Moli Jai Jain, Vishnu Vardhan, Vaishnavi Yadav, Pallavi R. Bhakaney, Ruhi Kumbhare

Journal of Pharmaceutical Research International, Page 798-802
DOI: 10.9734/jpri/2021/v33i59A34331

Rheumatic heart disease is one of the principal contributors that has a negative influence on a patient's quality of life and makes it challenging for them to perform their daily activities. The disorder predominantly impairs the function of heart valves, specifically the mitral valve, resulting in stenosis that can be managed by repair or replacement of the valve. The purpose of treatment is to improve the patient's quality of life. As an adjunct to that, cardiac rehabilitation and exercise therapy are used. This case study discusses a patient with mitral stenosis and mitral regurgitation, who underwent mitral valve replacement. She was given with physiotherapy for a week of phase I cardiac rehabilitation and was prescribed home exercise.

Open Access Case Study

Physiotherapy Rehabilitation in Arthroscopic Rotator Cuff Repair Patient- A Case Report

Anushri Patil, Swapna Jawade, Neha Chitale

Journal of Pharmaceutical Research International, Page 872-876
DOI: 10.9734/jpri/2021/v33i59A34342

Rotator cuff pathology is usual, and the ailment's natural history suggests that tears enlarge with age. Rotator cuff tears are a familiar origin of pain and ailment in the shoulder. The research on treatment of rotator cuff tears is mixed. The aim of this review is to evaluate the evidence regarding the effectiveness of physiotherapy in lowering pain and enhance shoulder function in patients with symptomatic rotator cuff tears. Rotator cuff injuries are typically followed by a gradual onset of pain, but they can also be the result of an acute injury. Chronicity, underlying anatomic and physical factors, age, and the presence and severity of tendon tears all influence how rotator cuff conditions are managed. Conservative care, such as physical therapy, is typically used as the first line of defence, but surgical repair may be required later on. Rotator cuff (RC) tears can range from partial to full thickness tears of a single tendon to massive cuff tears. Rotator cuff tearing can be caused by glenohumeral trauma as well as pathological process. As a result, Treatment necessitates a diligent diagnosis as well as a distinguished approach that considers morphological and patient-specific effects. The therapeutic approach is determined by the patient's pathogenicity, tear morphology, clinical symptoms, and functional demands. The current case is about an 51 year old male who was admitted to the hospital with tear injury to right shoulder due to fall from truckmuscle strength and range of motion were main focus of physiotherapy intervention. The prime goal of this case study was to assess the patient’s response to physiotherapy for reinforcement and functional task.

Open Access Study Protocol

Evaluation of Efficacy of Phalatrikadi Ghan Vati in Patients of Non-Alcoholic Fatty Liver Disease through Reverse Pharmacology Approach – Study Protocol

Piyush Chaudhary, Bharat Rathi, Renu Rathi, Neha Lamba, Vidushi Tyagi

Journal of Pharmaceutical Research International, Page 88-96
DOI: 10.9734/jpri/2021/v33i59A34252

Background: Non-alcoholic fatty liver disease (NAFLD), mostly diagnosed incidentally, is a rapidly emerging liver disorder. In absence of any specific treatment, current management focuses on theuse of hepatoprotective agents in addition to lifestyle modification and prevention of metabolic syndrome. Several Ayurveda agents have shown promising effects in patients over centuries of use. But this evidence needs to be assessed scientifically through reverse pharmacology approach. A polyingredient Ayurveda drug, Phalatrikadighanvati (PGV) has been selected for this study because of its long history of use and that its individual contents have shown positive results in liver disorders.

Objective: Evaluation of efficacy of Phalatrikadighanvati in patients of non alcoholic fatty liver disease (NAFLD) along with its pharmaceutical and analytical study.

Materials and Methods: The drug shall bepharmaceutically processed and analyzed as per pharmacopoeial standards.Present study has been designed as a randomized placebo controlled double blind clinical trial in two stages. The first stage shall be a pilot study to decide the best effective and safe dose in patients of NAFLD. The pilot study shall include two groups of 10 patients each in a dose of PGV 500mg and 1gm respectively twice a day for 12 weeks. After theselection of thebest dose, RCT will be conducted on that dose in the second stage.It shall be a Phase 2 trial with 60 patients divided equally in two groups.The patients in group one shall be given a dose as per the outcome of the pilot study twice a day and another group shall be administered placebo for a period of 12 weeks.

Results: Efficacy of Phalatrikadi ghan vati will evaluated in terms of subjective and objective parameters using paired and unpaired t-test.

Conclusion: PGV is expected to improve the diagnostic parameters in patients of NAFLD thus proving to be efficacious in managing NAFLDand act as a potent hepatoprotective agent.

Open Access Study Protocol

Developmental Coordination Disorder, Impact of Fine Motor Skills on Handwriting and Academic Performance in School Going Children: A Research Protocol

Shwetambari Morghade, Mohammed Irshad Qureshi, Rakesh Krishna Kovela

Journal of Pharmaceutical Research International, Page 847-852
DOI: 10.9734/jpri/2021/v33i59A34338

Introduction: Developmental Coordination Disorder (DCD) is a neurodevelopmental disease that inhibits muscle coordination that affects everyday life tasks and academic achievement. Children with DCD are often characterized as "clumsy" and "uncoordinated" and often lead to performance problems that most often create (TD) children can easily execute. Generally, treatments for DCD are not expected to succeed and the disease has no treatment. Therapies, on the other hand, will include skills, solutions, and accommodations that make it simpler for children with DCD to execute the motor activities required in everyday life and school settings. Some studies emphasize that child’s developmental status plays an important role in academic performance, but there is limited evidence which focuses on fine motor performance in children suspected of DCD, and its effect on their handwriting and academic performance.

Methodology: This observational cross-sectional study will be conducted at several schools around Wardha, with 1511 school-aged children of both genders ranging in age from 8 to 14 years participating.

Discussion: Some studies stress the importance of a child's developmental status in academic achievement, however, there is minimal data that focus on fine motor skills in children suspected of having DCD and its impact on handwriting and academic performance.

Conclusion: This study will help us in determining the prevalence of developmental coordination disorder and the relationship between handwriting and academic performance in these children.

Open Access Study Protocol

Necessity of Structured Exercise Training Program and Its Feasability on Physical Capacity and Health Statuswith Post COVID-19 Syndrome Patients

Ruhi Kumbhare, Vishnu Vardhan, Vaishnavi Yadav, Rashmi Walke

Journal of Pharmaceutical Research International, Page 877-883
DOI: 10.9734/jpri/2021/v33i59A34343

Abstract: Corona virus Disease 2019 (COVID-19) has spread worldwide and has become a global public health emergency. The World Health Organization declared the outbreak a pandemic. Pulmonary Rehabilitation has shown good impact on Quality of life , Functional capacity and health status of patients  with  Chronic Respiratory Disease Recently there are various  guidelines  and  consensus  available  for  Pulmonary Rehabilitation in Post – COVID patients that has been extrapolated from other respiratory condition. There is paucity of literature that has shown the effect  of  Exercise  training  program on Physical capacity  and  Health status of  patient  with  Post  COVID 19 syndrome. So the present study uses the available evidence on COVID 19 patients to prepare the exercise program and implement it on post COVID syndrome patients.Thus, the aim of this study  is  to  evaluate  the  effect  of  supervised  Exercise  Training   Program on  Post  COVID-19 syndrome patients

Methodology: In this experimental study total 70 patients with Post Covid Syndrome will be included and they will be equally divided into two groups. Group A will receive supervised exercise training, while Group B will receive unsupervised exercise training. Participant will be evaluated at the beginning of therapy or after 6 weeks.

Discussion: This study is conducted to evaluate effectiveness of structured exercise training program and its feasibility on physical capacity and health status of patients with Post COVID19 syndrome.

Conclusion: Its effectiveness of a structured exercise program and its feasibility on physical capacity and health status of patients with Post COVID19 syndrome will be evaluated.

Open Access Short Research Article

Antioxidant Studies of Thiazole Ring Bearing Chalcone Derivatives

Ashok Babu Kasetti, Jayesh Dwivedi, Ravindra Nagasuri

Journal of Pharmaceutical Research International, Page 355-359
DOI: 10.9734/jpri/2021/v33i59A34280

Oxidative stress is one of the common problems seen in a variety of diseases. Chalcones and in particular heteroaryl chalcones had reported with promising antioxidant activities. Hence, in the present work, we reported the antioxidant activity of twenty thiazole ring bearing chalcone derivatives (1-20). Among the tested compounds, compounds 17, 19 and 20 containing 2-pyridinyl, 3-pyridinyl and 2-thiazolyl scaffolds showed superior antioxidant activity than the standard with their IC50 values 4±1µg/mL, 3±1 µg/mL and 5±1 µg/mL respectively. The compound 19 is an interesting lead for the development of newer antioxidant agents.

Open Access Short Communication

Milk Fortification with Vitamin A & D: A Need of the Hour in India

B. Kishore Babu, T. Pavan Sai

Journal of Pharmaceutical Research International, Page 501-509
DOI: 10.9734/jpri/2021/v33i59A34297

Micronutrient deficiency is caused by a diet deficient in important vitamins and minerals, and it continues to be a serious public health issue for many low- and middle-income countries' populations. Vitamin A and D deficiency is extremely common in India, affecting both young children and adults. With 146.3 million tonnes of milk produced annually, India is the world's largest producer, yet only around 9% of the milk is fortified with vitamins and minerals.

Milk fortification is one of the treatments for vitamin deficiency. Milk is one of the most nutrient-dense foods available. In India, it is a staple dish that is consumed by people of all age groups. Regular consumption of fortified milk led to an 18% reduction in diarrhoea, a 26% reduction in pneumonia, 7% fewer days with a high fever, and 15% fewer days sick with severe sickness. Out of 416 LLPD produced, about 198.4 LLPD gets fortified currently in India, reaching about 121 million people.  There is still a significant gap between production and fortification. Governments must take appropriate steps to improve milk fortification and make India a healthy country.

Open Access Original Research Article

Evaluation of the Relationship of Various Patterns of Quid Usage in Patients with Oral Submucous Fibrosis and Leukoplakia in Central India Population: A Cross Sectional Study

Rakhi Chandak, Manoj Chandak, Runal Bansod, Ramhari Sathawane, Rutuz Bansod, Pranali Thakre

Journal of Pharmaceutical Research International, Page 6-15
DOI: 10.9734/jpri/2021/v33i59A34243

Background: Oral habits can cause severe oral potentially malignant disorders. There is a need to deeply analyse the role of betel nut in the causation of these disorders. Patients must be educated in order to prevent them from grabbing these conditions as inspection leads to prevention.

Aim: The aim of our study was to study and analyse the different patterns of quid usage among the participants with oral submucous fibrosis and leukoplakia in Central India population.

Patients and Methods: The study was performed on 90 patients amongst which 45 patients were clinically diagnosed of oral submucous fibrosis & the other 45 patients were diagnosed of leukoplakia.  The cases were then subjected to a detailed questionnaire which aimed to extract information regarding the various types of quid usage habits, their frequency and duration. The data was recorded and statistical analysis was done.

Results: The study included 90 subjects – 86 males & 4 females. Out of 6 types of quid habits it is found that type IV (processed areca nut), Type VI (combined quid usage) quid caused OSMF stage II, Stage III & homogenous leukoplakia respectively. There is a strong association between duration and frequency of habit in causation of OSMF & leukoplakia.

Conclusion: The present study showed increased prevalence of OSMF & leukoplakia with type IV & VI quid usage among the population of Central India.

Open Access Original Research Article

To Evaluate Fear and Assess Practice Modification among Dentist against COVID-19 in India – A Questionnaire Based Survey

Anil Ingole, Jayashree Sajjanar, Jaykumar Gade, Minal Soni, Karan Jaiswal, Anand Agarkar

Journal of Pharmaceutical Research International, Page 16-23
DOI: 10.9734/jpri/2021/v33i59A34244

Introduction: This highly infective new virus, named Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2), is a corona virus responsible of an acute respiratory syndrome, often asymptomatic but potentially lethal, named Corona Virus Disease 19 (COVID-19). Airborne and direct contact contamination is a major infection pathway of Sars-CoV-2. SARS-CoV-2 transmission during dental procedures can therefore happen through the inhalation of aerosol/droplets from infected individuals or direct contact with mucous membranes, oral fluids, and contaminated instruments and surfaces .Therefore, dentists have a high risk of getting infected from patients and potentially spreading it to their peers, families, and other patients.

Aim: To evaluate fear and assess practice modification among dentist against COVID-19 in India

Materials and Methods: In this cross-sectional study a total of 260 general dental practitioners, postgraduates and graduates across Central India, who were registered under the Dental Council of India, were included in the survey. A questionnaire consisting of 22 Questions with regard to COVID -19 fear and practice modification was designed and the questionnaire was circulated through a web designed program. The responses were collected, and data were analyzed descriptively using SPSS Statistics for Windows version 27.0.

Results: There is a description of the fear and anxiety levels of dental care professionals towards COVID-19; 83.85% of participants were afraid of getting infected with COVID-19 from either a patient or a co-worker. While treating a coughing or a patient suspected to be infected with COVID-19, 90% were anxious. In terms of using personal protection, 63.85% believed that a surgical mask is not enough to prevent cross-infection of COVID-19. In comparison, 93.08% favored the use of N-95 masks for routine dental procedures during the current outbreak. Although the majority 91.15% recommended routine universal precautions of infection control.

Conclusion: Overall, this study sheds light on the association of COVID-19 factors and fear and anxiety elevated among dentists during working in this pandemic. Covid-19 spread all over world and is worsening day by day. On current scenario several dental practices have either modified their services according to recommended guidelines to emergency treatment only, or closed down practices for an uncertain period.

Open Access Original Research Article

Application of E-Pharmacies in India

Aman Agarwal, Shilpa Parkhi

Journal of Pharmaceutical Research International, Page 32-42
DOI: 10.9734/jpri/2021/v33i59A34247

Consumer convenience and access are improved through E-pharmacy. This will mostly benefit chronic old patients living in nuclear families, as well as people who are unable to travel to a pharmacy. E-pharmacy also offers competitive prices, making drugs more affordable to those who are less well-off. Consumers in India focused on staying indoors after the COVID-19 lockdown was announced, which forced people to go digital, whether to pay bills or contact doctors. There are no exceptions when it comes to e-pharmacies. Brick-and-mortar pharmacies' home delivery of medicines has also increased. The aim of this paper is to discover and experimentally validate the many characteristics that influence customer acceptance, usage, and intent to suggest E-pharmacy for pharmaceutical purchases. This paper also aims to identify the factors that influence customers on choosing between the various e-pharmacies (PharmEasy, Tata 1mg, Net Meds,                             Apollo 24x7) providing their service in the market. For this research, the information from 106 respondents was collected and it was found that factors like ease of buying, discounts, user experience, customer care, and availability of the medicines/healthcare products influences their buying behaviour.

Open Access Original Research Article

An Evaluation of Stress Induced by Neet Coaching among School Children

K. Esha Gayathri, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 43-52
DOI: 10.9734/jpri/2021/v33i59A34248

Aim: Stress is the feeling of emotional or physical tension. The body produces a surge of emotions when you are in a stressful situation. Human beings of all age groups are more prone for stress. Students are more stressed due to the huge syllabus, pressure from family and parents. Stress causes immune suppression and myocardial infarction. In today’s highly competitive world, students face various academic problems including exam stress, disinterest in attending classes and inability to understand the subject. It can cause students to be unable to perform to their full potential in an exam. The purpose of the present study is to examine the prevalence of the effect of NEET coaching stress among private secondary school students in Chennai.

Materials and Methods: Participants were 115 adolescent students from private                    secondary schools in Chennai who were studying in grades 10, 11 and 12. Participants were selected using a simple random sampling technique and were assessed using a study-specific questionnaire.

Results: Most of the students reported higher stress levels, but males reported significantly higher stress levels than females. The main sources of stress were examinations, academic reasons, and family troubles. The students’ main responses to stress were listening to music, talking with someone about the problem, and exercise.

Conclusion: The study concluded an innovative finding that Private high school students in Chennai report high levels of NEET coaching stress. As such there is a need to develop effective interventions to help these students better manage their stress and anxiety.

Open Access Original Research Article

Analysis of Histological Features of the Cerebral Cortex and Hippocampus of Albino Rats Using Haematoxylin & Eosin Stain- An Observational Study

M. V. Shreejha, R. Priyadharshini, Palati Sinduja, V. Meghashree

Journal of Pharmaceutical Research International, Page 53-64
DOI: 10.9734/jpri/2021/v33i59A34249

Background: The study determined the histological layers of the cerebral cortex and hippocampus of the albino rat brain samples has been used in the study. The Cerebral cortex is composed of the Molecular layer, external granular, external pyramidal layer, internal granular layer and interior pyramidal layer. The layers of the hippocampus are alveus, stratum oriens, stratum pyramidale, stratum radiatum, stratum lacunosum and stratum moleculare. The aim of the study is to analyze the detailed histological features of the cerebral cortex and hippocampus layers of albino rats at the magnification of 10X,100X,40X. By using haematoxylin and eosin stain as an observational study.

Materials and Methods: The samples were preserved and fixed with the formalin and stained by haematoxylin and eosin and observed with a light microscope.

