Open Access Case Report

Pleomorphic Adenoma of Neck: Case Report

Deepankar Shukla, Nitin Bhola

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 54-58
DOI: 10.9734/jpri/2021/v33i60A34454

Pleomorphic adenomas are benign tumour of the salivary glands that mostly affect the parotid gland. The tumor's "pleomorphic" form can be explained by its epithelial and connective tissue origins. Females between the ages of 30 and 50 are more likely to get the tumour. The tumour usually presents as asymptomatic swelling that progresses slowly. The majority of treatment is surgical removal of the tumour mass, with special attention paid to preserving the facial nerve. This is a case report of a 42-year-old female patient who had a pleomorphic adenoma of the submandibular gland. On the right side of the face, the patient had a slowly growing asymptomatic swelling. Pleomorphic adenoma is the commonest salivary gland tumor characterized by  diverse  histomorphological  features.  Early diagnosis and treatment plan entails thorough history taking, clinical examination, coupled with radiographic and histopathological findings.

Open Access Case Report

Case Report of Maggot Infestation on Diabetic Foot Ulcer

K. Menaka, Elsa Jacob, Gladys Kalpana, T. Sivakumar, Noveena Rao, R. B. Chithra Devi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 194-197
DOI: 10.9734/jpri/2021/v33i60A34474

Myiasis is originated from the Greek word, Miya, which means fly.  Fly larva are called maggots. Infestation in humans by maggots is called myiasis. Fly maggots feed on and develop in the tissues of living beings and this condition is known as myasis. The maggot (larvae) invades the skin and subcutaneous tissue is known as Maggot infestation. It was found that farmers who are working in agricultural fields are more susceptible to this infestation. Myiasis symptoms may vary according to the fly type, the number of larvae, and the location of the infected area. Many organs can be infested by these larvae and the most common form is cutaneous myasis. The predisposing factors of cutaneous myasisare cutaneous immobilization, advanced age, poor social conditions, mental retardation, diabetes mellitus, alcoholism, vascular occlusive disease, and infected dermatitis as myiasis. Myiasis is more common in tropical and subtropical countries, especially in rural regions where people are in close contact with animals.Myiasisrepresents the fourth most common travel-associated skin disease. Here we report case on 55-year-old female patient was admitted with complaints of diabetic foot ulcer over left foot for 1 and half months and maggots were examined in the wound. The complete blood cell count [CBC] test shows that her HbA1c level was increased to 10.1%. The patient has undergone wound debridement on left forefoot and maggots were completely removed.

Open Access Case Report

Acute Pulmonary Embolism Post COVID-19 Pneumonia – A Case Report

M. Nitharsha Prakash, N. N. Anand, Karthick Ramalingam, G. Venkat Sai

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 315-318
DOI: 10.9734/jpri/2021/v33i60A34490

COVID-19 has been associated with multiple venous thromboembolism events such as pulmonary embolism and deep vein thrombosis. Here we report a 64-year male with COVID-19 pneumonia who developed pulmonary thromboembolism following the COVID illness. This patient developed VTE complication in spite of receiving anti-coagulation therapy during admission. This case brings out the need for evidence-based post-discharge VTE prophylaxis approach and guidelines in patients who recover from COVID-19.

Open Access Case Report

Avascular Necrosis of Left Femoral Head Following Trivial Trauma and the Need for Early Magnetic Resonance Imaging

. Pugazhendhi, K. Arvind Natarajan, H. Pankaj

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 427-431
DOI: 10.9734/jpri/2021/v33i60A34503

Trivial Trauma is one of the causes of avascular necrosis of the femoral head. Even trivial trauma can cause loss of blood supply to the femoral head and results in ischemia and aseptic necrosis. A 68 year old male patient came with 2 month history of left hip pain. X-ray pelvis (fig-1) with both hips which was taken immediately after the trauma, showed no significant bony abnormality and patient was managed conservatively with analgesics. Patient had persisting pain for 2 months which increased in severity and patient developed difficulty walking. Therefore a Magnetic Resonance Imaging (MRI) L hip (fig-2) was done and which showed avascular necrosis grade III of left femoral head. Total hip replacement was then carried out for the patient and patient improved symptomatically. Earlier MRI imaging following trauma could have resulted in early diagnosis and intervention to prevent progression of the disease and salvage the femoral head.

Open Access Case Report

A Rare Case of Mitochondrial Neurogastrointestinal Encephalopathy

V. S. Hamsa, . Harivasudevan, . Jagadeeshwari, . Sundari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 694-696
DOI: 10.9734/jpri/2021/v33i60A34534

Mitochondrial Neuro Gastrointestinal Encephalopathy (MNGIE) is rare genetic disorer. It is characteristic by progressive gastrointestinal dysmotility, cachexia, opthalmoplegia and leucoencephalopathy.We hereby report a case of MNGIE in a female.

Open Access Case Report

Mummified Dead Body in Hanging Position: A Case Report

Toshal Wankhade, Ninad Nagrale, Swapnil Patond, Jayant Giri

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 855-859
DOI: 10.9734/jpri/2021/v33i60A34558

Mummification refers to all-natural and artificial processes that bring about the preservation of the body or its parts. Such processes include mainly the drying of the soft tissues instead of liquefying putrefaction. We are presenting here a case of a medicolegal autopsy performed at the mortuary of MGIMS, Sevagram.  The body was found in the jungle in a hanging position to the branch of a tree. Body was completely mummified. Facial identification could be made out as facial features were well maintained. Investigation agency has query regarding condition of the body (mummification) and what is the time since death. After performing the autopsy, police were explained regarding the factors responsible for mummification to occur in the dead body and also given opinion regarding time since death. From the time since death police investigated the various missing complaints which were present at neighboring police stations during that period. So the relatives from one of the missing person identified the body and it was handed over to relative after completion of all legal formalities by the police officials.  In this case report we have discussed; autopsy finding in mummified body and factors responsible for formation mummification of the body.  Hot, dry and airy environment are well known factors contributing the mummification of body but apart from this hanging of the body along with other contributing factors mentioned earlier is responsible for mummification of the body in present case.

Open Access Systematic Review Article

Study on Septal Correction: Review of Literature and Clinical Findings

Aarya Bomanwar, Chandra Veer Singh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 14-21
DOI: 10.9734/jpri/2021/v33i60A34448

Septal reconstruction has many needs and usages. Nowadays, people are very concerned about looking and would like to correct them. Septal reconstruction has been immensely used in the field of cosmetics. A successful septoplasty would lead us to know about the pathology of the septum by which we can avoid further complications. It would be further significant in nasal obstruction or difficulty in breathing. Deviation of the nasal septum can also be corrected by septal   reconstruction by various techniques used for septoplasty. Complete septal reconstruction is the best method for extreme S-shaped and wave-like deviations or multiple fractures. The septoplasty is performed endonasal for caudal septal deviation. Traction sutures to rectify the caudal septum deviation is another type of surgery. Septoplasty usually opens the way for all other rhinoplasty procedures, as a straight, stable septum reflects the attractiveness and functionality of the nose. The patient's history and the surgeon's expertise play a favorable outcome. In conjunction with other nose procedures, such as cosmetic rhinoplasty and endoscopic sinus surgery, Septoplasty is frequently done to alleviate nasal airway obstruction or headaches induced by rhinology irritation produced by touch. Endoscopic septoplasty requires the same amount of time and delivers equal, if not better, results than previous procedures. Visualization is vastly improved by endoscopic technology. Isolated deviation, spurs, perforations, and contact sites are examples of distinct septal disorders that can be treated individually using this procedure. In this review article, the importance of traction sutures is mentioned. The article gives us an idea about Septoplasty and how it can be achieved, its complications, risk factors, and a few postoperative points.

Open Access Systematic Review Article

Psychosocial Impact of COVID-19: Health Impact and Clinical Findings

Alisha Guru, Sunita Vagha

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 697-702
DOI: 10.9734/jpri/2021/v33i60A34535

Besides its high mortality rates, COVID-19 disease has dramatic psychosocial and psychological effects worldwide. There are significant reports of mental issues, panic attacks, anxiety, depression, and financial difficulties, and the effects continue to persist months after recovery [1]. The disease itself multipliedgic by many other problems like post-traumatic stress disorder, depression, change in behaviors. All these have a significant impact on their lives [1]. It also has adverse effects on pregnancy. COVID-19 has affected the mother as well as the child’s health. There are many panic and anxiety issues. Many deaths were not even reported. Coronavirus pandemic has led to many health and mental illnesses. Many lockdowns led to financial difficulties and problems in the present and future.

Long-term neuropsychiatric effects may be caused by more than only the massive psychological trauma suffered during the outbreak.

Poor developmental outcomes in offspring have been associated with prenatal psychological distress, including abnormalities in brain development 4, 7, and worse socio-emotional and cognitive development.

This article tends to define the psychosocial (psychosocial remove) impact of COVID-19 on students, health workers, pregnant women, how their lives and mental health are affected worldwide. COVID-19 affected the workplace. Stress throughout pregnancy and early life has been linked to cancer lately. It has affected many lives in agricultural areas, economic-financial losses. Current reports put forward feasible passing on vertical coronavirus, although longitudinal studies offspring are needed. The paternal infection on the offspring and generational upshot can be contemplated.

Open Access Case Study

Open Reduction & Internal Fixation of a Distal Radius Fracture with a Volar Locking Plate: A Case Report

P. M. Mervinrosario, Vijay Narasimman Reddy, Aravind Ravichandran

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 37-40
DOI: 10.9734/jpri/2021/v33i60A34451

The present case report describe Open Reduction & Internal Fixation of a Distal Radius Fracture With a Volar Locking Plate. Anatomical reduction & stable fixation of fracture with or without bone grafting, greatly reduces the incidence of post-traumatic osteoarthritis & stiffness. The accuracy of fracture reduction co- relates directly to the final outcome. A 34-year-old man fell on his right outstretched h&. He presented to the casuality & on physical examination, he was noted to have deformity about his right wrist with moderate swelling. There was no neuro-vascular deficit. Various treatment modalities have been developed for distal radius fracture fixation. Treatment options range from closed reduction & cast application to open reduction with plates & screws. Locking plates address intra-articular & metaphyseal comminution. Biomechanical studies comparing volar fixed- angle locking plates with that of conventional dorsal plates report volar fixed-angled plates to be superior in terms of their strength.

Open Access Case Study

Pain Management by Ayurveda in Lumbar Spondylosis– A Case Study and Selective Review of Literature

Satyajit Pandurang Kulkarni, Pallavi Satyajit Kulkarni

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 249-256
DOI: 10.9734/jpri/2021/v33i60A34482

Introduction: In Ayurveda, Snehana is an important method of treatment for diseases of the spine. As per Ayurveda, fatty substances are having properties opposite to that of Vata Dosha which is the root of many diseases. Therefore, Sneha (fatty substances) have an important position in Ayurvedic treatment. Fatty substances are of 4 types of Ghrita (Ghee), Taila (oil), Vasa (muscle fat), and Majja (bone marrow fat).

Among these types, the literature is available about Ghrita (ghee), Taila (oil), and Majja (bone marrow fat) only, but Vasa (muscle fat) is not currently practiced. We got a case study, in which cod liver oil capsules were used as a representative of Vasa Sneha.

A male of 35 suffering from lumbar spondylosis approached for moderate to severe low back pain. We successfully used cod liver oil capsules as representative of Vasa Sneha in this case.

Study Design:  A single case study and selective review of the literature.

Place and Duration of Study: Panchakarma OPD, Yashwant Ayurvedic medical college, PGTRC, Kodoli, 416114, Dist. – Kolhapur, Maharashtra, India.

Presentation of Case: This is a single case study in which a male of 35 years was suffering from chronic low back pain (CLBP) due to lumbar spondylosis The patient had chronic low back pain which was aggravated for 3 months.

We prescribed him Ayurvedic medicines and cod liver oil capsules orally. The patient was followed for 16 months.

Results: The outcome measure was assessed by the Oswestry low back pain disability questionnaire. The low back pain score was measured in different positions. The before treatment value was 36 (median ẋ = 3.5) and the score was 72, and after treatment value was 2 (median ẋ = 0) and the score was 4. The Mann Whitney U test was performed. The p was 0.00009 (<0.05).

Conclusion: It is concluded that cod liver oil can be successfully used as a representative of vasa Sneha, and it is very effective in relieving chronic low back pain in lumbar spondylosis along with other ayurvedic preparations.

Open Access Case Study

A Case Report on 2 years Child: Hirschprung’s Disease

Anushri Kale, Aditi Badwaik, Pallavi Dhulse, Archana Maurya, Bibin Kurian

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 558-564
DOI: 10.9734/jpri/2021/v33i60A34519

Introduction: Hirschsprung's disease is the most common cause of large intestinal obstructing in neonates. Hirschsprung's disease is a congenital anomaly caused by migratory failure of neural crest cells leading to abnormal innervations of the bowel .The defect begins in the internal and sphincter and extends proximally for a variable length of gut. Hirschprung's disease is a disorder of the gut caused due to congenital absence of ganglion cells in the sub-mucosal and myenteric plexus of intestine. This disease is also known as megacolon or congenital Aganglionic megacolon. Case presentation: A 2 years old male child, known case of Hirschprung’s disease, was brought to AVBRH for further management. As narrated by the mother, the child was not passing stool since birth. There was no history of abdominal distention, vomiting or fever. The child pass the stool with the help of enema which was given to the child in the morning and evening. Mast. Devansh has past history of NICU stay. In View of not passing stools, USG of abdomen and pelvis done. Endorectal pull through surgery was done on 4/02/2021 under general anesthesia. No any past surgical history. There is a past history of rectal biopsy done in 1 1/2 month of age. Conclusion:The patient was admitted in AVBRH for further management. Then the report mainly focused on surgical management and quality nursing care due to which patient was discharged without any further complication and satisfaction.

Open Access Case Study

A Fatal Case of Infant Congenital Cytomegalovirus and Neonatal Herpes Simplex Virus Infections Type 1 and 2

Varsha Gajbhiye, Sarika Gaikwad, Shubhangi Patil (Ganvir), Sushma Myadam, Lalit B. Damahe

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 972-976
DOI: 10.9734/jpri/2021/v33i60A34573

Introduction: Cytomegalovirus (CMV) is an essential and most frequent vertically transmitted infection from mother to fetus through the placenta. Neonatal Herpes simplex virus (HSV) enters a child by physical contact with its mother’s potentially infected vaginal secretions. There are many case reports where the newborn is infected with either CMV or HSV, but only one case of a 67-year-old Chinese male with the coinfection of CMV and herpes simplex virus type II (HSV-II) 11 was found. We report a rare case of newborns with congenital infection by CMV and herpes simplex who succumb to multiorgan failure.

Case Report Presentation: 8 weeks male infant came in our hospital complaining of not feeding and not gaining weight, abdominal distension, diarrhea, and jaundice. As narrated by the mother, the baby was delivered vaginally at 36 weeks of gestation, and the birth weight was 1880 grams. Mother was not recommended blood test for TORCH (toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV, syphilis) by her obstetricians. TORCHES profile was favorable in the baby. Newborns succumb to treatment and die due to multiple organ failure.

Conclusion: Torch’s panel test is used to help diagnose infections that could harm the unborn baby during pregnancy and have fatal consequences after birth; therefore, it should be mandatory in each pregnancy.

Open Access Study Protocol

Evaluating the Quality of Life in Oral Sub Mucous Fibrosis Patients by WHOQLF-Brief Questionnaire: A Study Protocol

Dhiran Talatule, Ramhari Sathawane, Romita Gaikwad, Rakhi Chandak, Ayesha Sayyad, Pranada Deshmukh, Vidyarjan Sukhdeve, Pranali Thakare, Simranjeet Singh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 171-175
DOI: 10.9734/jpri/2021/v33i60A34470

Background: - Oral Submucous fibrosis (OSMF) is a chronic insidious inflammatory disease which presents with the clinical presentation of burning sensation, fibrosis which ultimately leads to reduced mouth opening. The quality of life is the perception of an individual on their oral health as well as their well-being. The assessment of quality of life in the patients with OSMF plays an important role in the cessation of the habit.

Aim: - To analyse the quality of life in patients diagnosed with Oral Submucous Fibrosis (OSMF).

Study Design: - Cross-Sectional Study

Methodology: This is a cross-sectional study will be conducted on 300 diagnosed patients of OSMF. Selection of patients will be done as per the inclusion criteria. The nature and Purpose of the study will be explained to the patients before the data collection.

Results: The results will be evaluated by the statistician after the data collection and the results will be published in the peer reviewed journals.

  • Improvement in the quality of life in OSMF patients.
  • Knowledge and awareness regarding the consequences of betelnut in the population of Central India.

Open Access Study Protocol

Evaluation of Comparative Dermal Toxicity and Efficacy of Aargwadhadi Oil and Aargwadhadi Ointment

Premadevi Kalmegh, Bharat Rathi, Renu Rathi, Poonam Madan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 264-273
DOI: 10.9734/jpri/2021/v33i60A34484

Introduction: Skin diseases are among the most common of all health illness in recent years, In Ayurveda, management of skin diseases includes internal and external administration. External administration includes various topical applications However, herbal medicines are not completely safe from adverse effects and develop irritation, rashes, redness and burning sensation on the skin as observed in recent researches.“Hence there is a requirement of a safe drug which should be economical & affordable for all. Hence present study is undertaken to study dermal toxicity profile Aargwadhadi oil and Aargwadhadi ointment in an experimental animal and make available safe and efficient drug to the human being.

Aim and Objective: Pharmaceutical development, standardization and evaluation of acute, sub-acute dermal toxicity and efficacy of a Aargwadhadi oil and Aargwadhadi ointment and compare efficacy and safety of Aargwadhadi oil and Aargwadhadi ointment.

Materials and Methods: Aargwadhadioil and Aargwadhadi Ointment will be prepared as per classical reference and it will be converted into ointment form. Analytical study for standardization of Aargwadhadi oil and Aargwadhadi ointment will be done.  Evaluation of Acute and sub-acute dermal toxicity study in experimental animals of both dosage forms as well, efficacy study of Aargwadhadi oil and Aargwadhadi ointment on animal model of vitiligo will be done.

