Open Access Case Report

Chronic Patellar Tendon Rupture Reconstructed with Hamstring Graft – A Case Report

M. Dharun Kumar, . Madhukar, . Shiva

Journal of Pharmaceutical Research International, Page 630-636
DOI: 10.9734/jpri/2021/v33i59B34425

Neglected patella tendon rupture which are presented 6 weeks after injury are rare but it can be disabling. Aim of study is to determine the outcomes of chronic patellar tendon rupture reconstructed using hamstring graft.

This case report concerns a 26 year-old man who came with complaints  of weakness of legs, difficulty in climbing stairs up and down, difficulty in getting up from squatting position. X-ray of Right knee showed high riding patella. MRI showed full thickness rupture of ACL. The patient was operated with a combination of Chen et al  and ganga hospital SR Sundararajan7. Our outcome was also excellent with no extensor lag, Kujala score was 94.1, Lysholm score was 92.3. From our study it is found that even in chronic neglected cases of patellar tendon rupture, good functional results can be obtained by repair using hamstring graft.

Open Access Case Report

Arthroscopic Management of Synovial Chondromatosis of the Knee Joint

V. S. Gowtham, . Mervinrosario, Vaishak Bhat

Journal of Pharmaceutical Research International, Page 651-656
DOI: 10.9734/jpri/2021/v33i59B34429

Synovial Chondromatosis is a rare and it is a benign condition characterized by multiple cartilaginous nodules in synovial facet spaces. Synovial Chondromatosis affects most commonly the knee joint. This is a case report of a 30-year-old male patient presented with pain and swelling over the left knee joint. On evaluation MRI shows loose bodies, for which he underwent, arthroscopic exploration. Viscous fluid and loose bodies were identified and showed synovial hyperemia. Synovial debridement was done and loose bodies were removed and sent to histopathological examination. The result signify that arthroscopy is efficient method both in diagnostic as well as therapeutic management of synovial chondromatosis.

Open Access Case Report

Acute Polyarticular Gout due to Chronic Kidney Disease

K. Arvind Natarajan, P. Saravanan

Journal of Pharmaceutical Research International, Page 666-669
DOI: 10.9734/jpri/2021/v33i59B34431

Gout is a crystal deposition disorder that typically presents as an acute flare of the first metatarso-phalangeal joint of the great toe. Rarely gout can present as an acute poly-articular disease with involvement of multiple joints. Evaluation of patients with poly-articular arthropathy with appropriate investigations like uric acid levels, renal function tests and synovial fluid analysis helps in the early diagnosis of poly-articular gout. Immediate treatment with urate lowering agents during the acute flare provides immediate pain relief and prevents progression of disease & bone destruction.

Open Access Case Report

Amphotericin B Induced Anaphylactic Reaction and Electrolyte Imbalance: A Case Report

Sheik Haja Sherief, Shilpa Johny Chackupurackal, S. Sengottuvelu, Mercy Dora, V. Manivannan, R. M. Ganesh

Journal of Pharmaceutical Research International, Page 735-739
DOI: 10.9734/jpri/2021/v33i59B34440

Amphotericin B, a polyene antifungal antibiotic derived from a strain of Streptomyces nodosus. It acts by binding to sterols in the cell membrane of susceptible fungi, with a resultant change in the permeability of the membrane. Amphotericin B can cause allergic reactions, electrolyte imbalance and severe side effects, such as chest discomfort accompanied by dyspnea, flushing, agitation, tachypnea, tachycardia, hypoxemia, hypotension, or hypertension, are likely to develop following the injection of Amphotericin B. Anaphylaxis, cardiac toxicity and respiratory failure have also been associated to different formulations of Amphotericin B as life-threatening acute events. This case report is on a 57-year-old male patient who was admitted with a condition of left diabetic foot with non-healing medial supra heel ulcer and fungal infection on the site of wound. The patient was given Amphotericin B in emulsion form due to the high priority of fungal infection and the need for antifungal medicine, which led to anaphylactic reaction and electrolyte imbalance, which were treated immediately and the same preparation was continued with a low infusion rate. When infusion is discontinued, antihistamines can assist to alleviate the symptoms. In this case, it is recommended that the patient's condition and clinical parameters should be closely followed after the medicine has been administered.

Open Access Systematic Review Article

Periodontal Findings in Children with Cleft Lip and Palate: A Systematic Review

Dalal Jumah Alturaif, laila Mohammed Alanazi, Norah Ali Al-Yousef, Hadeel Ali Aleiydi, Afnan Ahmed Altowyrqi, Hanadi Abdullah Bawazir, Shahad Saleh Alnajashi, Razan Abdulaziz Almehman, Nada Habib Ahmed Habib, Khalid Mohammed S. Abu Nakha, Omar Nagy, Fatima Sultana

Journal of Pharmaceutical Research International, Page 525-535
DOI: 10.9734/jpri/2021/v33i59B34411

A cleft lip occurs when the tissues that compose the lip fail to fuse together before delivery. There is a gap in the upper lip in the case of a cleft lip. An affected child may also have a cleft palate if they have a cleft lip. The condition is also sometimes diagnosed after birth. A cleft palate sometimes takes a long time to be diagnosed (such as sub mucous cleft palates and bifid uvulas). The surgical repair of a child's face can improve their breathing, hearing, and even their speech and language skills. Using the Medline and PubMed Central databases, this study examined periodontal findings in children with clefted lip and palate using a systematic literature search in English. All search terms were in English and were applicable to the articles related to periodontal findings in children with cleft lip and palate. To electronically extract data from Medline and PubMed Central, an electronic form is designed by the principal investigator. Upon screening using filters, inclusion and exclusion criteria, around 6 articles were selected related in this study. These articles were systematically reviewed and analyzed using PRISMA.  When a child has a cleft lip or palate, it affects oral hygiene and the amount of periodontal pathogens in the oral biofilm. In the literature, there is a lack of studies which utilize validated, reliable measures to determine how individuals with oral clefts perceive their quality of life. It will be important to perform additional studies that utilize specific tools for assessing Quality of Life in patients with oral clefts with larger samples in hopes of better understanding their Quality of Life.

Open Access Systematic Review Article

Comparison of Bone Morphogenic Proteins’ and Platelet Rich Fibrins’ Effectiveness in Socket Preservation

Abdulhamid Alshami, Mohamad Nabil Azmouz, Abdulrahman Hasan Hasan, Majed Mahmood Shaheen, Abdullah Mohammed Al Naji, Samira M. Osailan, Khames T. Alzahrani, Abdulrahman Jafar Alhaddad, Rayyan A. Kayal, Osama Ahmed Qutub

Journal of Pharmaceutical Research International, Page 719-727
DOI: 10.9734/jpri/2021/v33i59B34438

The dentist faces a difficult challenge in preserving the quantity and quality of gum and bone tissues. Furthermore, the processes adopted should meet these objectives while posing no substantial future issues. In current dental and maxillofacial surgery, a variety of materials as Morphogenic Protein of Bone (BMP) and Platelet Rich Fibrins (PRF) are employed to repair and reconstruct bone tissue. The purpose of this review was to compare the efficiency of both BMP’s and PRF’s in Socket preservation. Reviewing the literature was conducted by using the following search strategies: Bone Morphogenic Proteins, Platelet Rich Fibrins, socket preservation approach, comparison of BMPs and PRFs, Bone Morphogenic Proteins and effectiveness in socket preservation and Platelet Rich Fibrins’ effectiveness in socket preservation. In conclusion, BMPs have been studied more completely than PRFs, and they have higher impacts on hard tissue regeneration and repair, according to the research. The fact that PRFs increase soft tissue healing shows how promising they are. Especially when we consider that soft tissue healing is more important than socket care in implant dentistry.

Open Access Case Study

Transient Myocardial Ischemia in a Case Post Intra-Muscular Adrenaline

Nipun Bawiskar, Aamil Rasheed, Jahnabi Bhagawati, Sourya Acharya

Journal of Pharmaceutical Research International, Page 36-40
DOI: 10.9734/jpri/2021/v33i59B34349

Background: Anaphylaxis is a medical emergency and requires immediate medical attention. Kounis syndrome is myocardial infarction or injury occurring in the setting of anaphylaxis and can also be due to the effects of epinephrine.  Adrenaline is a common drug in the management of anaphylaxis but the electrocardiographic consequences of its administration post an attack are seldomly seen. Vasospasm is generally the cause for myocardial injury in an acute setting following the administration of epinephrine.

Case Presentation: A 21-year- old female developed sudden onset breathlessness and giddiness post vaccination with the oxford –AstraZeneca COVID -19 vaccine. She was administered 0.5 ml adrenaline (1:1000) intramuscularly on the lateral aspect of the left thigh, following which she complained of chest tightness and palpitations. This was accompanied by hypotension and global ST segment depression on her Electrocardiogram. The second electrocardiogram, done after 30 minutes showed a relative resolution in ST segment depressions with sinus rhythm in the one done at 16:00 hours. Creatine Kinase- MB and Troponin I were within normal limits and the patient experienced symptomatic improvement with normalization of blood pressure post fluid challenge.

Conclusion: This case report highlights the case of a young female with no comorbidities who developed transient myocardial ischemia after administration of intramuscular adrenalin in therapeutic dose in view of an anaphylactic reaction. The probable action is alpha mediated coronary vasospasm. The potential adverse effects in an acute setting are hence outlined in this case report without discouraging its use given the potential benefits outweigh the risks.

Open Access Case Study

An Early Comprehensive Physiotherapy Approach towards Reconditioning of Patient with Empyema Thoracis: A Case Study

Anam Pathan, Vaishnavi Yadav, Moli Jain, Sakina Saifee

Journal of Pharmaceutical Research International, Page 108-112
DOI: 10.9734/jpri/2021/v33i59B34358

Pulmonary tuberculosis is considered among the most common air-borne respiratory disease. TB is found almost all over the globe but it is also curable and preventable. However, it frequently has several negative consequences on the lung, which affects the patient's exercise tolerance capacity, everyday activities, and, ultimately, quality of life. The PTB is frequently associated with various subsequent problems. Few of which are presented in this case, along with their management. The current case involves a 36-year-old girl who had a history of pulmonary tuberculosis and was re-diagnosed with it, albeit with difficulties. She initially suffered pleural effusion, for which therapeutic tapping was performed, but it later progressed to empyema thoracis. She underwent thoracocentesis, which involved draining the fluid and breaking the fibrous septations, followed by the insertion of ICD drainage. Medical management was successful, but to return the patient to her normal daily routine activities without any signs of dyspnea or fatigue, a comprehensive rehabilitation program incorporating various respiratory techniques was devised, which proved to be an effective protocol in improving the patient's respiratory condition.

Open Access Case Study

Case Report on Mucormycotic Osteomyelitis of Maxilla

Paras R. Nasare, Archana Teltumde

Journal of Pharmaceutical Research International, Page 159-162
DOI: 10.9734/jpri/2021/v33i59B34365

Introduction: The upper jaw is formed by the maxilla, one of the basic bones of the face. It is a crucial viscerocranium structure that aids in the creation of the palate, nose, and orbit. The upper teeth are held in place by the alveolar process of the maxilla, which is vital for mastication and speaking. Because of its substantial vascular supply, maxillary necrosis is uncommon compared to mandible necrosis [1]. Maxillary necrosis can be caused by bacterial infections like osteomyelitis, viral infections like herpes zoster, or fungal infections like mucormycosis, as well as trauma, radiation, and other factors [2]. Long-term use of antibiotics or corticosteroids, on the other hand, may result in an opportunistic infection. Mucormycosis is a fungal infection that mostly affects immunocompromised persons. These fungi are widespread in many people, although the symptoms have been linked to a weakened immune system. Mucormycosis is a life-threatening illness that frequently affects immunocompromised individuals due to diabetic ketoacidosis, neutropenia, organ transplantation, and elevated blood iron levels.

Clinical Findings: The patient have a complaint of discomfort in the upper left side of the jaw was rapid in start, dull hurting, intermittent in character, and worse on mastication. A radiating headache on the left side is also a complaint.

Diagnostic Evaluation: CRP - 12.48 m/ L, Calcium 8.1 mg/dl, KFT-Ser (urea – 29 mg/dl, Creatinine 0.4 mg/dl, Sodium 138 mmol/L, Potassium -4.3 mmol/L, Albumin 2.6 g/dl,) Urine exam routine Pus cells 1-2 cells, urine albumin nil, Crystal 3-4 calcium oxalate Crystal, 2D echo was done on dated 31/5/21, MRI was done,  Cardiac call was done.

Therapeutic Intervention: If not recognised and treated early, fungal osteomyelitis is more invasive than bacterial osteomyelitis. Treatment is given to the patient as a follow-up.

Debridement of necrotic tissue on a local level. Antibiotics - Tab Augmentine 625 mg, Tab paracetamols 500 mg, Inj T. T 0.5 ml in a single dosage, Antifungal treatment, and Betadine gargle twice a day.

Conclusion: On 04/06/2021, a 58-year-old male was hospitalised to AVBR Hospital's Oral Surgery Ward 35 after being diagnosed with Mucormycotic Osteomyelitis of the Maxilla. The patient is being counselled on how to proceed with his treatment.

Open Access Case Study

Case Report Postoperative Case of Explore Laparotomy for Ruptured Ectopic Pregnancy with Septicemia

Minakshi Choudhary, Akhtaribano Sayyad, Seema Yelne, Sagar Bhovare, Deepesh Choudhary, Darshana Khobragade, Roshan Umate

Journal of Pharmaceutical Research International, Page 270-274
DOI: 10.9734/jpri/2021/v33i59B34380

Introduction: Ectopic pregnancy is a pregnancy problem when the embryo attaches itself outside the uterus. Signs and symptoms include abdominal pain and vaginal bleeding, but less than 50 percent of affected women have both. it happened. Excessive bleeding may lead to a rapid heartbeat, fainting, or panic attack. Without abnormalities, the fetus can no longer survive. Obstetricians and gynaecologists face various obstacles in dealing with Jehovah's Witnesses.

Main Symptoms and/or Important Clinical Findings: A 20-year-old man with a post-operative case of Explore Laparotomy For Ruptured Ectopic Pregnancy with pyosalpinx with septicemia underwent surgery on 14/02/2021 investigating Laparotomy under GA. His diagnostic ultrasonography was performed. Complete the blood test. She had not dropped down before 8 days she was a primigravida at 2 months of pregnancy and then had abdominal pain as she grew stronger over time.

The Main Diagnoses, Therapeutic Interventions, and Outcomes: A 20-year-old man with a post-operative case of Explore Laparotomy for Ruptured Ectopic Pregnancy with pyosalpinx withsepticemia, with a complaint of abdominal pain, Treatment began on the day he received V fluids, Antibiotics Injectable. Initiated, Zonac suppository PR consulted. TPR Charting treatment interventions, I / O Charting, abortion chart,

Nursing Perspectives: Laboratory techniques are urgently required. To limit the development of treatments to enhance the outcome.

Conclusion: Although it is not uncommon for an ectopic pregnancy to exceed the first trimester, it does occur occasionally. As a result, in any emergency, abdominal surgery during pregnancy, Today, early intervention saves lives and reduces morbidity, but ectopic pregnancy still kills 4 to 10% of pregnant women and results in a higher ectopic pregnancy rate following pregnancy.

Open Access Case Study

Case Report on Carcinoma on Hard Palate

Sonali Wavare, Dharti Meshram, Kanchan Bokade, Pranali Wagh

Journal of Pharmaceutical Research International, Page 275-280
DOI: 10.9734/jpri/2021/v33i59B34381

Background: The hard palate is a thin horizontal bony plate made up of two bones of the facial skeleton, located on the roof of the mouth. The bones are the palatine process of the maxilla and the horizontal plate of the palatine bone. The hard palate spans the alveolar arch formed by the alveolar process that holds the upper teeth (when these are developed). If cancer is detected early, the overall 5-year survival rate for all persons is 85 percent. If cancer has progressed to other tissues or organs, as well as regional lymph nodes, the overall 5-year survival rate is 67%.

Objective: Want to highlight the importance of primary prevention; education on risks of alcohol/tobacco use and oral hygiene. Secondary prevention; Early biopsy of any ulceration of the hard palate that does not regress with medical treatment. This would allow early diagnosis and minimal treatment with less morbidity and better survival chances.

Case Presentation: A male of 58 yrs. old came with Pain in the mouth, difficulty in breathing, difficulty in mastication, difficulty in deglutition, balm application, change in voice tooth exfoliation, lack of appetite. Aggravates on mastication, difficulty in deglutition for 2 months, burning sensation on the consumption of spicy food for 2 months change in voice, nasal discharge, loss of appetite, weight loss, tooth exfoliation in the upper front region of jaw, and balm application (2-3episodes, 15 days back). All necessary investigations were carried out such as X-ray, MRI, CT scan, a biopsy of the tissue sample, and diagnosed Carcinoma on the Hard Palate. Treatment of this patient received antiemetic, analgesic, antibiotic, vitamin supplementary.

Prognosis: After treatment, the patient shows great improvement.

Conclusion: The therapeutic management for malignant tumors of the hard palate is essentially surgical, with or without postoperative radiotherapy, discussed on a case-by-case basis. The survival rate depends on several factors, including early diagnosis, histological characteristics and appropriate management. When ca of the palate is detected primary, the management is very effective.

Open Access Case Study

Case Report on Guillain-Barre Syndrome (GBS) in Adult

Pranay Bende, Seema Singh

Journal of Pharmaceutical Research International, Page 432-436
DOI: 10.9734/jpri/2021/v33i59B34400

Introduction: Guillain-Barre-syndrome is when the immune system attacks the peripheral nervous system were disease progresses to trembling and muscle weakness in both hands and legs, which progress to upper body and arms.

Clinical Findings: High grade intermittent fever, low back pain, B/L LL weak, urinary incontinence which is intermittent in nature.

Diagnostic Evaluation: Neurological examination- revealed B/L UL and LL weakness, acute onset of quadriparesis. X-Ray – revealed normal sinus rhythm.  CSF examination – revealed No RBC; No pus cell; No Organism seen.

Lab investigation – Hb% 10%, total RBC count 4.45, total WBC 10400, total platelet 2.33, SGOT 226 SGPT 83, Peripheral Smear RBCs - Normocytic Normochromic platelets adequate smear no Haemoparasite seen. Blood Culture: revealed Growth of Acinetobacter species.

Therapeutic Intervention: Inj. Optineurone 1gm, Inj.Pantop 40mg, Tab.PCM,Inj. Tramadol 500mg, Immunoglobin (Ig) 100ml , physiotherapy and supportive therapy.

Outcome: The symptoms and clinical state of the patient improved over time. The patient's weakness began to improve after 5 days of IV-Ig therapy.

Conclusion: The patient was hospitalised to the neurosurgery ICU AVBRH on 05/06/20 with the known case of guillain-barre syndrome-(GBS). After receiving therapy, she showed significant progress.

Open Access Case Study

A Case Report on Post COVID -19 Vaccine Associated Guillain–Barré Syndrome

S. Hemalatha, M. Karishma, J. Bera, S. Blessy, J. Thirumaran, T. Loganathan, A. Gopala Krishnan

Journal of Pharmaceutical Research International, Page 454-458
DOI: 10.9734/jpri/2021/v33i59B34403

Guillain–Barré syndrome (GBS) is an autoimmune demyelinating illness in which a patient’s immune system attacks and cause deterioration of peripheral nervous system leading to progressive paralysis and polyneuropathy. The exact cause of the GBS is unclear but the main mechanism of behindis the demyelination of nerves especially the motor, sensory, and autonomic nerves which can be triggered by any immunologic or infectious agent. The infectious agent elicits the humoral and cellular mediated immune response due to their molecular mimicry in which the antibodies created against the infection matches with the proteins on the nerve. The characteristic features of Guillain–Barré syndrome are ascending flaccid paralysis, paresthesia, impairment of muscle reflexes, respiratory failureetc. The GBS is diagnosed via nerve conduction studies, lumbar puncture (Cerebrospinal fluid analysis), electromyography, Brighton criteria. Treatments like intravenous immunoglobulin therapy, plasma exchange can ease the symptoms and reduce the duration of the illness. This case report focusing on a 43-year-old female patient admitted seeking ventilatory support for respiratory distress caused by Guillain–Barré Syndrome in a tertiary hospital. Patient had developed limb weakness with ascending paralysis along with facial weakness within a couple of weeks after receiving the COVID -19 vaccination (COVISHIELD)one month back. Patient underwent nerve conduction study and routine monitoring of vital parameters. After conservative management with physiotherapy, ventilation, intravenous immunoglobulins and prophylaxis for pain and DVT patient gradually started improving the muscle power and was discharged to continue the rehabilitation care at home.