Results: The molecular layer is the superficial layer containing neurons. The outer granular layer of the cells are densely packed. Outer pyramidal layer contains rich pyramidal cells, Inner granular layer contains stellate cells, Inner pyramidal layer contains glial cells and the deeper multiform layer is composed of pyramidal cells. The hippocampus contains three layers of cornu Ammonia CA1, CA2, CA3. CA1 responds to memory and is covered by the choroid plexus. CA2 contains 3 major cell dentate gyrus, pyramidal cells, pyramidal neurons and CA3 composed of stratum lucidum.

Conclusion: The study of brain analysis of histological features of the cerebral cortex and hippocampus of the brain adds a greater insight in understanding the histology of various types of layers in rat brain and morphology of brain cells.

Open Access Original Research Article

Comparative Randomised Study between Bupivacaine with Clonidine and Ropivacaine with Clonidine Used Caudally for Postopertaive Analgesia in Paediatric Hypospadias Surgery

Aditi Shatalwar, Nikhil Bhalerao, Jui Jadhav, Dnyanshree Wanjari, Suhas Landge, Karuna Taksande

Journal of Pharmaceutical Research International, Page 97-105
DOI: 10.9734/jpri/2021/v33i59A34253

Background: This study was conducted to compare and evaluate the caudal epidural clonidine when mixed with ropivacaine and bupivacaine in prolonging postoperative analgesia in children of Indian genotype undergoing hypospadias surgery, as well as compare the intraoperative haemodynamics using caudal bupivacaine with clonidine vs ropivacaine with clonidine. The study was also aimed at studying the side effects and the duration of post-operative pain relief of bupivacaine with clonidine v/s ropivacaine with clonidine.

Methods: This is a prospective randomised comparative study that was carried out in the Department of Anaesthesiology, KEM Hospital, Pune, over 12 months (from October 2016 to September 2017), among 56 children having an ASA Grade of II, aged between 1 to 8 years admitted for hypospadias surgery. The data gathered was cleaned using Microsoft Excel, before statistical analysis was done.

Results: It was observed that caudal epidural analgesic duration was more in the bupivacaine clonidine group than in the ropivacaine clonidine group. The sedation score was higher at the second hour in the bupivacaine clonidine group. The HR and mean arterial pressure values were found to be notably higher in the ropivacaine clonidine group than those in the bupivacaine clonidine group. Intraoperatively and postoperatively, there was a decrease in pulse rate and MAP but at no time did the value reach the criteria for intervention. Other side effects like postoperative vomiting, nausea, motor blockade, respiratory distress not observed in any group.

Conclusion: Bupivacaine 0.25 % 0.5 ml per kg with clonidine 1 microgram / kg via caudal route increased the duration of postoperative analgesia with no adverse effects as compared to ropivacaine 0.25 % with clonidine 1 microgram/ kg. Hence clonidine is more efficient in increasing postoperative analgesia when added with Bupivacaine as compared to ropivacaine in Indian genotype in hypospadias surgery.

Open Access Original Research Article

An Evaluation of Stress Levels in Professionals Performing Work from Home in it Industry during COVID-19 Pandemic

K. Dhruv Kiran, G. Sridevi, S. Preetha

Journal of Pharmaceutical Research International, Page 106-115
DOI: 10.9734/jpri/2021/v33i59A34254

Background:  Stress is a feeling that comes from emotional and physical tension. Stress can come from any thought that makes you feel sad, angry or nervous. It is a natural feeling of not being able to cope with specific demands and events. Stress is your body’s reaction to a challenge or demand.  Negative responses to challenges can have an adverse effect on the health and happiness of the person who is undergoing stress. IT industry is a filed that poses lot of stress on the workers due to the peer pressures, working hours and work stress.

Aim: The aim of this study is to evaluate the stress among IT professionals who are working from home.

Materials and Methods: The study design involves a cross-sectional study was done among IT professionals to evaluate the stress among IT professionals who are undergoing work from              home admist the COVID- 19 Pandemic situation (6 months duration). A study involved a self-developed questionnaire consisting of 27 questions to assess the stress level of IT people              working in IT industry for more than 2 years. This questionnaire was circulated in Google forms and 137 people responded for the survey, out of which 123 participants were undergoing work from home.

Results: Out of 137 study participants, 18.25% of them were female and 81.75% of them were male. 25.55% participants were of age group 18 - 35 and 74.45% participants were of age group 35 -50. 90.51% participants are IT professionals and out of those 86.86% of participants are doing work from home. 72.26% of the participants feel that they are stressed too much due to work from home, and 27.47% of the participants feel that they are not that much stressed due to work from home. 45.99% of participants are more stressed, 28.47% of them are moderately stressed, 13.14% of them are lightly stressed and 12.41% of them are not stressed.

Conclusion: Thus, the study concluded an innovative finding that IT professionals experienced severe stress due to high peer pressures, home environments and were more prone to psychosomatic disorders.

Open Access Original Research Article

Effect of Ultraviolet Radiation on Pseudomonas Aeruginosa, Staphylococcus Aureus and Enterococcus

B. Madhumitha, N. P. Muralidharan

Journal of Pharmaceutical Research International, Page 116-123
DOI: 10.9734/jpri/2021/v33i59A34255

Background: The study of microorganism is called microbiology, which includes bacteria, viruses, fungi and Protozoa. Microbes play a major role in this field. Microbes are also used for life-saving drugs etc.. The effect of ultraviolet rays on the bacterias are mostly lethal to them, UV is a minor fraction of the solar spectrum reaching the ground surfaces, the UV light radiation will reduce the microbes in the surroundings as well as in the labs.

Aim: The aim of this study was to evaluate the effect of the ultraviolet rays on pathogenic bacterias.

Materials and methods: Three organisms were selected for the study. Pseudomonas, S. Aureus and Enterococcus. 30 watts Uv tube was used to evaluate the antibacterial activity of the Uv radiation. The exposure time was determined as 5, 10 and 15 mins at a close distance of 10cm. 20 microliter of suspension was taken and mixed in 2 ml of sterile normal saline and exposed for respective duration. Sub culture was done on suitable media after the exposure . Time exposed plates were incubated at 37 degree Celsius overnight and checked for the total CFU and data were tabulated.

Results: The Ultraviolet radiation of pathogenic bacteria resulted in a significant reduction of the total colony forming unit.

Conclusion: Ultraviolet rays were lethal to the bacterias. There are many  airborne bacterias surrounded by environment ultraviolet rays exposure will cause an apparent decrease in the pathogenic bacterias.

Open Access Original Research Article

The Diagnostic Usefulness of Bone Marrow Examination and Bone Marrow Culture in Patients with Pyrexia of Unknown Origin

Waseem Raja Memon, Uzma Hashami, Abdul Manan Khaskheli, Atif Ahmed, Kamran Ali Qureshi, Bedar Bakhat Khan

Journal of Pharmaceutical Research International, Page 144-149
DOI: 10.9734/jpri/2021/v33i59A34258

Introduction: Bone marrow cultures (BMCs) are usually obtained in the diagnosis of pyrexia of unknown origin (PUO). In the effort to identify the cause of systemic infection, BMCs are often performed in addition with blood cultures (BCs) and cultures of other body fluids and tissues. The practice of performing BMC and Blood cultures is long-standing, but the medical importance is questionable. Given the importance of cost effectiveness, such practices must be assessed on the basis of their cost-benefit to patient outcomes. In this study we compared the value of BMC with BC and studied the usefulness of the histopathological features of bone marrow trephine biopsy specimens in detecting the cause of systemic infections in selected patient population with PUO.

Objective: To determine the usefulness of bone marrow culture for the diagnosis of different causes of pyrexia of unknown origin.

Study Design: Descriptive Cross-sectional study

Place and Duration of Study: This study was conducted at Peoples University of Medical and Health Sciences for Women Nawabshah Pakistan from June January 2020 to January 2021.

Materials and Methods: A total 150 patients were included in this study who fulfilled the criteria of pyrexia of unknown origin. The bone marrow aspiration, biopsy, and blood cultures specimens were obtained using standard techniques and bone marrow culture send for microbial analysis.

Results: 1.5% of patients had hematomas, one diagnosed with Behcet disease, other patients with acute leukemia. The bone marrow aspiration results exhibited that 23 patients (15.3%) diagnose with a hemophagocytic syndrome where 3 cases of infection, 3 cases with hematological malignant disorder, and 7 cases with hemophagocytosis, and repercussion of bone marrow aspiration diagnosed 5 acute leukemia and 2 with visceral leishmaniasis. The usefulness of BMB was determined through an odd ratio of few parameters including thrombocytopenia with odd ratio 4.59 and 95% CI (1.07-8.4), anemia odd ratio 3.17, and CI (1.09-12.92) were considered most associated factors for the usefulness of BMB. BMC in 13 (8.66%) patients out of 150 were found with bacterial growth and 2 (1.33%) cases with bacterial growth were observed in blood culture. There was no fungal and mycobacterial growth observed. In the BMC analysis 2 cases of E. coli, 3 cases with Staphylococcus aureus, 2 cases of Enterococcus sps. while 4 cases of Salmonella typhi and 2 cases of Salmonella paratyphi-A were diagnosed in blood culture analysis.

Conclusion:  The obtained data indicate that blood culture did not divulge bacterial growth without the bone marrow culture. Therefore bone marrow culture was found to be an important diagnostic modality and correlation was found for thrombocytopenia and anemia. Bone marrow biopsy is deemed a useful method to diagnose pyrexia of unknown origin.

Open Access Original Research Article

Anti-Inflammatory and Cytotoxic Effect of Stevia and Neem Based Herbal Formulation

S. Selvapriya, R. Priyadharshini, S. Rajeshkumar, Palati Sinduja

Journal of Pharmaceutical Research International, Page 150-160
DOI: 10.9734/jpri/2021/v33i59A34259

Introduction: Nanotechnology is being used in developing countries to treat diseases and prevent health issues. Stevia, conjointly stated as Stevia rebaudiana member of the chrysanthemum family, a subgroup of the Asteraceae family. Azadirachta indica is a native tree to Asian nations. Azadirachta indica could facilitate the fight against plaque buildup and stop periodontal disease. Applied science in drugs needs the employment of nanoparticles to transmit the drug, heat, lightweight, or alternative substances to specific cell sorts like cancer cells.

Aim: In this present investigation, Stevia and Neem-based plant extract was prepared and analyzed its anti-inflammatory and cytotoxic effects.

Materials and Methods: The plant extract was prepared and an anti-inflammatory and cytotoxic effect was done using a UV-Beckmann spectrometer. The anti-inflammatory activity of nanoparticles prepared using plant extract was investigated by albumin denaturation assay. The results of the test were described as the standard deviation and analyzed using UV-Vis spectroscopy. For the cytotoxic activity, wells are used, wherein the mortality rate of the shrimps was estimated when the plant extract mediated of nanoparticles of different concentrations was added.

Results: The nanoparticles synthesized using the stevia and neem extract showed the highest absorbance at a concentration of 50µL (90%) when subjected to inhibition of albumin denaturation assay to check for its anti-inflammatory activity. Brine shrimp lethality was done and the cytotoxicity of these nanoparticles was found to be increasing with increasing concentration of the administered nanoparticles.

Conclusion: Anti-inflammatory and cytotoxic activity of Neem and Stevia mediated nanoparticles showed a successful outcome in both the assays.

Open Access Original Research Article

QTc Changes Associated with Tyrosine Kinase Inhibitors in Cancer Patients

Marvi Zaka, Bushra Ghaffar, Muhammad Fahad

Journal of Pharmaceutical Research International, Page 161-165
DOI: 10.9734/jpri/2021/v33i59A34260

Objective: To look for QTc changes associated with tyrosine kinase inhibitors and factors related to these changes among patients suffering from cancer.

Study Design: This correlational study was conducted in Avicenna Medical College and Hospital Lahore with the collaboration of SKMH during November 2020 to May 2021. 

Methodology: One hundred and eighty patients with solid or hematological malignancies taking tyrosine kinase inhibitors for more than three months were included in the study. They underwent 12 lead ECG inside oncology department. QTc interval was calculated on ECG of all the patients and they were evaluated for presence of prolonged QT interval. Age, gender, duration of tyrosine kinase inhibitor use and presence of comorbid illness were correlated with presence of QTc changes in our study participants.

Results: Out of 180 cancer patients using tyrosine kinase inhibitors for more than three months included in the study, 96 (53.3%) were male while 84 (46.7%) were female. One hundred and eighteen (65.5%) had normal QTc interval while 62 (34.5%) had prolonged QTc interval in our study participants. Binary logistic regression analysis revealed that advanced age of the patient and prolong use of tyrosine kinase inhibitors was statistically significantly associated with QTc prolongation in our study (p-value<0.001).

Conclusion: Significant number of cancer patients using tyrosine kinase inhibitors had prolonged QTc interval in our study. Special attention should be paid to the cancer patients with advancing age and prolonged use of tyrosine kinase inhibitors.

Open Access Original Research Article

Comparative Hypolipidemic Evaluation of Aframomum Melegueta Seeds and Moringa Oleifera Leaves

L. U. Nwankwo, F. A. Onyegbule, C. C. Abba, E. Agbamu

Journal of Pharmaceutical Research International, Page 166-182
DOI: 10.9734/jpri/2021/v33i59A34261

Aims: The study was carried out to compare the lipid lowering effects of both crude drugs as well as deducing the extracts with the best lipid lowering property; and the fractions.

Study Design: The research was conducted with an experimental design solely based on laboratory trials which involved the use of ninety-six (96) male albino wistar rats to compare the hypolipidemic effects of both crude drugs and respective fractions.

Place and Duration of Study: Department of Pharmacognosy Laboratory, Faculty of Pharmacy, Delta State University, Abraka, Nigeria and Department of Pharmacology and Toxicology Laboratory, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Agulu, Anambra State, Nigeria. The research was carried out from March to August, 2021.

Methodology: Ethanol extracts of both plants were prepared using soxhlet extraction. Each extract was then subjected to VLC fractionation using four solvents: n-hexane, chloroform, ethyl acetate and methanol. The fractions were bulked together after conducting thin layer chromatographic procedures and each extract was bulked into four fractions. The acute toxicity studies (LD50) of both extracts were determined in the rats using Lorke’s method. The crude extracts were screened for the presence and quantity of phytoconstituents using standard methods. The antilipidemic study was carried out using sixty-eight (68) rats randomized into seventeen (17) groups of four (4) animals each. Lipid profile was determined using spectrophotometer. Liver function tests and histology was also carried out using standard procedures.

Results: Administration of various treatments (both crude extracts and fractions) evoked a significant (p<0.05) reduction of TC, TG, and LDL-C as well as significant (p<0.05) elevation of HDL-C when compared with the negative control. With a percentage serum lipid reduction of 45.11%TC, 48.23%TG, 63.39% LDL-C and 174.69% elevation of HDL-C, the group treated with the combination of 500 mg/kg Aframomum melegueta and 500 mg/kg Moringa oleifera produced the best hypolipidemic effect. This is closely followed by fraction MO4. Comparatively, Moringa oleifera extracts exerts a better antilipidemic effect than Aframomum melegueta seed extract. The liver function test showed that both plants has no toxic effect on the liver cells at doses of 250 mg/kg and 500 mg/kg, hence confirming the hepatoprotective effect of both crude drugs at the doses administered.

Conclusion: In conclusion, results from this study suggests that ethanol extract of Moringa oleifera leaves is more effective than ethanol extract of Aframomum melegueta seeds as a                   hypolipidemic agent, however, combination of both crude drugs as a lipid lowering agent has proved to be more effective and reliable when compared to each crude drug administered independently.

Open Access Original Research Article

Clinical Peripheral Atypical Presentation of Tuberculosis in the Head and Neck Region in Asian Population —11 Years Experience and Review of Literature

Mayur J. Gawande, Rishabh R. Agrawal, Parul Nimbalkar, Rakshita Nitnaware, Tannu Mishra, Akshay Navdhinge, Dimple Lawhale, Sanjana Pandharkar

Journal of Pharmaceutical Research International, Page 183-190
DOI: 10.9734/jpri/2021/v33i59A34262

Tuberculosis TB one of the major health problem in developed countries, with extremely high prevalence in Asian countries, mainly caused by "Mycobacterium Tuberculosis". Although pulmonary tuberculosis is the most common form of the disease, it also can occur in other organ systems such as lymph nodes, central nervous system, skeletal system, hepatic system, and gastrointestinal system, including the oral cavity. Extrapulmonary tuberculosis is an uncommon form of chronic infection that does not present typical signs and symptoms of pulmonary tuberculosis. Oral tuberculosis is an uncommon form and is often overlooked as it shows no path gnomic signs. This article presents our experience of unusual atypical tuberculosis in the Head and Neck region.

Open Access Original Research Article

Anti-microbial and Wound Healing Properties of Leaf Extracts of Spermacoce verticillata L

R. A. M. Jainaf Nachiya, G. Sangeetha, R. Ragunathan, SD Shahanawaz, Sumanta Bhattacharya

Journal of Pharmaceutical Research International, Page 191-197
DOI: 10.9734/jpri/2021/v33i59A34263

The Rubiaceae family is one of the most important medicinal families that are found in the tropical region of the world. There are many species under the Rubiaceae family such as Coffea arabica, Cinchona officinalis, Spermacoce verticillate. There are several plant parts used to extract the metabolites from, such as the leaf, bark, root, seed, or fruit. The leaf of Spermacoce verticillata has many medicinal values as it contains metabolites which help to reduce microbial activity and help to heal the wound. The microbial activity can lead to skin infections and internal disease. The plant metabolites can act via inhibition of cell wall formation or inhibition of protein synthesis.