Observations and Results: Observation will be done on the basis of assessment criteria evaluation of control group and experimental group will be noted. Results will be drawn on the basis of observations and applying suitable tests. It will be noted and presented in form of table, charts, graphs etc.

Conclusion: Conclusion of the study will be drawn accordingly from the recorded observations, analysis of data.

Open Access Study Protocol

Comparison of Root End Sealing Ability of Three Retrograde Filling Materials in Teeth with Root Apices Resected at 90° using Dye Penetration Method under Fluorescent Microscope: An In-vitro Study

Payal Chaudhari, Manoj Chandak, Arvind Ramdas, Patil Bhagat, P. S. Pande

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 319-325
DOI: 10.9734/jpri/2021/v33i60A34491

Background: Inadequate seal at the apex is the substantial cause for surgical endodontic dissatisfaction. The retrograde filling material which is used should prevent the egress of potential contaminants into periradicular tissue.

Objectives: To evaluate the ability of MTA Angelus, Zirconomer and Bioactive bone cement to seal the root end as retrograde filling material; and to compare root end sealing ability of these three different retrograde filling materials with apices resected at 900 angles using dye penetration method under fluorescent microscope.

Methodology: Thirty six extracted upper anterior teeth are to be cut horizontally at the CEJ. After following the standard protocols of, “cleaning, shaping and obturation” with gutta percha and “AH Plus sealer”, the samples will be resected 3mm at the apical end at 90 degree angle along the long axis of the tooth with the help of diamond disc. A root end cavity of depth 3mm will be made with Diamond coated ultrasonic surgical tip S12 90 ND. The teeth will be randomly categorized in 3 groups: Group 1: MTA angelus; Group 2: Zirconomer; Group 3: Bioactive Bone Cement. Following which the roots to be coated with nail varnish except the tip. Each material will be compressed in the root end cavity with the help of small pluggers. All the samples which are retrofilled will be kept in acrydine orange for a duration of 24 hours, following which cleaning & bucco-lingual sectioning(vertical) will be done. Fluorescent microscope will be used for observation of sectioned root samples.

Expected Results: Bioactive bone cement is expected to have better sealing ability of the retrograde cavity preparation with minimal or no microleakage followed by MTA Angelus and then Zirconomer.

Conclusion: If this study proves correct, this would be helpful for the clinicians to choose better and the most efficient retrograde filling material with best sealing ability and minimal microleakage in a retrograde preparation which will aid in success of the root canal treatment further resolving the infection.

Open Access Study Protocol

A Protocol RCT on Comparative Evaluation of Efficacy of Prakriti (Unique Constitution) Based Pathya-Apathya with Routine Diet in Healthy Children to Evaluate Its Future Observation towards Diseases to Prevent and Treat Morbidities

Prakash Dwivedi, Renu Rathi, Bharat Rathi, Vidyabhushan Pandey, Jitesh Verma, Ibamedabha Japang

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 371-379
DOI: 10.9734/jpri/2021/v33i60A34493

Background: Prakriti is a term that refers to an individual's inherent behavioural tendency. Acharyas have outlined many do’s and don'ts for maintaining a person's excellent immunity and health, such as Ritucharya (seasonal routine), Dinacharya (dietary regulations), and so on. Pathya (healthy) and Apathaya (unhealthy) are two ideas that are equally essential in the treatment of illnesses.

Objectives: To Study Prakriti analysis as per systematic protocol (C-DAC) and its perception towards different diseases. To assess the impact of Pathya-Apathya concept to prevent morbidity status in adolescent.

Materials and Methods: 12-16 years age group adolescent of nearby CBSE schools from MGAC will be selected Pathyapathya intervention will be given and study its perception towards different diseases prevention.

Results: To summarise categorical variables such as gender, religion, education, Ahara, Vihara, and various participant complaints, frequency and percentages will be utilised. Subjective and objective criteria will be used to calculate the percentage of alleviation. The difference in results before and after intervention in this group will be observed, and the results will be presented using statistical data. 

Conclusion: If this prakriti wise pathya concept will be significantly efficacious then so many diseases can be prevented which is a need of the hour.

Open Access Study Protocol

Effectiveness of Myofascial Release vs High Frequency TENS for Pain Relief and Functional Improvement in College Students with Trapezius Myalgia: A Comparative Study

Aditi Joshi, Swapna Jawade, Neha Chitale

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 352-358
DOI: 10.9734/jpri/2021/v33i60A34495

Background: Trapezius Myalgia is characterized by pain in the trapezius muscle. The patient suffering from myalgia usually complaints of pain, stiffness and tightness of the upper trapezius muscle. Acute or chronic neck-shoulder pain is the hallmark of this condition. The pain in the muscle usually lasts for few days or it can be even longer. The presence of spasm in upper trapezius muscle is shown by neck pain in the back of the neck and between the bases of the neck and the shoulder. This protocol has been created that describes the design of experimental study to evaluate and compare the effect of Myofascial Release (MFR) versus High-Frequency TENS for pain relief and functional improvement in subjects with Trapezius Myalgia.

Methods: The participants (n=45) will be recruited in the study suffering from Trapezius Myalgia and meeting the inclusion criteria. Two groups will be formed such that group A will be treated with Myofascial Release technique and group B will be treated with High Frequency TENS modality. The protocol will cover 4 weeks of treatment. Regular assessment will be carried out on 1st and 4th week of the rehabilitation period. During the rehabilitation period, we will evaluate pain status and functional improvement and range of motion of the neck in the subject at regular intervals. Our outcome measures will be – Numerical Pain Rating Scale (NPRS) and Neck Disability Index (NDI).

Discussion: The efficacy of the intervention will be evaluated by analyzing pain relief using Numerical Pain Rating Scale (NPRS) and functional improvement by using Neck Disability Index (NDI). The result of the study will significantly provide affirmation on using these modalities for treating myalgia patients. 

Open Access Study Protocol

Evaluation of Cardioprotective action of Suvarna gairik (Redochre) in Indian Cobra Envenomation, Aluminium Phosphide Poisoning and Doxorubicin Cardiotoxicity in Albino Rats- A Protocol

Santoshi Mane, Nilima Wadnerwar, Sudhir Ninave, R. D. Wajgi, R. R. Dighade

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 405-411
DOI: 10.9734/jpri/2021/v33i60A34500

Background: Poisoning is major health issue all over the world. Poisoning is one of basic causes for Out Hospital cardiac arrest (OHCA). P-OHCA (Poison induced Out Hospital cardiac arrest) can be prevented by immediate primary management. The agent for poisoning is unknown in most cases, which leads to difficulty deciding the emergency antidote. In Ayurveda Hridyavaranchikitsa (Cardio protection) is one of the treatment modalities mentioned in all types of poisoning as first aid treatment. Suvarna Gairik (Red ochre) is one of drugs mentioned for the cardioprotection. Snake bite and organophosphate poisoning are the threats to life in India. Doxorubicin is commonly used drug for Chemotherapy in malignancies, and its major side effect is cardiotoxicity. Hence these poisonings are included in study.

Aim and Objective: Evaluation of cardioprotective activity of Suvarna Gairik (Red ochre) in cardiac biomarker like Lactate dehydrogenase, Creatinine phosphokinase, Alkaline transferase, Cardiac Troponins and Survival Time in Indian Cobra Envenomation, Aluminium phosphide poisoning and Doxorubicin cardiotoxicity in Albino Rats.

Methodology: Animal study is designed. 56 wistar rats will be divided in 7 groups as Vehicle Control Group, Disease control Group -1 Indian Cobra envenomation, Disease control Group -2Aluminium Phosphide poisoning, Disease control Group -3 Inj. Doxorubicin induced cardiotoxicity, Test Group -1 Indian Cobra Envenomation and Suvarna gairik Test Group -2 Aluminium Phosphide poisoning and Suvarna gairik Test control Group 3- Inj. Doxorubicin cardiotoxicity and Suvarna gairik.

Results: Outcome will be assessed in between groups and among groups.

Conclusion: Suvarna Gairik (Red ochre) may show statistical significant cardioprotective activity.

Open Access Study Protocol

Effectiveness of Intrauterine Infusion of Autologous Platelet-Rich Plasma in the Treatment of Thin Endometrium of Infertile Women

Namrata Choudhary, Akash More, Roshankumar Jha, Ashish P. Anjankar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 521-526
DOI: 10.9734/jpri/2021/v33i60A34513

One of the key factors in implantation and pregnancy is endometrium. Sufficiently great percentage of in vitro fertilization failure is because of the endometrial receptivity therefore, high quality embryo and adequate receptive endometrial growth are important for successful implantation. Platelet rich plasma has beneficial effect in advancement of endometrial thickness for women with thin endometrial thickness. PRP can be used in various medical conditions including  patients with refractory endometrium as a complementary therapy to conventional  treatment.

Aim: To determine the effectiveness of intrauterine infusion of autologous platelet-rich plasma in the treatment of thin endometrium of infertile women.


  1. To identify infertile female patients with inadequate endometrial growth (less than 7 mm) in the past frozen embryo transfer (FET) cycles despite standard treatments.
  2. To observe intrauterine infusion of autologous platelet-rich plasma (PRP) in these infertile female patients with thin endometrium.
  3. To determine the effectiveness of intrauterine infusion of autologous PRP in the treatment of thin endometrium of infertile women during In vitro fertilization (IVF).

Methods: It is a prospective observational study. Present study will be carried out with 30 patients. Women having inappropriate endometrial thickness of less than 7 mm, in past FET cycles will be included. Sonographic machine will be used; to measure endometrial thickness by  an expert Gynecologist, where thickest part of uterus will be measured in longitudinal  axis. 

Expected Results: It is expected that intra uterine infusion of PRP will be effective in thickening of endometrial wall in patients with thin endometrium. Once the results are satisfactory it can be helpful for endometrial preparation in reproduction techniques.

Conclusion: Present study is purposed to testify PRP as a novel method for advancement of reproductive medicine, it will be helpful to overcome with the issues such as inadequate thickness of endometrium, poor response to conventional therapy and increase clinical pregnancies and live births positively.

Open Access Study Protocol

Evaluation of the Effect of Cranioplasty Using Different Prosthetic Materials on Functional Improvement in Patients with Post-traumatic Brain Injury: A Protocol

Ramnath P. Revankar, Sweta Kale Pisulkar, Sandeep W. Iratwar, Samidha S. Pande, Nitin Wange

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 821-826
DOI: 10.9734/jpri/2021/v33i60A34553

Background: Cranioplasty is considered an essential step for restoring defects in the skull, generally due to the esthetic appearance, safety of the brain, or handling the adverse effect of the Trephined Syndrome (TS) or sinking skin flap syndrome. Moreover, many studies saw the unexpected enhancement of cognitive and motor function after cranioplasty. These favorable progressive effects can be helpful in further therapy preparations in association with cranioplasty effects. Nevertheless, the proof is mainly restricted to case studies that do not target comparison between different materials in post-traumatic brain injury (P-TBI) people even though it is helpful but not enough.

Objectives: To comparatively evaluate the effect of cranioplasty using autologous bone graft, polymethylmethacrylate (PMMA), titanium, and bone cement on cognitive and functional improvement in patients with P-TBI.

Methodology: 40 subjects will be allocated into four groups. Group A (10 using Autologous bone graft) Group B (10 using PMMA), Group C (10 using Titanium), and Group D (10 using Bone cement). Glasgow Coma Scale (GCS) and Mini-Mental State Examination (MMSE) will be used for cognitive improvement. For functional improvement, Muscle power and Barthel index will be used. The data will be compared before and after cranioplasty.

Expected Results: Cognitive and functional improvement will be present after cranioplasty. But the effect of cranioplasty using autologous bone graft, polymethylmethacrylate (PMMA), titanium, and bone cement has to be evaluated & compared to assess the patient’s cognitive and functional improvement and provide desired intervention as required.

Conclusion: This study will comparatively evaluate the effect of cranioplasty using different prosthetic materials and determine which material is better for patients' cognitive and functional improvement.

Open Access Study Protocol

Utility of Rescue Flap in the Reconstruction of Skull Base Defects Following Transnasal Endoscopic Excision of Sellar/Supra-sellar Lesions

Arjun Saini, Shraddha Jain, P. A. Deshkar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 904-910
DOI: 10.9734/jpri/2021/v33i60A34565

Background: Naso-septal Rescue Flap(NSRF) technique involves the preservation of unilateral posterior septal artery pedicle without harvesting full Naso-Septal Flap (NSF). This enables usage of NSF flap when needed while allowing enough exposure to resect tumor completely. This also provides with added advantage of tailoring flap according to preference to cover the defect post tumor removal. This technique involves partial harvestation of only the most superior and posterior aspect of the flap to protect its pedicle, providing better instrumentation for the sphenoid sinus. At the end of the procedure, if there is unexpected CSF rhinorrhea or resultant bony defect is large then Nasoseptal flap is harvested from the rescue flap.

As very few studies have been conducted for rescue flap technique in anterior skull base defect reconstruction following excision of sellar/supra-sellar lesions, the technique requires further validation, hence the present study is being undertaken.


  1. To study the post-operative outcome of Nasal Septal Rescue Flap (NSRF) in terms of donor site morbidity and CSF leak.
  2. To study the post-operative outcome of posterior nasoseptal flap in terms of donor site morbidity and CSF leak.

Methodology: A cross-sectional study will be conducted at Department of E.N.T, AVBRH, Sawangi Wardha, during a period of August 2020 to August 2021. A sample size of 20 within 18 -70 years of age with sellar/supra-sellar lesions will be included for the research.

Results: The observations obtained will be analyzed statistically and will be discussed in light of literature available.

Conclusion: This study will help in formulating the guidelines for the NSF harvest with the goal of preventing unnecessary harvest, thereby decreasing peri-operative and post-operative disadvantages as well as preserving the flap for reconstruction in patients requiring revision surgery.

Open Access Short Communication

Brain Changing Advantages of Exercise

Akshat Sahu, Dhruba Chandi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 149-153
DOI: 10.9734/jpri/2021/v33i60A34467

Exercise is defined as any activity that causes your muscles to work and your body to burn calories. Physical activity includes swimming, running, jogging, strolling, and dancing, to name a few. Physically and mentally active people have been shown to have various health benefits. It could even help you live a longer life. In this article, we attempt to explain the beneficial effects of exercising regularly on our brain and how this helps with cognitive tasks. We also describe the various neurotrophic neurochemicals that aid in this phenomenon. We then describe the process of neuroplasticity and how exercise can help accelerate this process. Regular physical activity is one of the most important things you can do for your health. If you're worried about being harmed if you start walking or increase your level of physical activity, it is safe for most people to engage in moderate-intensity aerobic activity, such as brisk walking. Reduced emotions of state anxiety (short-term anxiety), increased sleep, and enhanced elements of cognitive performance are some of the benefits of moderate or intense physical exercise on cerebral health that happen immediately after moderate or intense physical activity (acute impact). People who engage in more moderate or intense physical activity generally have better mental processes to gain knowledge and comprehension than those who do not. Improvements in cognition, as well as performance, might be expected. For example, standardized assessments of academic achievement and performance on mental ability tests are examples of neuropsychological testing. Processing speed, memory, and executive function are all factors to consider.

Open Access Minireview Article

Causes of Death in COVID-19: A Minireview

Shravani Dhale, Swarupa Chakole, Neha Bhatt

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 311-314
DOI: 10.9734/jpri/2021/v33i60A34489

Background: More than two million people have died worldwide as a result of the new corona strain virus SARS-CoV-2 and the associated COVID-19 syndrome. Older patients with pre-existing health problems are more likely to die from their illness. We found that septic shock and multiple failures were the most common causes of death, mainly due to inflammation of the lungs, although there was no definitive study on the causes of death and the role of pre-existing conditions. In a few cases, respiratory failure caused by excessive alveolar injury was the cause of immediate death. Comorbidities such as asthma, heart disease, and obesity were present in most cases.

Conclusion: Our findings indicate that COVID-19 was related to death in the majority of decedents, rather than being a direct product of pre-existing health conditions and comorbidities. As a result, we conclude that COVID-19 killed most patients, with pre-existing health issues playing only a minor role in the death mechanism.

Open Access Minireview Article

Microscopy and the COVID-19 Pandemic, What We Need to Know?-The Hygiene Protocols and Digitalization

Huchanahalli Sheshanna Sreeshyla, Hegde Usha, B. R. Premalatha, N. M. Nandini, Priyanka Nitin, J. Srinivas

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 841-847
DOI: 10.9734/jpri/2021/v33i60A34556

The COVID-19 pandemic has reemphasized the significance of personal protection at all the levels, from public places to hospitals, to working spaces to residence and at individual levels. It is inevitable for personnel in a common working space to share items multiple times one after the other frequently. Laboratory is one such arena and is also of great concern as it is associated with handling pathogenic specimens, investigating and diagnosing pathologies.  By nature, it can be of great concern due to the possibility of higher chances of cross contamination. This fact is made even more precarious by the current COVID 19 pandemic. Hence there is a great need for a set of guidelines, appropriate protocols, best hygiene practices and digitalization in reporting and teaching learning, to be followed in the laboratory to prevent cross contamination. Microscopy work area is part of laboratory where microscopes are placed and used by the professionals for pathological diagnosis or research. Though there are set guidelines to be followed for most aspects of the laboratory, the cleanliness and personal protective guidelines for microscopes are sparse. Use of a disposable or reusable plastic film for covering microscopes, selection of suitable disinfectant, use of proper cleaning and protective tools and safeguarding the sensitive parts of microscope are highly recommended.

Open Access Original Research Article

Development of Validated RP-HPLC Method for Estimation of Empagliflozin and Metformin in Combined Formulation

Vichare Vijaya, Kandekar Ujjwala, Dhaware Pallavi, V. P. Choudhari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 1-7
DOI: 10.9734/jpri/2021/v33i60A34446

Aim: The aim of the present study include development of validated RP-HPLC method for estimation of Empagliflozin and Metformin in combined dosage form by using LC-MS compatible volatile mobile phase.