Open Access Case Study

A Case Report on Pelvic Floor Dysfunction

Dipali D. Zade, Pooja Kasatwar, Rupali Thorat

Journal of Pharmaceutical Research International, Page 556-561
DOI: 10.9734/jpri/2021/v33i59B34414

Background: Pelvic floor dysfunction and pelvic myofascial pain are treatable and common musculoskeletal conditions. Understanding the relationship between pelvic girdle and pelvic floor muscles (PFM), hips and spine will help the practitioner to diagnose and treat these conditions. Pelvic floor dysfunction and pelvic pain are treated with clinical examination and complete medical history of PFMs. Treatment is a in cooperatives approach, which consists of medications, pelvic floor physical therapy, injection and other treatment options.

Case Presentation: We are presenting case of 40 female with complaints of pain in abdomen and discomfort during micturition. On evaluation she was diagnosed with the pelvic floor muscle dysfunction. For the management of same she was referred to physiotherapy department.

Treatment: For the management of pelvic floor dysfunction, various levels of physiotherapeutic interventions were given to the patient, which includes strengthening exercises, endurance exercises to improve the overall functional capacity of the patient.

Conclusion: This examines the physical and anatomical examination of the pelvic floor, discusses the epidemiology and definition of pelvic floor dysfunction and explains the physiotherapy approach to treating these common conditions.

Open Access Case Study

Advanced Collateral Physiotherapy Management for Pneumothorax Following Dengue Encephalitis: A Case Study

Abhishek Gujar, Vishnu Vardhan, Moli Jai Jain, Vaishnavi Yadav, Rashmi Walke, Pallavi Bhakaney, Ruhi Kumbhare

Journal of Pharmaceutical Research International, Page 571-576
DOI: 10.9734/jpri/2021/v33i59B34416

Dengue fever is a mosquito-borne sickness that has become a serious international public health issue in recent years.A 54 years old male patient, farmer by occupation came to rural hospital on 10TH September 2021 with complaint of fever associated with chills and rigors, slurring of speech 2 days back and 2 episodes of generalized tonic clonic seizures. Dengue was confirmed by the non-structural protein 1 (NS1) antigen and immunoglobulin M (IgM) antibody test. Radiological investigations revealed encephalitis and pneumothoraxfor which medical management along with inter costal drainage and collateral physiotherapeutic rehabilitation was administered.The goals of the physiotherapy rehabilitation were to reduce bronchospasm, to clear secretions lung fields, to regain full expansion of lungs and best possible functional recovery. Physiotherapy management has shown satisfactory results in regaining pulmonary function.After the completion of the treatment the patient gained maximum re-expansion of the lungs, had no breathing difficulties, the lungs were clear of sputum and was functionally independent.

Open Access Case Study

Case Report on Cellulitis with Diabetes

Nidhi Ganeshpure, Darshana Kumari Wankhede, Shalini Lokhande

Journal of Pharmaceutical Research International, Page 600-603
DOI: 10.9734/jpri/2021/v33i59B34420

Introduction: Cellulitis is a bacterial skin condition that is very frequent. In reality, cellulitis affects about 14 million people in the United States each year. If left untreated, the infection can spread to any part of the body and cause serious problems. Obesity and an inactive lifestyle are two of the most common causes of type 2 diabetes.

Clinical Findings: Pain or tenderness in the leg, Skin redness or inflammation that gets bigger as the infection spreads, Skin sore or rash that starts suddenly, and grows quickly , Warm skin.

Diagnostic Evaluation: Hb%- 10.7, MCHC- 33.4, MCV- 88.8, MCH- 29.8, Total RBC count- 3.6, Total WBC count- 7200, Total platelets count - 1.63, HCT- 37, Monocytes- 01, Granulocytes- 75, Lymphocytes - 20, RDW - 17.2, Eosinophils - 01.

Therapeutic Interventions: Inj. Ceftriaxone 1mg x BD (IV), Inj. Pan 40 mg x OD (IV), Tab. Limcee 500 mg x OD, Tab. Pan 40 mg x OD, Protein powder 2 tsp x TDS, Inj. Insulin.

Outcomes: A Male Patient of 88 year old was admitted in AVBRH with a chief Complaint of Cellulitis after getting treatment his condition is improving.

Conclusion: Diabetic foot infections that aren't treated well or aren't treated at all result in lower-extremity amputation in about 10% of patients. Amputations of the lower extremities can be debilitating and have a significant impact on the patient's quality of life.

Open Access Case Study

Case Report on Intertrochanteric Fracture Femur Left Side

Saloni Inwati, Darshana Kumari

Journal of Pharmaceutical Research International, Page 612-615
DOI: 10.9734/jpri/2021/v33i59B34422

Fractures of the femur are a common injury among the elderly. Understanding the pathogenesis as well as the appropriate treatment options can help to reduce the risk of mortality and morbidity associated with this condition injury. This activity focuses on the diagnosis and treatment of intertrochanteric femur fractures, emphasizing the importance of the In evaluating and treating people with this condition, an interprofessional team is used [1].

Clinical Findings: Pain in leg, swelling over the leg.

Diagnosis Evaluation: Hb-11.3gm%, total WBC count- 1011/ cu.mm, total RBC count- 5.44 million/cu. mm, RDW- 14%,HCT-35.4%, Granulocytes-60%, Monocytes- 0.2%, Lymphocytes-36%, Basophils- 00%, Eosinophils- 0.2%, total platelet count - 3.16 lacs/cu.mm.

Therapeutic Intervention: Inj.voveron- two time in a day. Tab. paracetomol- two time in a day. Tab. pantaprazole- two times in a day. Inj. tramdole- two times in a day.

Outcome- After treatment, the patient show improvement. His pain is reduced.

Conclusion: My patient age is 40 year old male. They are suffering from intertrochanteric fracture femur left side with same complaint. He is admitted in 8 -11-21.

Open Access Case Study

Fournier Gangrene: Case Report & Litarature Review

Ankit Selokar, Sonali Kolhekar, Shalini Lokhande, Suwarna Ghugare, Ruchira Ankar, Archana Dhengare, Manjusha Mahakalkar, Shalini Moon

Journal of Pharmaceutical Research International, Page 642-646
DOI: 10.9734/jpri/2021/v33i59B34427

Introduction: Necrotizing fasciitis of the perineal and vaginal region is a symptom of Fournier's gangrene, which is caused by a synergistic polymicrobic infection. The clinical presentation varies depending on the original aetiology, ranging from anorectal or vaginal pain with limited evidence of cutaneous necrosis to a rapidly spreading necrosis of the skin and soft tissue, to systemic sepsis without any obvious signs or symptoms.

Case history: A 65-year-old male who was admitted in hospital with the chief complaint of Scrotal enlargement, discomfort, hyperemia, pruritus, crepitus, and fever. There may also be a foul-smelling discharge. Symptoms usually appear during a two- to seven-day period. Soft-tissue gas may be present before clinical crepitus is detected. The patient with Fournier gangrene frequently seems poorly on physical examination, with prodromal signs of fever and lethargy lasting 2-7 days. Edema of the overlaying skin is usually present, as is acute pain and tenderness in the genitalia; pruritus may also be present.Skin may show evidence of trauma, surgery, insect or human bites or injection sites, In Respiratory system, B/L Air entry present. In cardiovascular system, S1 and S2 sound heard and Patient get conscious and well oriented to time, place, and person. Then, as quickly as possible, treatment was began; he did not improve after treatment, and treatment would continue till the conclusion of my care.

Conclusion: We focus on professional management and superior nursing care in this study so that we may provide the complete treatment that Fournier Gangrene requires while also effectively managing the complex case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and happiness.

Open Access Case Study

Mixed Germ Cell Tumour of Ovary WTH Chemotherapy Side Effect

Anupriya Biswas, Shalini H. Moon, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 766-773
DOI: 10.9734/jpri/2021/v33i59B34444

Introduction: Mixed germ cell tumour is a very rare type of aggressive cancer, consisting of more than one type of germ cell components. The most common component reported was dysgerminoma, followed by endodermal sinus tumour, teratoma, choriocarcinoma and embryonal carcinoma respectively. This study focuses on the combination of dysgerminoma and endodermal sinus tumour (yolk sac tumour) along with the hearing loss as the side effect of chemotherapy.

Clinical Findings: Pain in the lower abdomen (lump is visible and has occupied hypogastrium along with bilateral iliac region extending 2-3 cm above the umbilicus), backache, fever (100.6 °F). Later after the third chemo cycle, it was found that the patient has progressive mild hearing loss.

Diagnostic Evaluation: HB= 9.7gm%, TLC= 10300/cumm, PLT= 5,49 lakhs/cumm, CA 125= 909 U/ML.

Histopathology Report: Ascitic fluid along with thirteen containers containing right ovarian mass, right ovary with mass, right fallopian tube, bowel deposits as well as residual nodules and pelvic deposits were sent of which, the reports indicated mixed germ cell tumour of the ovary.

Therapeutic Intervention: Packed red blood cells transfusion, Pre-chemo and post-chemo hydration, Pre-chemo and post-chemo drugs, BEP Chemotherapy (Bleomycin, Etoposide, Cisplatin).

Conclusion: My patient aged 11 years old female was admitted to Gynaecology Ward No – 16, AVBRH on 27/12/2020 for the first cycle of chemotherapy with the complaints of lower abdominal pain, backache and fever. The patient was diagnosed as the case of mixed germ cell tumour, further had mild hearing loss as the side effect of chemotherapy  The patient is on chemo and is advised for follow up care once a month.

Open Access Study Protocol

Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Children with Spastic Diplegia: A Study Protocol for a Randomized Clinical Trial

Vikrant Salphale, Rakesh Krishna Kovela, Mohammad Irshad Qureshi, Pallavi Harjpal

Journal of Pharmaceutical Research International, Page 88-95
DOI: 10.9734/jpri/2021/v33i59B34356

Background: Cerebral Palsy is a spacious term which highlights an extensive gamut of motor affliction which has a stagnant tendency. The estimated Cerebral Palsy is indeed very prevalent in developed nations 2 out of the next 1000 live births and neonatal survivors. Among several Cerebral Palsy comes in a variety of manifestations. Spastic Diplegia is common in a majority of Preterm babies. Several treatment strategies of Physical therapy are utilized for Spastic Diplegia. This research focusses on assessing the Efficiency of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) techniques over the Dimensions of Balance and Gait in children with Spastic Diplegia.

Objective: To evaluate the Effectiveness and impact of the techniques of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) on Balance, Gait Parameters and Pelvic Asymmetry in children having Spastic Diplegia.

Methods: In this Randomized Clinical Trial, subjects (n= 40) having Spastic Diplegia will be selected and segregated in two groups using simple random sampling method with 1:1 allocation ratio. The allocation will be done through sequentially numbered opaque sealed envelope (SNOSE). Subjects in the experimental group will receive Pelvic PNF techniques like Rhythmic initiation and Slow reversal with Task- Oriented training which will contain sit to stand exercises, walking on the ground and reaching tasks for improving the balance and those in the other group will be given only Task- Oriented training for 4 weeks following baseline assessments. Throughout the treatment session and following 4 weeks follow up will be taken by assessing the Balance and Gait parameters of the subjects. The study duration will.  be of 1 year. Subjects with Spastic Diplegia with an age group of 8 to 12 years  who are able to do independent sitting, who are coming under GMFCS level I to III and those who are having pelvic asymmetry will be included in the study while subjects who had any surgery of spine or lower limb in past 6 months, who are having fixed deformities of spine or lower limb or any fracture or dislocation of spine or lower limb will be excluded from the study. 

Results: Results will be recorded by using the outcome measures and instruments such as Pediatric Balance Scale, Gait Parameters and Palpation meter device at the end of the intervention and the effects of Pelvic PNF techniques will be compared with the other group which will receive Task oriented training. The statistical analysis will be done by using paired t test but if the data does not follow a normal distribution then Wilcoxon sign rank test will be used.          

Discussion: The intention and motive of the study is to check the Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation techniques on Balance and Gait Parameters in children with Spastic Diplegia.

Conclusion: The conclusion of this research is to acquire the fruitfulness of Approaches of Pelvic PNF on Balance and Gait Parameters in children having Spastic Diplegia.

Open Access Study Protocol

Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

Divya Jain, Swapna Jawade, Neha Chitale

Journal of Pharmaceutical Research International, Page 536-542
DOI: 10.9734/jpri/2021/v33i59B34412

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome.

Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI).

Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

Open Access Short Communication

Osmotic Activity of Drugs is an Important Factor of Their Local Action at the Injection Site: What We Don't Use to Prevent Post-Injection Abscesses

Aleksandr Urakov, Natalya Urakova

Journal of Pharmaceutical Research International, Page 647-650
DOI: 10.9734/jpri/2021/v33i59B34428

It is established that very few modern high-quality drugs in the dosage form "Solution for injection" have isoosmotic activity in the range of 280-300 mosmol/l of water. The main part of solutions for injection is hypotonic or hypertonic solutions, which can have osmotic activity in the range of 0 - 4000 mosmol/l of water. The reason for this was that the osmotic activity of drugs is not included in the list of controlled indicators of drugs quality, so it is not subject to control. It is shown that the osmotic activity of drug solutions increases with an increase in the total concentration of all dissolved ingredients present in the solution.  It was found that an excessively high concentration of the drug in the solution gives it an excessively large hyperosmotic activity, which can cause a local irritant and cauterizing effect at the injection sites due to dehydration of the cells. Therefore, to exclude post-injection abscesses, it is proposed to dilute the hypertonic drug with water for injection until it is given isotonic activity.

Open Access Minireview Article

Spinal Cord Injuries in Emergency Medicine

Hisham Mohammed Sonbul, Razan Mohammad N. Aljohani, Abdullah Sulaiman Alqefari, Zahra Ahmed Alasfoor, Noor Ayman Adel Abualsaud, Zahra Mohammed Alsrori, Razan Mohammad S. Almokri, Hamoud Mohammed Alfawzan, Meshari Ibrahim A. Alayshan, Malak Hamed A. Alshammari, Sultan Mahmoud S. Gharib, Talal Mohammed Alzahrani, Rawan Mohammed O. Bahattab

Journal of Pharmaceutical Research International, Page 8-16
DOI: 10.9734/jpri/2021/v33i59B34345

Spinal cord injury is a serious medical disorder that frequently leads in significant morbidity and permanent impairment. Direct damage to the spinal cord or compression owing to broken vertebrae or masses such as epidural hematomas or abscesses are the most common causes of spinal cord injury. When examining a blunt trauma victim, medical professionals are taught to presume the patient has a spinal column damage unless it is proven otherwise. The early examination of a patient with a suspected cervical spinal injury in the emergency department (ED) is no different than that of any other trauma patient. The ABCs, or airway, breathing, and circulation, procedures are being taken into consideration. In acute spinal cord damage, hypotension can be hemorrhagic or neurogenic. Because of the high prevalence of concomitant injuries and vital sign confusion in acute spinal cord injury, a thorough search for hidden sources of bleeding is required. Surgical removal of bone fragments, foreign objects, herniated discs, or broken vertebrae that appear to be compressing the spine is frequently required. In order to avoid future discomfort or deformity, surgery may be required to stabilize the spine. In this review we’ll be looking at spinal cord injury, it’s diagnosis and treatment.

Open Access Original Research Article

Phytochemical Screening and In-vitro Free Radical Scavenging Activity of Unani Formulation Habb-e-Asgand

Ansari Imtiyaz Ahmed Tufail Ahemad, Qazi Majaz Ahamad Aejazuddin, G. J. Khan

Journal of Pharmaceutical Research International, Page 1-7
DOI: 10.9734/jpri/2021/v33i59B34344

Aim: In the present work we aimed to perform phytochemical Screening and In-vitro free radical scavenging activity of Unani formulation Habb-e-asgand.

Study Design: The present work was designed to determine the total antioxidant capacity (TAC), Ferrous reducing antioxidant capacity assay (FRAC), DPPH radical scavenging assay, hydroxyl radical scavenging activity, and nitric oxide scavenging assay.

Place and Duration of the Study: The present work has been carried out at Ali-allana College of Pharmacy, Akkalkuwa, from February-2020 to November-2020.

Methodology: Habb-e-asgand (HEA), a Unani polyherbal drug used in arthritis, gout, and joint pain, is a blend of many herbal medicinal plants. Scientific attempts to test and validate its effectiveness are scarce. The selected Unani formulation was evaluated for DPPH radical scavenging activity, hydroxyl radical scavenging activity, and nitric oxide scavenging assay. The given formulation also evaluated the total antioxidant capacity and the reducing antioxidant capacity of ferrous metals.

Results: It was found that DPPH radical scavenging activity of HEA and BHT at a concentration of 100 μg/ml was 95±0.74 and 59±0.94 μg/ml. Hydroxyl radical scavenging activity of HEA, at the concentration of 100μg/ml, was 55±0.64, whereas at the same concentration catechin was 63±0.84 μg/ml. The IC50 value for nitric acid scavenging activity was found to be 49.60±1.57 for HEA, and 186.34 ± 3.28 µg/ml for ascorbic acid. The result obtained from TAC and FRAC activity demonstrates that HEA possessed the highest TAC and FRAC values in comparison to standards catechin and ascorbic acid.

Conclusion: From the above results it was concluded that HEA has a potent antioxidant activity. HEA showed moderate to high TAC and FRAC in dose-dependent manner compared to standards catechin and ascorbic acid. HEA shows dose-dependent DPPH and hydroxyl radical scavenging activity. Nitric oxide generation was observed after the incubation of solutions of sodium nitroprusside in PBS at 25°C for 150 min. HEA effectively reduced the generation of nitric oxide.

Open Access Original Research Article

Microbiological Profile of Neonatal Septicemia by Automated Blood Culture System (BacT/ALERT) at a Tertiary Care Hospital in Jamnagar, Gujarat, India

J. Ghedia Bindiya, Manish R. Shah

Journal of Pharmaceutical Research International, Page 17-22
DOI: 10.9734/jpri/2021/v33i59B34346

Background: This study was carried out to do rapid diagnosis of neonatal septicemia to prevent septicemia related complications and neonatal morbidity and mortality.

Materials and Methods: This study was carried out in a tertiary care hospital from a period of March 2014 to August 2015. This is a non-randomized, prospective study in which one hundred and nine cases of suspected neonatal septicemia on the basis of antenatal high risk factors and signs and symptoms of sepsis were studied. Blood samples were collected from neonates in whom septicemia was suspected usually before antibacterial agents were given and both positive and negative samples were detected by automated system BacT/ALERT.

Results: Out of 109 samples tested, 69 samples were positive and 40 samples were negative. The incidence of neonatal septicemia due to Gram positive organisms (62.85%) was found to be high. Among them Coagulase negative staphylococci (CONS) (27) (38.57%) was most common organism followed by Staphylococcus aureus (11) (15.71%), Enterococcus spp. (7.14%) and Streptococcus spp. (1.43%). Rate of Gram negative organisms was quite low (32.85%). Out of them Acinetobacter spp. (17.14%) was most common followed by Klebsiella spp. (7.14%), E.coli (5.71%) and Pseudomonas spp. (2.86%).