Wound healing is referred to as the repair of cuts and infections of the human skin. Leaf extracts may help to increase the fibrin formation to clot the blood, and the metabolic compounds may also help to reduce the microbial load in the wound to reduce the chance of infection.

Plant leaves contain many metabolites that can act as antimicrobial substances for humans such as minimoidiones A, Cytochalasin D, multiforicin I, and xylarenones E.. Some of those factors can disrupt the sequence of wound healing such as factors of controlling blood sugar level which seriously affect the wound healing and external factors such as contamination of microbes in the wound. The wound healing properties of leaf extract help the immune system to fight the microbes which slow down the wound healing process by the release of harmful metabolites.

Open Access Original Research Article

Insulin Resistance in Type II Diabetes Mellitus Patients and Their First Degree Relatives- An Observational Study

Aarti Sati, Amit Varma, Neeraj Kumar, Tariq Masood

Journal of Pharmaceutical Research International, Page 198-204
DOI: 10.9734/jpri/2021/v33i59A34264

Type II diabetes (T2DM) is caused by environmental, genetic, metabolic, and unknown variables. In diabetics, insulin resistance is the most of prolonged hyperglycemia. T2DM is induced by insulin resistance and cell dysfunction. The interaction of genetics and environment further complicates T2DM development. Insulin resistance and beta cell dysfunction are two of the most common Type 2 Diabetes Mellitus symptoms. A vicious triangle of cell failure (80% cell function) and insulin resistance in the muscles and liver causes major physiological issues. A group of diabetes patients (Group I), non-diabetic first-degree relatives of diabetic patients (Group II), and a non-diabetic healthy control group (Group III) were studied. The diabetes patients had the greatest systolic and diastolic blood pressures, followed by first degree relatives and healthy controls. We found that people with diabetes had higher fasting (FBS) and postprandial sugar, glycated haemoglobin (HbA1c) than diabetic offsprings and control group. Moreover, fasting insulin levels are higher in first degree relatives than in diabetes patients in the control group. The HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) levels of diabetics and their progeny do not differ much. The HOMA-IR measures insulin resistance severity. Common reference levels for HOMA-IR insulin resistance range from 0.7 - 2. Insulin resistance in diabetics and their first-degree relatives is evident from the results.

Open Access Original Research Article

Prevalence of MRSA and Antimicrobial Susceptibility Staphylococcus aureus in Clinical Samples in National Capital Region, India

Pradeep Kumar, Geeta Gupta, Gajendra Kumar Gupta, Vashishth Mishra, Gaurav Gupta

Journal of Pharmaceutical Research International, Page 209-215
DOI: 10.9734/jpri/2021/v33i59A34266

Background: Infections caused by Staphylococci are frequently linked to indwelling medical equipment. These are extremely difficult to treat with antibiotics. In India, the prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) varies from 30 to 70%, resulting in high mortality, increased economic burden, and high treatment failure in tertiary care hospitals. Rapid and reliable identification of MRSA is critical for infection management and avoiding the needless use of antibiotics.

Materials and Methods: This prospective study was carried out in the Department of Microbiology, Santosh Medical College, Ghaziabad, from the 1st of August 2020 to the 31st of January 2021. MRSA isolates were screened and confirmed using standard methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Methicillin resistance, in Staphylococcus aureus strains, was evaluated using oxacillin/cefoxitin. The Kirby-Bauer disc diffusion technique was used to assess the antibiotic susceptibility pattern of all MRSA strains.

Results: In this investigation, MRSA was identified in 29.4% of the 384 Staphylococcus aureus strains. When compared to females, men outnumbered females. Cefoxitin detects a greater amount of MRSA than oxacillin. In this investigation, the majority of MRSA was found in pus samples.

Conclusion: MRSA prevalence is known to vary depending on geographical region, hospital type, investigated population, and technique of detection used. Given the clinical implications of MRSA infection and its fast transmission capability, MRSA strains must be monitored on a regular basis.

Open Access Original Research Article

Antimutagenic Activity of Cassia Auriculata Linn Fractions along with Anticancer Activity in Male Albino Mice

Shailesh M. Kewatkar, Dipak V Bhusari, Madhav chakolkar, Amit Joshi, Shirish P. Jain, Chanchal Navin Raj

Journal of Pharmaceutical Research International, Page 216-228
DOI: 10.9734/jpri/2021/v33i59A34267

Background: In recent years, there has been a surge in interest in studying plant-derived materials and their impact on DNA. Herbal products include a number of natural substances that may help protect cells against mutagen-induced cell damage.

Aim: The purpose of this research was to assess the genotoxic effects of Cassia Auriculata Linn flavonoids (CAF) and Cassia Auriculata Linn saponin (CAS) rich fractions on mouse bone marrow cells utilizing chromosomal aberration test and micronucleus assay.

Methodology: The suppressive impact of CAF and CAS on 7, 12-dimethylbenz (α) anthracene (DMBA) and Croton oil induced skin tumor promotion in mice with topical administration twice weekly for 18 weeks is also investigated in this work. Three dosages of 100 and 200 mg/kg body weight were used. Single oral dosages of CAF and CAS Fraction at the three levels did not enhance the number of micronucleate polychromatic erythrocytes in the micronucleus experiment.

Result: In mice bone marrow cells, a single oral treatment of CAF and CAS fraction revealed no significant alterations in mitotic indices or chromosomal aberration induction. The clastogenicity of CYP was considerably decreased by pretreatment with CAF and CAS fraction. As a result, it can be stated that CAF and CAS fraction had no genotoxic impact on mouse bone marrow cells.

Conclusions: The portions of Cassia Auriculata have been shown to be non-genotoxic and non-clastogenic at the quantities utilized in this investigation. CAF and CAS Fraction might possibly be a promising skin tumor promotion reducing agent, according to this research.

Open Access Original Research Article

Assessment of Health Seeking Behavior of Gestational Diabetes in Pregnancy among Elderly Primi Mother

Prachi Dhale, Pragati Dhawale, Amrin Dosani, Gaurav Dongare, Bali Thool

Journal of Pharmaceutical Research International, Page 261-267
DOI: 10.9734/jpri/2021/v33i59A34270

Introduction: Gestational diabetes mellitus (GDM) is diagnosed by elevated blood glucose in pregnancy though the definition has changed repeatedly since its first description in the 1960’s. The most frequently reported perinatal consequence of GDM is macrosomia (usually defined as a neonate weighing over 4 kg) which can increase the risk of caesarean section and shoulder dystocia. For the mother, there are also potential longer-term consequences including an increased risk of type 2 diabetes post-pregnancy and/or in later life. The investigators of a large international Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study aimed to identify a cut-point in the continuum to decide the blood glucose level (BGL) thresholds that should be used to define GDM.

Objective: To assess the incidence rate of gestational diabetes in pregnancy among the elderly primi mother. To assess the health seeking behavior of gestational diabetes in elderlyprimimothers.  To associate the demographic variables of gestational diabetes in elderly primi mothers.

Materials and Methods: A Descriptive research study was to assess the incidence and Health seeking behavior of gestational diabetes in pregnancy among the elderly primi mother. The target population for the study includes all antenatal women (12-36 weeks of gestation) who attend the antenatal clinics of AVBRH Out Patient Department. Sample consists of sub set of units that compose accessible population. In this study sample size was 100 elderly primi mother of selected area of community of Wardha. A tool is an instrument or equipment used for collection of data. A blue print was prepared prior to the construction of knowledge questionnaire based on which items were developed.

Results: A finding shows that (41%) were having good, (40%) were having very good, (17%) were having average and (2%) were having excellent knowledge score. The minimum score was 05 and maximum score was 14, the mean score for the test was 8.93 ± 2.23 and mean percentage of knowledge was 59.54%. There was no significant association in relation to age, education, occupation, No.of gravida, income etc.

Open Access Original Research Article

Design of Lipid Nanoparticles Containing Fenugreek Seed Extract

P. Ananth, Marina Koland, Sridhar Deshpande, G. S. Mahendra

Journal of Pharmaceutical Research International, Page 268-278
DOI: 10.9734/jpri/2021/v33i59A34271

Background: The main purpose of this study was to maximize the efficacy of fenugreek seed extract by loading it in an optimised solid lipid nanoparticles (SLNs) formula.

Methods: To achieve an effective extraction method, preliminary studies were carried out to confirm the extract, and the extract was standardised using trigonelline. The influence of independent variables lipid concentration (X1), surfactant concentration (X2), and cosurfactant concentration (X3) on dependent variables particle size (Y1) and entrapment efficiency (Y2) was also studied and optimised using the Box–Behnken design. Melt emulsification followed by ultrasonication was used to prepare SLN formulations. To understand the effect of independent variables on the dependent quality parameters, response surface plots and mathematical equations were produced.

Results: The results confirmed that soxhalation was the most suitable method for extraction of fenugreek seeds, confirmed by standardization. Further optimization revealed that particle sizes ranged from 193.4 to 312.3 nm, with entrapment efficiencies ranging from 61.2 to 74.32 percent. This implies that the developed formulations can be used for further in vitro and in vivo characterizations.

Open Access Original Research Article

Social Grievances and Drugs Rummage-Sale as Performance Enhancement Attitude of Mature Athletes – An Inferential Approach

Saeed Javed, Aisha Shoukat, Abida Naseer, Muhammad Jafar, Nabeel Safdar, Ali Sher

Journal of Pharmaceutical Research International, Page 279-286
DOI: 10.9734/jpri/2021/v33i59A34272

Objective: The central objective of the present study was to determine the relationship between social grievances and drugs rummage-sale (performance enhancement attitude) of the mature athletes of Pakistan and examine their difference as well.

Methodology: The targeted population was mature national athletes belonging to national sports departments. The respondents were recruited through snowball and convenient sampling methods. Total 105 questionnaires were posted at the given addresses of athletes. However, 73 athletes (69.5%) returned the questionnaires. For achieving study objectives, quantitative approach was adopted wherein several statistical tests were performed including descriptive statistics, Pearson’s correlation, and t-test analyses and implemented to draw the required study findings.

Results: The findings revealed that a strong association exists between social grievances and drugs rummage use. Therefore, the relationship was considered positive and highly significant among the constructs. On the other hand, the findings revealed no difference between social grievances and drugs rummage-use. The findings revealed that social grievance and drug rummage-sale positively contribute to enhance the sports performance of athletes.

Conclusion: It was concluded that athletes use drugs for several purposes such as enhancing performance, competing for highest sports level, gaining fame, and jobs opportunities. However, with these benefits, the athletes fell in diverse health complications as a side effect of drugs being taken for above said purposes.

Open Access Original Research Article

Study on the Anti-cancer Potential of Aegle marmelos Fruit Extract Pro and Anti Apoptotic Molecule in Human Melanoma Cell Line-A375

G. V. Venkatakarthikeswari, R. Gayatri Devi, J. Selavaraj, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 287-294
DOI: 10.9734/jpri/2021/v33i59A34273

Aegle marmelos is also known as bael which is commonly found in south East Asia and Indian-sub continent. The origin of bael is India. Bael is also known as the golden apple, Bengal-quince in India. In the ancient medical system, Aegle marmelos play an important role and its extract is also useful in inflammation, diabetes, cancer and asthma. The leaves are used for anti-inflammatory, nervous disorder, control blood sugar and fruit is used to treat antiviral, anti-diabetics, and brain and heart tonic. In addition, studies have proved that bael is used for the treatment and prevention of cancer. The main aim of this study is to assess the anti-cancer potential of Aegle marmelos fruit extract pro and anti apoptotic molecules in human melanoma cell line-A375. In the present study, Human Melanoma A375 cells will be produced, grown and will be passed in different culture flasks, then RNA isolation was done and by reverse transcriptase process, RNA gets converted into cDNA. This cDNA will be used for the amplification of growth factor beta using gene specific primers by commercially available real time PCR kit.  The anticancer potential effect was found in 400µg/ml, as the concentration increases, the cell viability is decreased. The current study explains the potential application of bael in pharmacological and medicinal uses in near future.

Open Access Original Research Article

Optimization and Characterization of Self Nano Emulsifying Drug Delivery System loaded with 18- β Glycerrhetinic acid

Heena Farooqui, Prashant Upadhyay

Journal of Pharmaceutical Research International, Page 304-324
DOI: 10.9734/jpri/2021/v33i59A34275

The purpose of this study was to prepare, optimize and evaluate self nano emulsifying drug delivery system (SNEDDS) containing 18- β glycerrhetinic acid which enhances the dissolution profile or bioavailability of the drug in comparison to pure suspension of 18- β glycerrhetinic acid.18- β glycerrhetinic acid loaded SNEDDS having geranium oil as oil phase, tween 80 as a surfactant, and dimethyl sulfoxide (DMSO) as co-surfactant were prepared using pseudo ternary phase diagram and Box-Behnken experimental design was used to optimize the different formulations. Optimized formulations were characterized for self-emulsifying time, globule size, zeta potential, and drug release. The mean droplet size and PDI of the optimized formulation were found to be in a variation of 93.42 nm and 0.401 respectively. FTIR data showed no physicochemical interaction between excipients and drug. The encapsulation efficiency of optimised 18- β glycerrhetinic acid SNEDDS was found 80.12±1.52% , % transmittance was found 99.34±0.134% and the viscosity of all the formulations was found 0.8872 cp. Three-dimensional response surface plots and two-dimensional contour plots of the responses across the selected factors were constructed that explained the relationship between the independent and dependent variables. Release kinetics was calculated by using KinetDS3.0. It was concluded that prepared formulations were formulated with approximately desired mean droplet size confirmed by Box- Behnken experimental design as well as properly optimized and characterized.

Open Access Original Research Article

Resistance Exercise Reduces the Necessity for Hypoglycemic Agent (Humulin) in Overweight Women with Gestational Diabetes Mellitus

P. Selvi, V. Manivannan, G. Liji Martina, V. Senbagavalli, C. Selvin Thanuja, N. Rengarajan

Journal of Pharmaceutical Research International, Page 325-333
DOI: 10.9734/jpri/2021/v33i59A34276

Background: Gestational Diabetes Mellitus (GDM) is currently treated with blood sugar monitoring, nutritional supplements, increased fatal police work, and hypoglycemic agent medical help PRN to achieve and maintain normoglycemia. Even though humulin therapy has been demonstrated to reduce low birth weight in women with GDM, using hypoglycemic drugs is likely challenging and may not address peripheral hypoglycemic agent resistance, which is a critical role in the development of GDM. Furthermore, the use of aggressive low blood sugar medication therapy may result in a twofold rise in the amount of small-for-gestational-age infants. The resistance exercise was used in overweight women with Gestational Diabetes Mellitus. Because resistance exercise increase the lean body muscle or decrease the body fat and Resistance exercise is an effective glycaemic management and cardio metabolic health strategy.

Methods: Fifteen patients with physiological condition DM were arbitrarily assigned whether it's to a group that received strength training or to a group that did not receive strength training to scale back the necessity for the hypoglycaemic agent.

Results: Despite therapy, the number of girls who required hypoglycemic agent medical care has been the same. However, a meta-analysis with only overweight girls (pre-pregnancy BMI) revealed that the exercise cluster used to have a lower rate of hypoglycemic medication use (P<05) than that of the non-exercise receiving patients.

Conclusion: Resistance exercise coaching might facilitate to avoid hypoglycaemic agent medical aid for pregnant overweight girls with physiological state diabetes

Open Access Original Research Article

Ameliorating the Effect of Mycotoxins in Poultry Feeds Using Plant Extracts

A. R. Varalakshmi, A. Josephine, R. Kunguma Priya, K. Revathi

Journal of Pharmaceutical Research International, Page 334-348
DOI: 10.9734/jpri/2021/v33i59A34277

Mycotoxins are toxic secondary metabolites of fungal origin that tends to contaminate agricultural commodities before or under post-harvest conditions. They are mainly produced by fungi in the genera, Aspergillus sp. (Aspergillaceae: Eurotiales), Penicillium sp. (Trichocomaceae; Eurotiales) and Fusarium sp. (Nectriaceae: Hypocreales). When ingested, inhaled or absorbed through the skin, mycotoxins causes sickness or death in humans and animals. Natural substances that can prevent AFB1 toxicity to human and animal health with minimal cost will be a great advantage. Traditional medicinal plants are currently used for their antifungal, anti-aflatoxigenic and antioxidant activity. Aspergillus parasiticus strain NRRL 2999 was used to produce Aflatoxin, as it is one of the highly toxigenic fungus available. Inhibitory activity of ethanol extracts of plants was enhanced upon gradual increase in their concentrations. Among them, the ethanol extracts of Trachyspermum ammi (Apiaceae: Apiales) completely arrested the fungal growth and inhibited the growth significantly, even at lower concentrations (1%) in comparison with other extracts and the negative control.  Hence, the present work has been carried out to find the aflatoxin antifungal activity of the plant extracts Albizia lebbeck (Fabaceae: Fabales), Syzgium aromaticum (Myrtaceae: Myrtales) and Trachyspermum ammi (Apiaceae: Apiales) against aflatoxin contaminated poultry feed. In conclusion, the present study serves as a base and arises a futuristic need for efficient cost effective sampling and analytical methods that can be used for detection and control of mycotoxins in poultry feed.