Methodology: Appropriate separation of drugs was achieved using C18 column as a stationary phase and Acetonitrile: Water (50: 50, v/v) at a flow rate 1mL/min as mobile phase. Detection was done at 230 nm.

Results: The Rt of Metformin and Empagliflozin was found to be 2.20 ± 0.02 min and 3.64 ± 0.02 min respectively. When the marketed formulation was analyzed by the developed method, the % drug contents were found to be 98.57 ± 1.28 and 99.86 ± 1.02 %w /w for Empagliflozin and Metformin, respectively. The method was found to be linear in a range of 11.25 – 56.25 μg/mL for Empagliflozin and 85 – 425 μg/mL for Metformin. Detection limit and quantitation limit were found to be 0.30 and 0.92 μg/mL for Empagliflozin and 1.12 and 3.36 μg/mL for Metformin, respectively. The accuracy and precision results were found to be near 100 % w/w for both the drugs. The method was also found to be robust and specific.

Conclusion: The developed RP-HPLC method was found to be linear, sensitive, accurate,     precise, specific and robust for the analysis of Empagliflozin and Metformin in combined dosage form.

Open Access Original Research Article

The Factors Altering the Age of Onset of Menstruation among Adolescent Girls in Wardha Region

Anupama Sawal, Vilas Chimurkar, Darshna Fulmali, Geetanjali Ingole

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 8-13
DOI: 10.9734/jpri/2021/v33i60A34447

Introduction: Several studies have found that the most common age of menstruation onset has come down dramatically over the previous century, and that there has been a profane (with respect to time) tendency toward early menstruation onset in most metropolitan countries.

Emerging economies, such as India, have also suffered a drop in recent years.

The purpose of our study was to determine how diet and socioeconomic status influenced menarche age in this location.

Methods: Following a simple random sampling among the schools, 100 girls between the ages of 10 and 15 were volunteered for this study.

The girls were given a pre-designed questionnaire after receiving clearance and agreement from the school principal/class teacher.

The female doctor gave the girls a brief examination.

The age of the mother during menarche, as well as the family's socioeconomic situation and other characteristics, were all enquired about in depth.

Results: Our study shows that the age of onset of menstruation in higher socioeconomic classes is lower as compared to Lower Socioeconomic class. No significant relation between BMI & type of food and usual age of onset of menstruation was seen in this study.

Conclusions: As we progress from a lower to a better socioeconomic level, we see a trend of lowering the age of first menstrual flow. Because such data is scarce in this portion of India, more research must be conducted among girls from other parts of the state before the data can be compared to national figures.

Open Access Original Research Article

Attitude and Views towards Mental Health among Dental Students

Sangaraju Soumya Sri, A. Jothi Priya, R. Gayatri Devi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 22-31
DOI: 10.9734/jpri/2021/v33i60A34449

Introduction: Stress can be a feeling of emotional or physical tension. It can come from any event or thought that can make us feel frustrated, angry, or nervous. Stress is your body's reaction to a challenge or demands.

Aim: The aim of the study is to assess attitude and views towards mental health and psychiatry among dental students.

Materials and Methods: Study Setting is prospective observational study.The advantages of this study was economical, easy to create, wide reach, and gathering larger data Quick Interpretation . It was approved by the scientific review Board Saveetha Dental college Chennai .Number of participants involved in this study are 138 college students .The responses from the google sheet were transferred into excel. Inferential statistics was done using Chi square test and exported to SPSS software, version 25

Results: From the survey conducted among dental students on mental health and psychiatry.Majority of dental students were female participants compared male participants.Interpretation was based on a p value less than 0.05, which was considered to be statistically significant.

Conclusion: The findings of the present study proves that the majority of dental students have awareness of attitudes and views of mental health .Among dental students, females are the major participants compared to males. In order to develop psychiatric and mental health services, public acceptance is necessary.

Open Access Original Research Article

Prescription Audit of Out-Patient Attendees in Gynecology Department in India

Aastha Sahni, Akshay Dahiwele

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 32-36
DOI: 10.9734/jpri/2021/v33i60A34450

Background: Prescription auditing is a comprehensive clinical audit process that improves the quality of care by systematically reviewing treatment against defined criteria and making changes as a consequence. A prescription is a written order from a doctor to the person who will supply the drug. Every country has its own set of prescription information requirements and rules and regulations defining which pharmaceuticals require a prescription and who is eligible to write it.

Objective: The study aims to determine the quality of out-patient department (OPD) prescription forms in Indian tertiary care, highlighting the elements that should be written in a prescription to improve the institution's overall quality of care.

Methodology: This will be a cyclical activity that will assess prescriber's practice of generating  prescription orders, refining it to solve problems detected, and comparing the outcomes to audit criteria that have been agreed upon. This will be a cross sectional study conducted in AVBRH hospital setting and data will be collected from OBGY OPD and will be analyzed using SPSS Version 25.

Expected Results:  According to the findings of the various prescription audits, the percentage of drugs administered by generic name is lower than required. The average number of antibiotic prescriptions is higher than the prescribed amount. NLEM's suggested drug list should be expanded.

Conclusion:  Prescribers must be aware of the need to write prescriptions in legible handwriting with capital letters for pharmaceuticals with generic names, as well as receive continuous training and be encouraged to do so. The most important condition for a prescription is that it be clear, understandable, and specific.

Open Access Original Research Article

Myths and Misconceptions about Novel COVID-19 Outbreaks among Wardha City General Population

Parmeshwari k. Pipare, Bhuvaneshwari B. Pothale, Rajani Rajiv, Adesh Raut, Ranjana Sharma, Samruddhi Gujar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 48-53
DOI: 10.9734/jpri/2021/v33i60A34453

Background: COVID-19 is a unique pulmonary ailment due to coronavirus, producing extremely severe pulmonary illness. On March 11, 2020, WHO declared the SARS-CoV-2 incident a pandemic because of its deadly global spread.

Objectives: To assess the myths and misconceptions about Novel COVID-19 outbreaks among the general population and associate the findings of the Novel COVID-19 outbreak with the selected demographic variable.

Materials and Methods: This descriptive research paper was undertaken to assess the perceived myths and misconceptions about novel COVID-19 outbreaks among the general population at Paloti, district Wardha. The sampling technique was used Non – Probability Convenient. A total of 150 members of the general population who met the inclusion criteria were chosen for this study. To assess their perceived myths and misconceptions, a Likert Scale was constructed.

Results: Findings of the study, 1.33% of general populations have disagreed, 10% were undecided, 50.67% of them were agreed, and 38% of them were strongly agreed about myths related to Novel COIVD-19. The Minimum perceived myths score was 19, and the maximum score was 48. The mean perceived myths score was 37.83±6.07, and the mean percentage of myths score was 75.66± of general populations were disagreed, 2% were undecided, 29.33% of them were agreed, and 68% of them were strongly agreed about misconceptions related to Novel COIVD-19. The minimum and highest misunderstanding scores were 18 and 49, respectively. The mean misunderstanding score was 83.179.09, while the mean misconception score was 41.584.54. There is no correlation between demographic factors and myths and misconceptions.

Conclusion: According to this study, myths and misconceptions related to the novel COVID-19 are surprisingly low among the general population.

Open Access Original Research Article

A Comparison of the Effects of Spinal Anaesthesia between Sitting and Lateral Positions in Patients Undergoing Hysterectomy Surgery

Karan Morje, Manna Debnath, Akhlaque Ahmad, Santosh Ojha

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 66-72
DOI: 10.9734/jpri/2021/v33i60A34456

Aim: The main purpose of this present study is to determine the effects of sitting (S) and lateral (L) position during spinal anaesthesia on patient satisfaction, Post dural puncture headache (PDPH), Post-Operative Nausea and Vomiting (PONV).

Study Design: Prospective comparative study

Place and Duration of Study: Charusat Healthcare and Research foundation (CHRF), Changa, Gujarat, between September 2021 to November 2021.

Methodology: A total of 50 female volunteers who were above the age of 18 years, had an American Society of Anaesthesiologist (ASA) status of I & II and those who have undergone hysterectomy surgery are included in this study. The patients were categorized into two groups, group S (n=25) and group L (n=25). Patients were asked about PONV 4 hours after surgery and the possibility of PDPH on post-operative days 1 and 2. The study was analysed by using descriptive statistics, chi-square and Kruskal-Wallis test.

Results: When comparing the incidence of PDPH on post-operative day 1 and day 2, there is a statistically significant difference between the Sitting (group S) and Lateral decubitus (group L) groups (P-value= 0.14 and.001). On the other hand, there is no statistical significant difference found for PONV when compared between both the groups (P- value= .776).

Conclusion: Spinal anaesthesia with lateral decubitus position has better outcomes than sitting position for the incidence of Post dural puncture headache. However, there is no difference in both groups for PONV.

Open Access Original Research Article

Effectiveness of Exposure to Virtual Learning before Cadaveric Dissection to Study Anatomy for Students in Health Sciences at DMIMSU Wardha, Maharashtra

Darshna Fulmali, Preeti P. Thute, Harsha Atul Keche, Vilas K. Chimurkar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 81-88
DOI: 10.9734/jpri/2021/v33i60A34458

Background: Anatomage dissection table offers detailed and interactive anatomical images which complement the anatomy textbook and the cadaveric studies. In this regard, the study was carried out to assess the effectiveness of exposure to virtual learning on the Anatomage table before cadaveric dissection and to assess the perception of students about the virtual dissection.

Methods: A comparative cross-sectional study was conducted on 200 first phase medical students  from Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science, Sawangi, Meghe, Wardha. Study participants were divided into two groups, group A and group B. Group A performed dissection of the triangle of the neck on the Anatomage table before performing the traditional dissection of the same region while group B performed traditional only. Pre and post-tests were conducted for both group participants using a pre-validated questionnaire. 5 point Likert scale was used for obtaining feedback from study participants. The student's t-test was used for statistical analysis.

Results: Observation Post-test score in group A, exposed to virtual dissection prior to cadaveric dissection was 9.18 (Std = 0.84) as compared to the post-test score of 7.11 (Std = 7.01) in group B which was not exposed to the virtual dissection table. 144 (72 %) of students agreed that virtual dissection helps in better understanding of the complex relation of structure with each other and 152 (76 %) students feel that prior exposure to virtual dissection develops an interest in cadaveric dissection. 

Conclusions: Exposure to virtual dissection before cadaveric dissection was very effective way to learn anatomy for students of first MBBS as students were used to enjoy learning anatomy when virtual dissection was complemented with used before real cadaveric dissection.

Open Access Original Research Article

Mean Levels of B-type Natriuretic Peptide (BNP) in Patients with Mitral Stenosis Caused by Rheumatic Heart Disease

Altaf Hussain, Faraz Farooq Memon, Iftikhar Ahmed, Syed Ahsan Raza, Lajpat Rai, Ashok Kumar, Atif Ahmed Khan, Javed Akbar Sial, Tariq Ashraf, Tahir Saghir, Nadeem Qamar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 96-102
DOI: 10.9734/jpri/2021/v33i60A34460

Objective: Mitral stenosis caused by rheumatic heart disease (RHD) is the most common cause of valvular lesion in adults and prevalent in developing countries like Pakistan. Higher natriuretic peptide (BNP) levels can be observed in patients with moderate to severe untreated mitral stenosis and are associated with higher rates of morbidity and mortality. That is why this study aims to determine the association between levels of pro-BNP with severity (mild. Moderate, and severe) of mitral stenosis.

Patients and Methods: This was a clinical prospective study carried out in the department of adult cardiology, national institute of cardiovascular diseases, Karachi from 8th august 2019 to 7th February 2020. Total 68 patients of either gender with age between 25-70 years had mitral stenosis of moderate to severe intensity (mitral valve area ≤1.5 cm2), diagnosed on echocardiography were included for final analysis. A simple blood sample was taken for the assessment of pro-BNP levels. Questionnaire was used for demographic & clinical data collection and analysed using SPSS version 22.0.

Results: The overall mean age of study subjects was 42.21±11.50 years, ranging from 25 – 70 years. Among them, females were prevalent (n = 43, 63.2%). The overall mean serum BNP level was 1071.12±807.26 pg/ml and the mean difference of serum BNP level was not significant among groups of gender, age, and diabetes mellitus with p>0.05. Significantly raised levels of BNP were observed in patients with severe mitral stenosis as compared to moderate mitral stenosis, p<0.05

Conclusion: In conclusion, the mean BNP levels were higher in patients with severe Mitral Stenosis. Therefore, BNP may be used to complement the clinical and echocardiographic assessments in patients with Mitral Stenosis.

Open Access Original Research Article

Awareness of Emergency Eye Diseases and Red Flag Symptoms in Population of Western Province

Abdulaziz Shehri, Atheer Ayad Alharthi, Bushra Faisal Alshehri, Ahlam Mohammed Aljuaid, Hanan Rizieq Alhuthali, Razan Abadel Algethami, Razan Abdullah Alhamyani, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 112-120
DOI: 10.9734/jpri/2021/v33i60A34462

Background: Emergency eye disease can lead to visual loss when the patient delay seeking medical care quickly due to poor knowledge and awareness of red flags and symptoms that eventually end by late diagnosis then possibly devastating outcomes for example permanent visual loss. This study aims to examine the level of awareness and knowledge regarding different emergency eye diseases in Western Province, kingdom of Saudi Arabia.

Methodology: This is a cross sectional study conducted via online questionnaire and approved by research ethics of Taif university. SPSS version 25 was used for statistical analysis. Chi-squared, Mann-Whitney and Kruskal Wallis tests were applied, and a P-value of <0.05 was considered as statistically significant. 

Result: A total of 702 participants to the online questionnaire from the western province of Kingdom of Saudi Arabia, with 565 (80.5%) females and 137 (19.5%) males. Regarding the awareness of different emergent ocular diseases, acute angle closure glaucoma has the highest awareness level (41.7%) and the least was giant cell arteritis (12.4%).

Conclusion: This study reflected the awareness and knowledge of retinal detachment, giant cell arteritis and central retinal occlusion in average population of the western province, Kingdom of Saudi Arabia which was extremely low. This will have an impact on seeking medical care early with delay in diagnosis and implementation of treatment that results in significant visual complications. So, we need to raise awareness of society about different emergency ocular conditions and red flags to help overcome the negative outcomes.

Open Access Original Research Article

Domperidone Prescribing in the Outpatient Setting in Al-Kharj

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

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 144-148
DOI: 10.9734/jpri/2021/v33i60A34466

Aim: This study aimed to describe domperidone prescribing in the outpatient setting in Al-Kharj.

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

Results: During the study period between January 2018 to June 2018, 173 patients received domperidone. More than 54% of the patients were males and the age of most of them was less than 20 years (61.85%). More than 27% of the patients used domperidone for 3 days and 23.12% of them used it for 7 days. Most of the prescriptions where written by residents (97.11%) and most of the prescriptions were prescribed by emergency department (89.02%).

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

Open Access Original Research Article

Knowledge, and Awareness of Covid Vaccines among Senior Citizens in Chennai

E. Ilammaran Varshan, Preetha S, G. Sridevi, Lavanya Prathap

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 154-162
DOI: 10.9734/jpri/2021/v33i60A34468

Introduction: The COVID-19 pandemic is caused by SARS-CoV-2. It first originated from Wuhan, China. It has caused many effects on each and every part of people all over the world. So many pharmaceutical companies have tried to find vaccines against. India found one of its kinds, named Covaxin and Covishield. The awareness of vaccines is needed to people of all age groups. This study is aimed to create awareness and knowledge about COVID-19 vaccines among senior citizens.

Materials and Methods: Online based, cross-sectional survey was conducted for a period of one week among 136 senior citizens aged between 55-100 years. The survey questions were created using Google forms and sent via whatsapp and email to their family members to translate them. The survey consists of 13 questions in which two were demographic details and the rest were questionnaires. Statistical analysis was done using SPSS software. Chi-square test was done to analyze the correlations p value less than 0.05 was considered significant.

Results: 136 senior citizens responded to the survey. The majority of the populations were females (62.5%) within the age group 60-70 years in Chennai. Out of 136, 91.8% were aware of covid pandemic, 81.6% were aware covid vaccine, 74.2% think vaccine is necessary for corona, 69.1% weren’t aware of types of vaccine available for coronavirus in India, 73.5% answered it’s an important tool to stop pandemic and 66.1% were willing to get vaccinated. 60-80 showed better awareness about the benefits of vaccines when compared to other age groups (p value 0.028)

Conclusion: The survey showed the senior citizens of Chennai were more aware (81.6%) about Covid vaccine and Covid-pandemic. Females (62.5%) had better awareness when compared to males (37.5%).

Open Access Original Research Article

Hypertension Related Knowledge and Its Relationship with Control of High Blood Pressure in Pakistan

Bilal Younas, Muhammad Fahad, Muhammad Arslan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 183-186
DOI: 10.9734/jpri/2021/v33i60A34472

Introduction: High blood pressure (HBP) is a leading major risk factor for chronic diseases such as CKD, CADx, and deaths. The prevalence of patients with hypertension (HT) has risen from 600 million in 1980 to one billion in 2008.

Aims and Objectives: The basic aim of the study is to find the relationship of knowledge about hypertension with the control of blood pressure.

Methodology of the Study: This cross sectional study was conducted in Mayo hospital Lahore from January 2021 to July 2021. The data was collected from 100 patients with high blood pressure who visited the OPD of our hospital. A questionnaire was prepared by the researchers in accordance with the literature to measure the level of knowledge about HT.

Results: The data was collected from 100 patients of both genders. On comparison of questions related to knowledge, there was a statistically significant difference in; meaning of hypertension (p <0.001), target SBP (p0.001), target DBP (p 0.001), importance of SBP versus DBP, improvement of health with lowering of blood pressure (p 0.002), high blood pressure being asymptomatic (p <0.001), changing lifestyle improves blood pressure (p 0.003), hypertension being a lifelong disease (<0.001), lifelong treatment with anti-hypertensives (<0.001) and high blood pressure being part of aging (<0.001).