Conclusion: Early detection of infection in neonates and proper antibiotics for the treatment leads to reduced morbidity and mortality.

Open Access Original Research Article

Ampicillin & Gentamicin V/S 3rd Generation Cephalosporin for the Management of Community-Acquired Pneumonia in Children; A Comparative Analysis

Aneel Kumar, Heena Rais, Arit Prakash, Amin Ali, Sandeep Jung, Fatima Ghayas Siddiqui

Journal of Pharmaceutical Research International, Page 29-35
DOI: 10.9734/jpri/2021/v33i59B34348

Background: Community acquired pneumonia (CAP) is a common cause of childhood morbidity, attributed to every 1 in 500 hospitalization of children under the age of 5 years. While science made therapeutic advancements to battle CAP, the pathogens too have acquired resistance to many drugs. In this fight for dominance, Ampicillin plus Gentamicin and 3rd Gen Cephalosporins are nowadays the cornerstone of treatment. However, their efficacy varies in different parts of the world owing to differing levels of drug resistance.

Objective: To compare the effect of Ampicillin and Gentamicin vs. third generation cephalosporin in treatment of severe community acquired pneumonia.

Methodology: This Randomized Controlled Trial was conducted at the Dept. of Pediatrics (Ziauddin University Hospital) upon a sample of 74 patients (in two equal groups) of either gender, aged 2 months to 5 years, presenting with CAP. After taking written informed consent, data was recorded onto a pre-structured questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, presenting complaints, immunization status of the pneumococcal and HIB vaccine, laboratory values, and treatment outcome.

Results: The mean age of the sample stood at 15 months (SD ± 3) with a majority of the sample comprising of male children (52.7%). The mean weight stood at 8.7 kg (SD ± 0.9) and the mean height was recorded to be 74.2 cm (SD ± 11). The commonest symptoms included fever, fast breathing, chest in-drawing and added sounds. It was revealed that both treatments achieved successful treatment outcomes in all patients with no mortality. The resolution of symptoms however varied with faster resolution observed in the Cephalosporin group.

Conclusion: After careful consideration, it can be concluded that 3rd generation cephalosporins is more efficacious at treatment of CAP with significantly faster resolution of disease symptoms.

Open Access Original Research Article

Correlation of Vitamin D Levels with Polycystic Ovary Syndrome: A Cross-sectional Study

Reenoo Jauhari, Prashant Mathur, Vineeta Gupta

Journal of Pharmaceutical Research International, Page 41-47
DOI: 10.9734/jpri/2021/v33i59B34350

Objective: To compare vitamin D status in, women with PCOS & fertile women without PCOS and its subsequent evaluation.

Introduction: PCOS is an endocrine disorder of women in reproductive age, characterised by obesity, hyperandrogenaemia and insulin resistance. Women with PCOS tend to be overweight and have increased risk of development of Type II Diabetes and cardiovascular disease. Exact Etiology of PCOS still remain an enigmatic dilemma however various studies conducted till date include diet and lifestyle modification as the key factor to promote health, BMI, reduced hyperinsulinemia and reduce the risk of development of PCOS.

Main aim of our study was to compare vitamin D status in women having PCOS, with fertile women in a tertiary care hospital in Uttarakhand.

Methodology: The conducted study was cross sectional, involving the enrolment of 100 women comprising of 50 women with PCOS and 50 fertile women without PCOS. Participants were selected from gynaecological OPD at Shri Mahant Indiresh Hospital, associated with Shri Guru Ram Rai Institute of Medical Sciences, Dehradun from July 2019 to January 2020. The diagnostic criteria of PCOS used was the Rotterdam criteria. The serum 25-hydroxy vitamin D and other metabolic markers were measured. Vitamin D deficiency was defined as serum 25 (OH) D concentrations less than 20 ng/ml measured on an instrument named as miniVidas (BioMerieux, Germany) based on ELFA (enzyme linked fluorescent assay).

Results: Serum 25-hydroxyvitamin D was significantly lower in women with PCOS compared to fertile controls (p< 0.0001), and the prevalence rates of 25(OH) D deficiency and insufficiency were higher in women with PCOS than in fertile women (p < 0.0001). The study results showed that the prevalence of 25 (OH) D deficiencies in PCOS women was significantly high. Serum 25 (OH) D concentrations were significantly negatively correlated with body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin, total cholesterol and low-density lipoprotein cholesterol (LDL-C), (P < 0.05). In comparison, serum 25 (OH) D concentrations were significantly positively correlated with high-density lipoprotein cholesterol (HDL-C) (P < 0.05). Increased BMI and WHR, high levels of fasting insulin, total cholesterol and LDL-C were regarded as risk factors, but high level of HDL-C was considered to be protective factor of vitamin D deficiency in PCOS women.

Conclusion: The study demonstrated that women with PCOS have a significantly lower 25(OH) D compared to fertile controls. A compromised vitamin D status in PCOS women is associated with a higher prevalence and metabolic risk of PCOS in women.

Open Access Original Research Article

Studies on Lectin Mediated Agglutination Reaction on Red Blood Cell Surface Antigens Using Hot and Cold Water Plant Extracts

Bhavya Sahithi Velagapudi, Hemanth Sai Nannapaneni, Akanksha Alampally, Suryanarayana Veeravilli, Duggipogu Praveen Kumar, Sai Prasad Kavuturi, Swarna Tejaswi Chodisetti, Nadeem Siddiqui

Journal of Pharmaceutical Research International, Page 48-52
DOI: 10.9734/jpri/2021/v33i59B34351

Lectin has various physiological roles in cell agglutination, based on their carbohydrate-binding properties, plant lectins are widely used for the detection, segregation, and characterization of glycoconjugates. Rhesus (Rh) factor is a protein that is inherited and found on the surface of red blood cells. If the surface protein is present, the RBC is Rh positive; otherwise, it is Rh-negative in nature. In this paper, we use agglutination reactions to investigate the effect of different cold and hot water extracted plants on RBC antigens as an alternative to commercial monoclonal antibodies. Extensive research on the sequence homology and 3-D structure of various plant lectins suggests that they have been conserved throughout evolution and may play important physiological roles that are still unknown.

Open Access Original Research Article

RP-HPLC Method Development and Validation for Simultaneous Estimation of Thymoquinone and Curcumin in Dosage form

Prajakta Jagtap, Namrata Mahajan, Anjali Parte, Jeeja Pananchery, Ashish Jain

Journal of Pharmaceutical Research International, Page 53-62
DOI: 10.9734/jpri/2021/v33i59B34352

Aim: The aim of work is to develop and validate simple, specific, accurate, precise HPLC method for the estimation of Curcumin (CUR) and Thymoquinone (THQ) simultaneously in bulk and its formulation as per ICH guidelines for analytical method development and validation.

Study Design: Developing RP-HPLC method using C-18 Inertsil column and optimization of variables for estimation of Thymoquinone and Curcumin in bulk and formulation.

Place and Duration of Study: The present work was carried out at Shri D. D. Vispute College of Pharmacy and Research Center, Panvel in year 2021.

Methodology: The RP-HPLC method was developed with an isocratic condition of mobile phase comprising acetonitrile and water in a ratio of (82:18) v/v, at a flow rate of 0.9 mL/minute over Inertsil ODS, 250× 4.6 mm, 5 µm column, at 30°C column oven temperature. Photodiode array at 256 nm was used for detection

Results: Retention time for curcumin and thymoquinone was found to be 3.5 and 4.3 mins respectively. The method showed excellent linear response in concentration range of 4-18 µg/mland 10-45 µg/mlfor thymoquinone and curcuminrespectively with correlation coefficient (R2) values of0.999 for both. System precision and method precision studies were less than the maximum allowable limit percentage of relative standard deviation ≤ 2.0 i.e., 1.61 % and 1.62 % for curcumin and 0.47 % and 0.42 % for thymoquinone respectively. Mean % Recovery for both the drugs were within acceptance limits. The developed and validated HPLC method is simple, accurate, precise and suitable for analysis as all the results were within acceptance criteria.

Conclusion: The developed RP-HPLC method at single wavelength was validated according to ICH guideline with respect to system suitability, specificity, linearity, accuracy, precision and robustness and can be used for routine quality monitoring of drug in pharmaceutical dosage form.

Open Access Original Research Article

Antagonistic Activity of Bacteriocins Produced by Lactobacillus Isolates against Multidrug Resistant Pathogens

Asma Bashir, Kashif Ali

Journal of Pharmaceutical Research International, Page 76-87
DOI: 10.9734/jpri/2021/v33i59B34354

Background: Multi drug-resistance pose a great threat to public health and are responsible for various life-threatening ailments. There is a crucial need to control the outbreaks by finding alternatives to the conventional drugs available. Over the last few years, the usage of probiotics, including Lactobacillus spp. and their bacteriocins has gained much attention to ward off various diseases.

Methods: This study was focused on characterizing bacteriocins extracted from Lactobacillus spp. and assessing their antagonistic effect against multi-drug resistant bacteria. Fifteen Lactobacillus spp. were isolated and identified from Pakistani dairy and fermented products (raw milk, cheese, butter milk, pickle and yoghurt). All the isolates were preliminarily screened by the antagonism method of agar well diffusion method, and the bacteriocins were isolated by ammonium sulphate method. Afterwards, to evaluate the release of bacteriocin in liquid medium, the Cell-Free Supernatant Fluid (CFSF) of the best producer strains were tested by agar well diffusion assay. To assess the thermostability of the bacteriocins, they were subjected to temperatures of 40ᴼC, 60ᴼC, 80ᴼC and 100ᴼC.

Results: The study allowed the selection of five bacteriocin producing strains Lactobacillus acidophilus KAL1, Lactobacillus casei KAL3, Lactobacillus plantarum KAL5, Lactobacillus reuteri KAL6 and Lactobacillus spp. delbrukei KAL7, endowed with the strongest and broadest inhibitory ability against both Gram-positive (Methicillin Resistant Staphylococcus aureus) and Gram-negative (Pseudomonas aeruginosa) bacteria. Bacteriocins isolated were significantly thermostable with activity at 80ᴼC (30, 20 min) respectively. Moreover, all the bacteriocins were considerably stable at a range of pH (4–8) but all the activity was eliminated against proteolytic enzyme Proteinase K.

Conclusion: From this study, it was concluded that bacteriocin extracts from five isolated Lactobacillus spp. can be considered a preferable candidate against multi-drug resistant pathogens. These partially purified bacteriocins should be further processed to attain purified product that could be useful for further studies for the control of pathogens, food spoilage and preservation purposes.

Open Access Original Research Article

Study of Morphofunctional Parameters of Blood Cells in Ischemic Stroke Using a Genome-wide Research

Ulyana Viktorovna Matveeva, Malika Ruslanovna Askhanova, Shamsi Aisayevich Saydaev, Alina Said-Alvievna Bakasheva, Diana Magomedovna Nauruzova, Z. I. Muzaeva, Nuryan Ruslanovna Bazaeva, Alina Yurievna Maslova, Marem Makhmudovna Magomedkhadjieva, Khadizhat Isaevna Mezhidova

Journal of Pharmaceutical Research International, Page 70-75
DOI: 10.9734/jpri/2021/v33i59B34355

Biomarkers can play many useful roles in modern neurology. Early diagnosis and immediate therapy are important factors for reducing the degree of brain tissue damage in ischemic stroke, reduces the risk of death from stroke. In the current study, apolipoprotein CIII (ApoCIII), a biomarker of ischemic stroke, was found.

Open Access Original Research Article

Antimicrobial Activity and Cytotoxicity of Mouthwash Prepared from Azadirachta indica and Stevia rebaudiana Extract– An In vitro Study

Bipin Maheshwaran, R. Priyadharshini, S. Rajesh Kumar, Palati Sinduja

Journal of Pharmaceutical Research International, Page 96-107
DOI: 10.9734/jpri/2021/v33i59B34357

Introduction: Mouth wash are generally utilized as subordinates to oral cleanliness and in the conveyance of dynamic specialists to the teeth and gums. These flushes can impact plaque development and adjust the course of gingival irritation. Azadirachta indica (Neem) was utilized to treat different skin illnesses, as a disinfectant substance and as a natural mouthwash. Stevia rebaudiana can inhibit the growth of microorganisms that are responsible for dental caries.

Aim: This study aimed to assess the antimicrobial activity and cytotoxicity from Neem and Stevia based Mouthwash.

Materials and Methods: Plant extract was prepared and an antimicrobial and cytotoxic effect was done by considering various parameters. The antimicrobial activity of nanoparticles prepared using plant extract was investigated and the results of the test were described as the standard deviation and analyzed. For the cytotoxic activity, an ELISA plate was used, wherein the mortality rate of the nauplii was estimated with the plant extract mediated nanoparticles at different concentrations. Data’s were statistically analyzed by Spearman correlation through SPSS version 23.

Results: Anti-microbial activity showed positive correlation with increase in concentration (r=1). The cytotoxic activity showed negative correlation with the number of live nauplii decreased in the second day when compared to the first day suggesting that the extract has potent cytotoxic activity (r=-1).

Conclusion: Neem and Stevia extract helped us to detect the antimicrobial activity and cytotoxic effect on the various species in different concentration levels. The study needs to be evaluated further for isolating the possible compounds to test the effectiveness of antimicrobial activity in the oral cavity of the human body to prevent various diseases.

Open Access Original Research Article

Comparison of Hemoglobin (Hb) and Hematocrit (HCT) Value in Normal and Cancer Patients- An In-vitro Study

V. Jaya Vabushana, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 113-119
DOI: 10.9734/jpri/2021/v33i59B34359

Introduction: Hemoglobin is the molecule in Red blood cells (RBC) that carries oxygen from the lungs to the body's tissues and returns carbon dioxide gas from the tissues back to the lungs. The hematocrit is the ratio of the quantity of Red blood cells to the amount of these components together, called blood. The hematocrit measures the amount of red blood cells compared to the whole blood volume (red blood cells and plasma). The research is required to find out whether the cancer affects the traditional Hb and HCT value.

Aim: The aim of this study is to evaluate the difference between the normal and cancer patient’s Hb and HCT values.

Materials and Methods: A Total of 20 samples were included in this study. Divided into two groups of normal and cancer patients. The details of Hemoglobin and Hematocrit values were noted down from the routine Complete blood count analysis and regression analysis is done through SPSS version 23.

Results: The results showed that there is significant difference between the Hemoglobin and Hematocrit value between normal and cancerous patients. Comparison of Hemoglobin and Hematocrit value in normal and cancer patients showed mean value of the Hb in control patients as 13.9g/dl with a standard deviation of 1.4 and in squamous cell carcinoma as 12.97g/dl with a standard deviation of 2.6 and the mean value of the HCT in the control group is 40.5% with a standard deviation of 3.9 and in the cancer group it is 39.0 with a standard deviation of 7.7. with a significant difference between Hb and HCT level with a p value <0.05

Conclusion: The study found that there is a significant difference between the Hemoglobin and Hematocrit value among Squamous cell carcinoma compared to normal patients. As the therapy for cancers target the bone marrow, proliferative cells, the hematological parameter analysis is necessary to know the prognosis of the cancer individual.

Open Access Original Research Article

Saudi Physicians' Awareness and Practice of Pulmonary Rehabilitation for Post-COVID-19 Syndrome Patients

Reem Al Maliki, Talal Ibrahim Hawsawi, Fatimah Ismail Alrajab, Nouf Abdulaziz Alatawi, Mohammed Omar Jamjoom, Mohamad Souleman Shakally, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Page 120-130
DOI: 10.9734/jpri/2021/v33i59B34360

Background: The coronavirus disease (COVID-19), caused by infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, has resulted in considerable mortality, morbidity, and unprecedented strain on healthcare systems throughout the world. As the pandemic evolves, one of those challenges has become increasingly common - the post-COVID-19 syndrome. Approximately 10-20% of SARS-CoV-2 patients who experienced an acute symptomatic phase are still experiencing some effects beyond 12 weeks. To assess knowledge, awareness and practice about effectiveness and benefits of pulmonary rehabilitation for post-covid-19 syndrome patients and their practical barriers and opportunities, and education and training needs among Saudi physicians.

Methodology: A cross-sectional online survey was held among healthcare providers in Saudi Arabia. Department of internal medicine, Heraa General Hospital, between January 2021 and November 2021. The questionnaire was sent to Saudi physicians from data collectors face-to-face through smartphone apps. The questionnaire covered the talk about pulmonary rehabilitation knowledge and familiarity among Saudi physicians, support and practice, barriers to pulmonary rehabilitation integration, and interest in learning more about pulmonary rehabilitation programs.

Results: A total of 1111 responded to the survey. The mean age of the participants was 33 years old, with mean years of experience of about 6.95 years. The majority of respondents (n=949) (85.4%) work in urban areas and come from various regions, including the west (n=407) (36.6%), east (n=195) (17.6%), north (n=150) (13.5%), south (n=150) (13.5%) and central region (n=209) (18.8%). More than half of the respondents were physicians (n=750) (67.5%) from different specialties, and the mean number of covid-19 patients seen by physicians was 5.68% per day.

Conclusion: Participants in this study showed a positive attitude toward pulmonary rehabilitation. They believe their patients would benefit from Pulmonary rehabilitation, are interested in referring post-covid-19 patients to rehabilitation providers and co-managing their care, and would like more educational opportunities in order to increase their knowledge of the safety and efficacy of pulmonary rehabilitation.

Open Access Original Research Article

Knowledge and Awareness on Tonsillitis among Dental Students - A Survey

T. K. Hariprasath, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 131-139
DOI: 10.9734/jpri/2021/v33i59B34361

Introduction: Palatine Tonsils are paired lymph node organs located on each side of the back of your throat. They function as a defense mechanism and help prevent body from getting an infection. When tonsils become infected, the condition is called tonsillitis.

Aim: This article aims to know the knowledge and awareness of dental students on Tonsillitis diseases.

Materials and Methods: A questionnaire of 16 questions was created and entered in the online survey creator ‘Google Forms’ and shared among each student of about 100 individually and privately and data were collected subject to statistical analysis using SPSS software. Statistical tests used were descriptive statistics and Chi-square tests. A P-value less than 0.05 will be  considered statistically significant.

Results and Conclusion: Results of this study suggest that Third-year students more aware of symptoms of tonsillitis 20%, complications of tonsillitis 20% and symptoms associated with strep throat 18% than students of other year and they need an effective education and awareness campaign to increase their knowledge and awareness on Tonsillitis.

Open Access Original Research Article

Co-infection of Dengue and Chikungunya viruses: A Serological study from Ananthapuramu District, Andhra Pradesh

Adireddi Paradesi Naidu, Chitralekha Saikumar, Kalavathy Victor, G Sumathi, N. S. Muthiah

Journal of Pharmaceutical Research International, Page 147-151
DOI: 10.9734/jpri/2021/v33i59B34363

Introduction: It is observed that the infections of Dengue and Chikungunya were rising in many parts of India. Aedes aegypti mosquitoes are common vectors for dengue virus (DENV) and CHIK virus (CHIKV). In areas where both viruses co circulate, they can be transmitted together. The present study was undertaken to study the clinical features of dengue–CHIK coinfection and compare it with mono infection.

Materials and Methods: This study was conducted at Government General hospital, Ananthapuramu on 100 hospitalized suspected patients from July 2021 and November 2021. They were serologically screened for DENV, CHIKV and both by performing RTPCR for dengue and ELISA CHIK IgM for Chikungunya.