Open Access Original Research Article

Antibacterial Activity of Padikara Parpam against ESBL Producing Escherichia coli and Klebsiella pneumoniae

Anitha Akilan, Josephine Anthony, Revathi Kasthuri

Journal of Pharmaceutical Research International, Page 349-354
DOI: 10.9734/jpri/2021/v33i59A34278

Aims: To evaluate the antibacterial activity of Padikara Parpam against Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia Coli and Klebsiella Pneumoniae using agar well diffusion method. To identify ESBL producing bacteria by phenotypic confirmatory test using disk diffusion method.

Study Design: Analysis of Antibacterial activity of Padikara Parpam using agar well diffusion method.

Place and Duration of Study: Central Research Laboratory, Meenakshi Academy of higher Education and Research, Chennai, between June 2021 and November 2021.

Methodology: Clinical isolates of ESBL were isolated by subculture into MacConkey agar and was identified by phenotypic confirmatory test. Padikara parpam's antibacterial activity was evaluated using the Agar well diffusion method at different concentrations of 0.5 %, 1 %, 1.5 %, and 2 % drugs. 30 µg Cefotaxime and 30 µg amoxicillin-clavulanic acid disk were used as controls to standardize the antibacterial activity test and to identify the ESBL by phenotypic confirmatory test.

Results: In this study, Padikara parpam at various doses of 0.5 %, 1 %, 1.5 %, and 2 %, revealed significant antibacterial efficacy against ESBL producing bacteria. Padikara parpam was more active against ESBL Escherichia coli than ESBL Klebsiella pneumoniae. As a result, it may be recommended as an antibacterial agent against ESBL.

Conclusion: Our findings suggest that Siddha Herbo mineral formulations of padikara parpam hold phenomenal antimicrobial activity against ESBL producing bacteria. Based on our findings, the drug may be prescribed successfully for urinary tract infections, which is caused by ESBL producing bacteria.

Open Access Original Research Article

Effect of Enzymatic Changes in Vitamin D Combination with LIV-52 on Carbon Tetrachloride Induced Liver Disease in Wistar Rats

K. Ponnazhagan, Ursula Sampson, N. Muninathan, J. Pratheeba, B. Sumanth Kumar, I. Jaiganesh

Journal of Pharmaceutical Research International, Page 360-367
DOI: 10.9734/jpri/2021/v33i59A34279

Aim: The present study was conducted to investigate the hepatoprotective effect of enzymatic changes in vitamin D combination with Liv-52 on CCl4 induced liver toxicity in Wistar rats. 

Background: The central organ of liver plays an essential vital role in the metabolism, and the liver is called as the metabolic “engine-room of the body”. Therefore, to maintain a healthy liver is a crucial factor for overall health and well being. The liver is the central organ for pharmaceutical drug or chemicals and xenobiotic detoxification metabolism, which regulates most of medication and xenobiotic-related toxic activity. High metabolic and synthetic activity in this organ is an important place for the generation of free radicals.

Materials and Methods: Adult male Albino Wistar rats weighing 150-250g were used in this study. The rats were split into six groups, each consisted of six rats. CCl4 were admitted  two days in a week for five weeks.   Liver disease associated animals were treated with Vitamin D and Liv-52 for 5 weeks.

Results: The levels of AST, ALT, ALP, γ-GT, and AFP were significantly reduced in vitamin D, and Liv-52 treated animals when compared with CCl4 induced animals. Moreover, the levels of Vitamin D and Liv-52, a good indicator of restoring the liver architecture, were also reversed in the damage after treatment.

Conclusion: The results of the present study indicate that the combination drugs were more hepatoprotective effect when compared with the individual.

Open Access Original Research Article

A Comparative Study to Assess Compassion Fatigue, Burnout and Compassion Satisfaction among Casualty Nurses with Intensive Care Unit Nurses at Selected Hospitals in Vadodara

Sachin Sadanandan, Lakhan Kataria, V. Suresh, Sajitha Sadanandan

Journal of Pharmaceutical Research International, Page 368-383
DOI: 10.9734/jpri/2021/v33i59A34281

Aim: This study is focussed on comparison and assessment of compassion fatigue, burnout and compassion satisfaction among casualty nurses with intensive care unit (ICU) nurses.

Study Design: Quantitative research approach and Descriptive - Comparative research design.

Materials and Methods: Study targeted casualty nurses and ICU nurses working at selected hospitals in Vadodara. A total of 80 casualty nurses and ICU nurses were asked to participate in this study. Convenient sampling technique was used. First tool consists of demographic variables. Second tool consists of Compassion Fatigue/Satisfaction Self-Test (CFS), assess the existing level of compassion fatigue, burnout and compassion satisfaction.

Results: Assessment of compassion fatigue among casualty nurses revealed that 18 [60%] nurses exhibited extremely high-risk level, Analysis of burnout among casualty nurses showed that 15 [50%] half of the nurses presented moderate risk level and among ICU nurses showed that 45 [90%] majority of the nurses presented high risk levels of burnout. Examining the final component of the CFS tool among casualty nurses, more than half of the respondents 16 [53.3%] were characterised as high potential level of compassion satisfaction and among ICU nurses, half of the respondents 25 [50%] were characterised as having a modest potential level of compassion satisfaction. Independent t-test shows that there was no significant difference in the level of compassion fatigue and compassion satisfaction between casualty nurses and ICU nurses. But there was a significant difference in the level of burnout between casualty nurses and ICU nurses, since the t value [18.256] was found to be greater than the table value [1.990] at .05 significant.

Conclusion: Study reveals an association was found to exist between the level of compassion fatigue and demographic variables. But there was no association found in the level of burnout and compassion satisfaction among subjects with their selected demographic variables.

Open Access Original Research Article

Evaluation of Nephroprotective Activity of Laportea interrupta Leaf Extract in Experimental Animals

Puneeth Kumar Shetty, Prasanna Shama Khandige

Journal of Pharmaceutical Research International, Page 396-405
DOI: 10.9734/jpri/2021/v33i59A34283

Laportea interrupta also called as Hen’s Nettle is a primitive plant that is known for its property of causing itch after its touch. This plant has been found useful in treating pre maternal health, anti-pyretic and anti-inflammatory action. Previously conducted scientific studies revealed that it is having potential of anti- microbial activity. It has also been proved to have anti-oxidant property as it contains flavonoid contents especially rutin and gallic acid. Extraction of the plant phyto constituent was by maceration process. Healthy Albino rats of wistar strain of 150 to 250 gm were used as experimental animal. Gentamicin induced renal injury and Paracetamol induced nephrotoxicity are the two methodologies followed in this experiment to induce toxicity in rats and then it is followed by ethanolic extract of the plant of low, mid and high dose. Biochemical analysis, Histopathological studies and statistical studies are also performed. There was significant decrease in the gentamicin-induced nephrotoxicity. Observation of change in body weight serum creatinine, serum albumin and serum protein were assessed for kidney function test. Histological and pathological study of kidney tissue was observed to identify the changes in the degree of cellular damage and healing effects in this research work.

Open Access Original Research Article

Serological Changes of Monoclonal Antibody CAMA3C8 against Human Breast Cancer Cell Line

N. Muninathan, K. Ponnazhagan, T. S. Meghalatha

Journal of Pharmaceutical Research International, Page 406-412
DOI: 10.9734/jpri/2021/v33i59A34284

Background: Tumor associated antigen are glycoproteins and glycolipids expressed on the surface or in the cytoplasm of tumor cells. The antigenic components are shed from the tumor cells into the tissue culture medium or blood or other human body fluids like human milk.

Objective: In the present study, investigate the serological assay of the antigen recognized by CAMA3C8 in patients with carcinoma of the breast.

Methods: The study is desgriptive cross section study.The study was divited into four groups based on the expression of tumor associated antigen.

Results: In breast cancer CAMA3C8 levels were significantly increased in stage 4 when compared with stage 1 breast cancer cell line. 

Conclusion: In the present study, we conclude that significantly recognized CAMA3C8 defined antigens in breast cancer.

Open Access Original Research Article

Estimation of Variations in the Erythrocyte Sedimentation Rate in COVID-19 Recovered Patients

Manoj Aravindan, Palati Sinduja, R. Priyadharshini, V. Meghashree

Journal of Pharmaceutical Research International, Page 413-418
DOI: 10.9734/jpri/2021/v33i59A34285

Background: A cluster of patients with pneumonia and severe acute respiratory syndrome developed in Wuhan, China in December 2019, and infection with a novel coronavirus virus called COVID -19 was later verified. Although fever and cough were the most common early signs and symptoms of COVID -19, extrapulmonary symptoms have also been reported. Many studies demonstrate that called COVID -19 swiftly progresses to acute respiratory distress syndrome and even multiple organ dysfunction.

Aim:The study aims to evaluate the erythrocyte sedimentation rate count in COVID -19 recovered individuals and compare it with healthy controls.

Materials & Methods: A cross-sectional pilot study in 5 healthy COVID -19 uninfected and 5   COVID -19 recovered individuals was conducted, the blood samples were collected and the erythrocyte sedimentation rate was calculated for each set of controls and samples. Statistical analysis was performed using SPSS software. An independent t-test was done to compare the results.

Results: The mean value of the control participants was found to be 8.08 ± 4.38 and the mean value of COVID -19 recovered patients was 20.60 ± 1.81. The difference in Erythrocyte Sedimentation Rate (ESR) values between control individuals and COVID -19 recovered patients was statistically significant with p value of less than 0.005.

Conclusion: Within the limitations of the study, we conclude that the COVID -19 recovered patients has higher ESR values compared to the healthy uninfected individuals.

Open Access Original Research Article

Frequency of Leading Factors of Severe Acute Malnutrition in Children Below Five Years of Age Attending National Institute of Child Health, Karachi

Iqra Rafique Khokhar, Mohsina Noor Ibrahim, Sanam Khan, Aiysha Farhat, Farah Jamil, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 438-443
DOI: 10.9734/jpri/2021/v33i59A34289

Aim: To determine the frequency of leading factors of severe acute malnutrition in children below five years of age.

Study Design: Cross-sectional study.

Place and Duration of Study: Outpatient department, National Institute of Child Health (NICH) Karachi from December 7, 2017 to June 9, 2018.

Methodology: All children of 6 months to 5 years of age of either gender presented with severe acute malnutrition were included. Information regarding age, gender, weight, height and all leading factors of severe acute malnutrition were noted.

Results: Out of total 157 children, pre-maturity was observed in 21 (13.4%) children, low birth weight in 84 (53.5%) children, anemia in 105 (66.9%) children, lack of complete immunization in 81 (51.6%) children, maternal illiteracy 96 (61.1%), paternal illiteracy 31 (19.7%), low income 116 (73.9%), lack of exclusive breastfeeding in 87 (55.4%) children, administration of Pre-lacteals as the first feeding in 54 (34.4%) whereas initiation of complementary feeding after nine months was observed in 48 (30.6%) children.

Conclusion: The presence of low income, anemia, maternal illiteracy, lack of exclusive breastfeeding and low birth weight were the leading factors of severe acute malnutrition in children below the age of five years.

Open Access Original Research Article

Evaluation of the Effects of Aqueous Fruit Extract of Tamarindus indica on Body Weight, Lipid Profile, Some Electrolytes and Urea of Wistar Rats

I. P. Ekpe, Dennis Amaechi, B. N. Yisa, O. G. Osarhiemen

Journal of Pharmaceutical Research International, Page 444-451
DOI: 10.9734/jpri/2021/v33i59A34290

Objectives: The objectives of this research is to evaluate the effects of aqueous extract of T. indica on  weight, lipid parameters, some electrolytes and urea of Wistar rats

Design & Methods: Twenty-five Male  Adult  rats were grouped into four  consisting of six rats each. Group I served as control group, group II was administered 100mg/kg of the Aqueous extract, group III was administered 150mg/kg of the Aqueous extract, and Group IV was administered 200mg/kg of the Aqueous extract.

The administration took place for seven days, and on the eight day, The Animals were sacrificed. The blood samples was collected via cardiac puncture and used for analysis using a visible spectrophotometer.

Results: From the result, there was no significant difference (p<0.05) in body weight of Wistar rats. In the Test Groups; Serum cholesterol, low density lipoprotein (LDL), High density lipoprotein (HDL), Very Low-density Lipoprotein and Triglycerides revealed a significant increase (p<0.05) compared to Group 1 which is the control Group but had a significant decrease (p<0.05) compared within test groups. For electrolytes concentrations, potassium, Sodium, Chloride and Urea concentrations was significant at p<0.05.

Conclusion: the results above ,T. indica extract may help to maintain healthy weight, may have hypolipidemic properties, may help in body homeostatic and fluid balance and may also prevent renal damages. 

Open Access Original Research Article

Association of Sub-Clinical Hypothyroidism with Abnormal Levels of Lipid in the Population of Nawabshah, Pakistan

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

Journal of Pharmaceutical Research International, Page 452-458
DOI: 10.9734/jpri/2021/v33i59A34291

Aims: Aim of this investigation was to access the association of dyslipidemia with subclinical hypothyroidism.

Methodology: In this cross-sectional investigation, 1948 participants were recruited. Two groups were made; participants up to 18 years were in group A and Subjects over 18 years were incorporated in group 2. They were subdivided into control, subclinical hypothyroid 1, and subclinical hypothyroid 2. SPSS 21 was used for data analysis.

Results:  Data of 1619 individuals were analyzed. The mean age of Group A participants was 12.79 ± 2.779, and the mean age of Group B participants was 42.58 ± 18.012. The prevalence of subclinical hypothyroid was found at 13.5 %. Significant differences have been observed while comparing Group A and Group B (P <0.001). Free tetraiodothyronine and Free triiodothyronine also showed a significant difference in both groups. (P<0.05). No significant difference between mean Thyroid-stimulating hormone levels was observed (P>0.05). No significant association between Controls and High-density Lipid values was found between Controls and subclinical hypothyroid.

Conclusion: We conclude that subclinical hypothyroidism leads to increased dyslipidemia. Lower Serum total cholesterol and low-density lipid levels were detected among children and participants under the age of 18 with Thyroid-stimulating hormone greater than 10 mIU/L. Thyroid-stimulating hormone less than 10.0 mIU/L had no lipid abnormalities in subclinical hypothyroid participants.

Open Access Original Research Article

A Cross Sectional analysis on the Impact of COVID-19 Pandemic on Plastic Surgery among Plastic Surgeons in India

Sanjay Selvaraj, Narayanamurthy Sundaramurthy, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Anand Prasath Jeyachandiran, Suresh Rajendran

Journal of Pharmaceutical Research International, Page 459-468
DOI: 10.9734/jpri/2021/v33i59A34292

Background: The COVID-19 pandemic reduced the amount of elective procedures dramatically. We, as healthcare workers, are at grave danger of contracting COVID-19. It is consequently critical for plastic surgeons to maintain their safety while attempting to resume routine activities as soon as possible. The goal of this research is to learn more about plastic surgery practises during the COVID-19 pandemic. We plan to serve as many people as possible while conserving medical resources for future crises.

Objective: To study the impact of COVID-19 pandemic on plastic surgery among plastic surgeons in India

Materials and Methods: A cross-sectional study was carried out using a questionnaire. The study population is made up of plastic surgeons, and the study location was chosen from several hospitals in India. The study duration was 6 months. Data was obtained using the snowball sampling method using a pre-tested, semi-structured questionnaire with 27 questions. The data was entered into an excel spreadsheet and analysed with SPSS version 16 software, with Fisher's exact test used for statistical analysis.

Results: A total of 61 participants were included in the study. The majority (60.7%) do not work in COVID-19 care in their hospital but the majority of the participants who took part in this study work in a hospital which is recognised as a COVID-19 centre for treatment (65.6%). 31 participants in their working hospitals there are more than 100 COVID-19 patients are being treated currently in Intensive Care Unit (ICU) and covid ward (50.8%) and but majority of the participants do not work in COVID-19 centre (60.7%). The Association between centres having separate wards for COVID and non-COVID patients and whether plastic surgeons working in COVID-19 centre on applying fisher’s exact test the p-value was found to be 0.215. The Association between centres having separate wards for COVID and non-COVID patients and practicing microsurgery during this pandemic on applying Fisher’s exact test the p-value was found to be 0.884. The Association between screening patients for COVID during emergency and group of patients operated without waiting for COVID report during emergency on applying Fisher’s exact test the p-value was found to be 0.408

Conclusion: The current study demonstrates how the COVID-19 epidemic has affected the plastic surgery department and imposed restrictions. Plastic surgeons should be kept up to speed and informed on the latest information and techniques for treating this problem, as well as infection prevention and control. Using online lectures and webinars to continue education for young plastic surgery trainees is beneficial during this time.