Conclusion: It is concluded that patients who were aware that elevated BP levels lead to reductions in life expectancy had a higher compliance level with medication use and follow-up visits than patients without this awareness.

Open Access Original Research Article

Stability Indicating HPLC Method for Estimation of Thymoquinone in Nasal Simulated Fluid: Method Development and Validation

Sagar Trivedi, Abhidha Deshpande, Veena Belgamwar, Vidyadevi Bhoyar, Kamlesh Wadher

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 233-240
DOI: 10.9734/jpri/2021/v33i60A34480

Introduction: A simple rapid and precise HPLC method was developed for estimation of TH in nasal simulated fluid and stability was assessed in various stressed conditions.

Methods: Chromatographic separation of TH in nasal simulated fluid was done using HPLC AS-4050 coupled with Jasco UV 2075 Plus detector, Jasco LC-Net 11/ADC valve, Jasco PU-2080 pump and hypersil gold C18 (250x6x5 µm) column, ChromNAV 2.0 Chromatography Data System software with mobile phase as acetonitrile: water (65:35) and acetonitrile: NSF (60:40) at a flow rate of 1ml/min and having run time of 10 min with loop volume of 20 µl and detection wavelength of 252 nm. The method was validated for accuracy, precision, linearity, specificity, and sensitivity in accordance with ICH (Q2B) guidelines.

Results: The results of all the validation parameters were found to be within the acceptable limits. The calibration plots were linear over the concentration ranges from 2 to 14µg/ml. The accuracy and precision were found to be between 97.04±0.112 to101.081±0.0191and ≤2% for three drugs. Developed method was successfully applied for the determination TH in nasal simulated fluid and recovery was found to be >98% for three drugs. The degradation products produced as a result of stress studies did not interfere with drug peak.

Conclusion: The developed method was found to be simple, specific, economic, reliable, accurate, precise, and reproducible used as a quality control tool for analysis of pure thymoquinone in nasal simulated fluid.

Open Access Original Research Article

A Cross Sectional Study on Knowledge and Attitude Regarding Exclusive Breast Feeding among Women of Reproductive Age Group in Chennai, Tamil Nadu

P. Tejesh Thanigavel, F. Margaret Harriet Priya

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 282-292
DOI: 10.9734/jpri/2021/v33i60A34486

Aim & Objectives: To assess the knowledge and attitude on exclusive breast feeding among reproductive age group women in Chennai.

Materials and Methodology This is a cross sectional quantitative descriptive study. The data was collected by handing out physical questionnaire forms to volunteers or by sending a link of the google form format of the same questionnaire. The data was collected from February 2021 to September 2021. The both physical and online forms data collected were compiled with help of Microsoft Excel. These compiled data were then analyzed using SPSS 16.0 software. All the frequencies and percentages were also obtained from this.

Results: In this study a total of 342 volunteers participated, all belonging to the reproductive age group i.e., 15 years to 45 years. Majority of the participants were among the age group 20 to 30 years belonging to both married and unmarried category. Out of the 342 volunteers, 74.2% (254) of the participants planned to breast feed their infants for several months. 60% of participants had scored more than 75% overall. The lowest score seen was 26/40 points. So no one in my study had low knowledge (less than 20). The knowledge percentage and attitude percentage here are 68.6% 65.4% respectively. My interpretation of the knowledge and attitude is that we need to increase the knowledge about the term “Exclusive Breast Feeding” and also encourage the mothers to breast feed their infants.

Conclusion:  Although most have scored more than 75%, some important questions were chosen incorrectly. This might be mostly due to the fact that there is lack of knowledge with respect to the term “exclusive” breastfeeding. This suggests that there has to be more awareness created amongst the youth population, who are tomorrow’s mothers. The need for them to know the importance of these matters lies in hands being doctors. It should be taught from school level itself.

Open Access Original Research Article

Role of Hepatic and Renal Profile in the Development of Gestational Diabetes Mellitus

Sobia Alyas, Nabila Roohi, Samina Ashraf, Sadaf Ilyas, Yasmin Ashraf

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 302-310
DOI: 10.9734/jpri/2021/v33i60A34488

Disturbances in hepatic and renal profile are well documented in diabetic patients. Antenatal pregnant women (n=300) selected for blood sampling during the early 2ndtrimester (14–18 weeks of gestation) including 176 pregnant women with positive family history of GDM and 124 women without any history of GDM. All the subjects were followed up to the early 3rd trimester (24-28 weeks of gestation) or until the onset of GDM for second sampling. Mean values of ALP, AST and GGT were significantly higher (p<0.05), however, mean albumin was found to be significantly lower in early 2ndtrimester in those patients who subsequently developed GDM. Levels of ALT, total protein, and total bilirubin did not show significant variations in comparable groups. Uric acid levels were found to be significant in those patients who developed GDM in late trimester but creatinine levels remained almost the same in both trimesters. Among 300 patients, 58 subjects developed GDM, however, in these established cases, 27% were having positive family history while 9% presented negative family history suggesting a stronger relationship of GDM with clinical/family history of pregnant women. The results of our study indicate that abnormal liver and kidney profile namely AST, ALP, GGT, albumin and uric acid may adversely affect insulin resistance and if not controlled and treated timely may cause GDM and lead to type 2 diabetes. However, ALT, serum bilirubin, total protein and creatinine appear to have no value in GDM prediction.

Open Access Original Research Article

Knowledge, Attitude and Practice of Dog Bite Patients and their Attendants Visiting Jinnah Post Graduate Medical Centre – A Tertiary Care Hospital in Karachi

Syed Mahboob Alam, Seemin Jamali, . Farah-Saeed, Uzma Umair

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 326-341
DOI: 10.9734/jpri/2021/v33i60A34492

Dog bite is a global issue and endemic to especially African and Asian countries, where due to lack of awareness dogs (both domestic and wild) are either un-vaccinated or unneutered. The higher authorities seems to be least bothered concerning the increasing number of stray dog in these countries. Although lot of planning is done, no proper execution of these strategies are observed.  The other issue is the negligent attitude of people towards wound management. The objective of this study is to assess the knowledge, attitude and practice of dog bite patients and their attendants visiting Jinnah Post-graduate Medical Centre, a tertiary care hospital in Karachi. The structured questionnaires were got filled via interview from both the patient and their attendant at the time they visited the dog bite clinic in the hospital. The results of the study revealed in appropriate and irresponsible attitude on both the part of patients and the concerned authorities responsible for is management. This research work was an endeavor to do the gap analysis in order to ensure practical implementation to overcome the endemic of dog bite and rabies. 

Open Access Original Research Article

Study to Find the Effect in Combined Protocol of Aquatic Therapy and Play Therapy in Attention Deficit Hyperactive Disorder in School Going Children from 7 – 10 Years to Improve the Quality of Life

R. B. Chithra Devi, M. Janani, B. Sruthi, V. Lalitha, A. Hamidhunniza, V. Parameshwari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 342-351
DOI: 10.9734/jpri/2021/v33i60A34494

The Objective of the Study: The aim of this study is to see the effect of combined protocol on aquatic and play therapy for children with ADHD based on inattention, hyperactivity, impulsivity, and anxiety.

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a severe threat to public health that affects a huge number of children and typically continues into adulthood. It is characterized by persistent lack of attention, hyperactivity, and impulsivity that impairs growth and performance. Children with ADHD are usually treated with a combination of pharmacological and non - pharmacological treatments, including academic, psycho-social, and behavioral aid, as well as aquatic therapy and play therapy. Aquatic therapy and play therapy, on the other hand, are ways in which the kid is provided the chance to undergo growth in the most optimum conditions. The goal of this study is to see how effective aquatic therapy and play therapy are in raising the standard of living of children aged 7 to 10 who have attention deficit hyperactivity disorder.

Methods: The design of the present study is quasi-experimental. Tools used for the study: Data were collected through Conner’s parent’s rating scale, pediatric balance scale, and hand-eye coordination scale as pre and post-test and the treatment group received aquatic therapy and play therapy for eight sessions.

Results: Conner's parent rating scale, pediatric balance scale, and hand-eye coordination test were used to compare before and after results. Conner's parent rating scale had a difference between the means of 21, a standard deviation of 4.79, and a paired-t-test value of 23.98. The pediatric balance scale's mean difference was 19, the standard deviation was 3.82, and the paired-t significance level was 27.20. The average difference in the hand-eye coordination test was 11, with a standard deviation of 1.67 and a paired-t-test score of 36.02.

Conclusion: According to the findings, using aquatic therapy and play therapy to help children with ADHD pay close attention, reduce hyperactivity, and manage impulsive behavior was beneficial. Play therapy and aquatic therapy are also good ways to have some exercise. This increased energy utilization causes them to be less impulsive and hyperactive over the rest of the day.

Open Access Original Research Article

Does Multiparity Affect Periodontitis Associated Adverse Pregnancy Outcomes' Awareness?

Mohamed Abdelrasoul, Bashayer Bahamdain, Raghad Hasanain, Renad Barayan, Nada Bugis, Ayat Fallatah, Bader Akhozai, Khames T. Alzahrani

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 359-370
DOI: 10.9734/jpri/2021/v33i60A34496

Background: Periodontal disease is a very common, undesirable, and neglected bacterial infection causing destruction of the connective tissue and dental bone support. During pregnancy, the oral bacteria could lead to tissue damage and mediate immune response which can impair the development and fetal growth in the placenta that it may be a risk factor for pre-term birth (before 37 weeks of gestation). The goal of this study to measure the knowledge and awareness of women in Jeddah, Saudi Arabia toward the relation between periodontitis and adverse pregnancy outcome.

Methodology: A cross-sectional study was done in Jeddah, Saudi Arabia from January 2020 until November 2021. based on a validated questionnaire developed by the authors. A convenience sample size of 966 women, aged 20-50 years, with a confidence level of 95%, and a 5% margin of error was selected. The questionnaire was divided into three main sections: demographics, knowledge and attitude.

Results: The study showed a mean score of awareness of 3.801.26 (54.35 ± 17.98%) while the mean score of attitudes was 1.60 ± 0.98 (39.91 ± 24.42%). There was no statistically significant relationship to age group, nationality, or parity, however, scores were significant to university education level.

Conclusion: Learning from previous multigravidas did not influence knowledge and awareness towards adverse pregnancy outcomes associated with PD.

Open Access Original Research Article

Perception of Dental Students towards the usage of Online Assessment during COVID -19 Pandemic

Trupti Chordia, Alka Dive, Anuraag Choudhary, Manoj Patil

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 380-389
DOI: 10.9734/jpri/2021/v33i60A34497

Background: The COVID-19 pandemic have forced educational institutions to shift rapidly to distance and online learning. This study aims to explore attitude and perception of dental students towards online assessment during pandemic.

Objective: To assess student’s perception, attitudes, and readiness toward online assessment.

Methodology: A self constructed questionnaire including 10 questions was designed with 5 specialists, to improve the design ambiguity. The study was conducted through electronic media.

Results: A total of 270 dental students answered the survey. The overall response rate was 70.68%. More than 50% students are well versed with online assessment. One fourth of the participants found convenience as the advantage while 64.7% students encountered technical issue as the limitation of online assessment. There was overall positive attitude towards usage of online assessment.

Conclusions: This study showed acceptable levels of individual characteristics and system ability levels as well as the perceived importance of using online tools in dental education among the participants.

Open Access Original Research Article

A Descriptive Study on Hematological Changes in Brucellosis Infected Individuals

Hameedullah Safi, Waheedullah Noori

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 390-395
DOI: 10.9734/jpri/2021/v33i60A34498

Background: Brucellosis is a zoonotic organism that causes diseases in both animals and humans. Human contact with infected domestic animals is often a transmission route of Brucellosis infection. This infection affects hematological parameters of the patients. We carried this study to determine the changes in various hematological parameters in our study subjects.

Patients and Methodology:

This study was carried out in Nangarhar regional hospital and safi medical complex on 45 Afghani people from December 2018 up to December 2020. The study design was prospective.

A total of 45 patients (Cases) with confirmed diagnosis of Brucellosis on the basis of serology enrolled in the study. Complete blood count and Erythrocyte sedimentation rate studies are also performed. Considered hematological parameters includes Hemoglobin (Hb), White Blood Cell count (WBC), Platelet count (PLT) and ESR.  As well interview was done with each patient and a questionnaire was used. The collected data was analyzed with Microsoft excel program Autosum statistics. Results. A total of 45 patients were enrolled. The mean age±SD of the patients under the study were (28.74±15.22) years. The most common hematological changes observed were; anemia (57.7%), thrombocytopenia (24%), leucocytosis (13.3%), pancytopenia (24.4%), lymphocytopenia (31.1%), lymphocytosis (55.5%) & leucopenia (40%). Erythrocyte sedimentation rate were elevated in about 66% of patients. Fever and headache were the most common presenting symptoms (73%) and (82%) respectively. Night sweats in (40%), joint pain (53%), muscle pain (53%) and lymphadenopathy in 46% of patients. Conclusion: This result of this study shows that Brucellosis commonly affects people of low socioeconomical states, female sex, uneducated, those consuming contaminated dairy products, peoples living in rural areas and those having consuming or contact with animal. Salmonella typhi causes changes in the hematological parameters due to involvement of bone marrow.

Open Access Original Research Article

In- vitro Hepatoprotective Action of the Crude Extracts of Luffa amara (Whole Fruit) and Rheum emodi (Rhizomes) in CCl4 Intoxicated Rat Hepatocytes

Muna Abid, Zakia Abid, B. Syed Asad, Mohammed Ibrahim

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 396-404
DOI: 10.9734/jpri/2021/v33i60A34499

Aim: The objective of this in-vitro study involves evaluating the protective action of the extracts of L. amara (LA) (whole fruits including seeds) and R. emodi (RE) (rhizomes) at various concentrations on isolated primary rat hepatocytes.

Methods: The pulverised dried whole fruits of L. amara (LA) and rhizomes of R.emodi (RE) were extracted successively with petroleum ether (PE), ethanol (EE) and distilled water (AE) and vacuum dried. These extracts of LA petroleum ether (PE), ethanolic (EE) and aqueous (AE) extracts and RE obtained were subjected to in vitro studies at doses of 25, 75, 100, and 150 µg/ml and silymarin (250 µg/ml) in CCl4 (1%) intoxicated primary hepatocytes monolayer cultures the hepatoprotective action of all the extracts of both plants at different doses was carried out using isolated rat hepatocytes which were subjected to CCl4 intoxication followed by estimating/ measuring the changes in serum biochemical markers – SGPT, SGOT, ALP, Total proteins (TP), total bilirubin (TB), albumin (ALB) and triglycerides (TGL).

Results: Hepatoprotective activity against CCl4 was demonstrated in the rat primary monolayer hepatocyte culture using MMT assay with the ethanolic extracts of both plants showing more hepatocyte protective action compared to the aqueous and petroleum ether extracts by reducing the elevated serum marker levels. Alcoholic and aqueous extracts were found to express more protective action towards CCl4 intoxicated isolated primary rat hepatocytes in a dose dependant manner.

Conclusion: Based on the result, it is suggested that the extract with the most hepatocyte protective action at a dose of 150µg is LA ethanolic extract (viability=88.24%), followed by LA aqueous extract (viability=84.31%), RE ethanolic extract (viability=88.24%) and RE aqueous extract (viability=88.24%) - which are comparable to the reference silymarin with viability at 92.15%. the petroleum ether extracts of both plants showed least hepatic cell viability with LA pet ether extract at 49.02% and RE pet ether extract at 47.85%

Open Access Original Research Article

Isolation of Chemical Constituents and Invitro Antidiabetic Activity of Mirabilis Jalapa Flower Extracts

Deepth D. Kodical, Jennifer Fernandes, Jane Mathew, K. Deepthi, K. Vijay Bhaskar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 412-419
DOI: 10.9734/jpri/2021/v33i60A34501

Objectives: The present work was designed to investigate the phytochemical and in vitro screening of the flower extracts of Mirabilis jalapa.

Materials and Methods: Phytochemical constituents were isolated using column chromatography and characterized of the compounds were carried out using IR, 1H NMR, 13C NMR and mass spectroscopy data. In vitro anti-diabetic activity was evaluated by alpha-amylase inhibition assay and Alpha-glucosidase inhibition assay.

Results: Phytochemical investigation of the ethanol extract revealed the presence of a flavonoid Kaempferol and a triterpenoid Lupeol. In vitro investigation indicated that the Mirabilis jalapa flowers extracts has considerable anti-diabetic activity

Conclusion: The anti-diabetic activity may due to the presence of phytoconstituents like flavonoids, triterpenoids, steroids.

Open Access Original Research Article

A Review on Deviated Nasal Septum: Classification, Clinical Features and Management

Suhani Jain, P. T. Deshmukh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 432-437
DOI: 10.9734/jpri/2021/v33i60A34504

The nasal septum separates the right and left part of the nasal cavity and columellar septum, membranous septum and septum proper are the parts of it. Deviation of nasal septum is a common case of nasal obstruction presented in a clinic. A lot of classifications have been developed to help ease the study of deviated nasal septum but none of them is used as a standard. Some of the classifications include the one given by Vidigal, Guyuron, Cerek, Mladina and Cottle’s. Apart from nasal obstruction other common clinical features involving deviated nasal septum are sinusitis especially in horizontal deviation type V. Pressure on lateral wall by spurs can also cause pressure headache. Due to increased air flow in the nasal cavity, dryness occurs causing epistaxis. Obstruction of nasal cavity causes mouth breathing in return either exaggerating or leading to obstructive sleep apnoea. Septal deviation also effects the choroidal thickness and choroidal blood supply. Histopathologically, lymphocytic infiltration and squamous metaplasia occurs in septal mucosa. These changes occur mostly due to change in the aerodynamic flow. There is decreased cilia movement and inferior turbinate hypertrophy. Thickness of inferior turbinate gains importance while septoplasty as, if thickened a lot, the inferior turbinate demands excision. The deviated nasal septum is associated with sinusitis, chronic suppurative otitis media and Eustachian tube dysfunction. Management involves sub mucus resection or septoplasty. Out of the two, septoplasty is preferred as it is a conservative surgery. Only symptomatic and cosmetically grossly disfigured cases require a surgical treatment while the asymptomatic cases are generally not indicated for surgery. This study tries to review the Classification, Clinical Features and Management of Deviated Nasal Septum.