Results: Out of the total 100 samples collected from suspected patients, 28 (28%) samples were positive for DENV while 5 (5%) samples were positive for CHIKV. In addition to this, 4 sera were positive (4%) for coinfection of DENV and CHIKV. Co infected patients had fever in all cases while rash was seen in only 50% cases. Fever, Myaliga, Arthralgia and thrombocytopenia were seen in many number of co infected cases which signifies the  overlapping nature of dengue–CHIK coinfection.

Conclusion: It is concluded that strict control measures should be implemented to stop the spread of these viruses  as there in Increase in the number of Dengue and Chikungunya infections and their co circulation.

Open Access Original Research Article

Comparative Analysis of Specific Gravity with Hemoglobin of the Blood - Clinicopathological Analysis

C. Surya, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 152-158
DOI: 10.9734/jpri/2021/v33i59B34364

Aim: The study aims to analyze the specific gravity with the hemoglobin of the blood.

Introduction: The ratio of the density of a substance to the density of the water at a specified temperature and pressure is known as specific gravity. Blood is a fluid connective tissue that delivers oxygen and nutrients to the cells and transports metabolic waste away from the cells. Red blood cells are biconcave disc-shaped cells produced from bone marrow. It contains proteins that transport oxygen from the lungs to all the parts of the body. The term heme reforms to the iron-containing porphyrin. The aim of the study was to analyse the specific gravity of Hemoglobin of the blood.

Materials and Methods: 10 random blood samples were collected from the patients in Saveetha Dental College. Then the samples were centrifuged and the blood-specific gravity and hemoglobin were analyzed from the sample using a multi-reagent strip and the specific gravity and hemoglobin was determined.

Results and Discussion: The mean specific gravity value of age group 21 - 30 years is 1.015, the mean specific gravity value of age group 31 - 40 years is 1.018, the mean specific gravity value of age group 41 - 50 is 1.016, and the mean specific gravity value of age group more than 50 years is 1.020. The mean specific gravity value of females is 1.01750 and the mean specific gravity value of males is 1.01750. The mean Hb value of females is 11.67 and the mean Hb value of males is 14.68.

Conclusion: The value of mean specific gravity is slightly increased among different age groups and the mean Hb value is also slightly increased with different age groups. Between genders mean specific gravity is equal to both genders and mean Hb value is more in males compared with females.

Open Access Original Research Article

Mitral Annular Plane Systolic Excursion (MAPSE) as a Simple Index for Assessing Left Ventricular Function: An Observational Study

Jayanti Venkata Balasubramaniyan, Ashutosh Prasad Tripathi, J. S. Satyanarayana Murthy

Journal of Pharmaceutical Research International, Page 163-170
DOI: 10.9734/jpri/2021/v33i59B34366

Background: Mitral annular plane systolic excursion (MAPSE) has been proposed as a parameter for assessing left ventricular function. The assessment of LVF has major diagnostic and prognostic implications in patients with cardiovascular diseases. LVF is measured by Left Ventricular Ejection Fraction, however the accuracy of LVEF estimation by two dimensional echocardiography is limited especially in patients with poor image quality. Mitral annular plane systolic excursion (MAPSE) measurement predicts left ventricular function even in conditions with suboptimal echo window.

Objective: To assess the correlation of MAPSE derived LVEF with LVEF measured by Modified Simpson’s method.

Methods: This is a cross sectional study which included 279 patients admitted at our tertiary care hospital from December 2019 to March 2020 and the patients were divided in two groups. Group A – Patients with LVEF>= 50% and Group B – Patients with LVEF<50%. All patients underwent 2D echocardiographic examination using Modified Simpsons’ method and MAPSE measurement. The VIVID E9, VIVID T8, VIVID E95 and PHILIPS echocardiography machine was used for the non-invasive measurements. MAPSE was recorded at medial and lateral mitral annuli in the apical four-chamber approach.

Results: On analysis, a cut off value for average MAPSE-S (medial mitral annuli) was 8.5 was obtained, denoting preserved LV function with sensitivity of 81.7%, specificity of 84.9%, positive predictive value of 91.6% and negative predictive value of 84.9%. The AUC for MAPSE-S was 0.822. Similarly, the cut off value of average MAPSE-L (lateral mitral annuli) was 7.5 denoting impaired LV functions with an AUC of 0.826, sensitivity of 82.8%, specificity of 72.0%, positive predictive value of 85.6% and negative predictive value of 72.0%. The AUC of 82.6% was observed for MAPSE-L.

Conclusion: MAPSE reflects longitudinal myocardial shortening. MAPSE is a rapid and sensitive echocardiographic parameter for assessing normal LV function and global LV systolic dysfunction.

Open Access Original Research Article

Comparison of the Modified Alvarado Score and Ultrasonography for Diagnosing Acute Appendicitis

S. Keerthana, . Vignaradj

Journal of Pharmaceutical Research International, Page 171-177
DOI: 10.9734/jpri/2021/v33i59B34367

Background: Acute appendicitis can be diagnosed much accurately by using Modified Alvarado score and Ultrasound together in the clinical setting.

Objectives: Comparison of the diagnostic accuracy of Modified Alvarado score and Ultrasonographic findings in acute appendicitis.

Materials and Methods: A total of 200 patients of age group ranging from 4-65 years, both male and female, who visited the tertiary health care center with clinical features suggestive of acute appendicitis were randomly selected. Data from the patients regarding their Modified Alvarado score, ultrasonographic findings and histopathological reports were collected for the study. Statistical analysis was performed for the results of both Modified Alvarado score and Ultrasonographic findings in contrast to the pathology reports. 

Results: The study included 200 patients, with maximum incidence of acute appendicitis seen in males (70.5%) and among 21-30 age groups (40.5%). The sensitivity, specificity of Modified Alvarado Score was 89.47% and 73.33%, with Positive Predictive Value, Negative Predictive Value and diagnostic accuracy being 40%, 73.33% and 45% respectively. Ultrasonography revealed 89.58% sensitivity, 15.62 % specificity, Positive predictive value and NPV were 75.88% and 50%, and diagnostic accuracy was 72%. The negative appendectomies rates accounted to 15%.

Conclusion: It is advised that both Modified Alvarado score and Ultrasound can be used to together to diagnose acute appendicitis. This can be useful in decreasing the negative appendectomies and hence reduce the morbidity and mortality.

Open Access Original Research Article

Incidence of Asymptomatic Bacteriuria in Pregnant Women

S. Roshini, R. Shruta lakshanaa, M. Sivasankar, M. Griffin, T. Suhas, V. Kamaraj, N. Muthulatha

Journal of Pharmaceutical Research International, Page 215-219
DOI: 10.9734/jpri/2021/v33i59B34371

Background: Asymptomatic bacteriuria is the presence of bacteria in the properly collected urine of a patient that has no signs and symptoms of urinary tract infection.

Aim: This study was carried out to determine the incidence of asymptomatic bacteriuria in pregnant women in Saveetha medical college, Thandalam, Tamil Nadu.

Materials and Methods: A total of 250 pregnant women attending antenatal clinic at civil hospital, Saveetha medical college, over a period of 3 months, with age groups between 18 to 30 years agreed to enter the study and were clinically evaluated. All these women were asked to submit clean catch midstream urine samples and it was examined under the microscope and by culture method.

Results: A total of 250 pregnant women included in our study, with varying age groups between 18 to 30 years and the highest incidence was seen in between the 26 to 30 age group. Asymptomatic bacteriuria was seen in 27.2% of the pregnant women. The prevalence of Escherichia coli was among the most dominant organism, followed by Staphylococcus aureus ,klebsiella and proteus species.

Conclusion: The study showed 27.2% of the pregnant women to have asymptomatic bacteriuria. This can be reduced by screening the mothers in first trimester and routine urine culture test must be carried out.

Open Access Original Research Article

The Relationship between C-Reactive Protein and COPD Patients

G. A. Bhuvaneshwar, . Dayanandan

Journal of Pharmaceutical Research International, Page 227-235
DOI: 10.9734/jpri/2021/v33i59B34373

Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable chronic inflammatory respiratory disease that affects 210 million people globally. Due to inflammation the resultant IL6 increases the level of C-REACTIVE PROTEIN (CRP) from hepatocytes. This study was conducted to evaluate the association of C-Reactive Protein in COPD patients. The study also includes the key role of C-reactive protein (CRP) in assessing the acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD), which has proven to be more valuable. This was a prospective study conducted over a period of three months between February 2021 and April 2021 at the department of General Medicine in Saveetha Medical College Hospital, Chennai. In a study of 50 patients, 25 were patients with COPD and 25 were a control group of healthy people. High Sensitivity C-Reactive Protein (hs-CRP), blood gases, spirometry, Body Mass Index (BMI), 6 Minute Walk Distance (6MWD) and GOLD stage of severity were measured. The serum hs-CRP was then evaluated for any correlation with the predictors of outcomes of COPD subjects. hs-CRP levels were higher in patients with COPD than in healthy individuals (4.82 / 0.8 mgl). A correlation was found between hs-CRP and the following variables:

FEV1 (r = -0.813; p < 0.01), 6MWD (r = -0.876; p < 0.01), GOLD stage (r = 0.797; p < 0.01) and evaluated. This study revealed that there is certain increase in hs-CRP in COPD patients due to inflammation. It acts not only as an inflammatory diagnostic marker, but also plays a role as predictor for the outcome of the disease and reducing the mortality rate.

Open Access Original Research Article

Atherogenic Plasma Index Levels of Colon Cancer Patients after Chemotherapy

Utku Donem Gundogdu, Funda Karabag Çoban

Journal of Pharmaceutical Research International, Page 236-239
DOI: 10.9734/jpri/2021/v33i59B34374

Objectives: Despite newly developed treatment modalities, colorectal cancer is still the leading cause of cancer deaths. In recent years, studies have been carried out to suggest that lipid metabolism may play a role in cancer development and metastasis.

Methods: Lipid metabolism both in conventional chemotherapy. It has also been found that it plays a central role in resistance to targeted therapies. In our study, we planned to compare the atherogenic plasma index levels of patients diagnosed with colon cancer before chemotherapy and in the month of chemotherapy.

Results and Conclusions: Evaluating the effect on the atherogenic plasma index after chemotherapy, we thought that lipid-regulating treatments would contribute to both cancer development and disease control.

Open Access Original Research Article

Emoxipine Modulates Concentration-Dependent Effects of Cytarabine and Cyclocytidine on Activation of Human T Cells

Darya B. Nizheharodava, Eugenii I. Kvasyuk, Marina M. Zafranskaya, Aliaksei G. Sysa, Tatyna N. Zhukovets, Viktar O. Lemiasheuski

Journal of Pharmaceutical Research International, Page 249-260
DOI: 10.9734/jpri/2021/v33i59B34376

Title: Emoxipine modulates concentration-dependent effects of cytarabine and cyclocytidine on activation of human T cells.

Introduction: Both cytarabine and cyclocytidine are used in the treatment of acute myeloid leukemia. Well known that cytarabine and other related cytosine-based nucleoside analogues are being toxic to tumor cells by increasing levels of cellular oxidative stress as it could be abrogated by antioxidants. However, very little is known both about both the effects of combinations of antimetabolites with antioxidants on the cytotoxic innate and adaptive immune cells and whether lymphocytes toxicity affects its anticancer efficiency.

Aim: To estimate effects of cytarabine and cyclocytidine with emoxipine on in vitro activated human T cells at concentrations reached during in vivo treatment with high doses, conventional doses and low doses.

Materials and Methods: T cells derived from blood donors were activated in vitro in cell culture medium alone or supplemented with cytarabine 0.1-10.0 μM or cyclocytidine 0.1-10.0 μM. Cell characteristics were assessed by flow cytometry.

Results: Only cytarabine 1.0-10.0 μM had both antiproliferative and proapoptotic effects. Additionally, these cytarabine concentrations increased the γIFN-producing by CD3+CD4+ T cells and did not affect the release of this cytokine by CD3+CD8+ T cells. In contrast, the lowest concentration (0.1 μM) did not have or showed minor antiproliferative or cytotoxic effects, did not alter the release of γIFN. Cyclocytidine did not affect viability of normal peripheral blood mononuclear cells but decreased the proliferative capacity of activated normal T cells in dose-dependent manner. Additionally, cyclocytidine  altered the percentage of γIFN-producing proliferative CD3+CD8+ cytotoxic T cells for any concentration tested (0.1, 1.0, 1 and 10.0 μM) meanwhile highly suppressed the number of the whole amount of CD3+CD8+ cells and did not affect the release of cytokines by CD3+CD4+ T cells.

The study of the expression of the CD107a marker showed a significant stimulating effect of 10 µm of citarabine on the activation of subpopulations of T-lymphocytes (CD3+) and cytotoxic T-lymphocytes (CD3+CD8+).

Open Access Original Research Article

In-vitro Antioxidant Activity and Preliminary Phytochemical Analysis of Different Leaf Extracts of Hemionitis arifolia

Rajendran Raja Priya, N. Bhadusha, Veramuthu Manivannan, Thanthoni Gunasekaran

Journal of Pharmaceutical Research International, Page 281-291
DOI: 10.9734/jpri/2021/v33i59B34382

Objective: To evaluate the preliminary phytochemical content and antioxidant potential of the hydroalcoholic leaf extracts of Hemionitis arifolia.

Methods: Total phenolic, flavonoid and alkaloid contents were evaluated using spectrophotometric methods. The free radical scavenging activity of the leaf hydroalcoholic extract were evaluated against DPPH+, ABTS+, Reducing power assay and nitric oxide assay were determined.

Results: The hydroalcoholic concentrate of H. arifolia uncovered the most elevated polyphenol content when contrasted and the other phytoconstituents. Absolute phenol content of the hydroalcoholic separate was observed to be 31.78%, flavonoid content is 1.02% and Alkaloid content is 30.40% individually. The Solvent concentrates showed huge cell reinforcement movement, with hydroalcoholic extract. ABTS Assay, DPPH assay, Reducing power assay and Nitric oxide assay where the Inhibition concentration were 667.75µg/ml, 734.25 µg/ml, 791.58 µg/ml and 899.67 µg/ml.

Conclusion: This study suggests that hydroalcoholic leaf extracts of H. arifolia could be a potential source of natural antioxidant and justifies its use in ethno-medicine.

Open Access Original Research Article

Effectiveness of Chilled Cabbage Leaves Versus Hot Application on Breast Engorgement among Postnatal Mothers in Selected Hospitals of Vadodara, Gujarat, India

Usha Rathava, T. Vinaya Kumary

Journal of Pharmaceutical Research International, Page 292-301
DOI: 10.9734/jpri/2021/v33i59B34383

Background of the study: Breast feeding is important imperious in the mother’s life.  Breast milk may be complete healthy and salubrious supplement for the baby to help of the conjointly growth and development [1]. Breast engorgement causes discomfort and tenderness and pain that affect breastfeeding mothers early in the postpartum. The breast engorgement is one of the main factors contributing to early interruption of breastfeeding. Very few researches have been proven to monitor the effect of cabbage leaves application on breast engorgement [2].

Methodology: A quasi-experimental design two group pretest posttest design was used. A conceptual framework of Imogene king goal attainment model (1981) used for the conceptualization of the study. Total samples of 40 postnatal mothers were selected for the study using non probability purposive sampling technique. The samples divided in two experimental groups i.e. 20 in chilled cabbage leaves and 20 in hot application (temperature 43-46 degree Celsius - and tool used sociodemographic, pain scale & breast engorgement checklist and post test data collected after the intervention on 3rd day.

Results: Both the intervention, chilled cabbage leaves and hot application were effective and reduced pain in postnatal mothers (p=0.001*) at p<0.05 level.  In chilled cabbage leaves & hot application are equally effective in reduced breast engorgement in postnatal mothers (p=0.001*) at p<0.05 level.

Conclusion: Findings of chilled cabbage leaves and hot application were effective and reduced pain and breast engorgement among postnatal mothers.

Open Access Original Research Article

Evaluation of Antioxidant and Xanthine Oxidase Inhibitory Potential of Methanolic Leaf Extract of Stevia rebaudiana

M. Rishikesan, R. Gayathri, V. Vishnu Priya, J. Selvaraj, S. Kavitha

Journal of Pharmaceutical Research International, Page 302-309
DOI: 10.9734/jpri/2021/v33i59B34384

Background: Stevia rebaudiana is a shrub-like plant that belongs to the sunflower family and is commonly referred as stevia.It is 1000 times sweeter than sugar even at a very low concentration. Xanthine oxidase is an enzyme that generates oxygen species and catalyzes the production of uric acid from purine metabolism.Overproduction of uric acid results in a  clinical condition called gout. The aim of this study is to explore the phytochemicals, antioxidant and xanthine oxidase inhibitory potential of methanolic leaf extract of stevia rebaudiana.

Methods: Methanolic leaf extract of Stevia rebaudiana was prepared by the Hot Percolation method. Phytochemical screening was done to analyse the presence of various phytochemicals. The leaf extract was tested for its antioxidant and xanthine oxidase inhibitory potentials. The data were analyzed statistically by a one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test was used to see the statistical significance among the groups. The results with the p<0.05 level were considered to be statistically significant.

Results: It was observed that the methanolic leaf extract of Stevia rebaudiana has significant antioxidant potential (Ic50 of = 310 μg/ml) as well as xanthine oxidase inhibitory potentials(Ic50 of = 270 μg/ml) and the activity increased in a dose dependent manner as compared to that of standard (Vitamin C and Allopurinol respectively).

Conclusion: The study proves the antioxidant and xanthine oxidase inhibitory efficacy of Stevia rebaudiana and throws light on the prospects of drug formation against oxidant activity and gout formation.

Open Access Original Research Article

Knowledge and Awareness about Obesity Complications in Pregnancy among Reproductive Women

S. MiSudharshan, . Annejohncy

Journal of Pharmaceutical Research International, Page 310-317
DOI: 10.9734/jpri/2021/v33i59B34385

Background: obesity in general predisposes expected to various noncommunicable diseases but its awareness in regards to the complications posed by it in reproductive women is underseen.

Methods: cross sectional study using an structured questionnaire.

Goal: To access the knowledge and awareness about complications of obesity in pregnancy among reproductive women

Statistical Analysis Used: Data was entered in excel spreadsheet and analysed using SPSS version 16.

Results: Majority of the participants [129 (86%)] knew that obesity affects reproductive health causing problem problems like just gestational diabetes mellitus GDM [ 136 (90.6%)], difficulties during labour, higher Chance of Caesarean [91(60.6)] section, Increased risk for hypertension [120 (80%)] infertility [ 53 (35.3%)], during pregnancy. Almost all of them know That obesity can increase problems in pregnancy for both mother and for the baby. Majority of them we are not sure if obesity causes increased chance of Foetal malformations [75 (50.2%)] Increased bleeding after delivery [103 (68.8%)] Most of them don’t know that obesity can cause increased bleeding after delivery, stillbirth [125 (83.3%)], miscarriage [111(74%)], difficulties in Ultrasound examination of the abdomen [81 (54%) ]Most of them thought that obesity does not cause difficulties in measuring BP [79 (52.6)], delivery of big baby [98 (65.3%) ], premature delivery [56 (37.3%)].

Conclusion: Generating Awareness about obesity and its complications in pregnancy is required to prevent those complications in future and bring behavioural and lifestyle modification for sustainability in the long run.

Open Access Original Research Article

Anthropometric Evaluation of Volume of Maxillary Sinus and Nasal Septum Patterns as an AID in Personal Identification Using CBCT-A Retrospective Study

Rakhi Chandak, Manoj Chandak, Pranali Thakare, Ramhari Sathawane, Runal Bansod, Pranada Deshmukh, Vidyarjan Sukhadeve, Zareesh Akhtar, Charwak Tayade

Journal of Pharmaceutical Research International, Page 318-331
DOI: 10.9734/jpri/2021/v33i59B34386

Aims: To determine the reliability and accuracy of maxillary sinus volume and nasal septum patterns in personal identification in forensics using CBCT (cone beam computed tomography).