Open Access Original Research Article

Novel Pyrimidinone Linked 1,2,3-Triazole Scaffolds as Anti-Microbial and Antioxidant Agents: Synthesis, In-vitro and In-silico Studies

Narendra Kumar Maddali, I. V. Kasi Viswanath, Y. L. N. Murthy, Vasavi Malkhed, Vani Kondaparthi, Pradeep Kumar Brahman, B. Govindh

Journal of Pharmaceutical Research International, Page 477-491
DOI: 10.9734/jpri/2021/v33i59A34295

The present study states the synthesis of a novel series of pyrimidinone linked 1,2,3-triazole scaffolds by click chemistry method. Further, the synthesized compounds were evaluated for their antimicrobial studies against S. aureus and S. pneumoniae. Among the synthesized compounds, almost all compounds demonstrated significant antimicrobial activity against S. aureus, S. pneumoniae, E.coli and P. aeruginosa, as evident from the zone of inhibition resulted. In addition, synthesised compounds were screened for their antioxidant activity by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay method. Furthermore, computational study was performed to understand the interactions between synthesised compounds with dehydrosqualene synthase of Staphylococcus aureus (PDB ID: 2ZCS) and few Compound revealed the highest binding energies ΔG = -9.5, -9.8, and -10.1 Kcal/mol.

Open Access Original Research Article

Vitamin D, A Predictor of Outcome in COVID-19 Patients

Y. R. Lamture, Varsha P. Gajbhiye, Ranjit Ambad, Md. Jawed Akther, Rajesh Domakunti

Journal of Pharmaceutical Research International, Page 492-500
DOI: 10.9734/jpri/2021/v33i59A34296

Introduction: Hypovitaminosis D is a commonly associated with increased prevalence of pulmonary  infections. High mortality rate of  COVID 19 infections is associated with immune dysfunction like cytokine storm. Many studies show important function of vitamin D in proper functioning of immune system.  Very few studies are available to associate vitamin D level and severity of Covid infection, Hence this study was undertaken  to find a relation of vitamin D levels and outcome of COVID-19.

Methods: Study design is retrospective observational analytical case control. A study population  was hospital base cases and medical examination with clear definition of cases, medical examination, inclusion/ exclusion criteria, outcome and exposure. The Statistical analysis was done to  measure the  association  of outcome (the death or severe disease risk ) with exposure (low vitamin D) and that was determined by measuring  Odds ratio.

Results: Most of the patients (45%) were in an age ranging from 40 to 59 years . Maximum number of the patients (68%) have one comorbidity. Diabetes mellitus and hypertension , both present in 28 % and other co morbidity in 40 % of patients and 32% of patient reported to have no comorbidities.  Present study reveals vitamin D deficiency in around for 74% of patients. Most of the patients were managed without supplementation of oxygen, but few needed high flow oxygen and even invasive ventilation. However prognosis was good. COVID-19 deaths occurred only in 2% of the cases.  All  dead patients and patients with a severe disease had vitamin D deficiency. This association of hypovitaminosis D was more significant than other co morbidities including hypertension and diabetes mellitus.

Conclusions: Our study concluded that, two third of patients were having vitamin  D deficiency. Study clearly depicts severe vitamin D deficiency is associated with fatal cases,  therefore  vitamin D level can be used as a predictor of mortality.

Open Access Original Research Article

Synthesis and Antibacterial Activity of Hydroxy and Chloro-Substituted Chalcone Derivatives

Shaik Ammaji, Shaik Masthanamma

Journal of Pharmaceutical Research International, Page 519-528
DOI: 10.9734/jpri/2021/v33i59A34300

Chalcones are a class of natural products reported with a wide range of biological activities. Among them antibacterial is much promising and many potent chalcones have been emerged as useful antibacterial agents. In view of this, we synthesized 15 chalcones (3a-3o) containing both hydroxyl and chlorine substituents and studied them by using spectroscopic methods. The compounds were tested for antibacterial efficacy against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Proteus vulgaris, among other harmful microorganisms. The compounds have moderate to high antibacterial activity, among them heteroaromatic ring containing compounds  (3m, 3n, and 3o) elicited higher activity than the standard drug benzyl penicillin. The compound 3m having the pyridinyl compound displayed the maximum activity against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Proteus vulgaris, with zone of inhibition (in mm) values of 27.52±0.16, 28.85±0.11, 22.05±0.16, and 23.18±0.17, respectively. The synthesized compounds could be used as lead molecules in the development of novel antibacterial medicines.

Open Access Original Research Article

Determination of Platelets Parameters among People Vaccinated with Oxford-AstraZeneca Vaccine - COVID Vaccine at Khartoum State -Sudan

Wafa Salah Eldein Ibrahim Mohamed, Elharam Ibrahim Abdallah, Alaa Eltayeb Omer, Lienda Bashier Eltayeb

Journal of Pharmaceutical Research International, Page 529-535
DOI: 10.9734/jpri/2021/v33i59A34301

Background: The global SARS-CoV-2 vaccination program has been hampered by the rare-and initially inexplicable emergence of vaccine-associated thrombosis, particularly venous territory strokes or other venous obstructions, including portal vein thrombosis, which has been dubbed Vaccine-Induced Thrombotic Thrombocytopenia (VITT). So, this study was conducted to determine platelets parameters among people vaccinated with the AstraZeneca vaccine at Khartoum state.

Materials & Methods: A total of 50 AstraZeneca vaccinated participants (22 male and 26 female) were utilized as a case and 50 healthy non-vaccinated participants (21 male and 29 female) were used as control. The age of both groups ranged between (20-62) years with a mean of 34.6 ± 11.9. Platelets parameters were assayed for all patients using Sysmex KX-21.

Results: The statistical analysis was performed by using SPSS. The results of the study showed that there was no significant difference in platelets count and platelets indices when compared according to vaccine intake and gender. Also, the most frequent symptoms among vaccinated people were: muscle pain at the site of puncture (56%), fatigue (54%), fever (34%), headache (22%), nausea (16%), and diarrhea (6%) respectively and developed no symptoms (30%).

Conclusions: The study concludes that the side effects of the COVID-19 AstraZeneca vaccine in Khartoum state, Sudan was consistent with the manufacturers’ data.  Healthcare providers and recipients of vaccines can be more confident about the safety of Oxford-AstraZeneca COVID-19 vaccines.

Open Access Original Research Article

The Outcome of Photo-Therapy on Serum Calcium Values in Term Neonates: A Cross Sectional Study

Sachin Mulye, Rohini Gulhane, Revatdhama J. Meshram

Journal of Pharmaceutical Research International, Page 536-539
DOI: 10.9734/jpri/2021/v33i59A34302

Background: In the management of hyperbilirubinemia in neonates, phototherapy is an important treatment modality. Photo-therapy can cause skin rashes, diarrhoea, increase in body temperature, retinal damage and bronze baby syndrome. Photo-therapy is thought to influence serum calcium levels by inhibiting pineal melatonin secretion.

Aims and Objectives: The aim of this research was to see how photo-therapy affected serum calcium values in a term neonate.

Materials and Methods: Over the course of six months, 74 neonates were studied in the neonatology department of a tertiary healthcare centre in Central India.

Results: Calcium values fell in 77 % of the neonates in our sample, but only one case fell into significant symptomatic hypocalcemic range (1 percent).

Conclusion: According to the findings, neonates who are receiving photo-therapy have a higher risk of falling into the hypocalemic range. As a result, neonates should be strictly observed for calcium shifts and treated appropriately.

Open Access Original Research Article

Production and Analysis of Lip Balm using Herbal Resources

Jayshri C. Pawar, Ujjwala Y. Kandekar, Vijaya S. Vichare, Pranali N. Ghavane

Journal of Pharmaceutical Research International, Page 540-546
DOI: 10.9734/jpri/2021/v33i59A34303

Lip care products are an integral part of a day-to-day lifestyle. These impart the colour and protect the lips from the external environment. The major function of lip balm is to protect and moisturize the lips. A variety of lip care products are available in the market. The main concern with this product is that these contain synthetic colourant and flavouring agents that may have adverse effects such as darkening of lips. Besides, these may contain heavy metals that adversely affect various body organs. The current research work deals with preparation lip balm by using maximum possible natural ingredients and evaluation of the formulation. Various natural ingredients used were beetroot extract, Cocoa powder, Almond oil and Vitamin E. The physicochemical properties such as colour, odour, consistency, spreadability, melting point, pH and stability were studied. It was found that the formulation possesses red colour due to the addition of beetroot pigments, it had a typical flavour of cocoa powder, uniform in consistency and good spreadability. The melting point and pH of formulation were found to be 58-60°C ± 0.62 and 6.9 ± 0.25 respectively. The stability study indicated that formulation is stable at room temperature and refrigeration temperature. It can be concluded that lip balm formulation was successfully prepared by using these natural additives and better alternatives to synthetic excipients.

Open Access Original Research Article

Factors Associated with the Mental Health of Health Care Workers Exposed to Pandemic-COVID-19

Kalyani Yede, Shiney Chib, Ragini Patil, Neha Bhatt

Journal of Pharmaceutical Research International, Page 568-578
DOI: 10.9734/jpri/2021/v33i59A34305

Background: Pandemic, COVID is spreading like a wild fire and it has already become a global issue.  People all over the world are going through mental trauma due to the current situation of the globe. The most vulnerable situation is of the front line volunteers like doctors, health care workers, social workers who are coming in direct contact with the COVID patients and working in highly risky work environment. Since its inception in December 2019, Novel Corona Virus Disease started spreading rapidly both locally and internationally and looking to the adversity of the disease, World Health Organization (WHO) declared it has pandemic. The aim of this paper is to explore the determinants associated with the Mental Health of Health Care Workers (HCW) during the pandemic Novel Coronavirus (COVID-19).  Questionnaire was developed having both demographic questions and questions related to mental health. Data was collected from 433 HCWs who were the front-line workers, involved directly in handling these patients. Questionnaire was classified into two parts; one included the demographic questions and the second part included questions related mental health and occupational stress.  These HCW were the front line works and were more vulnerable and were having the high risk of getting affected.  Percentage analysis was used to analyse the demographic data.  Exploratory factor analysis was used to explore the dimensions related to mental health and occupational strength.  Multi regression model was used to check the impact of emerged factors like increased workload, the continuous contact with COVID-19 patients and emotional aspects to mental health and occupational stress.

Results: Value of R2 obtained was 0.778, which means, the derived factors namely Work pressure, optimism ,Risk factor, Emotional Exhaustion , Self control, Discomfort were able to explain 77.8 % of the dependent variable ‘Mental Health’. All the above factors influence Respondent’s Mental Health, as the significant the factors namely work pressure; risk factor and emotional exhaustion are directly proportional to Mental health.  Work pressure is the most influencing factor among it.  Optimism, self-control and discomfort are inversely proportional to Mental Health of HCW.

Conclusion: Most important emerged from this study was ‘Work Pressure’.  Due to the fast spread of this deadly virus, a war like situation has emerged and Health Care Workers are the most vulnerable people as they are serving the patients directly.  They are sacrificing their own physical and mental health and are serving the mankind.  These people deserves lots of appreciation and salutations.

Open Access Original Research Article

Formulation Development and Evaluation of Doxofylline Sustained-Release Tablets by Using Chitosan and Guar Gum

Pawan Avhad, Revathi Gupta

Journal of Pharmaceutical Research International, Page 552-567
DOI: 10.9734/jpri/2021/v33i59A34306

The sustained-release dosage form is a well-characterized and reproducible dosage form that is designed to control drug release profile at a certain rate to reach desired drug concentration in blood plasma or at the target site. There is immense demand in the market for new sustained-release formulations used for new drug molecules which release the drug at a sustained rate. Doxofylline is one of the widely useful drugs in the market and needs to be given in a single dose for a long duration of time. For the same, we have prepared a sustained released Doxofylline tablet.

Aim: This research was done to design, formulate and evaluate Doxofylline sustained-release tablets by using different concentrations of Chitosan and Guar Gum. 

Methods: The factorial design was used to prepare Doxofylline sustained-release tablet. Doxofylline sustained-release tablets were prepared to employ different concentrations of Chitosan, Guar Gum, Lactose, and Magnesium Stearate in different combinations by wet granulation technique. Total 9 formulations were designed, formulated, and evaluated for the hardness, thickness, friability, % drug content, and in-vitro drug release.

Results: A study of the release of drug by in-vitro found that F8 is to be the best efficient formulation which consists of both Chitosan and Guar Gum helped in delayed the release of drug up to 24 hours and performs excellent release of drug in starting hours of drug release in the body. The drug released from the F8 formulation indicates the kinetic model of First Order, by anomalous diffusion. The formulation F8 shows optimum thickness, hardness and at 40ºC±2 99.35% drug release after 24 hours shows optimum formulation. 

Conclusion: This study concludes that better drug release was observed by using natural polymers.  Doxofylline with natural polymer shows good release and better dissolution rate as compared with a single synthetic polymer. Synthetic drug with natural polymer shows more future scope and this work will help the researcher in the future.

Open Access Original Research Article

Molecular Docking and Validation of Methicillin Resistant Staphylococcus aureus Targets against Geninthiocin

G. S. Subha Lakshmi, A. Ronaldo Anuf, Samuel Gnana Prakash Vincent

Journal of Pharmaceutical Research International, Page 579-590
DOI: 10.9734/jpri/2021/v33i59A34307

Antibiotic resistance has been a serious public health concern in recent years. Methicillin resistant “Staphylococcus aureus” (MRSA) is a superbug that causes life threatening infections of Humanity which is difficult to treat. Geninthiocin is a macrocyclic thiopeptide with a 35-membered core moiety, which was isolated from marine streptomyces sp. ICN19, which has proven potent activity against MRSA.  Five target proteins PDB ID: 4YMX, 3ZDS, 3QLB, 4IEN and 1DXL were identified from MRSA for their presumptive action for Geninthiocin. In this study, we used molecular docking and molecular dynamic simulation, in order to validate Geninthiocin’s potential target protein.  Target proteins were subjected to ligand-protein docking studies. Based on their docking scores and Hydrogen bonding interactions, two possible proteins 4YMX and 3ZDS were further subjected to simulation strategies to validate the protein-drug interaction. Out of which, homogentisate1,2 dioxygenase turned out to be a possible drug target for Geninthiocin. The compound Geninthiocin could be developed as a potential inhibitor against the target protein homogentisate1,2-dioxygenase for exhibiting an effective antimicrobial activity.

Open Access Original Research Article

Frequency and Risk Factors of Wound Complications in Type II Diabetic Patients Undergoing Abdominal Surgery

Abdul Samad Tayyab, Maria Qurban, Maryam Mazhar, Zaid Tayyab, Mariam Tahir, Zain Tayyab

Journal of Pharmaceutical Research International, Page 591-595
DOI: 10.9734/jpri/2021/v33i59A34308

Introduction: Poorly controlled type II diabetes is associated with an array of micro-vascular, macro-vascular, and neuropathic complications.

Objectives: The main objective of the study is to analyse the frequency of wound complications in type II diabetic patients undergoing abdominal surgery.

Material and methods: This cross sectional study was conducted in THQ haveli lakha, Okara with the collaboration of Sir Ganga Ram Hospital, Lahore during March 2021 to August 2021. The data was collected through non-probability consecutive sampling technique. There were 120 patients which were enrolled in this study according to the inclusion and exclusion criteria. A systematically designed questionnaire was made for the collection of data.

Results: The data was collected from 120 patients. The mean age was 55.5± 2.57 years. Most of the particpants was male (51.1%), non-smokers (95.6%) and didn't have hypertension (67.8%). The mean time of diabetes mellitus was 6.1±5.6 a long time. The majority didn't have neuropathy (81.1%), peripheral strokes (90.0%), pre-ulcerous states (90.0%), insensitive (89.9%), crevices on feet (64.4%), nail pathology (97.1%), injury disfigurement (93.3%) or incapacity (94.4%).

Conclusion: It is concluded that it is difficult to treat the wound complication in diabetic patients. Diabetic patients are at an increased risk of postoperative surgical site infection while undergoing open surgery, laparoscopic cholecystectomy has no increased morbidity in diabetic patients as compared to non-diabetic patients.

Open Access Original Research Article

Awareness and Knowledge of the Adult Population in Saudi Arabia on Teeth Discoloration and Treatment Options: A Cross-Sectional Study

Basil Y. Alamassi, Hatem S. Alahmari, Mohammed S. Alhabashy, Abdulrahman A. Talha, Khalil W. Alfehaid, Abdulaziz A. Alhuwaymil

Journal of Pharmaceutical Research International, Page 603-613
DOI: 10.9734/jpri/2021/v33i59A34310

Background: Tooth discoloration is a common condition. Discoloration can be a major aesthetic concern for some people and it can indicate pathology, so it needs to be addressed. The success of treatment of tooth discoloration is largely dependent on the knowledge and attitude of people towards it. Hence the aim of this cross-sectional questionnaire-based study was to evaluate knowledge and awareness of the adult Saudi population about the causes of tooth discoloration and its treatment options.

Materials and Methods: An online close-ended questionnaire consisting of 21 questions about tooth discoloration causes and treatment options were uploaded in Google Forms and was sent to 2000 adults in Saudi Arabia via email and social media websites. The questions were designed to evaluate patients’ knowledge about the various causes of tooth discoloration.