Open Access Original Research Article

Development of Innovative Gel Sunscreen Products from Momordica cochinchinensis (Lour.) Spreng. Extract

Narin Kakatum, Supalak Fakkam, Meentraporn Donbandranchoke, Jatupat Anuchon, Natphapat Supatsaraphokin

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 484-490
DOI: 10.9734/jpri/2021/v33i60A34509

A study on the development of sunscreen gel products from Momordica cochinchinensis(Lour.) Spreng. extract aimed to study phenolic content, inhibitory effect of Elastase and Tyrosinase, product stability, toxicity, astringent effect of M. cochinchinensis extract, skin elasticity value, suitable product formula calculation for preparing sunscreen gel products from M. cochinchinensis extract, and irritation test. The process started fromthe selection of raw materials, preparation of extracts for determining the total phenolic content, development of suitable formula, test of safety and product physical characteristics, and then test of the anti-allergic effect of 10 volunteers to get efficient and safe sunscreen gel from M. cochinchinensis extract. The study result indicated that M. cochinchinensisaril extract had antioxidant activity DPPH of 1.51±0.05 mg/ml, compared to standard substance - Vitamin C, and total phenolic content of 13.18±0.18 (mg equivalent of gallic acid per 100 g - dry weight). Regarding Cytotoxicity at a concentration of 0.0001-1 mg/ml, it revealed that M. cochinchinensisaril extract was not toxic to human skin cells with the cell survival percentage at a concentration of 1 mg/ml equaled to 95.35±1.86 and 88.15±4.73%, respectively. M. cochinchinensisaril extract concentration of 1 mg/ml had astringent effect which can stimulate human skin cells to move together faster than the control group but showed effect slower than Vitamin C concentrate of 1 mg/ml. and did not have inhibitory effect on Elastase and Tyrosinaseenzymes. Regarding M. cochinchinensis seed oil extract, it did not toxic to human skin cells at the concentration of 0.0001-1 mg/ml with the survival percentage equaled to 105.67-111.46%, and had a few antioxidants activity of unsaturated fatty acids with an IPC50 more than 1000 mg/ml. This study was only the development of sunscreen gel products from M. cochinchinensis extract.

Open Access Original Research Article

Effect of Stress on Mental Health

Medha Rajiv Ranjan, A. Jothi Priya, R. Gayatri Devi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 491-500
DOI: 10.9734/jpri/2021/v33i60A34510

Introduction: Stress can come from any event that makes an individual feel anxious, frustrated, depressed due to the inability to cope with the situation. Stress is caused due to various stressors stimulating responses in the individual's body. The stressors usually increase the potential of the individual to face a stressful situation and overcome it however if the stressors are constantly triggered they can cause physiological damage to the individual. Physiological impact includes high blood pressure, rapid breathing, aches and pains, in severe cases it can also lead to stroke. Stressors can also impact an individual emotionally and mentally by causing insomnia, depression and anxiety. Mental health is the state of the overall well-being of an individual which helps them to overcome anxiety and stressful situations and thereby increases the productivity of the individuals in order to contribute to the society. It is important to maintain good mental health in order to keep the individual healthy.

Aim: The study has been conducted to assess the overall mental health of the study population and thereby suggest ways in which we can deal with stress. Stress and anxiety can be managed by practising yoga, meditation, discussing problems with a counsellor or spending time with family and loved ones.

Materials and Methods: A cross-sectional survey was conducted among the population with a sample size of 100. A self administered structured questionnaire was prepared based on the effect of stress on mental health. It was circulated to participants through an online platform (google form). The statistics were done using SPSS software, chi-square test effect of stress on mental health  was used to check the association and P value of 0.05 was said to be statistically significant. The pros of the survey is that individuals of different lifestyles and cultures were surveyed. This study was conducted among individuals of the age group 14-46 years. Simple random sampling method was the sampling method used to minimise the sampling bias.

Results: The p value obtained from statistical data analysis was 0.02 which is statistically significant. The results revealed that most of the individuals of the study population had experienced stress in their life and some of them were already aware about the ways in which they could overcome stress. This study provided alternate ways to overcome stress and anxiety for individuals experiencing stress in their day to day lives.

Open Access Original Research Article

Physicochemical Characteristics and Thermal Stability of Perilla Seed Oil of Indian Origin

Akriti Dhyani, Priyanka Prajapati, Rajni Chopra, Meenakshi Garg, Priyanka Singh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 501-511
DOI: 10.9734/jpri/2021/v33i60A34511

There is an increasing interest of food scientists in finding new alternatives to PUFA rich edible oil. Perilla seed oil (CPSO), an underutilized oilseed, can be used as an edible oil source. Oil extracted by the cold-pressed method from perilla seeds gives a yield of 36.50%. This study reports the physicochemical properties, the oxidative and thermal stability of the cold-pressed perilla seed oil. The viscosity, specific gravity, refractive index, and smoke point of CPSO were 28 m.Pa.s, 0.92, 1.43, and 241 ℃, respectively. The peroxide, acid, iodine, saponification value, and unsaponified matter of CPSO were 4.81 meq O2/kg oil, 1.61 g KOH/kg oil, 132 g KOH/kg oil, 180 g I2/kg oil, and 0.64%, respectively. It consists of high α -linolenic acid (55.80% of total oil) followed by oleic acid (20.54%). The extracted oil is analyzed for its thermal stability (peroxide value, free fatty acids, p- anisidine value, totox value, and total polar compounds) and storage stability for 120 days in two different storage conditions (refrigerated and room temperature). Despite having high nutritional benefits, the oil stability index (0.50 h) of the perilla seed oil is low, limiting its utilization as a frying oil. Therefore, perilla seed oil requires process optimization to increase its stability during heating.

Open Access Original Research Article

Relationship between Visual Impairment and the Use of Electronic Devices in Kingdom of Saudi Arabia: A Cross-Sectional Study

Nawal Ali Mohd Arishi, Ghada Badr Alghubaini, Manar Salah Ahmed, Rahaf Salah Ahmed, Abdurhman Ahmed Alshikhi, Ali Omar Alshargi, Mohammad Saleh Alzughaibi, Aseel Hussain Alqahtani, Badr Abdulmohsen Aldughather, Abdulrahman Mauafaq Aljifri, Hanaa Mohammed Shabain, Hanan Mohammed Ali Garawi, Abdullah Abdualrhman Basheikh, Faisal khaled Albrkati, Mohammed Shaker Simsim

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 512-520
DOI: 10.9734/jpri/2021/v33i60A34512

Background: Overuse of electronic gadgets has been highlighted as a possible preventable risk factor for eyesight loss. Excessive use of electronic gadgets, on the other hand, has been linked to vision impairment in a variety of ways.

Methods: This was an analytical cross-sectional study to spotlight on the relationship between visual impairment and addiction to electronic devices use. The study's goal was to see if there was a link between Saudis' vision impairment and their addiction to using electronic devices, this is the suitable design for this research. The study was carried out among Saudi population. Data were collected from general population using questionnaire during the period from 22 August to 22 November 2020.

Results: The study included the participation of 344 participants from both genders and different age groups in the Kingdom of Saudi Arabia. There were 211 female participants (61.3%) and 133 males (38.7%) took place in this study. The most prevalent age group was under the age of 25 years (n= 111, 32.3%) followed by the age group 25-35 (n= 104, 30.2%) while the least frequent age group was above 45 years (n= 54, 15.7%). On asking the participants whether they think that they have vision impairment or not, their answers were as follows: yes (n= 156, 45.3%), no (n= 131, 38.1) and maybe (n= 57, 16.6%). Due to the use electronic devices, there were 107 participants complained of headache (31.1%). And this was significantly related to the number of hours spent by study participants using electronic devices (P= 0.002) as well as significant for female gender more than male gender (P= 0.03).

Conclusion: The study showed statistically significant relationship between the number of hours spent on using electronic devices and visual impairment among study participants especially among female population more than male population. There is a need for awareness campaigns to increase health awareness among population to cut down the use of electronic devices.

Open Access Original Research Article

Autoimmune Disease and Chronic Illness in KSA (Cross Sectional Study)

Eman AbdulAziz Balbaid, Miasser Mustafa Alarnaouti, Hoda Jehad Abousada, Sahar Abdulhaq Albloshi, Salma Ali AlAhmar, Sarah Salem Almohammadi, Hanan Misfer Alzahrani, Aisha Zaher AlAbdali, Abdulaziz Abdullah AlHarbi, Abdulelah Ali Asiri, Mohammed Abed Bukhari, Ziyad Sultan Aljohani, Gaith Abdullah Sabrah, Mosaab Mansour Alshaalan, Mawaddah Kamal Yousef

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 527-532
DOI: 10.9734/jpri/2021/v33i60A34514

Background: The shortage of prevalence data based on a representative sample of the general population, as well as the small number of disorders covered in co-morbidity studies, are major issues in autoimmune disease research. In this study, the incidence of autoimmune illnesses in a representative sample of Saudi Arabia's general population is documented, and the hypothesis of an overall relationship between these diseases is explored.

Methods: This was an analytical cross-sectional study to spot light on the prevalence of autoimmune disease among Saudi population. Since the aim of the study was to determine the prevalence of autoimmune disease and their relationship with chronic illnesses among Saudi, this is the suitable design for this research. The study was carried out among Saudi population. Data were collected from general population using questionnaire. Participants were chosen via probability simple random sampling technique. Participants were selected from the general population. The expected number of sample size was 700 participants. However, the study included 802 participants.

Results: The study included the participation of 802 participants from both genders and different age groups in the Kingdom of Saudi Arabia. There were 436 female participants (54.4%) and 366 males (45.6%) took place in this study. The most prevalent age group was 45-54 years (n= 232, 28.9%). There were 199 participants reported having a family history of autoimmune diseases (24.8%). Furthermore, there were 186 participants who are using medications for high cholesterol level (23.2%) with no significant for gender (P= 0.08). Diabetes was prevalent among 203 participants (25.3%), blood pressure disorder (n= 211, 26.3%), ulcerative colitis (n= 137, 17.1%) and other comorbid conditions.

Conclusion: In conclusion, this survey confirm relatively high prevalence of autoimmune disease among Saudi population. In addition, participants suffered from additionally comorbid conditions.

Open Access Original Research Article

Patient’s Knowledge and Attitude towards Post-extraction Instructions Following Permanent Teeth Extraction

Sundar Ramalingam, Mohammed Sulaiman Alsaleh, Nasser Marje Almhidy, Abdurrahman Abdurrazzaq Aljeadi, Omar Mohammed Almosa, Abdulaziz Mohammed Alshehri, Abdulaziz Abdulrahman Almayouf, Abdulaziz Fahad Alosaimi, Abdulrahman Mohammed Aldosari, Mohammed Mansoor Albaker, Abdullah Mansoor Albaker, Rahaf Mohammed Alrefaie

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 533-540
DOI: 10.9734/jpri/2021/v33i60A34516

Background: Post extraction complications may arise if the extraction done is traumatic or the tooth was placed at a difficult position; this could lead to post-extraction complications and knowledge about the prevention of the same is the need of the hour. Hence, the present study was conducted to explore the knowledge of the participants about the prevention of post-extraction complications.

Material and Methods: This was a questionnaire-based cross-sectional descriptive study.

A total of 135 patients (75 males and 61females) were included in the study by the convenient method of sampling that visited the dental clinics of the College of Dentistry, Validated questionnaire was asked about post-extraction preventive knowledge. The statistical analysis was performed by the Statistical Package for Social Science version 21 (SPSS Inc Chicago, IL, USA). The significant value was obtained by using the Chi-Square test and p < 0.05 was set to be significant.

Results: Females more than 50 years of age group had better post-extraction preventive knowledge and there was significant relation (p < 0.05). Socioeconomic level and gender distribution had significant relation with the level of post-extraction preventive knowledge (p < 0.05). The patients who had better knowledge followed their instructions precisely.

Conclusion: It was concluded that female, patients above the middle age group and more qualified patients had more post-extraction preventive knowledge and they also followed the instructions very strictly. The importance of the study came out that dentists and the dental assistants should explain and convince patients to follow proper post-operative instructions to avoid post operative complications.

Open Access Original Research Article

Comparative Study of Safety and Efficacy of Three Different Doses of Fentanyl on Hemodynamic Response to Laryngoscopy and Tracheal Intubation in Patients under General Anaesthesia

Bhavini Shah, Dipanjali Mahanta, Ruchir Sakhrani, Samsuddin Afreen Boat

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 541-551
DOI: 10.9734/jpri/2021/v33i60A34517

Aim of Study: Laryngoscopy and endotracheal intubation are the commonest method for securing a definitive airway for general anaesthesia. It is one of the most invasive and painful stimuli in anaesthesia producing clinically relevant changes in the hemodynamic variables.

This study has been designed to compare the safety and efficacy of three different doses of fentanyl (2µg/kg, 3µg/kg and 4µg/kg) in attenuating hemodynamic response, following laryngoscopy and endotracheal intubation.

Materials and Methods: In this observational study, three groups of 90 patients belonging to ASA grade I and II, aged between 18 to 65

years, including either gender, posted for elective surgery under GA with informed consent. Baseline vital hemodynamic parameters and the serial heart rate, arterial pressures, SpO2 and respiratory rate were noted at five minutes after intravenous fentanyl administration, during laryngoscopy & intubation and at 1-, 3-, 5-, 10- and 20-minutes after laryngoscopy. Ramsay sedation scores were also noted at five minutes after intravenous fentanyl administration, during extubation and at 10-, 20- and 30-minutes after extubation.

Results: There was substantial difference in mean HR, SBP, DBP & MAP values post 5 minutes after intravenous fentanyl administration, during laryngoscopy, at 1, 3-, 5-, 10- and 20-minutes following laryngoscopy and intubation between the three groups. Patients’ behaviour belonging to group C (IV fentanyl 4µg/kg), followed by the patients of group B (IV fentanyl 3µg/kg) presented considerable amount of attenuation of all the hemodynamic stress parameters effectively, with statistically significant results when compared to group A (IV fentanyl 2µg/kg).

Conclusion: Intravenous fentanyl 4µg/kg and 3µg/kg are better at attenuating the laryngo-tracheal stress response, in comparison to intravenous fentanyl 2µg/kg.

Open Access Original Research Article

A Study on the Alleviating Effects of N-phthaloyl-γ-Aminobutyric Acid (P-GABA) on the Behavioral, Histopathological and Biochemical Adverse Effects of Sleep Deprivation in Zebrafish (Danio rerio)

Uthirakumar Devaraj, Tamilarasan Shanmugasundaram, Ammu Ramu, Elumalai Balamurugan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 580-596
DOI: 10.9734/jpri/2021/v33i60A34522

Background: Sleep is defined as a reversible behavioural state of perceptual disconnection from insensitivity to the environment that facilitates the interaction of physiological and behavioural processes. Sleep Deprivation (S.D.) is defined as a decrease in sleeping duration below the recommended minimum, which has been linked to learning and memory problems.

Aim: The primary objective of this work was to determine the effect of P-GABA on metabolic parameters, behavioural changes, whole-body cortisol, and brain histology in light-induced sleep-deprived zebrafish, as well as the optimal dose of P-GABA neutralizing undesirable effects.

Methodology: The present study was conducted for ten days, consisting of three days in a row of sleep deprivation and seven days of treatment with P-GABA. The current investigation used six fishes in a group (n=6).

Group 1: Control ; Group 2: 24h Total SD ; Group 3: 48h Total SD ; Group 4: 72h Total SD ; Group 5: 24h Total SD + P-GABA (100 mg/L) ; Group 6: 48h Total SD + P-GABA (100 mg/L) ;Group 7: 72h Total SD + P-GABA (100 mg/L)

Results: The current study provides scientific data demonstrating the positive effects of P-GABA in treating sleep deprivation and associated cognitive impairment. To test if P-GABA treatment can alleviate the cognitive and memory impairment caused by S.D., we established non-toxic concentrations and treated the zebrafish with a safe dose of 100mg/L. The use of P-GABA increased cognitive performance in the T-maze, demonstrating that it has a favourable effect in a sleep-deprivation condition. The SD group exhibited neutrophil infiltration, and this S.D fish treated with P-GABA at a concentration of 100 mg/L demonstrated a moderate reduction in neuronal cell degeneration compared to controls. The levels of biochemical parameters during sleep deprivation and treatment phase with P-GABA were checked. It was evident from the results that the SOD, CAT and GPX levels in the S.D groups were drastically decreased, whereas treatment with P-GABA could show a significant increase in the levels of biochemical parameters.

In contrast to the control group, zebrafish subjected to sleep deprivation showed enhanced AChE activity in the brain. The results of the P-GABA indicated an anti-AChE profile, which corresponds to improved memory parameters in zebrafish, as observed in the NTT and T-maze tests. When comparing the sleep-deprived fish to the control group, the MDA level, which indicates lipid peroxidation, was higher. Treatment with P-GABA considerably reduced the amount of MDA produced compared to the amount produced in sleep-deprived fish. The cortisol levels gradually increased in the single row 24h, 48h, and 72h sleep deprived groups. There was a gradual decrease in cortisol levels in the groups that received P-GABA treatment. The levels of neurotransmitters were seen to be decreased in the sleep-deprived groups when compared with the control. Upon treatment with P-GABA, the neurotransmitters were restored to near normal.

Conclusion:  This study showed that P-GABA counteracts cognitive performance decrease and anxiety increase resulting from sleep deprivation through a mechanism implying mitigation of brain oxidative stress and regulation of AChE activity.