Study Design: Retrospective Study

Place and Duration of Study: Department of Oral Medicine and Radiology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital Nagpur, from September 2019-December 2019.

Methodology: 110 CBCT scans of bilateral maxillary sinuses and nasal septum images were retrospectively obtained from the Oral Medicine and Radiology database (68 men and 42 females). The study was divided into two groups based on age. Group

-I consists of 58 CBCT scans taken between the ages of 20 and 40, while Group -II consists of 52 CBCT scans taken between the ages of 41 and 80. The height, breadth, and depth of the maxillary sinus were measured linearly. The nasal septum was classed as simple deviation to the right or left, sigmoid type, reverse sigmoid type, and straight based on the septa's deviations. Each person's combined maxillary sinus and nasal septum pattern was documented.

Results: The difference in maxillary sinus volume between two age groups was significant (P<0.5). In age group I, there was a substantial change in the left deviation pattern, and there was a significant change in the reverse sigmoid pattern in males and the straight nasal septum pattern in females. With whatever nasal septum configuration, there were no volumetric alterations(P>0.5).

Conclusion: In future, further research will be needed with a larger number of images to compare in order to arrive at a definitive identification.

Open Access Original Research Article

Prevalence of Depression in Medical Staff in KSA: Cross Sectional Study

Eman AbdulAziz Balbaid, Abdulaziz Ateeq Alotaibi, Abdullah Hazza Alqahtani, Nashwa Nasser Alsaeedi, Faisal Ali Abutaleb, Majdi Abdullah Alrabie, Rahaf Ghormallah Alghamdi, Atheer Ahmed Bayahya, Basil Abdulaziz Almutairi, Hanin Abdullah Asiri, Khalid Hazza Alotaibi, Meshal Faihan Aldajani, Saad Omar Alsaab, Renad Abdullah Alghamdi, Mohammed Abdullah Babtain

Journal of Pharmaceutical Research International, Page 349-355
DOI: 10.9734/jpri/2021/v33i59B34388

Background: According to the international classification system ICD -10 (International Classification of Diseases), doctors speak of a mild depressive episode if at least two main symptoms such as depressed mood and lack of drive and two additional symptoms such as feelings of guilt and sleep disorders occur. In a moderately depressed phase, there are two main symptoms and at least three, but no more than four other symptoms. Major depressive episodes are diagnosed when all three main symptoms and at least four additional symptoms are present. In addition, the complaints must last for at least two weeks. In the American classification system DSMIV is referred to as "major depression" (corresponds to a severe depressive episode) and "minor depression" in the case of a less severe episode.

Methods: This was an analytical cross-sectional study to spot light on the relationship between different chronic conditions and variables, specifically: age group, gender, medical specialty, years of experience, nationality, Vitamin D deficiency, Diabetes mellitus, and hypertension; and depression symptoms, among Saudi and non-Saudi medical staff in the KSA.

Results and Conclusion: Results of this study concluded that there is a significant relationship found between depressive symptoms and gender, specialty, years of experience, and vitamin D deficiency. Relationship with age group, nationality, diabetes mellitus and hypertension, is not statistically significant. These results are concordant, in most parts of this study, with the previous studies in different times and regions, done for nearly similar purposes.

Open Access Original Research Article

Impact of Glyphosate Exposure on Glycogen Metabolic Enzymes in the Liver of Adult Male Rats

N. Vishal Prakasam, R. Gayathri, V. Vishnu Priya, J. Selvaraj, S. Kavitha

Journal of Pharmaceutical Research International, Page 341-348
DOI: 10.9734/jpri/2021/v33i59B34389

Background: Glyphosate is a broad spectrum herbicide and desiccant. Diabetes is a group of metabolic diseases resulting due to  deficiency in insulin secretion. Chronic hyperglycemia will lead to long term damage and failure of different organs like eyes, kidneys, nerves etc. Liver is the major site for gluconeogenesis and a lot of glycolytic enzymes will be involved. Expression of Glycogen synthase and glycogen phosphorylase, the glycolytic enzymes are studied in this research.

Aim: To determine whether glyphosate exposure is detrimental to the glycogen metabolic enzymes (Glycogen synthase and phosphorylase) in the liver of adult male rats.

Materials and Methods: The following study was done on albino rats of wistar strain, and was approved by the institutional animal ethics committee. They were fed with a rat pellet diet. In our study the rats were divided into 4 groups with 6 rats in each and were subjected to glyphosate orally with different dosage in each group and mRNA expression analysis of glycogen related enzymes was done after a span of 16 weeks. The data were analyzed statistically by a one way analysis of variance (ANOVA) followed by Duncan’s multiple range test was used to see the statistical significance among the group. The results with p<0.05 level were considered to be statistically  significant.

Results: The present result showed that the  mRNA expression of glycogen synthase significantly reduced (P<0.05)  and mRNA expression of glycogen phosphorylase activity increased significantly with an increased  dose of glyphosate (P<0.05) to that of control.

Conclusion: Exposure to glyphosate causes detrimental changes in the glycolytic enzymes glycogen synthase and glycogen phosphorylase leading to diabetes.

Open Access Original Research Article

Comparative Evaluation of the Success Rate of Pulpotomy in Primary Molars Using Ferric Sulphate (FS) and Mineral Trioxide Aggregate (MTA): A Clinical and Radiographic Study

Yogesh Somwanshi, Pankaj Chavhan, Arun Sajjanar, Snehal Ughade, Nutan Gutte, Pratima Kolekar, Shruti Bhamare, Swapnil Yadav

Journal of Pharmaceutical Research International, Page 356-363
DOI: 10.9734/jpri/2021/v33i59B34390

Purpose: The aim of this present study was to observe clinical, radiographic response of pulp to Ferric Sulphate and Mineral Trioxide Aggregate when used as pulpotomy agent in primary molars.

Materials and Methods: Sixty restorable primary molars were selected for the study. The children were chosen who require minimum two pulpotomies in either arch preferably each on the opposite side (i.e. right and left). Primary molars on the right side of the patient were assigned to Ferric Sulphate (FS) (Group A) and left side was assigned for the Mineral Trioxide Aggregate (MTA) (Group B). Statistical analysis was done for pain, swelling, sinus, and fistula and for internal resorption, furcation radiolucency and periapical pathology using the chi-square test.

Results: outcome of the present study was observed at 3 month interval and after 6 months. The clinical success rate for MTA (AQUA) and ferric sulphate during 3 and 6 month follow up was 100%. The radiographic follow up of MTA was 100% during 3 and 6 month, whereas it was 96.6% for 3 and 6 month follow up with respect to ferric sulphate. There were no significant differences in the clinical (p>0.1) and radiographic (p>0.98) success rates among both the groups.

Conclusion: ferric sulphate was found to be equally effective when compared with MTA. Radiographic success rate was lower for Ferric sulphate (Group A) than that of MTA (Group B) with occurrence of one internal resorption seen with first primary molar.

Open Access Original Research Article

The Development of Innovative Clay Mask Product Mixed with Theacanthus ebracteatus Vahl Extract

Narin Kakatum, Papawee Sookdee, Thanaporn Phromhan, Ilham Hamai, Natphapat Supatsaraphokin

Journal of Pharmaceutical Research International, Page 364-370
DOI: 10.9734/jpri/2021/v33i59B34391

This research is a study on the development of innovative clay mask mixed with the Acanthus ebracteatus Vahl extract product. The purposes of this research are as follows. Firstly, the research is to develop a clay mask product mixed with natural extracts from the Acanthus ebracteatus Vahl. Secondly, it is aimed to study on the antioxidant activity, anti-inflammatory effect, antimicrobial effect and total Phenolic contents of the Acanthus ebracteatus Vahl extracts. Thirdly, it is tostudy stability of the product. Finally, the research is to study on the calculation of suitable product formulations for clay products mixed with Acanthus ebracteatus Vahl extracts. By starting from the selection of raw materials, the extracts are prepared to determine the total phenolic content. Later, 2,2-diphenyl-1-picrylhydrazyl (DPPH) Assay method is conducted for antioxidant activity test, followed by anti-inflammatory effect test (Nitric oxide production inhibitory activity test, inhibition of LPS-induced TNF-α secretion test and Anti-inflammatory activity test (COX-2). Afterwards, a suitable formulation is developed. The test for the safety and physical properties of the product is then carried out followed by the skin irritation test in a group of 10 volunteers in order to ensure that the clay mask product containing Acanthus ebracteatus Vahl extracts is effective and safe. From the results of the product stability study, the findings indicated that the clay mask product containing Acanthus ebracteatus Vahl extracts did not show any phase separation. The irritation test in 10 volunteers after 12 hours of using the product showed no sign of allergic reaction, itching or irritation. Toxicity test results found no cytotoxicity. The anti-inflammatory effect test was found to have potent anti-inflammatory properties, when tested in the RAW 264.7 macrophage cell. This study is only for the development of an innovative product of skin clay mask mixed with the Acanthus ebracteatus Vahl extracts.

Open Access Original Research Article

Awareness of the Practice and Use of Contact Lenses amongst Students of the Health Faculty at Jazan University during the COVID-19 Pandemic

Ismail Abuallut, Abdulaziz A. Hakami, Mohammed I. Alameer, Mohammed O. Shami, Nasser M. Hakami, Alfadhel A. Khawaji, Abdualrhman Attiah, Elaf H. Madkhli, Mohammad A. Jareebi, Maryam M. Al Hammadah, Ahmed Z. Alkhars, Norah M. Almalki

Journal of Pharmaceutical Research International, Page 371-382
DOI: 10.9734/jpri/2021/v33i59B34392

Background: Contact lenses are medical devices which are used as an alternative to spectacles to correct problems with eyesight. Poor hygienic handling of these lenses poses an ocular health risk. Increased popularity and usage of contact lenses in combination with insufficient cleanliness results in increased bacterial infections of the eye, even resulting in blindness.

Materials and Methods: We employed a quantitative cross-sectional study, where we used questionnaires to gather data. We conducted the study among students of the Health Faculty at Jazan University where we recruited 361 participants. Using the questionnaires, we assessed the use of contact lenses and the hygiene practice when handling them among the participants. To the best of our knowledge, only one study has been conducted in the Jazan region to assess contact lens awareness and practice, which can be consider as a gap of knowledge that make our study can be consider a vital observation about usage of contact lens in the Jazan region.

Results: We found that 52.6% of the participants use contact lenses. Among those it is predominantly females who use contact lenses, and their motivation is primarily for cosmetic reasons. We further found that the majority of contact lens users exhibit good hygiene practices when handling contact lenses. However, there remains more than a quarter of participants for whom the hygiene practice is poor to moderately good.

Conclusion: The majority of participants 172 (84.7%) had good practice level regarding wearing contact lenses. Considering the significant fraction of participants who showed inadequate hygiene practice, we recommend better information and training for those who use contact lenses. This information and training should be predominantly made available on the internet or through contact lens vendors, as these are the most common information channels among the participants.

Open Access Original Research Article

Evaluation of Plasma Levels of Interleukin 6 and Iron Status of Football Players in a Nigerian University

Emmanuel Ifeanyi Obeagu, Gideon Ojochegbe Amedu, Ijeoma L. Okoroiwu, Chukwuma J. Okafor, Ohikhuare Okun, Ogochukwu M. T. Barbara Ochiabuto, Chukwulete Okafor Ukeekwe

Journal of Pharmaceutical Research International, Page 383-388
DOI: 10.9734/jpri/2021/v33i59B34393

To determine the levels of interleukin 6 (IL-6) and iron status of football players in Madonna University, Elele, Rivers State, Nigeria. A total number of 100  subjects were recruited for the study, comprising of 50 of football players before playing football (25 males and 25 females) and 50 of football players after playing football (25 males, 25 females) from Madonna University Nigeria, Elele Campus, Rivers State, Nigeria. The data obtained from the study were presented as Mean  SD in tables and analysed using student t-test for parametric data using SPSS version 20. The level of significance was set at p<0.05. The results showed significant increase (p=0.004) in interleukin 6 (IL-6) of football players after playing compared to it before playing and no significant change (p=0.505) in the iron level of football players after playing compared to before playing respectively. The results also showed no significant change in interleukin 6 compared among football players based on gender and age groups and no significant change in the iron level of all the subjects. The study showed increase an in interleukin 6 (IL-6) of the football players after playing compared to the level before playing which shows that the physical activity increases the level of interleukin 6 and but has no effect on the iron level after football game.

Open Access Original Research Article

The Study of Correlation of Incidence, Severity of Renal, Cardiovascular Complications with Duration, Severity of Type 2 Diabetes Mellitus in a Tertiary Care Hospital

R. Aruthra, M. Ramkumar

Journal of Pharmaceutical Research International, Page 389-396
DOI: 10.9734/jpri/2021/v33i59B34394

Background: Type 2 Diabetes Mellitus (DM) is a disorder of the endocrine characterised by hyperglycaemia which results from variable degrees of insulin resistance and insulin deficiency.Chronic hyperglycaemia in diabetes may lead to multi organ damage resulting in renal, cardiovascular and other complications.In our study, we aim to look for correlation between the degree of glycemic control, duration of type 2 DM, incidence, severity of renal, cardiovascular complications in type 2 DM patients.

The objective of our study is to analyse the correlation between glycemic control and occurrence of cardiovascular, renal complications in type 2 DM patients.

Materials and Methods: 50 type 2 DM patients were selected from the Medicine outpatient of Saveetha Medical College and Hospital from January 2021 to March 2021.The study was explained and informed consent was obtained. Ethical committee clearance was obtained.The duration of the disease, regularity of treatment are recorded, serum HbA1c was done to evaluate the degree of glycemic control.Renal function tests like estimation of urea and creatinine are done to look for renal complications. Echocardiogram was done to evaluate the cardiac status of the patient.

Expected Outcome: We expect a direct correlation between the severity of uncontrolled hyperglycaemia, duration of the disease with the incidence of renal and cardiovascular complications.

Results: 50 patients who were selected for the study having type 2 Diabetes Mellitus, were made into two groups - people with uncontrolled diabetes (HbA1c >7.5%) were more prone in developing renal and cardiac complications which were assessed by urea, creatinine, urine protein levels and ejection fraction (EF %) values.

The significant cut off values to cause complications were taken as for urea (>40mg/dl), creatinine (>1mg/dl), urine protein (+/++/+++), EF value(>50%) and the presence/absence of regional wall motion abnormality (RWMA) was noted.

It was also observed that longer age duration of the disease, more was the risk to develop cardiac complications than disease of shorter duration.

Hence a poor control of hyperglycaemia made the subject prone to renal and cardiovascular complications.

Conclusion: We arrive at a direct correlation between the severity and extent of uncontrolled hyperglycaemia with the incidence of severity and complications in the form of nephropathy and cardiac dysfunction.

Open Access Original Research Article

Formulation, Characterization and Release Behaviour of Metformin Hydrochloride Modified Release Tablet by Using Hydrophilic Polymers

J. Thirumaran, S. Tamilarasi, S. Punitha, T. Sivakumar, C. N. Marimuthu, D. Kiruthika

Journal of Pharmaceutical Research International, Page 397-405
DOI: 10.9734/jpri/2021/v33i59B34395

Amongst the many public health problems, the diabetes mellitus is considered as a chronic life-style related disease which is now growing as an epidemic in both developed as well as developing countries. The current study is about formulation of metformin hydrochloride tablet to confirm their sustained release property by using various polymers. The tablets are prepared by granulation techniques using binding solution containing polyvinyl pyrolline K30. The possible interaction between the pure metformin hydrochloride and polymers are identified by Fourier transform-infrared spectroscopy. Tablets were formulated with different polymers like Hydroxy propyl methyl cellulose K100 and sodium carboxymethyl cellulose. Matrix prepared with high concentration of HPMC K100 polymer retards the drug release up to 6 h at 59 %, but the formulation 2 (F2) showed 72.72% of drug release in 6 h. The release of drug from the F2 formulation was found to be prolonged drug release when compared to other formulations. Hence our study conclude that the HPMC K100 polymer containing formulation showed good sustained release property owing to the high gel strength and well high viscosity nature of the polymer.

Open Access Original Research Article

Predicting the Difficulty Score of Spinal Anaesthesia

Isha Godwin, . Girimurugan

Journal of Pharmaceutical Research International, Page 406-410
DOI: 10.9734/jpri/2021/v33i59B34396

Background: Spinal anaesthesia is the commonest regional anaesthesia conducted for several surgical procedures.

Objectives: This study aims to predict the difficulty score of spinal anaesthesia to scale back the complications and ultimately improve anaesthesia quality.

Materials and Methods: Patients undergoing various surgeries involving spinal anaesthesia were taken in this study and several parameters like demographic details, body mass index, spinous process condition were recorded pre operatively to see how they influenced the difficulty of performing spinal anesthesia on them.

Results: Out of the 101 patients enrolled in this study, 53 underwent an easy SA by the first attempt in the first space. It was moderate in 36 and difficult in 12 patients.

Conclusion: Considering the examination of patients with respect to BMI, lumbar spinous process status and deformities, radiological signs of lumbar vertebrae can be helpful in predicting how difficult the SA procedure is going to be.

Open Access Original Research Article

The Prescribing of MEBO Ointment in a Public Hospital in Alkharj

Nehad J. Ahmed, Ahmed H. Almutairi, Faris A. Alotaibi, Menshawy A. Menshawy

Journal of Pharmaceutical Research International, Page 411-415
DOI: 10.9734/jpri/2021/v33i59B34397

Aim: The present study aimed to describe the prescribing of moist exposed burn ointment (MEBO) in Alkharj.

Methodology: This is a retrospective study that includes reviewing the electronic prescriptions that included MEBO among the patients who received medications from the outpatient department in a public hospital in Alkharj.

Results: More than 61% of the patients who received MEBO ointment were female patients and about 61.98% of them received MEBO ointment for 1 week. Most of the prescribers were residents (76.86%). More than 46% of the prescriptions were prescribed by emergency department, about 24% were prescribed by plastic surgery department.

Conclusion: The use of MEBO ointment in the outpatient setting in Alkharj was uncommon. Further studies are needed to explore the pattern of using burn treating ointments such as MEBO ointment in the outpatient setting and in other settings.

Open Access Original Research Article

Role of Oxidative Stress as a Marker of Cardiovascular Risk in Children on Regular Hemodialysis

Muhammad Abrar, Mazhar Nadeem, Sunila Fatima

Journal of Pharmaceutical Research International, Page 416-421
DOI: 10.9734/jpri/2021/v33i59B34398

Introduction: Chronic kidney disease (CKD) is a major public health problem worldwide, and its main consequences include loss of renal function leading to end-stage renal disease (ESRD), increased risk of cardiovascular disease (CVD), significant increase in morbidity and mortality, and a decrease in health-related quality of life.

Aims and Objectives: The basic aim of the study is to analyze the oxidative stress and total antioxidant capacity as a biomarker of cardiovascular risk in those children who are on regular hemodialysis.

Materials and Methods: This cross sectional study was conducted at DHQ hospital, Faisalabad during July 2020 to January 2021. The data were collected from the age of less than 18 years children of both sexes. There were 50 children who was selected for this study. At the time of the study, all the patients were on regular three HD sessions per week. In HD patients, venous blood samples were drawn immediately before and after hemodialysis session. Baseline laboratory investigations were carried out for all patients and controls including complete blood count, serum urea and creatinine, arterial pH, arterial blood gases and infection screening, which included blood and urinary cultures by standard methods. 

Results: The data were collected from 50 dialysis patients. The mean age of this study is 15years. We collected all the demographic data of patients. The mean value of Urea is 64.34±2.44 mg/dl). At before-dialysis session, duration of disease positively correlated with TPX (r = 0.969, P <0.001), but, negatively correlated with TAC (r = −0.469, P <0.002). At after-dialysis session, HIF-1α negatively correlated with each of TPX (r = −0.529, P <0.001) and OSI (r = −0.459, P <0.003); while, OSI positively correlated with TPX (r = 0.944, P <0.001).