Results: A total of 1041 participants responded to our questionnaire. The study included 560 females (53.79%), and 448 participants aged between 18 and 24 years (43.04%), 192 (18.44%) between 25 and 35 years, 246 (23.63%) between 36 and 51 years, and 155 (14.89%) above 51 years. Most of the participants (n= 649; 62.34%) had a bachelor's degree. The most common answer to the type of teeth discoloration was internal and surface discoloration (n= 511; 49%). There was a positive response to the effect of diet, smoking, aging, and bacteria on tooth discoloration. 79% of the participants did not know what dental fluorosis is. The response to the effect of drugs on teeth discoloration split between "Yes" and "I don't know," and 688 of the participants (66.09%) did not know which drugs cause teeth discoloration. The personal effort was the most common way to obtain information about teeth discoloration (n= 678; 65.13%).

Conclusion: Within the limitations of this study, the level of knowledge about tooth discoloration was more concentrated on extrinsic factors, and the majority of the participants demonstrated poor knowledge about the intrinsic causes of tooth discoloration. The preferred treatment option of teeth discoloration was in office bleaching.

Open Access Original Research Article

DNA Extraction and Quantification of Some Economically Important Fruits in Tamil Nadu

K. Kamalakkannan, V. Balakrishnan, R. Sumathi, N. Manikandaprabu

Journal of Pharmaceutical Research International, Page 614-622
DOI: 10.9734/jpri/2021/v33i59A34311

Humans can benefited greatly from functional foods in order to preserve good health. The research began with the extraction of DNA from the white edible section of Cocos nucifera and the flesh of Borassus flabellifer fruits using the simple, Edward, PCI, and CTAB methods. To confirm the existence of DNA, the complete isolated DNA was examined using the DPA and Keller-killani tests. Following the identification test, UV spectroscopy was used to quantify the results by taking the absorbance of the samples at 260nm and 280nm and quantified using absorbance ratio procedure. When compared to other procedures, the CTAB approach produces acceptable results at low temperatures. Both the white edible part of Cocos nucifera and flesh of Borassus flabellifer gave high purity DNA on extraction. Further the concentration of DNA obtained from Cocos nucifera was 4.94, 4.7, 5.25 and 8.25 µg\ml by simple, Edward PCI and CTAB methods respectively and for Borassus flabellifer the concentration DNA isolated was found to be 2.48, 2.14, 4.25, 6.4 µg\ml by simple, Edward PCI and CTAB methods respectively.

Open Access Original Research Article

Effect of Use of Antifungal (Clotrimazole) Drug in Reducing the Number of Colonies of Candida albicans and Its Correlation with Clinical Candidiasis in the Patients Undergoing Progressive Radiotherapy for the Cervicofacial Region

Ashish Lanjekar, Pranada Deshmukh, Devendra Palve, Monal Kukde, Isha Madne, Komal Deotale

Journal of Pharmaceutical Research International, Page 626-633
DOI: 10.9734/jpri/2021/v33i59A34313

Aims: To evaluate the effect of topical antifungal Clotrimazole on candida colonies and its correlation with clinical candidiasis in patients undergoing radiotherapy.

Study Design: Randomised Clinical Trial

Place and Duration of Study: Rashtrasant Tukdoji Maharaj Cancer Institute, Nagpur between June 2020 and July 2021.

Methodology: 64 patients (52 males and 12 females) undergoing Co60 teletherapy for cervicofacial malignancies were randomly divided in two groups. 32 patients referred to as study group were put on antifungal treatment (1% Clotrimazole) for topical application and other group was the control group and was not given antifungal medication. During the radiotherapy and 6 weeks after the completion of radiotherapy, patients were examined every week for possible oral changes for clinical candidiasis, and swabs were taken at every end of the week for determining candidal colonies.

Results: The overall incidence of clinical oral candidiasis was 46.9% throughout RT in the control group and there was no incidence of clinical candidiasis in the study group. Patients with clinical candidiasis 6-week post-radiation therapy showed continuous symptoms of clinical candidiasis but with the reduction in candidal colonies.22% of patients were oral carriers for candidal colonies. Also, the study group showed not a single patient with clinical candidiasis.

Conclusion: During radiotherapy, although with the use of clotrimazole some patients with negative culture may also become positive for Candida albicans and there may be some increase in the several colonies of Candida albicans (very less in number as compared to the control group), but its use prevents the development of clinical candidiasis. Antifungal prophylaxis is useful in combating clinical candidiasis.

Open Access Original Research Article

Evaluation of Nutrient, Mineral Analysis and Quality Characterization of Gymnema sylvestre Multi Grain Cookies for Diabetes

Dhanapal Indumathi, Ramasamy Sujatha, Palanisamy Shanmuga Sundaram

Journal of Pharmaceutical Research International, Page 638-648
DOI: 10.9734/jpri/2021/v33i59A34315

Diabetes is a group of metabolic disorders with various etiologies that are defined by persistent hyperglycemia and worsening carbohydrate, lipid, and protein digestion due to flaws in insulin discharge and insulin activity. Indians account for one out of every five diabetics of the world. Around 35 million Indians suffer from diabetes, which affects around 150 million individuals worldwide. Because health is a major concern in people’s daily lives, foods that are healthy and beneficial to health are becoming increasingly popular. Natural food variations are widely used for the prevention and treatment of a variety of healthy issues. Supplements such as protein, iron, and calcium can be found in plenty of treats. The goal of this study was to develop solid treats using Gymnema sylvestre leaf powder, an Ayurvedic component with increased nutraceutical value. Multigrain powder, heating powder, palm sugar, cardamom powder, Margarine, salt, bubbling blend, and G.sylvestre leaf powder were among the ingredients used to make the solid snacks. The powder was created by drying the leaves in a plate dryer at 50°C for 2 hours before crushing in a home processor. G.sylvestre leaf powder was fused at different percentages: 0.25 percent, 0.50 percent, 0.75 percent, and 1.00 percent. Supplement testing, mineral analysis, and tactile testing are not set in stone. Atomic Absorption Spectroscopy was used to determine mineral composition. Over a variety of examples, test 0.50 percent sound snacks were found to be organoleptically superior.          

Open Access Original Research Article

Pulsatile Delivery of Fexofenadine Hydrochloride Pulsincap by Box-Behnken Design

D. Prasanthi, Shreya Ajay Rajguru, C. Aishwarya, Aisha Rahman

Journal of Pharmaceutical Research International, Page 649-663
DOI: 10.9734/jpri/2021/v33i59A34316

Objective: Fexofenadine hydrochloride is a selective peripheral H1-blocker, used for allergy symptoms, such as hay fever and urticaria. Allergic symptoms are aggressive during early morning hours, so a pulsatile delivery system with a lag time of 4-5 hours was formulated and optimized by Box-Behnken design.

Materials and Methods: Pulsincap system using formaldehyde-treated capsules and hydrogel plug.  Box-Behnken design was applied for optimization in which three independent variables, X1= Drug: polymer ratio, X2 = Polymer: polymer ratio (Ethylcellulose: HPMC E15) and X3 = Plug weight were selected. Three dependent variables R1 = Percent release of drug after 4 hours, R2 = percent release after 10 hours and R3 = Lag time were selected.

Results: FTIR and DSC studies confirmed compatibility of drug and excipients. The empty formaldehyde-treated capsules were evaluated for physical appearance, solubility, capsule dimensions and formaldehyde content. Hydrogel plugs, powder blend and pulsincap formulations were evaluated for Physico-chemical parameters and all the parameters were within acceptable limits. Contour plots and Response surface plots indicated that as Drug: Polymer ratio (X1) and Plug weight (X3) increased, Lag time increased but% drug release decreased. As Polymer: Polymer ratio (X2) increased, the lag time was at a moderate level. Predicted vs actual responses showed the correlation of 0.786 for% release in 4hrs, 0.9744 for% release in 10hrs and 0.6281 for lag time. Optimized formulation G1 was suggested by design (with criteria 4.5-6hrs lag time, 10-20% release in 4hrs & 60-70% drug release within 10hrs). The optimised formulation was stable.

Conclusion: Pulsincap system of Fexofenadine hydrochloride can be obtained by using retarding polymers like ethyl cellulose, HPMC E15 and formaldehyde cross-linked capsules.

Open Access Original Research Article

Pharmaceutical Care Network Europe (PCNE) Drug-Related Problems Classification Version 9.1: First Implementation in Sudan

Kannan O. Ahmed, Hiba F. Muddather, Bashir A. Yousef

Journal of Pharmaceutical Research International, Page 699-706
DOI: 10.9734/jpri/2021/v33i59A34321

Background: Clinical pharmacy services are an emerging specialty in Sudan. Many tools exist to document drug-related problems (DRP), such as the Pharmaceutical Care Network Europe (PCNE) classification. However, none has been attempted and published in Sudan.

Objectives: The study aimed to identify the DRP and its characteristics in real hospital setting using non-modified version of PCNE.

Method: Prospective study of clinical pharmacists' interventions during the routine care work of reviewing patients over a period from December 2020 to February 2021 at the wards of National Cancer Institute, University of Gezira, Sudan. Main outcome measure Using non-modified PCNE version 9.1 to identify the number, types, causes of the DRP, clinical pharmacists' interventions, acceptance, and outcomes.

Results: Five minutes (range, 3-15 minutes) was the median time spent for evaluation and intervention by the clinical pharmacists, a total of 51 DRP were discovered among 40 patients with an average of 1.3 DRP per patient, an adverse drug event (possibly) occurring (29.4%) was the main problem, no or incomplete drug treatment (27.5%) was the main causes, above one-third of the clinical pharmacists' interventions were proposed to the prescriber, these interventions were accepted in 96% and fully implemented among 72.5% of the cases. At the end of the process, the majority of DRP (72.5%) were totally solved.

Conclusion: Non-modified PCNE version 9.1 provides a suitable tool for the DRP process for Sudanese clinical pharmacists during routine work in the oncology setting. It hence can be considered as an optimal tool for further quality and policymaking.

Open Access Original Research Article

Study of the Stages of Cardiorehabilitation in Patients with Acute Coronary Syndrome

Aset Magomedovna Elizhbaeva, Alexandra Viktorovna Em, Tamila Khizirovna Iusupova, Albina Borisovna Kubanova, Kamila Monarbekovna Tyurubaeva, Irina Nicolaevna Forostovskaya, Fatima Elderkhanovna Khuseinova, Alina Yurievna Maslova, Artem Evgenievich Mishvelov

Journal of Pharmaceutical Research International, Page 739-744
DOI: 10.9734/jpri/2021/v33i59A34323

According to Russian clinical guidelines, there are three main stages of cardiorehabilitation associated with the periodization of the disease. Acute coronary syndrome is one of the most dangerous conditions in the world of modern cardiology, after which patients are at high risk of the appearance and development of chronic pathologies, in particular the development of type 2 diabetes mellitus. According to the latest data, there was a statistically significant increase in the number of new cases of diabetes mellitus after an episode of acute coronary syndrome. Doctors should provide high-quality assistance in the rehabilitation of patients after acute coronary syndrome, especially at the last stage of cardiorehabilitation, which is carried out in outpatient settings.

Open Access Original Research Article

Spectroscopic Estimation of Doxylamine Succinate in Tablets and Human Plasma by Formation of Ion-pair Complex

Narender Malothu, Sowjanya Ravuri, Balakrishna Muthyala, Narayana Rao Alla, Anka Rao Areti

Journal of Pharmaceutical Research International, Page 686-698
DOI: 10.9734/jpri/2021/v33i59A34325

Aim: To develop a simple spectroscopic method for estimation of doxylamine (DOX) succinate in its tablet dosage form and human plasma with the aid of an ion-pair complex formation.

Methods: In this method, methyl orange (0.05 % w/v) dye was used to form an ion-pair complex in acetate buffer (1M; pH: 5.00) at 300 C ± 20C. The ion-pair complex formed was extracted with chloroform. The maximum absorbance for the ion-pair complex was measured at 420 nm.

Results and discussion: The method conditions were obeyed Beer's law in the concentrations ranging from 5-25 µg/mL of DOX succinate with a correlation coefficient (r2) of 0.992. The ion-pair (drug-dye) complex was formed in a 1:1 ratio which was demonstrated by Jobs' method of continuous variation. The method was satisfied the validation criteria as per ICH (Q2R1) guidelines. Accuracy studies showed 99.06-100.9 % recovery of the analyte. The responses of the precision and robustness were found within acceptable limits (<2% RSD). The LOD and LOQ values were found as 0.31 and 0.939 µg/mL, respectively.

Conclusion: The developed method was simple, specific, and economical and requires a short analysis time. Therefore it could be considered for precise analysis of DOX succinate in biological matrices.

Open Access Original Research Article

A Stability Indicating RP-HPLC Method Validation for Simultaneous Estimation of Metformin HCl, Dapagliflozin and Saxagliptin in Pharmaceutical Dosage Form

Darshak Patel, Ujashkumar Shah, Jayvadan Patel, Darshana Patel, Pavan Patel

Journal of Pharmaceutical Research International, Page 754-767
DOI: 10.9734/jpri/2021/v33i59A34326

Aims: Metformin HCl, Dapagliflozin and Saxagliptin is a new drug combination for the treatment of Diabetes Mellitus which is one of the oldest and lethal diseases of mankind. Aim of the research work was to develop and validate novel, rapid, sensitive, specific, robust stability indicating analytical method for simultaneous estimation of: Metformin HCl, Dapagliflozin and Saxagliptin in pharmaceutical dosage form as fixed dose formulation.

Study Design: Method development and validation was performed as recommended in ICH guideline “Validation of analytical procedures: Test and Methodology Q2 (R1)”.

Methodology: Method develop with chromatographic parameters as C18 column (250mm×4.6 mm, 5mm particle size), HPLC system with PDA detector and mobile phase contained a mixture of Phosphate Buffer pH 3.5 and Acetonitrile (80:20 v/v) + 1 ml triethylamine per 100 ml mobile phase. The flow rate was set to 1 ml/min with responses measured at 265 nm, injection volume was 20 µl, and run time of 15 mins.

Results: The retention time of Metformin HCl, Dapagliflozin and Saxagliptin was 5.8 min, 6.8 mins and 8.4 min respectively with resolution of 3.5 between Metformin HCl and Dapagliflozin and 4.5 between Dapagliflozin and Saxagliptin. Linearity was established in the range of 250-1500 µg/ml for Metformin HCl, 1.25-7.5 µg/ml for Dapagliflozin and Saxagliptin with correlation coefficients more than 0.999. The percentage recoveries were between 98.39-101.66 for Metformin HCl, 99.01-101.77 for Dapagliflozin and 98.88-101.87 for Saxagliptin Validation parameters were evaluated according to the International Conference on Harmonization (ICH) Q2 R1 guidelines. The forced degradation studies were performed by using HCl, NaOH, H2O2, thermal and UV Radiation. The developed method was successfully applied for the quantification and hyphenated instrumental analysis.

Conclusion: Significance of developed method is that it can be utilize for routine or unknown sample analysis of assay of Metformin HCl, Dapagliflozin and Saxagliptin in pharmaceutical dosage form developed by various Pharmaceutical Industry.

Open Access Original Research Article

A Novel Ultra Performance Liquid Chromatographic Method for the Estimation of Lercanidipine in Bulk and Tablet Dosage Form

Satyabrata Sahu, U. Sunila Kumar Patra, Pratap Kumar Patra

Journal of Pharmaceutical Research International, Page 768-776
DOI: 10.9734/jpri/2021/v33i59A34327

Aim: In this present study an accurate reverse phase ultra-performance liquid chromatography (RP-UPLC) method has been developed, validated and applied to stability indicating studies to determine Lercanidipine HCL in bulk and marketed dosage form.

Methods: Optimized chromatographic conditions were achieved by using Waters Acquity BEH C18 (2.1 x 50mm, 1.7m) UPLC column. Empower 2 is a software, dihydrogen Orthophosphate Buffer : Methanol (40 : 60)  as eluent at flow rate 0.3 ml/min. PDA detection was performed at 254nm.

Results: The developed method was validated and stability study was conducted as per ICH guidelines. The retention time was found at 0.503 min. The method shows linearity over a range of 1 μg/ml to 60 μg /ml with the obtained correlation coefficient is 0.999. The LOD and LOQ values were found 0.025 and 0.05 μg /ml. The acidic and peroxide stressed study shows more degradation of 6.23% and 3.03%.

Conclusion: The present developed method was found stability indicating, reliable, validated method was applied for the routine analysis of lercanidipine in bulk drug and the pharmaceutical formulations.

Open Access Original Research Article

Fractures of Tibia Diaphysis Managed with Internal Fixation by Elastic Nails: An Alternative Approach

Bhushan Patil, Mohit Dadlani, Shounak Taywade, Amit Saoji, Sarthak Gupta

Journal of Pharmaceutical Research International, Page 777-783
DOI: 10.9734/jpri/2021/v33i59A34328

Background: Intramedullary nailing techniques specially using elastic nails like Enders nail are a good treatment option, owing to their cost effectiveness, less use of fluroscopy and ease of procedure with short learning curve. This study is aimed to bring evidence to the hypothesis that Ender nails can be used successfully in tibia shaft fractures under certain indications. Due to the economic nature and easy procedure, we aimed specifically to demonstrate that elastic IM nailing, esp. Ender nails can be a good alternative to interlock nailing for select cases of diaphyseal fractures. The study aims at evaluating outcome of Enders nail in diaphyseal tibia fractures.

Material and Methods: This study was carried on in the Department of Orthopaedics, tertiary care hospital during the period of April 2019 to March 2020. It is a prospective type of study. Patients were evaluated based on functionality and radiology, post-surgery.