Open Access Original Research Article

Study of Prevalance of Nephropathy among Sickle Cell Disease Patients in Waghodia Region, Vadodara, Gujarat

Charmi C. Thakkar, Inampudi Sailaja

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 607-613
DOI: 10.9734/jpri/2021/v33i60A34524

Introduction: Sickle-cell disease (or drepanocytosis) is a life-long blood disorder Characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickle cell disease (SCD) has several complications, including chronic renal failure, manifesting with hypertension (high blood pressure) proteinuria (protein loss in the urine), hematuria (redblood cells in urine) and worsening anaemia. Progression to end-stage renal failure confers a poor prognosis.

Objective: The objective of the study was to determine the Prevalence of Nephropathy among sickle cell disease patients.

Materials and Methods: This cross sectional study includes a total 150 participants who suffering from sickle cell anemia and attending our Institute. Renal function test and Urine examination of all participants was done. Estimated Glomerular Filtration Rate (eGFR) calculated using the Cockroft Gault formula. Comparison of results was done between Sickle cell trait and Sickle cell disease Group.

Results: The mean age of the SCA patients were 25.54±10 years. Maximum participants are found to be from age group 25-30 yr(n=35) followed by 20-25 yr(n=30). Of the 150 SCA patients, 89 (59.33%), and 61 (40.66%) were males and females, respectively. The Mean value of S.Creatinine of SCT group is 0.73±0.46 mg/dl and SCD is 1.0±0.35 mg/dl, while the Mean value of eGFR is 134.19±87.21 ml/min and 124.20 ±58.25 ml/min in SCT and SCD Group respectively.

Conclusions: From our study we conclude that the Derangement of Kidney function in sickle cell disease is frequent in our setting especially among young adult. It concerns SCD as well as SCT patients. Albuminuria is more frequent in homozygote patients and its prevalence increase with age. Age ≥ 25 years is associated with high risk of CKD in SCA group and albuminuria in SCD.

Open Access Original Research Article

A Case-Control Study on Risk Predictors Associated with Periodontitis in Systemically Healthy Patients; a Regression Analysis

Hina Mahmood, Sehar Naeem, Uzma Saeed, Ayesha Usmani, Batool zara

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 623-632
DOI: 10.9734/jpri/2021/v33i60A34526

Aim: This case-control study was conducted to analyze the association of periodontitis with risk predictors i.e. age, gender, education status, brushing habits and past dental visits in systemically healthy patients.

Materials and Methods: The study included total of 1097 systemically healthy, non-tobacco using patients with age ≥ 18 years that reported to periodontology department from year 2018. The demographic details and dental care pattern of the patients were extracted from the records of periodontology department, and their frequencies were formulated. The association of five study variables i.e. age, gender, education status, brushing habits and past dental visits was assessed using forward step-wise logistic regression analysis.

Results: Total of 471(42.9%) patients were diagnosed with periodontitis. Higher frequency of periodontitis was observed in patients who were male and ≥ 50 years of age. Regression analysis showed that the subjects with < 50 years of age, ≥ 12 years of education, regular brushing habits and regular past dental visits had greater odds of being safe from periodontitis.

Conclusion: Since the population chosen for this research was systemically healthy, non-tobacco using individuals, a high prevalence (42.9%) of periodontitis was observed indicating the need to analyze the factors other than systemic conditions contributing in prevalence of periodontitis. Furthermore, a positive association between study variables and periodontitis was observed in this research, which will help the clinicians in prediction of periodontitis in systemically healthy, non-tobacco using individuals.

Open Access Original Research Article

Efficacy of Aspergillus sp in the Production of Protease Enzyme with Different Substrates

D. Manimekalai, G. Senthilkumar, V. Ambikapathy, A. Panneerselvam

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 643-653
DOI: 10.9734/jpri/2021/v33i60A34528

In the present study, the soil samples were collected from marine environment of Arichalmunai,  Dhanushkodi, Ramnad District, Tamilnadu ,India. Fungal species were isolated by plating method, in 50% sea water containing potato dextrose agar medium .Totally 16 fungal species were isolated and identified from the soil sample. The production of protease from Aspergillus niger , A.flavus and A. terreus by liquid state fermentation. The production of     protease  enzyme was optimized by using fermentation medium containing different substrates. The maximum protease production was observed on wheat bran, containing medium. The protease production was maximum in temperature 35ºC were recorded. Wheat bran produced the maximum level protease. The optimization work also carried out.  This study revealed that coastal environment provides impressive density of fungi in the East Coast of India and are unexplored  for microbial resources can be useful in industry.

Open Access Original Research Article

Eradication of Helicobacter Pylori with Triple Therapy Comprising Probiotic & Proton Pump Inhibitor

Hina Amjad, Sadia Sundus, . Ata-ur-Rehman, Kiran Khan, Ghazala Nasim Pasha, Muhammad Furqan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 703-709
DOI: 10.9734/jpri/2021/v33i60A34536

Objectives: The current clinical trial compared the effects of conventional triple therapy and probiotic (Lactobacillus reuteri) plus omeprazole combination in peptic ulcer patients. The secondary objectives included estimating the effects of these regimens on safety and tolerability.

Study Design: Randomized clinical trial

Abode and Period of Study: This was a six month research study conducted at the National Medical Centre, Karachi, Pakistan in October 2020 – March 2021.

Materials & Methods: A total of 100 patients were recruited, had baseline positive stool antigen test. All the participants were separated into dual groups: conventional triple remedy (group A1) and probiotic with omeprazole combination (group B1). The study's primary endpoint was stool antigen assay and secondary included change in Hb, LFTs and renal function test.

Results: The primary endpoints for combination therapy led to significantly greater reductions in positive stool antigen assay than triple therapy. This means that combination therapy is far better than triple therapy. The stool antigen test showed 56.5% positive and 43.5% negative in group A1 while in group B1 34.8% positive while 65.2% negative after treatment were seen with statistically significant difference (p=0.036). Insignificant findings were observed for level of Hb, LFTs and renal function test between both groups during the entire study.

Conclusion: This is the first randomized clinical trial in peptic ulcer patients of Pakistan treated with probiotic plus omeprazole combination. Combination therapy was generally well-tolerated and effective in eradicating the Helicobacter pylori after initiation of therapy.

Open Access Original Research Article

Evaluation of Anti-inflammatory and Antioxidant Effects of Punicalagin (Pomegranate Extract) on IL-1 Beta and Superoxide Dismutase Levels in Patients with Chronic Periodontitis – A Randomized Controlled Trial

Tamilselvan Kumar, S. A. Jacob Raja, Johnson Raja James, M. S. Ravi Sankar, P. Fairlin, Dhivya Rajendhran

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 718-726
DOI: 10.9734/jpri/2021/v33i60A34538

Purpose: Pomegranates have been shown to possess anti-inflammatory and antioxidant properties. This study aimed to evaluate the effects of Punicalagin (Pomegranate extract) on IL-1β and SOD levels in chronic periodontitis patients.

Materials and Methods: 30 patients were included in the study. The sites were randomly divided into control site and test site. Control sites were treated with Scaling and Root Planing (SRP) alone and test sites were treated with punicalagin gel along with SRP. Clinical parameters such as probing pocket depth, Clinical Attachment Level (CAL), Gingival Index (GI), Plaque index (PI), Sulcus Bleeding Index (SBI) and biochemical markers such as IL-1β and Superoxide Dismutase levels were compared between baseline and at 21 days post therapy.

Results: Test sites showed significant differences when compared to control sites in relation to all clinical and biochemical parameters.

Conclusion: Within the limitations of this study, there is an improvement in the clinical parameters with an increase in the anti-oxidant marker level and a decrease in inflammatory marker level when punicalagin gel was placed along with Scaling and Root Planing in patients with Chronic Periodontitis.    

Open Access Original Research Article

Knowledge, Perception and Attitude of the Undergraduate Healthcare Students Relative to COVID-19 Infection at a Teaching Institute of Karachi

Ata Ur Rehman, Kiran Khan, Jai Dev Maheshwari, Muhammad Aslam Bhatti, . Kainat, Kashmala Khan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 736-744
DOI: 10.9734/jpri/2021/v33i60A34540

Coronavirus disease 2019 (COVID-19) has been declared a pandemic by the World Health Organization. Efforts are being made all over the world to raise awareness in order to prevent the disease from spreading. The purpose of this study was to assess undergraduate healthcare students' attitudes, perceptions, and knowledge of COVID-19 disease. We conducted a cross- sectional survey in which a questionnaire with 12 questions was transformed online on Google forms and distributed online to healthcare students. Data was collected between May and June of 2021. The convenience sampling technique was used, resulting in a sample size of 926 people. A total of 926 individual questionnaires were evaluated. The findings revealed that the majority of participants learned about COVID-19 through social media and electronic media, which was the most common source of information. The majority of participants stated that older and middle-aged people are more likely to be affected. The protective measure against symptomatic and asymptomatic COVID 19 is N95 and surgical masks, as well as sanitization.

Half of the participants believe that COVID 19 is a bioweapon, and that it affects all religious groups equally. In general, undergraduate healthcare students had a fair understanding of the disease and a favorable attitude toward preventive measures. The government and the public are taking effective measures to combat disease spread; however, there is still a need for additional awareness campaigns and knowledge of safe interventions to combat disease spread.

Open Access Original Research Article

The Outpatient Prescribing Pattern of Sevelamer in Al Seih

Nehad J. Ahmed, Mohd Faiyaz Khan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 751-755
DOI: 10.9734/jpri/2021/v33i60A34542

Aim: The present study aimed to explore the outpatient prescribing pattern of sevelamer in Al Seih.

Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained sevelamer among outpatients in the city of Al Saih.

Results: During 2017 and 2018, 47 patients received sevelamer from the outpatient pharmacy in a public hospital in Alkharj. More than 23 % of the prescriptions were prescribed in January and about 21.28% of the prescriptions were prescribed in May. All of the prescriptions that contained sevelamer were prescribed for the duration of 1 month (100.00%), all of the sevelamer prescriptions were written by residents (100.00%) and all of the prescriptions were prescribed by nephrology department (100.00%). More than half of the patients who received sevelamer were females (60.00%). The age of about 90% of the patients who received sevelamer was more than 39 years.

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

Open Access Original Research Article

The Outcome of Cervical Spine Injury Associated with Traumatic Brain Injuries: Tertiary Care Hospital Study

Sher Hassan, Aurangzeb Kalhoro, Lal Rehman, Abdul Samad

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 763-768
DOI: 10.9734/jpri/2021/v33i60A34544

Objective:  Outcome of cervical spine injury associated with traumatic brain injuries.

Materials & Methods: This study is a cross-sectional descriptive study that was performed at the Jinnah Post Graduate Medical Centre, Karachi. 158 total patients were included in the study, this study by non-probability consecutive sampling. The diagnosis was based primarily on a CT scan brain plain and an x-ray of the cervical spine of all the patients who were admitted to the ward.

Results: Among 158, the age distribution of the patient was observed as 43(27%)patients presented as less than 20 years, 32(20%) were between the age of 21-30 years range, 28(18%) patients were ranged between 31-40 years, 16(10%) patients aged in a range of 41-50 years while 39(25%) were above 50 years. Head injury severity was observed at 47% as mild head injury, 32% as moderate injury and 21% had a severe head injury while cervical injury in association with traumatic brain injury was found in 10% of patients.

Conclusion: The prevalence of cervical traumatic injury associated with moderate to severe head injury remained similar in the world overall with minute differences in the percentages that we have noticed in our study. The severity of the head injury is directly proportional to cervical injury.

Open Access Original Research Article

Role of Ultrasonography and Conventional Radiography in the Detection of Maxillofacial Fractures: A Comparative Study

Ayesha Kamran, Wisam A. Razzak Al-Gorjia

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 776-781
DOI: 10.9734/jpri/2021/v33i60A34546

Objective: With the collaboration of the trauma department, our study was designed to compare the effectiveness of ultrasonography (USG) and conventional radiography in the detection of bony fractures related to oral and maxillofacial regions.

Methodology: This comparative study was conducted from March 2020 to March 2021 by the Radiology department of Sarghoda medical college hospital with the collaboration of the trauma department. Ultrasonography was performed by using GE- USG machine along with a linear extraoral transducer (frequency range 7-15 MHZ). Patients were asked to sit in a seated position facing the sinologist. Transducers were placed over the site by applying the sterile gel.

Results: The overall sensitivity and specificity rate of ultrasonography was reported as 83.33% and 98.88% respectively in all sites whereas the sensitivity and specificity rate of conventional radiographs were reported as 70.24%, 100%. The negative predictive value of USG was reported as 96.17% along with 94.59% positive predictive value. In the contrast, conventional radiography gave a better positive predictive value (100%) than USG In our study we found better results of ultrasonography in terms of sensitivity and negative predictive value.

Conclusion: In conclusion, our study depicts that ultrasonography is an economical, useful diagnostic tool for examining the bony fractures of facial trauma with a better sensitivity rate when compared to conventional radiographs.

Open Access Original Research Article

Maternal and Fetal Outcome in Pregnancy with Sickle Cell Disease in the Third Trimester in Central India: A Retrospective Study

Rashmi Prasad, Mugdha Jungari, Deepti Shrivastava, J. M. Kumbhare

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 782-787
DOI: 10.9734/jpri/2021/v33i60A34547

Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. However, SCD is expected in Maharashtra, especially the Vidarbha region. SCD in pregnancy can cause various maternal and fetal complications. This study was conducted to know maternal and fetal outcomes in pregnancy with sickle cell disease in the third trimester.

Methodology: This retrospective data were collected from hospital records of medical colleges located in central India for one and a half years, from November 2019 to January 2021. Forty-two women were admitted with pregnancy with sickle cell disease in the third trimester during the study period. The baseline characteristics, frequency of sickle hemoglobin variants, and maternal and fetal pregnancy outcomes were collected.

Results: Compiled data were analyzed by simple descriptive statistics and frequency tables. Majority were primigravida (59.52%). Type of sickle cell was determined based on HB electrophoresis; out of 42 patients, 36 had AS pattern, 5 had SS pattern SCD, and 1 had As+b thal minor. The most common medical complication was anemia [73.80%] and UTI 26.19%. The most common adverse obstetric outcomes observed were IUGR/Oligohydramnios 42.85% and pre-eclampsia 21.42%. Majority of patients delivered by LSCS 42.85%. An adverse outcome in the fetus was fetal distress 45.23% and meconium-stained amniotic fluid 42.86%.

Discussion: Due to hematological changes, extra demands, and sickle crisis, complications in both mother and fetus are more common in sickle cell anemia.

Conclusions: Early detection and management of sickle cell anemia during pregnancy can reduce the adverse outcome in both mother and baby.

Open Access Original Research Article

Workforce Diversity and Organizational Performance during COVID-19: Evidence from Pharmaceutical Companies

Ikramuddin Junejo, Saba Shaikh, Jalil Ahmed Thebo, Syed Salahuddin

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 801-808
DOI: 10.9734/jpri/2021/v33i60A34550

The aim of this study is to identify the impact of workforce diversity on organizational performance. For achieving research objectives and testing hypothesis the primary data collected with help of adopted questionnaire. The respondents were considered from Pharmaceutical companies which are operating in Sindh, Pakistan. Sample was consisting of 300. Findings of this study confirmed all proposed hypothesis are found to have significant impact of Gender diversity during covid-19, Age diversity during covid-19, Education diversity during covid-19 and Experience diversity during covid-19 on Organizational performance during covid-19 in pharmaceutical companies. However, new insights of this study revealed that gender diversity during covid-19 has more positive and significant impact with respect to other workforce diversity variables due to higher beta value. For better future performance this study results suggest to top management of Pharmaceutical companies should manage the workforce diversity.

Open Access Original Research Article

The Outpatient Prescribing of Miconazole in a Tertiary Hospital in Riyadh Region

Nehad Jaser Ahmed, Hasan Soliman Yusufoglu

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 816-820
DOI: 10.9734/jpri/2021/v33i60A34552

Aim: The present study aimed to describe the use of miconazole in the outpatient setting of a tertiary hospital in Riyadh Region.

Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained miconazole among patients in a public hospital in Riyadh Region.

Results: Most of the patients who received miconazole were females (89.29%) and the age of 51.79% of them was between 30 and 39 years. Most of the prescriptions were written by residents (96.43%) and most of the prescriptions were prescribed by emergency department (66.07%). Most of the patients received miconazole as vaginal suppository (50.00%) or as cream (39.29%).

Conclusion: The present study showed that miconazole was uncommonly prescribed in in Riyadh Region. Further studies are needed to explore the frequency and pattern of miconazole use as well as to explore the frequency of prescribing other antifungal medications in different settings.

Open Access Original Research Article

Association of Total Ischemic Times and In-Hospital Outcomes of Acute STEMI Patients who Underwent Primary Angioplasty at a Tertiary Cardiac Care Facility

Arshad Ali Shah, Syed Dilbahar Ali Shah, Muhammad Sami Khan, Faisal Ahmed, Iftikhar Ahmed, Fawad Farooq, Dileep Kumar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 827-833
DOI: 10.9734/jpri/2021/v33i60A34554

Aims: To determine the association between total ischemic time and in-hospital outcome of acute ST elevation myocardial infarction (STEMI) patients who underwent primary angioplasty.

Study Design: Prospective observational study.

Place & Duration of Study: Department of Cardiology, Dow university of health sciences Karachi between October 2017 till March 2021.

Methodology: Data for total ischemic time analysis were collected from 366 STEMI patients who consecutively underwent primary angioplasty. Total ischemic time was measured from the onset of chest pain to o the first balloon inflation during primary angioplasty and in hospital outcome was measured.

Results: Total ischemic times were available in 366 STEMI patients which was ≥ 30 minutes and < 24 hours: ≤ 2 hours in 15.5%, >2-3 hours in 11.4%, >3-5 hours in 25.4%, and >5 hours in 47.5% of STEMI patients. In addition, STEMI patients with total ischemic times <5 hours demonstrated complete ST-segment resolution and reduced death rate than those with total ischemic times >5 hours.