Conclusion: It is concluded that HD patients, the clinical and prognostic significance of oxidative status associated with cardiovascular risk factors is very different from the general population. Although a direct causality cannot be inferred from such kind of correlative investigations.

Open Access Original Research Article

Phytochemical Screening and In vitro Albumin Denaturation Inhibitory Potential of Methanolic Root Extract of Acorus calamus

M. Sanjay Varshan, R. Gayathri, V. Vishnu Priya, J. Selvaraj, S. Kavitha

Journal of Pharmaceutical Research International, Page 437-445
DOI: 10.9734/jpri/2021/v33i59B34401

Introduction: Medicinal plants are chief antidotes for numerous diseases and have been used since time immemorial. Sweet flag’s (Acorus calamus) presence is in Ayurveda and belongs to the genus Acorus L. of the family Acoraceae and is widely distributed in temperate to sub temperate regions. It is commonly used to treat appetite loss, diarrhoea, digestive disorders in traditional medicinal systems of Asian and European countries. The aim of this study is to explore the phytoconstituents, antioxidant and anti-inflammatory potential of methanolic root extract of Acorus calamus.

Materials and Methods: Methanolic root extract of Acorus calamus was done by the Hot Percolation method. Later it was dried and used to analyse the antioxidant and anti-inflammatory potentials. Phytochemical screening was done to analyse the presence of various phytochemicals. Antioxidant effect of Acorus calamus was tested by 2, 2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity and Albumin denaturation inhibitory potential test was organised for testing it’s anti-inflammatory Activity. The data were analysed statistically by a one-way analysis of Variance (ANOVA) followed by Duncan’s multiple range test was used to see the statistical significance among the groups. The results with the p<0.05 level were considered to be statistically significant.

Results: Methanolic root extract of Acorus calamus was found to be rich in Alkaloids, Flavonoids, Terpenoids, Sapanoids, Steroids and Phlobatannin. The presence of phytochemicals like alkaloids, saponins, Flavonoids indicates that the extract has potential for further in vitro analysis like antioxidant and anti-inflammatory potentials. It was observed that Acorus calamus has both antioxidant (IC50 of = 295 µg/ml) as well as anti inflammatory potentials (IC50 =310 µg/ml) and the activity increased in a dose dependent manner as compared to that of standard (Vitamin C and Diclofenac respectively).

Conclusion: The study proves the antioxidant and anti-inflammatory efficacy of Acorus calamus and throws light on the prospects of drug formulation against oxidant activity and inflammation.

Open Access Original Research Article

Impact of Clinical Pharmacist Mediated Discharge Counseling and SMS Reminders Service on Medication Adherence in Chronic Disorders

Y. Samhitha Reddy, K. Somashekar Reddy

Journal of Pharmaceutical Research International, Page 446-453
DOI: 10.9734/jpri/2021/v33i59B34402

Aims: This study aimed to assess the effect of discharge counseling with SMS reminders on medication adherence in chronic disorders.

Study Design:  Prospective randomized open-label trial

Place and Duration of Study: The study was conducted at the dispensing department of a secondary care referral charity hospital located in a small village. The study was conducted for a period of six months from October 2018 to April 2019.

Methodology: Upon consent, a total of 364 patients were enrolled in this study and randomized into two groups viz., intervention group (n=182) and control group (n=182) respectively, with and without discharge counseling and SMS reminder on medication usage by the clinical pharmacist.  The level of medication adherence was measured using a pill count and visual analog scale (VAS) methods at two follow-up visits includes baseline and final follow-up visit (gap of two months). A two-sample Wilcoxon rank‑sum (Mann–Whitney) was used to compare the statistical mean difference of medication adherence levels between two groups at each follow‑up visit.

Results: The mean age of intervention and control groups were 57.1±8.55 and 58.5±8.53; most of the subjects were >60 years of age and were typically suffering from hypertension (30.2%) and diabetes (34.8%). Initially, at baseline, the values of medication adherence level (pill-count method) were closer in both intervention (82.4±7.3) and control group (81.35±6.4), whereas at follow up visits, the levels of the intervention group (93.2±6.0, 95.6±2.25) were significantly increased (p<0.0001) as compared to the control group (81.2±8.5, 80.6±8.1).

Conclusion: Thus, the statistical significance infers that the clinical pharmacist-mediated discharge counseling with SMS reminders would increase medication adherence levels in chronic disorders.

Open Access Original Research Article

Estimation of Lung Function Test among Healthy and Blow out Whistle Beginners

Padmalochini Sudharsan, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 459-464
DOI: 10.9734/jpri/2021/v33i59B34404

Introduction: Pulmonary function test is a non-invasive test. It is measured by the spirometer and it gives an idea about the lung volume, lung capacities, rates of flow and gas exchange. Breathing exercise can increase lung function. The commonly performed breathing exercises are blowing bubbles, blow out whistle, pinwheels, Hoberman spheres etc. The aim of this study is to estimate lung function among healthy and blow out whistle beginners.

Materials and methods: 60 Dental students consisting of 2 groups were involved in this study. Group 1: Control individuals (30). Group 2 individuals: blow out whistle beginners (30). Standardised RMS Helios spirometer was used. Age of 18-22, Healthy individuals and non-smokers were included in this study and smokers, alcoholic individuals, respiratory disorder individuals and post- COVID individuals were excluded from the study. Data was collected and analysed using paired ‘t’ tests. Significance is considered at P<0.05 level.

Results: In this study FVC, FEV1, FEV3 were found to be significant and FEV1/FVC, FEF 25-75, PEFR were found to be insignificant. The post test values of FVC and FEV1 are comparatively higher than the pre test values. The pre test values of FEF 25-75 and  FEV3 are comparatively higher than the post test values.

Conclusion: When this blow out exercise is performed there was a significant difference between healthy individuals and blow out whistle beginners. Significant increase in lung function is found. This recreational activity increases lung function which can be a preventive for many pulmonary diseases.

Open Access Original Research Article

Cardiotoxicity among Patients Using Pertuzumab, Trastuzumab and Taxane with HER2-Positive Early-Stage Breast Cancer: A Single-Centre Experience

Alanood S. Algarni, Anan A. Alfi, Azuf T. Turkistani, Layal E. Malki, Nouf F. Alghanam, Shayma S. Abdulghani, Majed Ramadan, Meteb Al-Foheidi

Journal of Pharmaceutical Research International, Page 465-474
DOI: 10.9734/jpri/2021/v33i59B34405

Aim: In this study, we aimed to investigate the incidence rate, risk factors, and mortality rates in patients with early-stage breast cancer using anti-HER2 (Human epidermal growth factor receptor-2) treatment.

Patients and Methods: A total of 106 patients diagnosed with human epidermal growth factor 2 (HER2)-positive early-stage breast cancer and receiving anti-HER2 treatment at King Abdulaziz Medical City (KAMC) from 2015 to 2019 were included in the analysis to assess the incidence of cardiotoxicity was collected as a retrospective study. Univariate and multivariate analyses as well as multiple exact logistic regression analysis were conducted to understand the relationships between the left ventricular ejection fraction (LVEF) and treatment combinations and comorbidities

Results: The LVEF measurements using an echocardiography method at the baseline (before any treatment) and during the anti-HER2 therapy were assessed. The results suggest that the higher the drug combination, the higher the odds ratio for the declined ejection fraction (EF) patient group. Further, patients treated with the pertuzumab and trastuzumab combination were four times more likely to have a decline in their EF than those who did not use the pertuzumab and trastuzumab drug combination (OR 4.28, 95% CI [1.68–10.91]).

Conclusion: This study demonstrated that the drug combination considered here is associated with reduced LVEF and, similarly, comorbidities were also related to EF. However, a larger study in a global patient population will confirm the present observations.

Open Access Original Research Article

Is Test Item Arrangement a Factor in the Academic Achievement of Undergraduate Pharmacy Students in Chemistry?

Basil C. E. Oguguo, John J. Agah, Nwadiuto N. Ukeoma, Ijeoma Hope N. Nwoji, Priscilla O. Dave-Ugwu, Oluchi J. Agugoesi, Felicia C. Ugwu, Cliff I. Okebanama, Bukar A. Umate, Judith N. Eke

Journal of Pharmaceutical Research International, Page 484-501
DOI: 10.9734/jpri/2021/v33i59B34407

Aims: To determine the effect of test item arrangements in ascending, descending and no consistent order of difficulty in multiple choice tests on undergraduate pharmacy students’ academic achievement in a chemistry course. The present study served as an attempt to relate the effect of test item arrangement on undergraduate pharmacy students’ academic achievement in a chemistry course in Nigerian Universities.

Study Design: Quasi-experimental research design of pre-test posttest non-equivalent group design was adopted in carrying out this research.

Place and Duration of Study: This study was carried out in ten Nigerian Universities between August, 2020 to April, 2021.

Methodology: We sampled 200 participants (111 male, 89 females; age range 16 – 27 years) undergraduate pharmacy students drawn from ten (10) Universities in Nigeria. Twenty undergraduate pharmacy students offering Basic Principle of Chemistry (Chem. 101) were randomly selected from each of the selected universities for the study.

Results: The mean scores when test items were arranged in ascending, descending, and no consistent orders of item difficulty were 44.38, 37.85 and 40.13 respectively. Their differential mean scores were 6.53, 2.28 and 4.26 in the same order. This implies that pharmacy students obtained higher scores when test items were arranged in ascending order of difficulty, followed by no consistent order and least in descending order of difficulty. The findings further revealed no significant arrangement by gender interaction effect on undergraduate pharmacy students` performance in the three tests.

Conclusion: This study will help pharmacy lecturers in determining the most appropriate test item order which will help the students obtain high scores in any pharmaceutical test. The researchers conducted a quasi-experimental study on the topic as part of their undergraduate curriculum to examine the best test item format that will enhance pharmacy students' academic achievement in a chemistry course.

Open Access Original Research Article

Frequency of Hypomagnesaemia in Children with Hypocalcemic Seizures

Muhammad Iqbal, Farzana Shaikh, Abdul Hameed Radhan, Muhammad Nadeem Chohan, Khuda Bux Khoso, Muhammad Akbar Nizamani

Journal of Pharmaceutical Research International, Page 514-518
DOI: 10.9734/jpri/2021/v33i59B34409

Aim: To determine the frequency of hypomagnesaemia in children with hypocalcemic seizures.

Study Design:  Cross sectional descriptive study.

Place and Duration: Department of Pediatrics, Liaquat University Hospital, Jamshoro / Hyderabad. From November 2017 to April 2018.

Methodology: Children (06 months to 06 years age and of either gender) having Two or more than two hypocalcemic seizures within 12 hours duration were included in the study . The children with hypocalcemic seizure were assessed for magnesium deficiency (hypomagnesaemia). The evaluation of hypomagnesaemia was done according to the cut off / reference values for hypomagnesaemia (<1.8 mg/dl). The data was collected on pre-structured proforma (attached).

Results: Total 147 children with hypocalcemic seizures were taken in this study, among them 49 (33.3%) patients had found low magnesium level and 98 (54.4%) patients had normal magnesium level.

Conclusion: Seizures associated with hypocalcaemia is one of the common type of convulsion in children. In our study, a positive relation was found between low levels of serum magnesium and hypocalcemic seizures.

Open Access Original Research Article

Acute Appendicitis in Pregnancy: Our Experience in Rural Area

Aditya Patel, Amit Kumar Singh, Meenakshi Yeola (Pate), Harshal Tayade

Journal of Pharmaceutical Research International, Page 519-524
DOI: 10.9734/jpri/2021/v33i59B34410

Acute appendicitis is the most prevalent non-obstetric surgical emergency in pregnant women. The diagnosis gets more challenging when the anatomical location of the appendix shifts due to the expansion of the gravid uterus. In cases of appendicular perforation, there is a higher risk of feto-maternal morbidity and mortality, so prompt and accurate diagnosis and treatment are essential. The goal of this study is to look into the clinical signs and symptoms of acute appendicitis in pregnancy, as well as how to treat it.

Open Access Original Research Article

Effect of Heavy Metals on Creatinine Level in Human Blood Samples of Inhabitants Living in the Vicinity of Hudiara Drain, Lahore, Pakistan

Saima Jadoon, Sumaira Sharif, Qurban Ali, Muhammad Asif, Fouzia Noureen

Journal of Pharmaceutical Research International, Page 562-570
DOI: 10.9734/jpri/2021/v33i59B34415

Aims: Modern industrialization, anthropogenic and industrial activities have increased the risk of human exposure to heavy metals and in turn effecting human health badly. Hundreds of millions of people are globally affected by heavy metal toxicity through contaminated water in one way or. another. In order to find a correlation between the heavy metal concentrations and serum creatinine level, a study was conducted on the inhabitants living near the Hudiara drain suffering from kidney diseases.

Study Design: The subjects (n=498) were selected from the vicinity of polluted Hudiara drain to conduct this matched case–control study in 2019-2020. Instrumental techniques were used for the determination of heavy metals and creatinine was determined by using Kit. The correlation between heavy metals and creatinine was checked.

Place and Duration of Study: To determine heavy metals and creatinine in blood, samples were collected from the habitants of Hudiara drain and the control group 100Km far from Hudiara drain.

Methodology: Blood samples of male subjects with and tested for heavy metals in the blood using atomic absorption spectrophotometer and creatinine level using Creatinine Elisa Kit. The study was conducted in 2020 and included n= 498 healthy volunteers (control) and n=498 effected (suffering from chronic kidney disease).

Results: The ANOVA shows the significant difference between two groups i.e.  control group and affected group in all traits of the respondents (weight, age, heavy metal values and serum creatinine level). Pearson’s correlation coefficient was calculated for heavy metals and creatinine subjects’ blood samples. It was found that heavy metal levels in subjects have a significant correlation with serum creatinine. The study shows that serum creatinine level has no significant correlation with age, so is independent of age.

Conclusion: The concentration of heavy metal contaminants (Cd, Hg, Pb) in the blood of the inhabitants of Hudiara drain flowing in Lahore city, Pakistan is highly polluted by industrial effluents. The effects of higher concentration of heavy metals in the inhabitants of Hudiara drain have been determined in serum creatinine levels. It was observed that high serum creatinine values are found in subjects suffering from CKD.

Open Access Original Research Article

Evaluation of Variations in the Various Blood Indices in COVID-19 Recovered Patients

T. Srinivasa Surya Sitaram, Palati Sinduja, R. Priyadharshini, V. Meghashree

Journal of Pharmaceutical Research International, Page 577-586
DOI: 10.9734/jpri/2021/v33i59B34417

Introduction: In December 2019, cases of pneumonia with an unknown cause were reported in Wuhan, Hubei Province, China. Novel coronavirus infectious disease (COVID-19) has been spreading worldwide and tracking laboratory indexes during the diagnosis and treatment of patients with severe COVID-19 can provide a reference for patients in other countries and regions. The disease is caused by the Severe Acute Respiratory Syndrome Coronavirus according to studies, and the World Health Organization just dubbed it coronavirus disease 2019.

Aim: The aim of this analysis was to evaluate COVID-19 patients' blood parameters changes in comparison with healthy controlled patients.

Methods: Blood samples were taken from 10 patients in which 5 are COVID-19 recovered patients and 5 are healthy controls. For these blood samples TBC (Total Blood Count) was taken and the readings of RBC, hemoglobin, WBC, lymphocyte, granulocyte and platelets count was recorded. Independent t-test was done to obtain the results. SPSS software Version 23 was used to give the output comparison as error bar charts.

Results: The patients have increased RBC count, increased hemoglobin and reduced WBC count with reduced lymphocytes and Granulocytes counts. Here it can be concluded that COVID-19 recovered patients should take care of themselves by having proper care, doctor consultation and follow up.

Conclusion: From this study it can be understood that COVID-19 recovered patients have increased RBC count and hemoglobin percentage. The recovered patients have reduced WBC, lymphocytes and Granulocytes percentage.

Open Access Original Research Article

“To Evaluate the Effectiveness of Self Instructional Module Regarding Perineal Care among Primipara Postnatal Mothers”

Sahili Mankar, Nilima Manmode, Sarthak Meghe, Asawari Meshram, Pradnya Sakle

Journal of Pharmaceutical Research International, Page 587-595
DOI: 10.9734/jpri/2021/v33i59B34418

Background: Perineal trauma, particularly caused following vaginal delivery, is associated with short and long-term morbidity for women; therefore, intervention that increases the probability of an intact perineum is necessary. When a child is born, the mother and the postnatal period are both extremely vulnerable.

Objectives: 1. To assess the pretest knowledge regarding perineal care in primipara postnatal mothers. 2. To assess the posttest knowledge regarding perineal care in primipara postnatal mothers. 3. To assess the effectiveness of Self Instructional Module on knowledge regarding perineal care in primipara postnatal mothers. 4. To associate the posttest knowledge score regarding perineal care in primipara postnatal mothers with demographic variables.

Materials and Methods: A pre-experimental one-group pretest and posttest design was adopted to assess the effectiveness of a self-instruction module on knowledge regarding perineal care among primipara postnatal mothers. This study was carried out using inferential and descriptive data. The techniques for testing knowledge regarding perineal care among primipara postnatal mothers are discussed in this chapter. It comprises a research method description, the design and validation of the tools and questionaries, the data collection procedure and data analysis plan, the identification of targets, and the sample and sampling techniques.

Results: Better care with regular maintenance of hygiene of perineal area among the primipara postnatal mothers in selected area in Wardha district allow them from preventing from perineal discomfort and infection and a better quality of life with other intervention and by providing knowledge.

Open Access Original Research Article

Frequency of Dydrogesterone Use in the Gynecological Outpatient Clinics

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

Journal of Pharmaceutical Research International, Page 596-599
DOI: 10.9734/jpri/2021/v33i59B34419

Aim: This study aimed to describe the use of dydrogesterone in the outpatient setting in Al-Kharj.

Methodology: This is a retrospective study that includes reviewing the electronic prescriptions of dydrogesterone among outpatients in a public hospital in Alkharj.

Results: During the study period between January 2018 to June 2018, 48 patients received dydrogesterone. The age of 41.67% of the patients was between 20 and 29 years. Most of dydrogesterone prescriptions were written by residents (89.58%) and more than 60% of dydrogesterone prescriptions were written by emergency department (60.42%).

Conclusion: The present study showed that the prescribing of dydrogesterone was uncommon in the outpatient setting. More studies are needed to explore the frequency of its prescribing in other settings and to explore the prescribing of other medications that are used for gynecological conditions.

Open Access Original Research Article

Determination of the Accuracy of Linear Height Bone for Implant Placement in Panoramic Radiography Relative to CBCT in the Posterior Areas of the Jaws

Sajad Ghorbanizadeh, Majid Zolfagharikhorshaneh, Fatemeh Gholamian, Mohamad Noori

Journal of Pharmaceutical Research International, Page 604-611
DOI: 10.9734/jpri/2021/v33i59B34421

Purpose: In the levels of implant treatment in the posterior region, determining the height of the bone has particular importance. The aim of the study was to compare the accuracy of linear bone height measurement for implant placement on panoramic view compared to CBCT in posterior jaw area.

Materials and Methods: The study was performed on 20 patients. In each of the posterior edentulous areas, a surgical guide for each patient was marked with gutta-percha (a total of 70 points). Panoramic radiographs and CBCTs were obtained from the patients and then the distance between the marked points in the maxilla to the maxillary sinus and in the mandible to the upper border of the alveolar canal was measured by Romaxis software and analyzed by Statistical software Stata 14. The obtained measurements of panoramic view were compared to CBCTs using t-test. P≤0.05 was considered significant.