Results: A total of 30 patients of tibial shaft fractures were selected and managed with closed reduction and internal fixation with Enders nail. Male to female ratio was 4:1. 24 (80%) patients sustained injury from motor vehicular accidents. 40% patients with open fracture and 60% closed fracture patients were involved. 60% if the patients showed clinic-radiological union in 12-14 weeks, while 50% of the patients achieved a post operative knee range of movement of 0 to 131-140 degrees.

Conclusion: Closed reduction with internal fixation by Enders nail can be a good alternative for management of tibia diaphysis fractures, when performed after proper patient selection and patient counselling.

Open Access Original Research Article

Brain Tumor Classification using Machine Learning

N. Pavitha, Atharva Bakde, Shantanu Avhad, Isha Korate, Shaunak Mahajan, Rudraksha Padole

Journal of Pharmaceutical Research International, Page 790-797
DOI: 10.9734/jpri/2021/v33i59A34330

This paper presents a technical analysis of tumor data with Machine Learning and Classification Approach. Feature parameters which are dependent for classification of tumor are used for analyzing and classifying the class of tumor. In the classification of tumor, KNN-Classifier is implemented with cross validating accuracy score and tuning hyper parameters. Experimental simulation for best average score for K makes it to the cross validation. Approaching the prediction with the best accuracy score, hyper parameters of KNN Classifier states the best score. Using Principal Component Analysis on the data, miss-classification of tumor class in data is visualized.

Aims: To declare and analyse tumor data from the source of MRI, CT scan, etc. for medication of tumor. To utilize smart predictions for the upcoming tumor patients using Machine Learning.

Study Design:  Tumor classification using K Nearest Neighbor algorithm and analysis of the miss-classification.

Methodology: We included 11 different studies and research papers which were relevant with tumor classification. Research papers include classification of tumors with different supervised learning approaches. Our proposed analysis and classification give visualization of two classes of tumor.

Results: The Project results in classification of tumor data using Machine Learning and analyzing the miss-classification of tumor. In implementation of KNN Algorithm, the accuracy score after cross validation and tuning K values is 0.97. The confusion matrix shows 4 false positives and 1 false negative value in testing.

Conclusion: Less miss-classification of tumor results best accuracy score and more efficient working on testing data. Visualizing the classification with 3-dimensional scatter plots made the analysis accurate.

Open Access Original Research Article

Phytochemical Analysis of Fagonia schweinfurthii Hadidi

Yamini Joshi, B. K. Jain

Journal of Pharmaceutical Research International, Page 803-811
DOI: 10.9734/jpri/2021/v33i59A34332

Fagonia schweinfurthii Hadidi (family zygophyllaceae) is plant of desert region .In Gujarat it is found on the coastal area of Dwarka, Bet Dwarka and Rann of Kachcha. It is locally called dhamasia or dhamaso. Plants parts including leaves, roots, rhizomes, stems, barks, flowers, fruits, grains or seeds which can be employed in the control or treatment of infectious disease which causes damage to the respiratory system, urinary tract, gastrointestinal and bilary systems and on the skin. The plant parts contain chemical components that are medically active. Tribal people living in desert region use this plant to cure number of ailments such as skin eruptions, skin diseases, anti- pyretic, in pain relief, in heal sores, ear infection, venereal diseases etc. In the new era of science and technology there is increasing need to validate the claims of traditional knowledge database for safe, easily available, cheap, side- effect free healthcare provisions. In the present study preliminary phytochemical analysis of plant parts of Fagonia schweinfurthii Hadidi was done by the standard method of Sofowora, 1982; Trease & Evans, 1989 method, which confirms the presence of alkaloids, tannin, saponin, terpinoid and steroids. High Performance Thin Layer Chromatography method was developed using mobile phase containing Chloroform: methanol: acetic acid in ratio 70:30:0.2 for detecting phyto-active constituents from the methanolic extracts of the leaf, stem and root of Fagonia schweinfurthii Hadidi. Methanolic extract of Fagonia schweinfurthii Hadidi of leaf, stem, fruit and root detected 8, 8, 7 and 4 numbers of peaks at 254 nm and at 366 nm 10, 12,  13 and 12 numbers of peaks from leaf, stem, fruit and root extract of Fagonia schweinfurthii Hadidi were detected.

Open Access Original Research Article

Saudi Population Awareness Regrading Methods of Colorectal Cancer Screening

Mohammed Abdelrazik, Osamah Zeid Aldakkan, Afnan Abdaljabbar Almurashi, Balsam Ghazi Alshareef, Saad Abdulmalik Almohareb, Khuloud Hussein Alshaya, Reema Saleh Alzahrani, Mohammed Ahmed Algarni, Miad Matuq Alosaimi, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Page 812-820
DOI: 10.9734/jpri/2021/v33i59A34333

Aims: To assess the level of knowledge about colorectal cancer screening methods among the population in Saudi Arabia.

Study Design: A cross-sectional study

Place and Duration of Study: General Surgery Department, between January 2021 and November 2022.

Methodology: This was a cross-sectional, survey-based study conducted in Saudi Arabia. Data was collected using a predesigned self-administered online questionnaire. Inclusion criteria include Saudi male and female between 18-65 years in Saudi Arabia. Then data were analyzed by the SPSS program, version 25 at a level of significance of 0.05.

Results: A total of randomly taken 794 participants who filled our questionnaire according to the inclusion criteria. Most of our participants (67.1%) were females and 32.9% of them were males. Only 17.5% of the participants were less than 20 years old, 62.5% of them were between 20 and 30 years old and 20% were more than 30 years old. Most of our participants (58.3%) were university educated,

Conclusion: CRC screening were not well known in Saudi Arabia. Educational programs are compulsory and should target people at risk.

Open Access Original Research Article

Awareness of Parents Regarding DKA Symptoms in their Children with Type I DM

Nazim Faisal Hamed, Manal Mohammed E. Alhawiti, Eman Hamed A. Albalawi, Lena Defallah G. Alzahrani, Raghad Mohammed E. Alhawiti, Sahar Yahya S. Alatawi, Maram Atallah M. Albalawi, Bashaier Musslum M. Albalawi, Alanoud Abdullah M. Alzahrani, Maram Saleh Ahmed Alsayed, Yassmeen Hmoud S. Alblowi, Ziad Saleh D. Albalwi, Khaled Abdullah S. Alasmari

Journal of Pharmaceutical Research International, Page 821-830
DOI: 10.9734/jpri/2021/v33i59A34334

Background: Diabetic ketoacidosis (DKA) is a common emergency and life-threatening illness. Also, if not detected early, early treatment in the emergency room can cause serious complications. The goal of managing type 1 diabetes is to maintain the correct levels of blood sugar, glycated hemoglobin (HbA1c), blood pressure, lipid levels, and body weight while avoiding hypoglycemia. Treatment of type 1 diabetes requires proper insulin treatment, proper nutrition, physical activity, preventive education, and patient self-care Objective: The purpose of this study is to determine parental perceptions of DKA symptoms in children with type 1 diabetes in the Northern Region of Saudi Arabia.

Methods: In the Northern Region of Saudi Arabia, a cross-sectional study was conducted from November 2020 to May 2021 among parents with diabetic children at the Diabetes Center in the Northern Region of Saudi Arabia using a pre-designed online questionnaire distributed on social media web-sites to collect data.  Data was analyzed by using statistical package for the social sciences (SPSS, version 23) and results was presented by tabular and graphical presentation according to the study objectives.

Results: only 42.9% of our participants responded that they have good knowledge about DKA. 19.2% thought it only occurs in children. 43.3% of our participants knew that DKA is a complication of diabetes due to hyperglycemia. Regarding the source of information about DKA among our participants, our data demonstrated that only 22.9% of our participants got their information about DKA from the doctors, and 31.8% of the participants had the internet as their source of information regarding DKA. In the current study, 14% of the participants said that they had a child had DKA at least one, and 91.6% of them were admitted to the hospital. There was a significant relation with gender, age of the parent, and educational level, while it showed insignificant relation with marital status.

Conclusion: In conclusion, knowledge of most of parents of diabetic children about diabetic ketoacidosis is poor. Their main knowledge source is not trustful or adequate. Their main knowledge source is not trustful or adequate. Therefore, we recommend policy makers to held health education to parents and/or caregivers of type 1 diabetic children regarding all aspects of DKA. It must be properly achieved in a structured manner based on a general outline that should include education at the onset of treatment and then repeated based upon an annual assessment of patients’ training needs or upon their own request. Areas of poor knowledge related to diabetes and diabetic ketoacidosis should be emphasized during health education sessions.

Open Access Original Research Article

The Outpatient Use of Ascorbic Acid in a Public Healthcare Organization in Riyadh Region

Nehad J. Ahmed, Mohammad Javed Ansari

Journal of Pharmaceutical Research International, Page 831-835
DOI: 10.9734/jpri/2021/v33i59A34335

Aim: The present study aimed to describe the outpatient use of ascorbic acid in a public healthcare organization in Riyadh Region.

Methodology: This is a retrospective study included reviewing the outpatient electronic prescriptions that contained ascorbic acid in a public healthcare organization in Riyadh Region.

Results: More than 51% of the patients who received ascorbic acid in the hospital during 2018 were females and the age of 57.14 % of them was less than 30 years. Most of the prescriptions were regular prescriptions (88.57%) and only 5.71% of the prescriptions were urgent prescriptions. More than 42% of the patients received ascorbic acid for 1 week and 37.14% of them received it for 1 month. Most of the prescriptions were prescribed by residents (85.71%) and most of these prescriptions were prescribed by emergency department (80.00%).

Conclusion: The prescribing of ascorbic acid was uncommon in the public hospital. More studies are needed to know the frequency and the pattern of using ascorbic acid in the public hospital and in other healthcare organizations in Riyadh Region.

Open Access Original Research Article

Mebeverine Prescribing in the Outpatient Setting in Riyadh Region

Nehad J. Ahmed, Mohamed R. Alsubaie, Abdullah T. Almutairi

Journal of Pharmaceutical Research International, Page 842-846
DOI: 10.9734/jpri/2021/v33i59A34337

Aim: The present study aimed to explore mebeverine prescribing in the outpatient setting in Riyadh Region.

Methodology: This was a retrospective study that included reviewing the outpatient prescriptions of mebeverine in a governmental hospital in Riyadh Region. The study excluded the prescriptions that were prescribed by other settings and the outpatient prescriptions that didn’t contain an mebeverine.

Results: During the study period between January 2018 to June 2018, mebeverine was prescribed to 113 patients. most of them were females (62.83%). The age of 29.20% of the patients was between 50 and 59 years. Most of the prescriptions that contained mebeverine were written by residents (86.73%) and most of the prescriptions that contained mebeverine were prescribed by internal medicine (34.51%), gastroenterology (23.89%), and emergency (21.24%) departments.

Conclusion: The present study showed that mebeverine was prescribed commonly in the outpatient setting. More studies are needed to explore the frequency of prescribing mebeverine and the frequency of prescribing other antispasmodic medications in different settings.

Open Access Original Research Article

Quantification and Stability Indicating Method Development and Validation of Vismodegib in Bulk and Pharmaceutical Dosage Form by Ultra Performance Liquid Chromatography

V. Mohan Goud, M. Harini, CH. B. Praveena Devi, M. Meghana Goud

Journal of Pharmaceutical Research International, Page 858-866
DOI: 10.9734/jpri/2021/v33i59A34340

Background: Vismodegib (VMD) is a drug of choice for the treatment of basal-cell carcinoma. Present studies carried out to estimate VMD by RP-UPLC technique and to develop a simple, précised, accurate method for routine analysis.

Methods: For this purpose Chromatographic conditions used were stationary phase STD BEH C18  column (100 mm x 2.1 mm, 1.8m), a mixture of Methanol:KH2PO4 taken in the ratio 50:50%v/v as a mobile phase with a pH 7.4 and flow rate was maintained at 0.3ml/min, detection wave length was Acquity TUV 254nm, column temperature was set to 30oC and diluent was mobile phase, Conditions were finalized as optimized method.

Results: System suitability parameters were studied by injecting the standard six times. Linearity study was carried out between 25% to150% (37.5-225µg/ml) levels, R2 value was found to be as 0.9992. Precision was found to be 0.6 for repeatability and 0.4 for intermediate precision. LOD and LOQ are 0.33 µg/ml and 0.99 µg/ml respectively and results were well under the acceptance criteria.

Conclusion: By using above method assay of marketed formulation was carried out and was found 100.12%. Degradation studies of VMD were done, in all conditions purity threshold was more than purity angle and within the acceptable range. The developed method was simple and can be used for routine analysis.

Open Access Original Research Article

The Outpatient Prescribing Pattern of Topical Lidocaine in Al Seih

Nehad J. Ahmed, Mohammad Javed Ansari

Journal of Pharmaceutical Research International, Page 867-871
DOI: 10.9734/jpri/2021/v33i59A34341

Aim: The present study aimed to describe the prescribing pattern of topical lidocaine in the outpatient setting in Al Seih.

Methodology: This is a retrospective study that includes reviewing the electronic prescriptions that contained topical lidocaine among outpatients in a public hospital in Al Seih.

Results: More than 52% of the patients who received topical lidocaine were males and the age of 36.84% of them was between 30 and 39 years.  Most of the patients who received topical lidocaine for 7 days (64.47%). Topical lidocaine prescriptions were written mainly by residents (96.05%). More than 55% of the topical lidocaine prescriptions were prescribed by the emergency department and 38.16% of the prescriptions were prescribed by general surgery department.

Conclusion: The present study showed that the prescribing of topical lidocaine was uncommon in Al Seih. Further studies are required to investigate the pattern and the frequency of topical lidocaine and other topical anesthetics in the outpatients setting and in other settings.

Open Access Review Article

Overview on Causes, Diagnosis and Management of Knee Injuries in Children and Adolescents: Review Article

Nazim Faisal Hamed, Mohammed Hussen Sheikha, Ahmed Sughayyir Albalawi, Abdulrahman Abdullah Aloufi, Abdullah Khalaf A. Alshammari, Sawsan Musri Althubyani, Nouf Dhaifallah Ali Almatrafi, Emtenan Adel Hussain Saraj, Manal Mohammed E. Alhawiti

Journal of Pharmaceutical Research International, Page 24-31
DOI: 10.9734/jpri/2021/v33i59A34245

This review aimed to summarize the updates in the causes, diagnosis and management of knee injuries in children and adolescents. Knee injuries are common and are often the result of multiple forces: varus, valgus, hyperextension, hyperflexion, internal rotation, external rotation, anterior or posterior translation, and axial loading. Certain combinations of force are known to cause specific patterns of injury. A knee injury can affect any ligaments, tendons, or fluid-filled sacs (bursae) that surround the knee joint, as well fas the bones, cartilage, and ligaments that make up the joint itself. ACL injuries are one of the most common types of knee injuries, including a torn meniscus that is common in sports that require jumping jacks, patellar fractures, and knee bruises. Magnetic resonance imaging (MRI) is often used to more fully evaluate knee injuries. Radiologists can accurately identify individual lesions and combinations of lesions. Surgical and non-surgical treatments are performed depending on the case.

Open Access Review Article

A Review on SLN and NLC for Management of Fungal Infections

B. G. Ramu, K. M. Asha Spandana, K. Divith, A. G. Nagashree, Amit B. Patel, S. Preethi

Journal of Pharmaceutical Research International, Page 65-81
DOI: 10.9734/jpri/2021/v33i59A34250

Fungal disease is an invasive, serious, and systemic topical infection that affects the mucous membranes, tissues, and skin of humans. Oral medicines, on the other hand, have significant side effects, making topical treatments a viable alternative. Many antifungal medications applied through the skin in various conventional forms (gels or creams) may cause skin redness, erythema, stinging, and burning sensations. A promising approach to overcome the limitation of conventional form is the use of Nanocarriers for the treatment of skin infections since it allows targeted drug delivery, enhanced skin permeability, and controlled release and hence offers a lower risk of side effects. During the last few decades, lipid nanoparticles (LNPs) such as solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) have gained a lot of attention. SLNs were designed to overcome the drawbacks of conventional colloidal carriers, such as emulsions, liposomes, and polymeric nanoparticles, by offering benefits such as a good release rate and drug targeting with high physical stability. NLCs are SLNs that have been modified (Second generation SLN) to improve stability and capacity loading. This review discusses the pathophysiology of the fungal diseases, the application of SLN and NLC, its method of preparation, Characterization, and an overview of clinical trials on SLN and NLC for the treatment of fungal infection.

Open Access Review Article

Green Approaches of Flavonoids in Cancer: Chemistry, Applications, Management, Healthcare and Future Perspectives

Jitendra Gupta, Reena Gupta, Bhaskar Varshney

Journal of Pharmaceutical Research International, Page 130-143
DOI: 10.9734/jpri/2021/v33i59A34257

In epidemiologic research, a cancer preventive benefit from plant-derived meals has been discovered with unusual consistency. However, identifying individual components responsible for this effect has been difficult. The polyphenols phytochemicals have been found to have biological activity, and they may work together to prevent cancer. Cancer is a significant public health concern in both developed and developing countries. Celery, chamomile, Ginkgo biloba, mint, red paper plants synthesized anticancer agents like taxol, irinotecan, camptothecin, topotecan, and vinblastine, vincristine, etoposide being used in clinical trials. In addition, Flavopiridol, roscovitine, combretastatin A-4, betulinic acid, and silvestrol are promising anticancer compounds. Flavonoids in vegetables, fruits, roots, and stems have demonstrated a wide range of anticancer properties, including modulating ROS, scavenging enzyme activities, participating in cell cycle arrest inducing apoptosis autophagy, and suppressing growth of tumour cell and invasiveness. This review highlighted flavonoids, cancer cell mechanism of action, applications in tumour management, and future perspectives. This review may play a significant role for industrialists and scientists working in this field.