Conclusion: This study showed that shorter ischemic times are significantly related to improved myocardial reperfusion and decreased mortality.

Open Access Original Research Article

Prevalence and Patterns of Sport Supplements Use among Gym Attendants and Competitive Athletes in North Cyprus

Deniz Erdağ, Özgür Tosun, Hasan Ulaş Yavuz

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 860-870
DOI: 10.9734/jpri/2021/v33i60A34559

Aims: The purpose of this study was to analyze and compare the prevalence, motivation for use, information and purchase sources of supplements among male competitive team sports athletes and recreational gym users in North Cyprus.

Study Design: The sample size was calculated based on the total population size according to the reports obtained from the gyms and the records of the related federations (soccer, basketball, volleyball) of TRNC. For a confidence level of 95 % and a confidence interval of 2.5 %; the required sample size was calculated as 804. The study covered more participants to ensure the statistical power to remain over 80 %. Calculations were performed with G*Power (for Mac Version

Place and Duration of Study: 8 gyms located in 6 different districts in Northern Cyprus between june2020 and July 2020.

Methodology: A structured questionnaire measuring prevalence and patterns of supplements was administered to 902 participants (329 gym attendants, 562 team sports athletes, 18-40 years old, men). Statistical differences between sex, age group and sports participation were done by using a Chi-square analysis. Differences were considered significant at a p-value <0.05.

Results: Overall, 54% of all subjects reported use of dietary supplements, showing a significantly higher percentage among gym attendants (62%) compared to team sport athletes (50%). The most popular dietary supplement among all subjects was protein (46.9%), followed by amino acids (22.6%), multivitamins (20.7%) and creatine (18.8%). Overall, the most important reasons for using supplements were increasing strength (52%), increasing energy (37.6%), insufficient nutrition (32.4%) and increase durability (32.4%). Trainers were the most common source of information for both groups and overall (33.5%), followed by gym friends for the gym attendants and pharmacies for the team sport athletes (30.2%).

Conclusion: The prevalence was higher among the gym attendants compared to competitive athletes. This finding is in conflict with the related literature. It might be explained by the low level of competition and athletic performance in North Cyprus. The most popular source of information was trainers in our study and these findings were in compliance with the related literature.

Open Access Original Research Article

Nomophobic Prevalence and Academic Achievement of Higher Secondary Students Practicing Blended Learning during COVID-19 Pandemic

Jijish Elias, P. M. Jayalakshmy, K. Jayaraman, M. Mirunalini, Issac Paul

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 871-877
DOI: 10.9734/jpri/2021/v33i60A34560

Introduction: Smartphone usage for academic and non academic processes increased among the adolescent students, especially among Higher Secondary students. This increased usage developed a kind of addiction among them towards the smartphones and other mobile gadgets. The mode of delivering learning experiences also changed due to the pandemic and this makes the need of the current study.

Aim: To identify the smartphone addiction termed as nomophobia and academic achievement of higher secondary students during blended learning activities which known for the mixing of appropriate theories, methods and technologies to optimise learning in a particular context.

Materials and Methods: A standardised nomophobic rating scale utilised to check the extent of smartphone addiction among the higher secondary students. Their academic achievement is identified using an achievement test in the relevant subject. The higher secondary students from Kerala constitute the population of the current study and 30 among them practicing blended learning activities are selected for the study in a convenient manner.

Results: The results show that students are more prevalent to the smart phone addiction during the blended learning process. The male students show a higher level of smartphone addiction when compared to their female counterparts while academic achievement does not differ with respect to gender. Locality of the higher secondary students has no significant role on their nomophobic prevalence and academic achievement.  Nomophobic prevalence correlated negatively with academic achievement but not at a significant level.

Conclusion:  This study reveals the major issues about the need for adequate supervision of adolescent mobile phone usage especially during blended learning. It also emphasises the need and importance of timely interventions from teachers, parents, and professionals as the learning process shifted to blended methods after the pandemic among higher secondary level.

Open Access Original Research Article

Addition of Cognitive Behavioral Therapy with Motor Control Exercises on Pain and Function in Elderly Individuals with Chronic Low Back Pain

Shenbaga Sundaram Subramanian, Riziq Allah Mustafa Gaowgeh, Thamer Ahmad Altaim, Ziyad Neamatallah, Saad S. Alfawaz, Mikhled F. Maayah

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 898-903
DOI: 10.9734/jpri/2021/v33i60A34564

Introduction: Low back pain is a common, disabling, costly medical problem in most countries. CLBP is one of the most frequently reported conditions affecting the older adults. Numerous studies have also documented the associations of pain-related beliefs and appraisals with pain intensity and related problems, including depression, physical disability, and activity and social role limitations. Recently there is an increased attention to the role of cognitions in mood, anxiety, and other psychological disorders sparked interest in incorporating cognitive therapy techniques into behavioral therapies for chronic pain. CBT is a form of psychological therapy. It focuses on actions are the behavioral part. CBT is a feasible treatment for cognitively intact, older persons with CLBP, and may be efficacious as well. The aim of the study is to analyze the effect of cognitive behavioral therapy with Motor control exercises programme on CLBP.

Methods: Study is an experimental study design includes 40 patients with CLBP with more than 6 months duration. 20 participants underwent motor control exercises with moist heat pack and 20 participants underwent motor control exercises with cognitive behavioral therapy and moist heat pack. Study was conducted for 8weeks of duration and the outcome measures were pain and disability which was measured using numerical pain scale and Oswestry disability index.

Results: The between group comparison was made using the unpaired t test and the results were found to be 10.15 ±0.502, at the 95% of the Confidence intervals for disability. The between group comparison was made using the unpaired t test and the results were obtained are 7.47 ± 0.22, at the 95% of the Confidence intervals for Pain.

Conclusion: The study concluded that motor control exercises with cognitive behavioral therapy were significantly effective in reducing pain and disability. 

Open Access Original Research Article

Analysis of White Blood Cell Count and Its Differential Count in Gingival and Periodontal Conditions Associated with Bleeding Gingiva

L. Sai Charan, Palati Sinduja, R. Priyadarshini

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 911-917
DOI: 10.9734/jpri/2021/v33i60A34566

Background: Bleeding gingiva is caused primarily due to the accumulation of plaque and calculus which eventually leads to gingivitis or periodontitis. Other causes of bleeding gingiva can be due to improper flossing, over brushing of the teeth and gingiva, hormonal changes due to pregnancy, ill-fitting dentures and any other dental appliances impinging the gingiva. The bleeding gingiva can also indicate serious health problems like leukemia, scurvy, idiopathic thrombocytopenic purpura, vitamin k deficiency and any bleeding disorder. Persistent gingival bleeding is a sign of serious medical problems like leukemia and platelet disorders. Leukemia is a group of cancer where there is an increased number of immature or abnormal white blood cells. In this study, the WBC and their differential count is analyzed in patients with bleeding gingiva to check the possibilities for the patient to get cancer.

Aim: To measure and observe the WBC count and its differentials by testing the blood from patients with bleeding gingiva.

Materials and Methods: The study was conducted in the clinical pathology lab at Saveetha Dental College and Hospitals, Chennai. 100 subjects were subjected to the study. Subjects with chief complaint of bleeding gingiva, without systemic diseases like diabetes, hypertension, and patients with the age of above 10 were included in the study.

Results and Conclusion: This study was conducted to analyze the WBC count and differential count among the patients with bleeding gingiva. No significant correlation was found between bleeding gingiva and white blood cells & their differential count in this study.

Open Access Original Research Article

Knowledge, Attitude, and Practice Analysis among Rural Mothers of 6 to 24 Month Age Child Regarding Complementary Feeding

N. T. Katole, J. S. Kale, Meghali Kaple, S. M. Waghmare

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 918-926
DOI: 10.9734/jpri/2021/v33i60A34567

Introduction: According to WHO, exclusive breastfeeding is essential for first 6 moth of life, afterward by six months to meet raised energy and nutrient needs of growing infant complementary feeding is necessary [1]. Proper complementary feeding very essential for the proper physical, neurocognitive development of the child.

Objectives: To assesses the knowledge, attitude, and practice among rural Indian mothers of age 6 to 24 month child regarding complementary feeding.

Methods: This cross-sectional analysis study was conducted at a tertiary care teaching rural hospital in India between December 2020 and June 2021. A self-administrated questionnaire was distributed to mothers of 6 to 24 month age children attending pediatrics outpatient department at hospital. The questionnaire consisted of 3 parts; first part consist of demographic variables, second and third part regarding knowledge, attitude and practice of mother towards complementary feeding practice. SPSS 21 was used for data analysis.

Results: Out of the 250 participants, 220(88%) completed questionnaire completely and validly, 96% mothers initiated breastfeeding within first 48 hrs of birth, and about 62% mothers continue exclusive breastfeeding till six moth age. 72 % mother knew that complementary feeding should start at 6 month of age but only 66% mother able to start at that age, major reason for delayed start is mother perception that her feeding is sufficient for baby, other that family member’s advice. 64% mother believe in homemade complementary feeds and 26% mothers believe in commercial feeds, though major source of knowledge is family members (69%), electronic media(12%) also important source of knowledge while only 19% mothers get information from health professionals. Significant number of mother have knowledge about iron rich foods(63%), iodized salt (50%) etc. however only 36% mother knows about dietary diversity. During illness 52% mothers prefer to decrease in feeding while, 10% prefer to withhold it. 91% mother practice washing hands before cooking and 85% practice giving boil water to baby. However, still 70% mother practice bottle feeding for their children’s.

Conclusion: Though there is good knowledge among mothers regarding exclusive breastfeeding, complementary feeding in term of age of start, type of feeding, nutrient value of feeding, importance of consistency, however still there is lack of knowledge about dietary diversity, cultural and social food taboos, bottle feeding etc. Strategies need to employ like health education, awareness programs, training programs for mothers to improve their practice and attitude towards complementary feeding.

Open Access Original Research Article

The Burden of Disease and Risk Factors of Iron Deficiency Anemia in Preschool Children Attending the Well-Baby Clinic in the National Guard Primary Health Care Centers in the Western Region of Saudi Arabia

Razaz Mohammed Wali, Abdulaziz Saeed Baghlaf, Abdulaziz Abdullah Almehmadi, Mohanad Gharmallah Alzahrani, Obada Tarik Fathi, Yasser Nasser Aloufi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 940-947
DOI: 10.9734/jpri/2021/v33i60A34570

Aims: To estimate the burden and risk factor of Iron Deficiency Anemia (IDA) in preschool children attending well-baby clinics in primary health care centers of the National Guard in Jeddah.

Study Design: Cross Sectional study design

Place and Duration of Study: This study was carried out in the primary health care centers of the National Guard Hospital in Jeddah, Saudi Arabia, which are the specialized polyclinic namely Iskan clinic district and Bahra Clinic. The study was started on 26 September, 2018 to January 2020.

Methodology: A cross-sectional study included all preschool children aged 2-5 years attending well-baby clinics. Data were collected by distributing a self-developed and validated questionnaire to parents or guardians in waiting areas outside the well-baby clinics.

Results: A total of 286 participants met the inclusion criteria. Anemia was found in 9.8% children. The prevalence of IDA among the participants was only 6.3%, but it was the most common compared to other types of anemia. The only findings that were found statistically significant with anemia were family history (P = 0.001) and use of supplement (P = 0.000).

Conclusion: IDA is still the most prevalent type of anemia; however, it was found in only 6.3% participants. The only statistically significant factors associated with anemia were positive family history and supplement intake.

Open Access Original Research Article

Protocol for RCT: Effectiveness of Traditional Breast Stimulations as Adjuvant Techniques to Breast Milk Expression on Lactational and Maternal Outcomes

Lt. Col. Asha K. Abraham, Archana Maurya, Gauri Dhopavka

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 983-991
DOI: 10.9734/jpri/2021/v33i60A34575

Background: Mothers of infants who are dependent on expressed breast milk often find difficulty to express adequate quantity of breast milk to ensure exclusive breast feeding to their babies and it has become a major stress factor among these mothers. Many cost-effective adjuvant techniques are proved to be very useful in improving the quantity and quality of expressed breast milk.

Objective: To determine the effect of two traditional breast stimulation techniques such as warm compress and breast massage as adjuvant to breast milk expression on maternal and lactational outcomes.

Methodology: A hospital-based cross over trial will be considered to compare the effects of two interventions such as breast massage and warm compress, adjuvant to breast milk expression method (breast pump) on lactational outcomes (Quantity and quality of expressed breast milk) and maternal outcomes (Nipple pain, anxiety and experience of breast milk expression). The setting of the study will be selected tertiary level hospital of New Delhi. Approval from Institutional the Ethical approval is obtained from Institutional Ethical Committee, DMIMS (DMIMS (DU)/IEC/2017-18/6979) and also from the institutional ethical committee of armed forces medical services hospital of New Delhi where the study will be conducted. The data collected will be entered to an electronic data sheet and analysis will be done using SPSS.

Expected Results: There will be a positive impact of interventions on locational outcomes such as quantity of expressed breast milk and quality of expressed breast milk.

There will be a positive impact of interventions on maternal outcomes such as nipple pain. Anxiety and breast milk expression experience.

This nurse led interventions will be made as a part of hospital policy to provide routine care to the mothers who are expressing breast milk in hospital settings.

Conclusion: Conclusion will be drawn after the analysis of data collected from the predetermined sample size. The findings of the study will be published in an open access peer reviewed journal.

Open Access Original Research Article

Preparation and Characterization of New 1,3,5-Trisubstituted-2-Pyrazolines Derivative for their Anti-Inflammatory Activity

Jitendra Kumar Chaudhary, Alok Pal Jain, O. P. Tiwari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 992-1004
DOI: 10.9734/jpri/2021/v33i60A34576

The objective of the paper was to design, synthesis and characterization of new 1,3,5-trisubstituted-2-pyrazolines derivative and evaluate for anti-inflammatory potential. The 1,3,5-tri-substituted-2-pyrazolines derivatives has been synthesized by the reaction of chalcone     derivatives with 4-hydrazinylbenzene sulfonamide hydrochloride and phenyl hydrazine hydrochloride. Total Sixteen compounds has been synthesized and characterized by the IR, 1HNMR and mass spectral analysis. Proposed compounds have been evaluated for anti-inflammatory activity. Anti-inflammatory activity of the compounds carried out by two animal     model i.e. Carrageenan induced, paw edema in rats and Inhibition of formalin induced paw edema in rats. Anti-inflammatory activity of the compounds C7, C8 and C2 were shown 98.26,  92.77 and 96.24 percentages of inhibition and compounds D7, D8 and D2  were shown 81.50, 83.81 and 78.32 percentages of inhibition as compared to the standard drug Diclofenac at 10 mg/kg was inhibit the inflammation 99.42 % after 6h. These result is a evident that synthesized compounds show relevant degree of anti-inflammatory activity as compared to the standard drug. It is also concluded that the presence of SO2NH2 group, Cl, CH3, OCH3 and N(CH3)2 group may provide the active compounds when attached to the pyrazoline group. But the addition of OH, Br and no substitution in phenyl ring may diminish the activity. 

Open Access Review Article

A Comprehensive Study on Environmental Pollution and Pregnancy Outcomes

Abhishek Adkine, Kalyani Mahajan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 41-47
DOI: 10.9734/jpri/2021/v33i60A34452

Vehicular traffic contributes significantly to the pollution of air and neighborhood noise. Since there is increasing affirmation that ambient air pollution hurts reproductive health, which is less known regarding the relationship between traffic noise and pregnancy outcomes. Many researchers have investigated all the possible adverse effects of ambient air pollution on birth outcomes during the last decade or so. We examined these studies, which were discovered by thoroughly searching the major scientific databases. Overall, research suggests that air pollution and noise pollution significantly impact birth outcomes, while the quality of the deposition varies. Researchers utilized connected administrative health data sources to discover pregnancy outcomes with detailed covariate data (gender, contemporary lifestyle, total no of pregnancies, birth month and year, and so on), earnings and education, and mother housing history. Using the deterministic model (CadnaA) and air pollutants exposure, they assessed noise exposure during pregnancy by assessing temporally adjusted land-use regression. Noise exposure is related to reduced birth weight. We also looked into various processes to prevent air pollution and noise. As a result of the policy change and technical innovation, the government, authorities, and industry have been at the forefront of combating pollution. Pollution levels in and around people's homes and workplaces are typically beyond their control. However, few things may be done to mitigate the impacts of contaminated air.

Open Access Review Article

A Review on Otitis externa: An Approach to a Etiopathogenesis, Epidemiology, Clinical Features and Management Protocol

Jatin Gupta, Sagar Gaurkar, Sonal Gupta

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 59-65
DOI: 10.9734/jpri/2021/v33i60A34455

Introduction: The external ear is the part of our ears which is seen from outside. It is made up of the auricles (pinna) and external auditory canal; and, includes the outer wall of the middle ear, i.e. the eardrum. Otitis externa is a regular presentation when on call for ENT or at the emergency ENT health clinic or centre. Infective and reaction groups of otitis externa are classified.

Methodology: The articles reviewed in this narrative review article have been traced from a variety of links and sources over the internet like PubMed, NCBI, ScienceDirect, NHSINFORM, Uptodate, WebmedCentral, American family physician, ClevelandClinic, StatPearls, and many more. References from high yielding sources were taken and the articles were properly assessed.

Results: Paying attention to the scientific elements while performing an operative procedure can  give a physician extended results. Which operative modality to be chosen depends on the patient. The patient’s choices are also important in the decision making of the operation.

Discussion: External otitis is possibly spotted in almost every peer category. Approximately ten percent (10%) of humans may face this condition during their lifetime. Most of the time, the infection is mixed. Medical intervention of the ear can prove painful for most cases, therefore, post-surgery analgesics must be utilized for a time period which the treating physician prescribes. The aim of curing the patient is to free him/her from the symptoms and getting rid-off any pathogen causing a specific infection.