Results: The mean difference between the sizes obtained from panoramic radiography and CBCT radiography in the maxilla was 0.34 mm (P = 0.57) and the mean difference between the sizes obtained from panoramic radiography and CBCT radiography in the mandible was 0.86 mm (P = 0.004).

Conclusion: According to the results of study, it is logical panoramic radiography just used to pre-assessment of implant procedures in posterior area of mandible were as it could be more reliable in maxilla.

Open Access Original Research Article

Formulation Development and Evaluation of Itraconazole Loaded Invasomes Hydrogel

Yogesh Singh, Anjana Bhardwaj

Journal of Pharmaceutical Research International, Page 657-665
DOI: 10.9734/jpri/2021/v33i59B34430

Topical drug administration is a localized drug delivery system anywhere in the body through ophthalmic, rectal, vaginal and skin as topical routes. Skin is one of the most readily accessible organs on human body for topical administration and is main route of topical drug delivery system. There are various skin infections caused by fungus. An antifungal medication is a pharmaceutical fungicide used to treat mycoses such as athlete’s foot ringworm, candidiasis. Antifungal works by exploiting differences between mammalian and fungal cells to kill the fungal organism without dangerous effect on host. Itraconazole (ITZ) is commonly used in the treatment of fungal infections. It has low bioavailability (55%) because of low aqueous solubility and first pass effect. Hence we attempted to develop Itraconazole-loaded invasomes hydrogel. ITZ-loaded invasomes were prepared by conventional thin layer evaporation technique using Phospholipon 90H, terpene (Limonene) and ethanol. The optimized ITZ-loaded invasomes was incorporated into carbopol 934p (0.5 to 2%) solution to get a hydrogel for improving convenience in superficial application. FT-IR studies revealed no interaction between the drug and excipients. The formulated hydrogel formulation was evaluated with parameter pH, viscosity, gel strength, drug content, spread ability, in-vitro release test, wash ability, extrudability study and stability studies. The formulation OIGF4 showed a drug content of 99.12% and drug release of 99.78% in 72 hrs, which contains carbopol 934p concentration 2%w/w. The present work also focuses on making the formulation more pharmaceutically acceptable.

Open Access Original Research Article

Assessment of Knowledge and Attitude Regarding Thyroid Disorders among Population in Taif City, Saudi Arabia

Lotfi Fahmi Issa, Moayyad Fateh Alotbi, Rami Faleh Algethami, Abdulrahman Awadh Alharthi, Faisal Abdullah Algarni, Khalid Awwadh Alharthi, Majed Adel Alosaimi, Sultan Abdullah Algarni, Sawsan Abdullah Awadh AlGarni

Journal of Pharmaceutical Research International, Page 670-678
DOI: 10.9734/jpri/2021/v33i59B34432

Background: Thyroid disorders are among the commonest endocrine disorders worldwide. Attention on people's knowledge and awareness about thyroid diseases is very important in helping for early diagnosis and early treatment of these disorders. The aim of this study to assess the degree of knowledge and attitude of thyroid gland and their disordersamong general population in Taif City, KSA.

Methodology: A cross-sectional study was conducted on a representative sample of 600 Saudi adults of Taif general population. A pre-designed online questionnaire was used for data collection which consists of sociodemographic data, questions regarding knowledge and awareness of thyroid disorders. All data was entered and analyzed by using SPSS program version 22.

Results: A total of 600 participants responded to the online questionnaire. Majority of respondents were aged between 18 to 32 years and males’ subjects were higher compared to the male counterparts (50.8%). Mean knowledge score of participants was 36.12. Participants who scored higher were 46.3% and considered as good knowledge level. 53.7% had bad knowledge level as they scored lower than mean score knowledge.

Conclusion: Our study population show relatively good knowledge level compared to previous literature. Knowledge score was significantly associated with gender, educational level, working status and family income per month.

Open Access Original Research Article

Anti-Proliferative Effect of Hydroethanolic Leaf Extract of Citrullus colocynthis (L) on Retinoblastoma Cell Line

Vedha R. Nair, A. Jothi Priya, J. Selvaraj, R. Gayatri Devi

Journal of Pharmaceutical Research International, Page 679-686
DOI: 10.9734/jpri/2021/v33i59B34433

Introduction: Citrullus colocynthis has many pharmacological, biological, and therapeutic properties making it a very important medicinal plant. The cucurbitacin produced/derived from the plant play an important role in anticancer activities. The retinoblastoma Y-79 cell lines are studied in attachment culture. A proper study of these cells can pave the way for control of its proliferative property. Cell viability was assayed using a modified colorimetric technique that is based on the ability of the live cells to convert MTT, a tetrazolium compound into purple formazan crystals. There was an effect on the proliferation and gene expressions of the retinoblastoma Y-79 cell line. Bioactive extracts of these plants are being majorly used as a potential chemopreventive element as an alternative approach for cancer progression management.

Materials and Methods: Human retinoblastoma cell line (Y-79)cell line was purchased from the National Centre for Cell Sciences (NCCS), Pune, India. Cell viability was assayed using a modified colorimetric technique that is based on the ability of live cells to convert MTT.

Results: The experimental study showed antiproliferative effects against the retinoblastoma Y-79 cells. The experimental study showed the effect on cell viability, Bcl2 mRNA expression and BclxL mRNA expression in Y-79 cells.

Conclusion: The hydroethanolic leaf extract obtained from the Citrullus colocynthis exhibited an antiproliferative effect on the retinoblastoma Y-79 cell line by affecting the expression of the Bcl2 mRNA and BclxL mRNA and hindering the cell viability.

Open Access Original Research Article

Prevalence and Determinants of Anaemia among Reproductive-aged Women in Ethiopia: A Nationally Representative Cross-sectional Study

Alemayehu Siffir Argawu, Gizachew Gobebo Mekebo, Ketema Bedane, Ravi Kanth Makarla, Bizunesh Kefale, Temesgen Senbeto, Reta Lemesa, Terefa Bechera, Kebede Lulu, Agassa Galdassa, Getachew Tadesse, Gosa Tesfaye Degaga, Jiregna Olani, Belema Hailu, Geribe Hemba, Girma Teferi

Journal of Pharmaceutical Research International, Page 687-698
DOI: 10.9734/jpri/2021/v33i59B34434

Anaemia in reproductive-aged women is a worldwide health problem. This study was aimed to assess prevalence and determinants of anaemia among reproductive-aged women in Ethiopia. Data for the study were obtained from 2016 Ethiopian demographic and health survey data, which is a national representative cross-sectional data. A Multivariable logistic regression model was applied to identify determinants of anaemia among reproductive-aged women. A total of 14460 women who aged 15 to 49 years were included in the study. Prevalence of anaemia of among reproductive-aged women was 27.08% (95% CI: 22.88, 31.08%). Women living in Afar (AOR=2.439; 95% CI: 2.006, 2.968), Amhara (AOR=1.269; 95% CI: 1.035, 1.556), Somalia (AOR=2.592; 95% CI: 2.142, 3.133), Benshangul-Gumuz (AOR=2.019; 95% CI: 1.666, 2.447), Gambela (AOR=2.465; 95% CI: 2.026, 2.998) were associated with high risk of anaemia. Women with 1 or 2 children (AOR=1.272; 95% CI: 1.103, 1.466), 3 or 4 children (AOR=1.277; 95% CI: 1.059, 1.539) and 5 or more (AOR=1.420; 95% CI: 1.213, 1.662) were associated with high risk of anaemia. Further, pregnant women (AOR=1.408; 95% CI: 1.263, 1.570) were associated with high risk of anaemia. Hence, concerned bodies need to pay special attention to women regarding anaemia based on place of residence and the region.

Open Access Original Research Article

Phytochemical Analysis and Hepatoprotective Activity of Elytraria acaulis

K. Gouri Sankar, B. Sri Venkateswarlu, M. Venkata Ramana

Journal of Pharmaceutical Research International, Page 704-712
DOI: 10.9734/jpri/2021/v33i59B34436

Introduction: The emerging of new diseases, resistance to contemporary using drugs and inadequate usage of commonly available drugs leading to different side effects and sometimes to mortality. So, there is need to identify efficient drugs from easily available sources. Traditional medicines from medicinal plants have been using since ancient times to treat different diseases, are easily available herbal formulations and there were still many medicinal plants were unexplored about their therapeutic potentiality. So, the current research is aimed to explore phytochemical constituent and hepatoprotective potentiality of Elytraria acaulis on paracetamol-induced liver toxicity.

Methodology: The root parts Elytraria acaulis were used for extraction through maceration procedure using hexane, ethyl acetate and hydro-alcoholic (70% ethanol). The dried extracts used for further for phytochemical analysis using standard procedures and evaluated liver protection on paracetamol-induced liver toxicity by estimating liver bio markable enzymes such as AST (SGOT), ALT (SGPT), ALP and total bilirubin levels.

Results: Qualitative phytochemical screening of E. acaulis extracts revealed the presence of different phytochemical constituents like steroids, terpenoids, flavonoids, alkaloids, glycosides, phenols, tannins, saponins and carbohydrates in them. The hydroalcoholic extract has more flavonoid content i.e., 23.84±0.28 (mg/gm) than other two extracts. The tested three extracts of E. acaulis had showed concentration dependent hepatoprotective activity. Among three extracts hydro-alcoholic extract had more potentially compared to other two extracts. The percentage protection produced by the hydro-alcoholic extract on the enhancement of AST(SGOT), ALT (SGPT), ALP and total bilirubin levels were 21.54%, 21.94%, 21.20%, and 20.52%, 36.27%, 38.26%, 37.55% and 36.14%, 67.76%, 70.04%, 69.83% and 68.61% respectively.

Conclusion: The Elytraria acaulis root extracts had showed significant biological activities and own different phytochemical constituents. The hydroalcoholic extract possess more phenolic, flavonoid contents and the same had showed more potentiality against liver toxicity. The current results offer vital information about the traditional medicinal value of it. The further research is valuable and is under progress in evaluation of different biological activities and isolation of individual bioactive molecules from E. acaulis.

Open Access Original Research Article

A Study on Antioxidant and Antimicrobial Activity of Organic and Inorganic Cauliflower Greens Powder (Brassica oleracea var. botrytis L)

R. Kaviyarasi, M. Sylvia Subapriya

Journal of Pharmaceutical Research International, Page 728-734
DOI: 10.9734/jpri/2021/v33i59B34439

Cauliflower greens is one such popularly consumed vegetable, possessing potent bioactive components where the leaves of the vegetables are often neglected or discarded and used as fodder. Hence an attempt was made to analyze the presence of different antioxidants such as DPPH, FRAP, SOD and Total antioxidant contents there by exploring the potential benefits of these leaves which is solely ignored by majority of population. The present study reveals that the presence of promising compounds can be consumed in regular diet in maintaining good health and can be technically applied in preparing natural therapeutic medicines to combat various degenerative diseases and can also be used in food processing industries due to its antimicrobial and antioxidant properties Cauliflower has a very high waste index, and this result throws  light on the importance and the properties of cauliflower leafs, thereby reducing  food wastage.

Open Access Original Research Article

Assessing Knowledge, Attitude, and Practices of Hand Hygiene among Health Care Workers in Eradah Complex in Jeddah

Emad Farouq Khodary, Abdalrhman Saleh Altamimi, Haifaa Hassan Alghamdi, Maryam Mohammad Alshehri, Saud Jabr Almehmadi, Nouran Harazi, Meshal Ghazi Alhazmi, Maha Mohammed Alajmi

Journal of Pharmaceutical Research International, Page 740-752
DOI: 10.9734/jpri/2021/v33i59B34441

Background: Most of the persons thought that nosocomial infection is spread from the hands of health care workers. The main aim of hand washing is to be aware for all to know that this is a myth that nosocomial infection is spread from hand. 

Methods: This cross-sectional study was conducted in Eradah Complex in Jeddah. The Saudi Commission for Health Specialties (SCFHS) has accredited Eradah Complex for Mental Health- Jeddah, as a training center for addiction medicine fellowship program. An observation is done by providing a Google form to the health care workers of the Eradah complex in Jeddah.  This is to observe the views of the health care workers on the issue of practices of hand hygiene.

Results: There were a total of 178 study participants (111 male and 67 participants). Age groups demonstrate that 34.27% of participants belong to the age group of 36 to 45 years. 32.02% of the participants belong to the age group of 26 to 35 years of age group. Moreover, the graph has shown that 14.04% of participants belong to the age group of 18 to 25 years. It has been seen that the number of female workers bearing the position of Nurse is less than those of males. It is important to have more respondents being nurses as the nurses usually communicate directly with the patients. There is a doctor too, but they are less interaction directly with the patient. Therefore, overall graph shows that only 6.18% participants prefer other professions whereas among other percentages, 7.30% participants are pharmacists, 25.28% people are nurses, and 18.54% participants are doctors.

Conclusion: The present study has discussed that maintenance of hand hygiene in the hospitals and clinics are of sheer importance. The research methodology that is incorporated in the present study has been helpful for the researchers in understanding the perception of the healthcare workers what they think about the aspect of washing hands primarily after the pandemic. Therefore, it has been seen that most of the participative healthcare workers primarily males do not find the aspect hand hygiene much important and so they rarely use soap for hand wash. On the contrary, the female workers understand the importance of hand wash more and thus, they support the thought of hand hygiene at the workplace.

Open Access Original Research Article

A Cross Section Study to Assess Factor Affecting the Work Life Balance of the Female Healthcare Professionals in the Private Hospitals of Vadodara – India

Khan Shabana Parveen, Subhasish Chatterjee, Medha Wadhwa

Journal of Pharmaceutical Research International, Page 753-758
DOI: 10.9734/jpri/2021/v33i59B34442

Purpose of the Research: work life balance is an important phenomenon concerning a lot of working employees. Females form a major proportion of the workforce in the healthcare industry and the policies should focus on their well being for a stress free environment. There has been a vast amount of research carried out focussing on this topic. However, there has been limited research concerning the work life balance of female healthcare professionals working in hospitals. Therefore, this study aims to assess the factor affecting the work life balance of the female healthcare professionals working in hospitals of Vadodara district (India).

Methodology: The data collection tool is a structured close ended questionnaire where in the respondents were asked to choose their option pertaining to various parameters of work life balance on a five point Likert scale. The collected from 335 female healthcare professionals working in seven private hospitals of Vadodara (India). The data collected were analyzed using SPSS version 23. The statistical test used was Kruskal-Wallis and Mann-Whitney test at 95% confidence level.

Major Results: There were 87 female doctors and 248 nurses in the study. Among the 335 respondents, 210 female healthcare professionals had 3-4 family size having the highest frequency, 297 female’s respondents were married, and 38 were single. The study showed that there was no difference in the work life balance of the females with respect to the family size because of cooking, child study, and other individual female’s responsibilities. Because of their marital status, there is a statistically significant difference in the work life balance of female healthcare professional.

Conclusions: For the employers the work life balance is an important human resource area of concern; hence, this study highlights an important issue to address for better satisfaction and content of the female healthcare professionals.

Open Access Original Research Article

The Prevalence of Serratia, Stenotrophomonas, Citrobacter and Morganilla Pathogens among Patients with Infectious Diseases at a Governmental Hospital in Riyadh Region

Nehad J. Ahmad, Mohamad Ayman Salkini

Journal of Pharmaceutical Research International, Page 774-778
DOI: 10.9734/jpri/2021/v33i59B34445

Aim: The present study aimed to explore the prevalence of Serratia, Stenotrophomonas, Citrobacter and Morganilla pathogens among patients with infectious diseases at a governmental hospital in Riyadh Region.

Methodology: This study was conducted in a governmental hospital in Riyadh region. Data were collected from the bacterial cultures results that was prepared the laboratory department in the hospital.

Results: In the 3 years, the total number of gram negative isolates was 2135. Citrobacter bacteria represented 2.25%, Morganilla represented 1.97%, Stenotrophomonas represented 1.64%, and Serratia represented 1.59% of the gram negative isolates.

Conclusion: The present study showed that the rate of Serratia, Stenotrophomonas, Citrobacter, or Morganilla was low. More studies are needed to know the prevalence of these 4 bacteria and to explore the bacterial resistance rate to the available antibiotics.

Open Access Review Article

Overview on Updates on Digital Dental Radiography

Ashwag Siddik Noorsaeed, Ali Hussain Almohammedsaleh, Mustafa Mohammed Alhayek, Abdullah Abdulhameed Alnajar, Osama Nasser Kariri, Abdullah Ibrahim Mohammed Albakri, A. Alhashmy Alamer, Mohammad Kamel, D. Alharbi, Thamer Abdullah, Alshaheen, Eyad Tariq, M. Aljanubi, Mohammed Omar

Journal of Pharmaceutical Research International, Page 23-28
DOI: 10.9734/jpri/2021/v33i59B34347

Wilhelm Roentgen first discovered X-rays in 1895. Since its introduction in the mid-1980s, digital radiography has surpassed traditional screen-film radiography. Since 2000, more than 75 percent of medical clinics in the United States have migrated to digital radiography (DR). In fact, the US government has ordered that all medical records be converted to digital. Indirect, direct, or semi-direct digital radiography pictures are types of digital radiography currently available. Forensic radiology is a branch of medical imaging technology that helps clinicians. Radiology technology has evolved and grown tremendously in recent years. When comparing aggregated antemortem and postmortem information, radiographs are crucial. Adopting new technologies into a dental business demands a certain amount of bravery. After all, why alter things if your practise is running smoothly?  To grasp the new equipment and procedures, the dentist and his or her staff will need further training.  It's not always apparent how the new strategy will influence the practice's present logistics. These factors may cause the practitioner to be hesitant to alter present techniques. In this article we’ll reviewing digital dental radiography, and what are the advantages of going digital. And also what are the challenges that face us.

Open Access Review Article

Obstructive Sleep Apnea (OSA), Overview and Treatment Options: A Review

Najeeb Ullah Ansari, Kaneez Fatima, Suresh Kumar, Waheed Ahmed Arain, Shahnawaz Sarwari, Ajeet Kumar

Journal of Pharmaceutical Research International, Page 63-69
DOI: 10.9734/jpri/2021/v33i59B34353

There are different forms of sleep apnea, each with different causes. Fortunately, they are all treatable. 1] Obstructive sleep apnea (OSA) occurs when the muscles and soft tissues in the upper airways relax and become blocked during sleep. It is often accompanied by loud snoring or snorting. OSA is the most common form of sleep apnea, 2] Central sleep apnea (CSA) occurs when the brain stops sending signals to the respiratory muscles while sleeping. Although the airways remain open, breathing stops. CSA is less common than OSA, 3] Mixed sleep apnea is a combination of central and obstructive sleep apnea, and Common to all of these disorders is the occurrence of apneas and hypopneas. Apnea is when the muscles and soft tissues in the upper airways slacken and collapse to the point that they are completely blocked for 10 seconds or more. Hypopnea is a partial blockage of the airways that decreases airflow by more than 50% for 10 seconds or more.

Open Access Review Article

Lumbar Stenosis with Necrosis of Foot a Diagnostic Approach

Mansi Deshmukh, Priyanka Telang, Rupali Thorat

Journal of Pharmaceutical Research International, Page 140-146
DOI: 10.9734/jpri/2021/v33i59B34362

Lumbar stenosis is characterised by decrease in spinal canal, neural foramina, lateral nerve .with the narrowing or compression which results in pain and progressive loss. The main objective of the review was to present etiology, pathogenesis and most importantly its clinical presentation along with the necrosis of foot . Study shows that lumbar stenosis can show its improvement by surgical Lumbar decompression and endoscopy.