Open Access Review Article

Recent Advances in Nanomaterials for Therapy and Diagnosis of Cardiovascular Disease

Jitendra Gupta

Journal of Pharmaceutical Research International, Page 229-244
DOI: 10.9734/jpri/2021/v33i59A34268

Cardiovascular diseases (CVDs) are among the world’s widely affected disorders, including ischemia and stroke. Acute Myocardial ischemia (AMI) is a deadly disease caused by irreversible damage to the left ventricular heart tissues.  The thromboembolic plaque stops the oxygen supply to the main blood vessels and ventricles. During chronic inflammation, myocardial infarction and free radicals damage stable myocardium, smooth muscles cell, and epithelial cells caused by outer membrane loss and ventricular wall smoothing and dilation. Specially constructed scaffolds made of biological and nanoparticles have been created to shield the left ventricle from further injury and recover ischemic endothelial cells. Preclinical experiments have demonstrated that scaffolds containing growth factors and cells will regenerate ischemic tissue into a stable pericardium in good working order. Various medicinal approaches that treat cardiovascular disease conditions at different stages are discussed in this review article, with biomaterials receiving special attention. This review further addresses the manipulation and manufacturing of biomedical implantable devices using nanomedicine methods and drug delivery principles. The use of graphene and exosomal nanovesicle in cardiovascular therapeutics recently progressed in research studies.

Open Access Review Article

Moodle Innovation Learning Technology for Medical Education: From Theory to Practice

Lobach Nataliia, Isychko Liudmyla, Dymar Nataliia Mykhailivna, Vakaliuk Ivanna, Yuryk Olha, Bokova Svitlana Ivanivna

Journal of Pharmaceutical Research International, Page 245-260
DOI: 10.9734/jpri/2021/v33i59A34269

Background: COVID-19 pandemic has affected the medical and pharmaceutical education globally by disrupting traditional educational practices such as classroom-based teaching. This necessitated implementation of a distance learning via online platforms by medical and pharmacy schools around the world, including Ukraine.

Aims: The short review aims at studying the global experience on use of innovative e-learning platform Moodle for distant medical and pharmaceutical education, figuring out its advantages and disadvantages for teaching medical/pharmacy students and healthcare professionals, and working out some recommendations for its further implementation in Ukrainian medical schools.

Methods: For this short review, the authors relied only on accredited and peer-reviewed resources with free access articles available, such as Pubmed. The searches identified 32 full-textual content articles, of which 19 had been included in this paper and submitted to a narrative review.

Results: The Moodle platform is successfully used for distant medical and pharmaceutical education worldwide, including both high and low income countries, to provide e-learning for medical/pharmacy students and healthcare professionals of different level of education, in the form of both online only courses and blended learning. The platform is a good alternative to conventional medical education with an ability to substitute hands-on teaching for video and audio materials. The potential issues related to its use include possible technical problems, i.e. insufficient technological support or Interment failure, and necessity for proper preparation of the medical and pharmacy teachers.

Conclusion: E-learning via Moodle can be easily accommodated in the medical curriculum and offer an adequate alternative to the traditional teaching and learning activities, including both theoretical knowledge and practical skills acquisition. Its potential benefits clearly overweigh possible problems involved. The Moodle platform is recommended for further wider practical application for providing e-learning to medical and pharmacy students and healthcare professionals in Ukraine.

Open Access Review Article

Shaken Baby Syndrome: Simple Review Article

Sawsan Hassan Abdullah Hashim, Haneen Obaid Alanazi, Reham Arif A. Alanazi, Rahaf Meshal Lafi Alanazi, Rasil Naif Muhalhil, Afnan Hamdan Owayn Alanazi, Amer Meshal H. Alanazi

Journal of Pharmaceutical Research International, Page 295-303
DOI: 10.9734/jpri/2021/v33i59A34274

Shaken Baby Syndrome (SBS) occurs in infants when the head is subjected to excessive acceleration and deceleration. Guthkelch first identified SBS when he noticed that infants with subdural hematoma did not always have gross markings, indicating the possibility of a baby shaking. The rotational force pushes the brain against the skull, causing various types of head and neck injuries. Ophthalmologic testing for retinal haemorrhages and ocular fundus, which can rule out SBS, is one of the tests for SBS. Immunohistochemical staining for -amyloid precursor protein (-APP) and magnetic resonance imaging (MRI) accurately identify brain injuries and bleeding, resulting in a more accurate diagnosis of SBS. SBS symptoms are shared by other etiologies, making it difficult to determine the true cause of infantile injury. Experiments using biomechanical models to recreate the whiplash movement have not revealed subdural haemorrhaging, but limitations in the models have doubt to these results.

Open Access Review Article

Analytical Strategies for the Detection and Quantification of Nano-formulated Antibiotics: Updates and Perspectives

Haragouri Mishra, Amulyaratna Behera, Sidhartha Sankar Kar, Gurudutta Pattnaik, Satish Kanhar, Swagatika Dash

Journal of Pharmaceutical Research International, Page 384-395
DOI: 10.9734/jpri/2021/v33i59A34282

The rapid development of drug resistant micro-organisms is a challenge to the mankind. Nano formulated compounds have proved to be effective strategy to combat bacterial drug resistance. Currently nanoparticulate systems such as nanoantibiotics are getting major attention due to their low inherent toxicity, biodegradability, bioincompatibility and tuneable mechanical characteristics. Nano formulated antibiotics are generally obtained by emulsification and gelification techniques. The effective uses of polymers in encapsulation of antibiotics show enhancement of the efficacy of antibiotics. Combined with techniques like diffraction laser spectroscopy (DLS), electron microscopy (EM) and atomic force microscopy (AFM), morphological research of nanoformulated antibiotics are conducted. The detailed study of the polymers used in the preparation of antibiotics nanoparticles as well as their impact on interactions is done by bio-analytical techniques. Antibiotics attached to nanoparticles can avoid the action of enzymes produced by drug resistant bacteria.  Nano antibiotics show higher efficacy and bioavailability so a lot of new formulations using nano methods can be developed with the help of bioanalytical techniques. The development as well as the estimation of antibiotics prepared as nano-formulations as per the recent advanced techniques is illustrated in this review.

Open Access Review Article

A Review on Chemical Permeation Enhancers used in the Formulation of Transdermal Drug Delivery System

. Shivani, Ritika Puri

Journal of Pharmaceutical Research International, Page 429-437
DOI: 10.9734/jpri/2021/v33i59A34288

Skin penetration enhancement technology is a rapidly evolving area that will greatly increase the quantity of transdermal drug delivery medications. Penetration enhancers are used to facilitate the movement of drugs through the skin barrier. Numerous methods exist for extending partition enhancement. The enhancers' contact with the polar head of the lipid groups is the potential means for increasing the penetration. Penetration enhancers improve the amount of free water molecules between the bilayer, leading to an improvement of the polar drug diffusion cross section. This article focuses on the different compounds assessed for improving penetration activity like sulphoxides, azones, pyrrolidones, alcohols and alkanols, glycols, surfactants and terpenes.

Open Access Review Article

How Liquid Based Cytology Surpasses Conventional Cytology - A Review Article

Devikala Kumaresan

Journal of Pharmaceutical Research International, Page 469-471
DOI: 10.9734/jpri/2021/v33i59A34293

Pap smear is the most widely used test for screening of cervical cancer and precancerous lesions. Liquid-based cytology is a cervical cancer screening technology that inspects cells by dissolving them in liquid and is used as a main screening tool for invasive cervical cancer. The purpose of this article is to demonstrate how fluid-based cytology has surpassed conventional cytology in the interpretation of cervical smear biopsy results in order to identify early cervical lesions in a more efficient and convenient manner, allowing for early diagnosis and treatment of cervical cancer patients and thus improving patient wellbeing.

Open Access Review Article

Newer Treatment Modalities in Urticaria

Meghana Pendam, Bhushan Madke

Journal of Pharmaceutical Research International, Page 472-476
DOI: 10.9734/jpri/2021/v33i59A34294

Wheals (hives), angioedema, or both are symptoms of urticaria, a chronic clinical disorder. Urticaria has a complicated pathogenesis, as well as a large disease burden, a negative effect on health-care expenditures and quality of living. Urticaria could also be a chronic condition that affects up to 1% of the general population at some stage in their lives and can drastically impair quality life. The use of second-generation, non-sedating antihistamines has replaced antihistamines to use as the first-line therapy. However, urticaria can be difficult to manage in some cases; in these cases, alternate treatment approaches must be considered. This article reviews antihistamines, leukotriene antagonists, anti-inflammatory drugs, biologicals, subcutaneous autologous serum therapy, doxepin, cyclosporine ,tranexamic acid and other newer treatment modalities.

Open Access Review Article

Covid-19: Preventive Measures, Vaccination and Way Forward: A Review

Snarvia Khambra, Swaroopa Chakole

Journal of Pharmaceutical Research International, Page 596-602
DOI: 10.9734/jpri/2021/v33i59A34309

Background: COVID-19 or coronavirus disease 2019 is the unprecedented medical emergency having widespread and multispectral impact. The treatment uncertainty, lack of health infrastructure, lack of available medical professionals, long term implications of COVID-19 are the reasons behind adopting preventive measure over curative measure.  Various preventive measures are available which are tried and tested in previous outbreaks. The measures are reliable and ready to use. Also its efficacy has also been proved. Vaccination drive must be accelerated so as to cover wide section of population as soon as possible. Various preventive measures approved by WHO and various local health authorities are being successfully used in order to gain control over the viral spread. Vaccination which is also a preventive measures has been successfully rolled out in various countries.

Conclusion: Vaccine hesitancy is the burning issue which needs to be addresses otherwise it can derail the vaccination efforts. Importance of preventive measure must be highlights time to time. Recent surge in cases in many countries is attribute to the complacent attitude and lax following of preventive guidelines. Many preventive measures are made not only for COVID-19 but it can also protect us from various other contagious diseases and daily allergies of pollution and dust.  Also more innovative mitigation measures should be synthesized in order to contain the viral spread.

Open Access Review Article

Crisis in Sickle Cell Disease: Review Article

Syed Athhar Saqqaf, Rajendra Borkar

Journal of Pharmaceutical Research International, Page 679-685
DOI: 10.9734/jpri/2021/v33i59A34319

Sickle cell disease is a very common inherited disorder of the hemoglobin. It is inherited in an autosomal recessive manner. Most affected are the people of African, Indian and Arabian origin. It occurs due to change in the single base pair gene wherein thymine replaces adenine in the 6th codon of the beta-globin gene. This result in the sickling shape of the red blood cells. Sickle cell disease includes a variety of phenotypes like the SS, AS, Sickle-thal, SC patterns, etc. Sickle cell- SS pattern also termed as sickle cell anemia is the most common of form of the disorder and is also responsible for the morbidity and mortality caused by the disorder. The sickling pattern of the red blood cells occludes the blood vessels and leads to a wide range of complication in the affected individuals. These complications can be seen in number of different systems of the body and also multiple systems at the same time. These complications are termed as crisis, which then include the vaso-occlusive crisis, acute chest syndrome, splenic sequestration crisis, etc. These crises can negatively affect the quality of life to a large effect, but are also largely controllable or rather delayed and effectively managed as far as possible with reduced effect in the normal well being. Hence the knowledge about these crisis and their treatment is an important aspect of medical practice, especially in the countries where this disorder is commonly seen. Here in this review article we aim to highlight the major crises seen in sickle cell disease and their treatment in brief.

Open Access Review Article

Dental Composite Restorations Repair: A Systematic Review and Meta-analysis

Abdulmohsen Al Rabiah, Alamri Zahrah, Tuwaym Malath, Al Daghri Ebtihal, Al Suhaibani Daniyah, Al Qahtani Abdullah

Journal of Pharmaceutical Research International, Page 707-738
DOI: 10.9734/jpri/2021/v33i59A34322

Background: Controversy exists in the literature regarding the most optimal repair procedure for improving the adhesion between the repair resin and the existing resin composite materials. Hence the aim of the present study was to do a systematic review and to analyze the adhesion potential of resin-based composites to similar and dissimilar composites and aimed to determine the possible dominant factors affecting the bond strength results.

Materials & Methods: Randomized clinical trials (RCTs) and prospective cohort design were searched through electronic databases including MEDLINE, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for randomized clinical trials (RCTs) until July 2020 that compared different methods of composite restoration repair and a minimum mean follow-up time of 1 year. There were no restrictions on a particular treatment indication or outcome measures. Two authors independently conducted screening, risk of bias assessment, and data extraction of eligible trials in duplicate. We applied the Cochrane risk of bias assessment tool to consider the risk of bias.

Results: We identified 10 articles; two of them were RCTs, and eight prospective cohort studies. There were 530 participants, with 990 teeth, dealing with resin-based composite (RBC) restorations. The intervention of defective restorations ranged from minimal intervention to total restoration replacement. The evaluation criteria were also varied with different evaluation protocols. The low number and heterogeneity of RCTs did not allow for meta-analyses.

Conclusions: Although different repair protocols are mentioned in the literature according to the included studies, an appropriate and definitive conclusion can't be drawn. However, it seems repairs versus replacements should be considered as the first line of treatment when all factors lead to repair rather than replacement. Further randomized controlled trials with high methodological quality need to be conducted in order to establish evidence-based recommendations, particularly for RBC repair.

Open Access Review Article

Intraoperative Bleeding Management: An Updating Literature Review: Review Article

Mansur Suliman Alqunai, Rawan Humaidy Alshammary, Alanoud Saleem Almuhaysin, Rahaf Abdulsalam Alsubayti, Amani jadid Alsharari, Jumanah Mohammed Alanazi, Nujud Hayyal Alruwaili, Noof Falah Aldhuwayhi, Faridah safar AlMutairi, Atheer Zaid Alfuhiqi

Journal of Pharmaceutical Research International, Page 745-753
DOI: 10.9734/jpri/2021/v33i59A34324

Background: Intraoperative bleeding remains a major complication during and after surgery, leading to increased morbidity and mortality. Several influences determine the complex causes of bleeding in surgical patients. About 75 to 90% of early intraoperative and postoperative bleeding is due to technical factors. In some cases, however, acquired or congenital coagulopathies can stimulate, if not directly cause, surgical bleeding.

Objectives: This paper aims to overview etiology, causes, diagnosis, and updated management of intraoperative bleeding.

Methods: The review article ran from July 1, 2021 to October 31, 2021. We searched articles on etiology, causes, and treatments published in English worldwide in the Medline, EBSCO and PubMed databases. No software was used to analyze the data. Team members reviewed the data to determine initial results.

Results: All patients scheduled for elective surgery should be screened for possible hemostatic defects using tests, and, if necessary, laboratory tests. Treatment of intraoperative bleeding consists of identifying patients at risk and understanding the effect of surgery on hemostasis. For patients at high risk of bleeding, a pre-operative meeting with a multidisciplinary team (anesthesiologist, surgeon, hematologist, radiologist) can discuss the correct surgical procedure.

Conclusion: Technical variables account for 75-90% of initial intraoperative and postoperative bleeding. However, in other cases it is associated with acquired or congenital coagulation disorders. All patients scheduled for elective surgery should be checked for problems with hemostasis. Treatment of intraoperative bleeding involves identifying those at risk and understanding the effect of surgery on hemostasis.

Open Access Review Article

Open vs. Closed Sphincterotomy for Surgical Treatment of Anal Fissures

Hisham Abdullah Almottowa, Hassan Hamdan Almohammadi, Hamzah Abdulaziz Alwehaimed, Osamah Salem Alsawat, Abdullah Sulaiman Alboseer, Mohammad Younes Alshammari, Abdulrahman Ibrahim Alsheikh, Rami Jaber Alzaidi, Abdulaziz Usamah Alseffay, Jasem Mohammad Ameen, Noora Ziyad Alsaadoon

Journal of Pharmaceutical Research International, Page 784-789
DOI: 10.9734/jpri/2021/v33i59A34329

There is currently no specific evidence regarding the exact etiology of anal fissures. However, various management options were reported and validated among the relevant research. Lateral internal sphincterotomy has been validated among relevant investigations in the literature as a valid modality for managing patients with chronic anal fissures. In the present literature review, we formulated evidence based on these studies to compare open and closed techniques of this surgery according to the reported outcomes. However, evidence regarding the superiority of either of the techniques over the other is not consistent among these investigations. For instance, some studies reported that closed sphincterotomy is more favorable than the open approach and should be considered the treatment choice for chronic anal fissures. This is because the technique is associated with less frequent rates of complications, less expensive, safe, and effective. On the other hand, many other relevant studies also demonstrated that the reported outcomes for the two modalities exhibited non-significant differences. Therefore, we suggest that researchers should furtherly conduct additional investigations before drawing any conclusions in this field.