Open Access Review Article

Tobacco use and Dependence in Adolescents: A Review

Faisal Suliman Algaows, Sara Gasem Alidan, Hamad Mohammed Al Saad, Mohammed Radhi Al Nasser, Maryam Nasser Alkhuwaytim, Jalal Yahya Mohammed Madkhali, Saqr Muhammad Altamimi, Talal Abdullah Al-Makki, Faisal Mohammed Alothman, Futun Awadah M. Almutairi, Ameera Ahmad Alhawsawi, Rahaf Abdulrahman Alotaibi, Hamed Hamad B. Alharbi, Amani Hassan Shook

Journal of Pharmaceutical Research International, Page 178-188
DOI: 10.9734/jpri/2021/v33i59B34368

Despite rising acknowledgement of the onset of tobacco smoking in children and adolescents, foundational understanding about many elements of early-life smoking behavior, as well as statistics to advocate for specific treatment approaches among children and adolescents, is inadequate. Nicotine addiction and withdrawal have been linked to continued cigarette use and difficulty stopping. When adolescents first start smoking, few expect to have trouble quitting. However, more than half of smoking teens say they try to quit every year, and fewer than 20% of those who smoke ten or more cigarettes per day say they are successful for even a month. Treatment of tobacco addiction rely mainly on the behavioral interventions as medications safety are not assessed for those less than 18 years old, so more research should be encouraged to find about the safety and availability for alternatives as behavioral intervention is not suitable alone for moderate to severe cases, Tobacco products are used by youth in a variety of ways,When smoking cessation efforts are undertaken in developed and developing nations, the wide diversity of tobacco products must be taken into consideration.

This research deals with the causes of tobacco dependence among young people, diagnosis and treatment methods.

Open Access Review Article

Nanobot: Artificial Intelligence, Drug Delivery and Diagnostic Approach

Gupta Jitendra, Gupta Reena, Tankara Abhishek

Journal of Pharmaceutical Research International, Page 189-206
DOI: 10.9734/jpri/2021/v33i59B34369

The design, construction, and programming of robots with overall dimensions of less than a few micrometres, as well as the programmable assembly of nanoscale items, are all part of nanorobotics. Nanobots are the next generation of medication delivery systems, as well as the ultimate nanoelectromechanical systems. Nano bioelectronics are used as the foundation for manufacturing integrated system devices with embedded nano biosensors and actuators in the nanorobot architectural paradigm, which aids in medical target identification and drug delivery. Nanotechnology advances have made it possible to create nanosensors and actuators using nano bioelectronics and biologically inspired devices. The creation of nanobots is fascinated by both top-down and bottom-up approaches. The qualities, method of synthesis, mechanism of action, element, and application of nanobots for the treatment of nervine disorders, wound healing, cancer diagnosis study, and congenital disease were highlighted in this review. This method gives you a lot of control over the situation and helps with sickness diagnosis.

Open Access Review Article

Role of Primary Care Physician in COVID-19 Response: A Review

Faisal Suliman Algaows, Amro Youssef A. Elias, Abdulwahab Abdulmannan M. Alshaikh, Rawan Saleh Nabzah, Anas Ebrahim Almejewil, Daad Taha Fouly, Zainab Jaber A. Al Mubarak, Mossab Mohammad F. Al Dosary, Abdullah Adel A. Alnaim, Abdulaziz Aoudah T. Al Dhabaan, Yousef Ali Abdali, Abdulrahman Abdullah Alkhulayfi, Mohammad Rajab Alkhalaf, Abdulmajeed Mohammad S. Alibrahem, Yasser Hamoud M. Alanazi

Journal of Pharmaceutical Research International, Page 207-214
DOI: 10.9734/jpri/2021/v33i59B34370

All healthcare providers have had to adapt and be flexible in order to respond to COVID-19. Nonetheless, the emphasis, particularly at the start of the outbreak, was on the impact and response of secondary and tertiary care. The primary care sector's responsibilities in the response focused on how it could help secondary and tertiary care centers respond. A small percentage of current research and evidence focuses on health services implications or applied public health approaches, with even fewer on the role of primary care and family medicine providers. So, while our scientific understanding of the virus and its subsequent clinical consequences has grown exponentially, information about primary care responses to COVID-19 in a variety of settings, as well as the interaction with patient perspectives and priorities, and broader public health responsibilities, remains significantly hazier.

Open Access Review Article

Management of Chemotherapy Induced Mucositis

Ashwag Siddik Noorsaeed, Mawaddah Saad Aljohani, Khawlah Salem A. BinAfif, Rafal Abdulrahman Alsaywed, Maha Ali Bakhshwain, Reham Mohammed Alharbi, Heba Abdulhakeem M. Bukhari, Omar Mohammed Albalushi, Ahmad Abdulrahman Aljuhani, Amal Abdullah Batarfi, Awatif Fakhri Subahi, Azzah Mohammed S Alghamdi, Moyssar tariq khallaf, Zainah Ali Asiri

Journal of Pharmaceutical Research International, Page 220-226
DOI: 10.9734/jpri/2021/v33i59B34372

Oral mucositis is a severe ailment that causes erythema, edema, and ulceration of the oral mucosa, as well as pain and oral intake restrictions. Chemotherapy and radiation therapy are the most often utilized cancer treatment options. Despite the fact that these treatments are used to improve a patient's quality of life, they are linked to a number of negative side effects. Oral mucositis is a common side effect in patients undergoing head and neck radiation therapy. While some chemotherapy-related side effects are being better managed, mucositis is becoming more common. Reducing patient risk factors, adopt proven preventative measures, and optimize supportive care practices targeted to the patients' needs and symptoms are all recommendations that can be made. In clinical practice and research, a variety of measures have been used to record the amount and severity of oral mucositis. The World Health Organization (WHO) scale is a simple, easy-to-use scale that can be used in clinical practice on a regular basis. There are multiple approaches for management of Mucositis.  Cryotherapy, palifermin, and sucralfate are among the three therapies that showed statistically significant effect in avoiding or lowering the severity of mucositis according to reports. In this article we’ll be looking at Chemotherapy induced mucositis, its etiology, epidemiology, evaluation. And most importantly management.

Open Access Review Article

Preoperative Management of Diabetic Patients, an Overview

Hashem Bark Awadh Abood, Ali Ahmed Al-Qadhi, Ossama Saed Alhindi, Mohammed Jaafar A. Al Sheef, Abdullah Saleh Salman Alwadani, Nura Jamal T. Alsaddah, Sulaiman Mohammed Mimish, Abdulelah Ahmed Alabdulwahab, Ammar Abdullah Basardah, Mohamed Eltahir Musa, Abdullah Suwaymil Alrashdi, Khalid Mohsen Alzahrani, Bassam Ibrahim AlJohani, Batool Mohammed S. Alshehri

Journal of Pharmaceutical Research International, Page 240-248
DOI: 10.9734/jpri/2021/v33i59B34375

Glycemic control is critical in the perioperative setting, especially in diabetic patients. The consequences of surgical tension and anesthesia on blood sugar levels are distinct, and should be considered in order to maintain optimal glycemic control. Each stage of surgery presents its own set of challenges in terms of keeping glucose levels within the target range. Furthermore, there are some surgical conditions that necessitate specific glucose management protocols. Authors hope to highlight the most crucial factors to consider when developing a perioperative diabetic regimen, while still allowing for specific adjustments based on sound clinical judgement. Overall, by carefully managing glycemic control in perioperative patients, we may be able to reduce morbidity and mortality while improving surgical outcomes.

Open Access Review Article

Anticancer Activity of "Ziziphus jujuba" - A Review

U. Vidhya Rekha, S. Bhuminathan, P. Ravi Shankar

Journal of Pharmaceutical Research International, Page 261-269
DOI: 10.9734/jpri/2021/v33i59B34377

Ziziphus jujuba Mill. (Z. jujube) is a conventional plant that has a long history of usage in nutrients and the therapeutic interventions of a wide range of ailments. It grows mainly in South and East Asia, and also in Australia and Europe. Mounting data supports the health advantages of Z. jujuba, including anticancer, anti-inflammation, anti-obesity, antioxidant, and hepato- and gastrointestinal protective characteristics. Chemotherapy, particularly with cis-diamminedichloroplatinium (CDDP, cisplatin) and its derivatives, is commonly used to treat cancer. Although it is an effective therapy for human tumors, drug resistance impedes successful treatment. A better knowledge of the processes and develop strategies to address chemoresistance can improve patient outcomes dramatically. Numerous researchers have recently focused their attention on the increasing occurrence of numerous types of malignancies worldwide. The anticancer efficacy of Z. jujuba was discussed in this review study.

Open Access Review Article

Diagnosis and Therapy of Patients with Colorectal Cancer Metastases, Endovascular Approach

Madina Idrisovna Khamidova, Diana Igorevna Komplektova, Irina Armenovna Kosyan, Aishat Aisayevna Madayeva, Sanyat Zaurbekovna Pshikhopova, Meri Martinovna Gonian, Mariia Sergeevna Kumacheva, Elvira Nazimovna Sherifova, Alina Yurievna Maslova

Journal of Pharmaceutical Research International, Page 332-340
DOI: 10.9734/jpri/2021/v33i59B34387

According to current data, in Europe and North America, primary colon carcinoma diseases are detected with a frequency of 60-75 cases per 100 thousand population. In Russia over the past 10 years, there are up to 40-46 thousand cases annually. Active surgical tactics in the treatment of patients with colorectal cancer metastases in the liver can increase the overall survival time. The study showed that with the use of chemotherapy, the life expectancy of patients increases. Various options for complex treatment of patients with colorectal cancer metastases in the liver, especially with the use of endovascular and radiofrequency interventions, are relatively safe and effective, provided they are carried out in specialized oncological and coloproctological hospitals.

Open Access Review Article

Role of Medicinal Plants for the Treatment of Alzheimer’s Disease

Ram Babu Sharma, Rajiv Sharma, Kundan Singh Bora

Journal of Pharmaceutical Research International, Page 422-431
DOI: 10.9734/jpri/2021/v33i59B34399

In today's era, most of the diseases are treated by allopathic drugs. The reliance on allopathic drugs for the treatment of most diseases is gradually increasing day by day due to their rapid effects and the immediate relief to patients. However, these drugs induce some serious side effects in patients, and in some cases, the patient may die. Thus, the interest of researchers is growing day by day towards medicinal plants for the treatment of diseases. It has also been viewed that some herbal plants have great therapeutic and pharmacological effects in the treatment of Alzheimer's disease. The initial studies, which have been carried out by different researchers, demonstrated very valuable results and enlighten a ray of hope for the treatment of Alzheimer’s disease which is associated with CNS disfunction. In this article, the author focused on those plants which are especially used in the treatment of Alzheimer's disease.

Open Access Review Article

An Extensive Review on Chitosan as Versatile Material for Pharmaceutical and Biomedical Application

Shivangi Abrol, Hitesh Kumar Dewangan

Journal of Pharmaceutical Research International, Page 475-483
DOI: 10.9734/jpri/2021/v33i59B34406

Chitosan is a polysaccharide and is derived from chitin. Chitosan every now and then referred to as a soluble chitin. chitosan is strongly basic polysaccharide. chitosan shows physiochemical and biological properties. This review presents the common source for chitosan manufacturing that is crabs and shrimp. According to researchers it is just a fat inhibitor. some of the application of chitosan in pharmaceutics/drug delivery and in biomedical field are also highlighted. Chitosan act as a diluent, as mucoadhesive excipient, as permeation enhancer, in vaccines delivery, as parenteral delivery, chitosan as food additive, cosmetics industry. chitosan also has a number of medicinal benefits. Chitosan is employed in a variety of applications because it is soluble in acidic aqueous conditions (food, cosmetics, biomedical and pharmaceutical applications). We give a quick overview of the chemical modifications of chitosan, a field in which a number of syntheses have been proposed but not yet realised on a large scale. This review focuses on current articles on these materials' high-value-added applications in medicine and cosmetics.

Open Access Review Article

A Comprehensive Review on Mouth Dissolving Tablet

C. Tamilselvan, M. Swamivelmanickam, S. Sivakrishnan, R. Vinoth

Journal of Pharmaceutical Research International, Page 502-513
DOI: 10.9734/jpri/2021/v33i59B34408

Oral drug delivery system of Mouth Dissolving Tablets (MDTs) is using a new concept that have been mostly accepted in the pharmaceutical industry in recent days. This system is the most comfortable, safest and inexpensive of drug delivery system, enhancing the patient compliance and extending the patient life. Mouth dissolving formulations using an important ingredient or active agent due to allow release of drug is rapidly after that produce faster dissolution process. The mouth dissolving tablets contain a unique property of tablets like quickly disintegrating or easily dissolving and releasing the active drug within a few minutes and its contact with saliva. In pediatric, geriatric, bed ridden, psychic, dysphagic patients are using the MDTs because of these tablets are easily engulfing or swallowing is most convenient and patient compliance is better to compared than other Delivery systems. The tablets are formulated with an aid of super disintegrant. It's more reliable because of better compliance in patients. There are several technologies used in the MDTs manufacturing process such as patented technology & conventional technology. The important patented technologies are Durasolve Technology, Orasolve Technology, Zydis Technology, Wow Tab Technology, Flash Dose Technology, Flash Tab Technology and Quick Solv Technology. The MDTs are improving the demand for rapidly growing areas in the pharmaceutical industry and other fields are also in demand on these formulations. The recent progress of pharmaceutical fields is allowing the improvement of a better route of health care management with avoidance of numerous difficulties are connected to the other Drug Delivery System (DDS).

Open Access Review Article

An Overview on Hyperlipidemia

D. A. Helen Sheeba, R. Gandhimathi

Journal of Pharmaceutical Research International, Page 543-555
DOI: 10.9734/jpri/2021/v33i59B34413

Introduction: Hyperlipidemia is a medical condition indicated by an increase in one or more plasma lipids, such as triglycerides, cholesterol, cholesterol esters, phospholipids, and/or plasma lipoproteins, such as very low-density lipoprotein and low-density lipoprotein, as well as decreased levels of high-density lipoprotein. This increase in plasma lipids is one of the most important risk factors for cardiovascular disease. In the meanwhile, statins and fibrates remain the most common anti-hyperlipidemic drugs for treating high plasma cholesterol and triglycerides.

Conclusion: Hence this review focused to study of hyperlipidemia. This review is useful to research work in hyperlididemia.

Open Access Review Article

Epidemiology & Prognostication of Acute Myeloid Leukemia (AML) in India – A Brief Review

E. Suguna, Chitralekha Saikumar, Florida Tilton

Journal of Pharmaceutical Research International, Page 616-623
DOI: 10.9734/jpri/2021/v33i59B34423

AML is represented by aggregation of ≥20% myeloid immature cells in the spongy marrow and most generally raise in the peripheral blood. A cytogenetic finding plays a vital role in the risk management and stratification of AML patients. AML is genetically and functionally a heterogenous malignant disease. In the western world leukemia is one of the most common among all cancers. India ranked 3rd in cancer disease after US and China. Management of AML is challenging specially for medium and low-income countries as it causes a huge economic burden to the patient and family. Molecular prognostic biomarkers will help in redefining the risk stratification more efficiently. Targeted drugs in pre-clinical and clinical trial recorded to have promising outcomes in AML. In this review we summarize the prevalence, incidence, and prognostication of AML.

Open Access Review Article

A Review on Phytoconstituents and Therapeutic Properties of Ancient Plant: Terminalia arjuna (Roxb)

. Harshita, Reena Sharma

Journal of Pharmaceutical Research International, Page 624-629
DOI: 10.9734/jpri/2021/v33i59B34424

Terminalia arjuna also known as arjun or arjuna, is a member of Combretaceae family. Medicinal or therapeutic plant plays a crucial role to cure various diseases and Terminalia arjuna is one such therapeutic plant. This comprehensive review helps in studying various aspects like phytochemical, pharmacological, ethnomedical, phytological and clinical significance. Alkaloids, flavonoids, triterpenoids, glycosides and mineral ions present in different parts of the plant are discussed. Terminalia arjuna is used mainly in cardiovascular treatment, shows antibacterial, antimicrobial and antifungal properties.

Open Access Review Article

A Review on Phytoconstituents of Brahmi and their Relation to Improve Nervous System

. Heemanshi, Reena Sharma

Journal of Pharmaceutical Research International, Page 637-641
DOI: 10.9734/jpri/2021/v33i59B34426

Ayurveda is a well-known practice for treating number of diseases from ages. It is a natural system from old age for the balancing of various body systems through herbs. There are lot of herbs used in curing the diseases and one among them is Brahmi. It has the ability to boost up the memory. Morphologically, it is a small sized succulent herb that have number of branches. This herb is well known for strengthening memory, brain functions and cooling properties. In this review paper, brief detail about its phytoconstituents and medicinal uses are discussed.

Open Access Review Article

The Effect of COVID-19 on Hospitalized Cancer Patients and Their Healthcare

Jahnvi Garg, Ranjit S. Ambad, Nandkishor Bankar

Journal of Pharmaceutical Research International, Page 699-703
DOI: 10.9734/jpri/2021/v33i59B34435

Introduction: This article includes the effect of Corona virus disease on cancer patients and their healthcare facilities. The global pandemic mentioned around the world has impacted the most vulnerable group of patients- cancer. With the assistance of RT PCR tests and HRCT, oncologists and doctors have tried to provide treatment to Covid-19 patients. Cancer patients are more susceptible to Covid-19 than non-cancer or non-survivor patients, according to reports. To avoid the prevalence and infection of cancer victims, WHO has suggested staying at home and continuing their treatment through telemedicine unless the situation is critical for which they might require therapy and/or surgery. Covid-19 is here to stay so we should practice with utmost care and precaution.

Open Access Review Article

A Comprehensive Review on Therapeutic Potential on Euphorbia hirta Lin

Vaishnavi Kalode, Manish Gagarani, Devyani Awari, Swapnali Mankar, Ashwini Armarkar, Rahul Gawali, Pranita Jirvankar

Journal of Pharmaceutical Research International, Page 713-718
DOI: 10.9734/jpri/2021/v33i59B34437

Euphorbia hirta Linn, a representative of the Euphorbiaceae family, is a widespread annual herb found in wastelands in humid conditions. The plant is high in phytochemicals such as tannin, quercetin, and phytosterol, however there are few phytopharmacological investigations on it. Plant components are normally employed in traditional medicine to treat respiratory problems, gastrointestinal issues, wound healing, and other ailments. The steroid of E. hirta was found to have CNS depressive and muscle relaxant effects, as well as a sub-maximal anti-stress and anxiolytic impact.

Open Access Review Article

Etiology and Epidemiology of Maturity-onset Diabetes of the Young

Abdulwahid Mohammad Alghamdi, Zahra Yaser Alamer, Mohammed Abdulrahman Alamri, Ablaa Mubarak Alkorbi, Abdullah Ghunaim Almtotah, Murtadha Ahmed Alatawi, Areej Osama Abukhodair, Mai Fahad Alassaf, Shatha Ahmed Alqahtani, Ahmed Yahya Asiri, Roayad Mouayed Abuaziz, Jumana Osama Alaama

Journal of Pharmaceutical Research International, Page 759-765
DOI: 10.9734/jpri/2021/v33i59B34443

Evidence indicates that Maturity-onset diabetes of the young (MODY) exhibits an autosomal dominant inheritance and is the most common type of monogenic diabetes. However, it should be noted that misdiagnosis of the condition is very common, as patients are usually mistaken for both types I and type II diabetes mellitus. In the present study, we have discussed the etiology, pathogenesis, and epidemiology of MODY based on an extensive literature review. Genetic mutations are mainly attributed to the development of the disease, which usually manifests throughout the second to fifth decades of life. Pancreatic islet cell destruction, impaired insulin secretion, defects regarding threshold to serum glucose levels, and other pathological events are usually observed in these patients. Data regarding the epidemiology of the condition is not adequately reported in the literature, especially among non-European populations, indicating the need to conduct future investigations. Ethnic and age variations are potentially epidemiological characteristics of the disease. However, not enough data are present in the literature to support such conclusions.