Conclusion: The efficacy of operative modalities of extremes of otitis externa will rely on complete patient examination, history and lab results. Selection of the correct intervention, proper knowlege of the regional anatomy, paying attention to scientific elements and good post-operative care is necessary. It is never easy  to avoid otitis externa, but we can make an effort to decrease the risk of developing this problem.

Open Access Review Article

A Brief Review on Viral Variants of COVID-19 Infection

Ishank Panchal, Sunita Vagha

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 73-80
DOI: 10.9734/jpri/2021/v33i60A34457

SARS is a type of acute respiratory syndrome. Coronavirus 2 (SARSCoV2), highly contagious, affecting people worldwide. Coronavirus Disease 19 (COVID19) leads to a rapidly spreading respiratory distress syndrome. It has caused a global pandemic and severe health crisis in most countries. Due to its continual evolution, further research into the virus's pathogenicity and virulence mechanisms and the development of efficient therapy techniques are urgently required. The current paper summarises what is known about the virus's evolutionary and structural features to comprehend better its mutational pattern and probable role in the current pandemic. In December 2019, the Coronavirus Disease (SARSCoV2) began a destructive path toward a global pandemic in Wuhan, China. Since then, several SARS CoV2 variants have been discovered. Despite the speedy development of a COVID19 vaccine and ongoing mass vaccination efforts around the globe, the discovery of the latest SARSCoV2 variants could undermine the substantial success till now in stopping the spread of SARSCoV2.This review aims to characterize the different SARS CoV2 mutations and investigate the associated morbidity and death.

Due to the virus's steady improvement, with its various unmarried nucleotide polymorphism (SNP) versions and lineages, figuring out SARS-CoV-2 infectivity is extraordinarily hard. but, similarly research into the virus's pathogenicity and virulence mechanisms, as well as the improvement of green therapy strategies, is urgent present-day The present day contribution summarises existing expertise regarding the virus's evolutionary and structural homes to clarify its mutational sample and ability function inside the ongoing pandemic.

Open Access Review Article

Pathophysiology of Complication in Diabetes Mellitus

Rohit Vaswani, Samarth Shukla, Sourya Acharya

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 89-95
DOI: 10.9734/jpri/2021/v33i60A34459

Blood sugar levels are elevated in diabetes mellitus (DM), the most prevalent metabolic disorder. Insulin deficiency or ineffectiveness is the primary cause of hyperglycemia, affecting carbs and protein, and fat metabolism. Diabetes mellitus can be of two types, type 1 and type 2. Apart from this, a certain amount of people suffers from prediabetes. Type 1 diabetes insulin-dependent dent diabetes happens when the pancreas produces less or no insulin, so these patients require insulin doses frequently. A patient has type 2 diabetes if the cells don’t respond to insulin. This is the most common kind of diabetes and affects 95% of people with diabetes. It is an insulin-independent type of diabetes. Nearly every organ in the body is affected by DM. Microvascular and macrovascular problems are caused by diabetes mellitus. Nephropathy (disease of the kidney), retinopathy (eye damage), and neuropathy (nerve damage) are examples of microvascular complications, whereas macrovascular complications include blood vessels, arteries, and veins, e.g., peripheral artery disease, cerebrovascular events, etc. Retinopathy is a visual manifestation of end-organ damage. Neuropathy is of two types: symmetrical and asymmetrical. Symmetrical neuropathy is primarily sensory and autonomic, whereas asymmetrical neuropathy may be sensory, motor, or both. Diabetes is a long-term medical condition, and no medications are available to treat the secondary issues in today’s market; it cannot be cured but may be controlled by a healthy lifestyle. Continuous, frequent glucose hemostasis is critical.

Open Access Review Article

An Association between COVID-19 and Diabetes Mellitus

Aaditi Bansod, Ashish Anjankar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 103-111
DOI: 10.9734/jpri/2021/v33i60A34461

Coronaviruses are a large group of viruses accountable for initiating severe acute respiratory syndrome  (SARS), Middle East Respiratory Syndrome (MERS), Common Cold, etc. Studies have found a certainly available development severity about covid epidemic over rising in blood glucose level sufferers. There is the effect of functioning dextrose equilibrium, rawness, change-resistant level together with a start regarding this peptide-aldosterone method (RAAS) caused by possible infective connection in the middle of  SARS-CoV-2 along with insulin-dependent diabetes. Your chance regarding come to have extremely unwell against SARS-CoV-2 live probable via occurring minor whether you all are blood glucose level crop up controlled. Experience coronary illness either more difficulty over inclusion on rising in blood glucose level would intensify this likeliness on obtaining solemnly sick by SARS-CoV-2, similar to another fervid contamination, on account of additional compared to only situation build that solid as you all are physique directed toward opposing this contamination. Growing contamination would too expand swelling, either inner bump, rising humans accompanied by a rise in blood glucose level, above-target blood sugars can also be the cause of that, and more severe complications can happen due to that inflammation. Instead of the other side, recently developed rise in glucose blood level and extreme catabolic difficulties regarding the previous rise in blood glucose level, as well as ketoacidosis diabetic including non-ketotic hyperglycemia considering whichever unusually excessive shots regarding hypoglycaemic agent come about validate, turned out to be seen within sufferer of SARS-CoV-2. In Hindustan throughout this, another upsurge regarding this SARS-CoV-2, seeing that unparalleled gush over patient regarding black fungus took place were seen: resistance down-regulation give rise to Covid-19 along with this utilization regarding effective against a wide range of organisms along with glucocorticoids-specific convalescent which is a dully restrained rise in blood glucose level along the ketoacidosis—are to be expected be obliged to come up with up to mutiny. SARS-CoV-2 comes behind alongside black fungus shore extreme risk bloodshed rate along with opportune observation, fungicidal treatment, cruel incision, the usually surgical removal of lacerated left important element of this operation.

Open Access Review Article

Cholinesterase Inhibitors Used for the Management of Alzheimer’s Disease: A Review

Aayushi Singh, Asha Jha

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 121-128
DOI: 10.9734/jpri/2021/v33i60A34463

Alzheimer’s disease (AD) is defined as a progressive neurodegenerative disorder that has lately become the top reason for dementia in the elderly population (usually above 60-65 years). As mentioned before, most AD cases are sporadic and have a late onset. This disease is characterized by impairment of higher cognitive functions like deficits in memory, language comprehension, coordination, etc. The primary pathophysiology behind Alzheimer’s disease is loss of cholinergic innervation due to the formation of neuritic (senile) amyloid-beta plaques and tau protein-containing neurofibrillary tangles (NFTs) in parts of the brain associated with memory functions. These neurofibrillary tangles (NFTs) and amyloid β plaques can cause the induction of other aetiologies of Alzhedisease-likes like neuroinflammation and central hyperexcitability. The brain's main regions affected by Alzheimer’s disease are the neocortex, the basal nucleus of Meynert, and the hippocampus. These areas are associated with higher cognitive functions like memory, arousal, attention, sensory processing, etc. Thus, cholinesterase inhibitors have been widely used as first-line drug therapy for symptomatic relief in Alzheimer’s disease. They function by inhibiting acetylcholinesterase or catabolizing it and henceforth enhancing synaptic availability of Acetylcholine. The commonly prescribed drugs of this class include donepezil, galantamine, physostigmine, metrifonate, and rivastigmine. This article will discuss the widely used cholinesterase inhibitors (old & new) for managing AD symptoms in detail.

Open Access Review Article

A Review on the Antioxidant and Antiaging Properties of White Tea

Deepak B. Somavanshi, Priyadarshani R. Kamble, Chandrashekhar D. Patil, Shivraj P. Jadhav, Ganesh B. Sonawane

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 129-136
DOI: 10.9734/jpri/2021/v33i60A34464

The present review explored to extend the current knowledge by highlighting the antioxidative and antiaging profile of white tea. White tea, the least processed of the teas, is one of the least investigated and has the highest phenolic content. The white tea has a great potential on the skin for cosmetics and the for better skin physiology. Tea polyphenols, particularly catechin derivatives, are powerful antioxidants that benefit human health. Because of their potential to scavenge free radicals and thereby prevent oxidative stress, antioxidant components have piqued interest. In this context, several studies have revealed antiaging activity of white tea, as it involved in preventing aging and other age-related disorders. White tea delays the process of aging and improves the longevity of life. This manuscript provides a summary of various bioactive components present in white tea along with the different alkaloids, enriched with (-)-epicatechin (EC), (-)-epigallocatechin (EGC) and (-)-epigallocatechin 3-gallate (EGCG), which are responsible for their health-promoting and antiaging properties.

Open Access Review Article

Role of Folic Acid in Type 2 Diabetes

Akshunna Keerti, Jayshri Jankar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 137-143
DOI: 10.9734/jpri/2021/v33i60A34465

The metabolic condition known as diabetes mellitus is marked by hyperglycemia, a host of symptoms affecting the heart, kidneys, nerves, and other organs. Diabetes nephropathy is one of the leading causes of diabetic impermanence and morbid state. Low parameters of pteroylglutamic acid in the blood are associated with Diabetic Nephropathy, whereas endothelial dysfunction increases the risk for T2D.

Endothelial dysfunction is associated with diabetes, which perhaps is caused by the disjunction of the endothelial nitric oxide (NO) synthase enzyme, which reduces NO availability. Because folic acid can repair the disjunction of NO synthase, we sought to see if pteroylglutamic acid supplementation may affect the function of the endothelial layer and inflammatory indicators in type 2 diabetes patients who did not have vascular disease.

Recent studies have shown that pteroylglutamic acid also has direct benefits on the function of endo, in addition to its natural function of lowering homocysteine. Folic acid might serve as a "biomarker" for the function of endothelial cells. Many mechanisms have been linked to higher total homocysteine levels and type 2 diabetes risk in diabetic patients. Higher folic acid levels altered endothelial-dependent vasodilation in T2D patients. In patients with coronary heart disease (CAD), folic acid supplementation has been found to reduce homocysteine parameters and improve the function of the endothelial layer. On the other hand, RCTs looking at IR and T2D outcomes have shown mixed results.

Several mechanisms link higher total homocysteine levels to increased risk of insulin resistance (IR) and type 2 diabetes mellitus (T2D). Treatment with folate has been shown to bring down homocysteine parameters and improve the endothelium functions in people with coronary heart disease (CAD). Randomized controlled trials (RCTs) on IR and T2D outcomes, on the other hand, have produced a wide range of results.

Open Access Review Article

Effect of COVID-19 Infection in the Patients with Diabetes Mellitus

Aditya Anand, Varsha Pande

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 163-170
DOI: 10.9734/jpri/2021/v33i60A34469

Background: Coronavirus is pandemic virus infection which has recently affected the globe, and as a result, in patients with non-communicable diseases, the associated morbidity and death are substantially greater. One of the most common non-communicable diseases linked to worsening clinical conditions in corona virus patients is diabetes mellitus (dm).

Covid-19 is a zoonotic illness that was firstly found in wuhan city of china, and is now recognized a zoonotic disease that spreads from moist animals to people in 2019. The disease has a low fatality rate and only affects the most seriously ill patients. Approximately 80% of the cases involve patients who are seriously to moderately ill. Since the outbreak of the disease, the number of people who have died has continuously increased.

Summary: The aim for this study is to determine the receptors involved in diabetes and the pathogenetic relationship btw. Covid-19 and diabetes. Both diseases are characterized by inflammation and the release of inflammatory markers. The roles of angiotensin-converting enzyme molecule and dipeptidyl peptidase in covid-19 and diabetes have been investigated. The effects of glucocorticoids and catecholamines, invasion of pancreatic islet cells, medications used to treat covid-19, and hence the lockdown policy, may have a deleterious impact on diabetes patients' glucose control. The results of covid-19 research involving diabetic and non-diabetic patients were also examined. Various medication trials, such as the dapagliflozin and linagliptin trials are still being conducted to see if certain medications are suitable for diabetic people with covid-19.

Conclusion: Diabetes is a risk factor for covid-19 patients, according to the data, leading to their severity and mortality. This article also contains guidelines and recommendations that may be useful in the management and avoidance of diabetic individuals who are infected with covid-19.

Open Access Review Article

Ear Wax and its Impaction: Clinical Findings and Management

Varun Agrawal, P. T. Deshmukh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 176-182
DOI: 10.9734/jpri/2021/v33i60A34471

Cerumen, sometimes known as "earwax," is a natural material that cleans, coats, and smooths the external auditory canal. It is the most common cause of ear canal obstruction. While cerumen blockage of the ear canal is usually painless, it can result in a variety of implications, for example, loss of hearing, tinnitus, overflowing, itching, otalgia, discharge, odour, and cough. Ear wax becomes a concern only when it causes hearing loss or other ear-related ailments. Cerumen build-up can arise for various causes, including an inability to self-clear, overproduction or underproduction of its essential components due to delayed skin movement, or mechanical difficulties such as usage of cotton buds or hearing aids. Wax can obstruct the understanding and view of the tympanic membrane and must be gone for investigative purposes or to take imprints before installing hearing support or creating earplugs. Cerumen impaction is usually innocuous; however, it might be associated with more significant symptoms. The removal of affected cerumen is typically regarded safe. However, as eardrum tear, canal laceration, and unsuccessful ear wax elimination. These dangers can be reduced by recognizing risky individuals and customising care measures to their specific needs. All common cerumen removal strategies are Cerumenolytics (ear wax emollient agents), irrigation, and manual elimination. It is also prudent not to interfere if asymptomatic individuals and tympanic membrane visualization are not required.

Open Access Review Article

Astigmatism in Infants: Study of Changing Visual Axis in Infants and Children

Nidhi Sohrot, Indrayani Jhadhav, Sohan Lohiya

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 187-193
DOI: 10.9734/jpri/2021/v33i60A34473

Background: Astigmatism is an abnormality within the curvature of the attention. It occurs when light rays strike a spherical lens obliquely, or the line of vision to its principal axis is not parallel. Refraction away from the axis occurs when light strikes a lens obliquely and distorts the image formed.

Aim: This study aimed to look at the prevalence of against-the-rule, with the-rule, and oblique-axis astigmatism in children. The change in cylinder index of refraction power and alignment of astigmatism in babies and young children is studied.

Methodology: To conduct the study and thoroughly search the literature separately, references and abstracts were reviewed. Books like Parson’s diseases of the Eye by Dr. Radhika Tandon and several articles, WHO website, etc., were referred.

Results: The study relied upon many studies on refractions procured by the near-retinoscopy methodology that knowledgeable Refractionist accomplished.

Conclusion: It can be concluded that young children have a high incidence of against (???) type of astigmatism and that after this age (which age?), most children are with the rule.

Open Access Review Article

Chronic Rhinosinusitis’s with Nasal Polyps

Tanishq Dubey, Prasad Deshmukh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 198-205
DOI: 10.9734/jpri/2021/v33i60A34475

Chronic Rhinosinusitis is a chronic disease that negatively affects the quality of life. When associated with nasal polyps, there is worsening of the condition, and it becomes harder to treat due to the high rates of recurrence and the increased morbidity rates. Though having a set treatment method, the condition still has unknown etiology and pathophysiology, which makes it extremely hard to diagnose and evaluate. Due to these unknown factors, treatment is still not as precise and effective; we still rely on systemic drugs like corticosteroids which most often do not resolve the disease, and we then present surgical options, though effective still do not pose as an effective cure, which may be a factor in the high rate of recurrences. However, there have been giant leaps in the specialized research of this particular topic, leading to classification through biomarkers allowing us to study and consolidate data on the disease pathology and all of the different options causing recurrences, which further enhances our understanding of how this disease affects a diverse population. The majority of the treatment given in this disease is not evidence-based but instead based on clinical observation and experience. Therefore, with CRSwNP, we are confronted with more questions than answers, which is problematic as the disease can often be associated with comorbidities leading to a further decrease in quality of life. Hence, this review article aims to aggregate and compile this valuable research and highlight the strides which have already been made while promoting additional research so that the disease can become more manageable without any recurrence.

Open Access Review Article

A Prospective Study of Urinary Albumin to Creatinine Ratio and Its Associated Causes

Jayamathi Govindaraj, U. Vidhya Rekha, Keerthidaa Govindaraj, S. Bhuminathan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 206-210
DOI: 10.9734/jpri/2021/v33i60A34476

Urine albumin-to-creatinine ratio have predictive values for hypertension, diabetes mellitus, renal dysfunction etc. Albumin-to-creatinine ratio represents the severity of proteinuria,  indicates high probability of damage to glomerular filtration capacity of the kidney and is of great diagnostic relevance. Emerging data suggested that reduction of albuminuria leads to reduced risk of adverse renal and cardiovascular events but also steps should be taken to suppress albuminuria to prevent future renal and cardiovascular adverse events. This review discusses the association between albuminuria and adverse cardiovascular and renal outcomes in type 2 diabetes and hypertension. This study aimed to review the association between normal ranges of urine albumin-to-creatinine ratio to cardiovascular and all-cause mortality.

Open Access Review Article

A Review on Management of Amblyopia

Khushboo Kolhe, Sachin Diaghvane

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 211-217
DOI: 10.9734/jpri/2021/v33i60A34477

Amblyopia is a visual cortex neurodevelopmental condition cause am vision abnormalities during childhood. It is one of the most typical causes of vision loss at an early age. It occurs due to abnormal development of the visual cortex. The part receiving signals from the diseased eye does not receive it correctly and thus develops abnormally. This abnormal development during the critical period of growth of child results in brain damage. Depending on its aetiology the  types of amblyopia are Strabismic amblyopia, Visual deprivation amblyopia, Anisometric, Ametropic, Meridional, Toxic amblyopia.

Clinical features are visual acuity is reduced, the effect of neutral density filter, the Crowding phenomenon is present. Complications of amblyopia include a Lazy eye becoming weak permanently, the eye may move out from the visual axis (squints). When treating amblyopia, our goal is that the eyes will work together in unison at an equal level; this will create a clear vision in the lazy eye. Amblyopia is treated in various ways depending on the seriousness of the disease and the patient's age. Patching of the non-amblyopic eye, as well as treatment with drugs like atropine, are common treatments. Vision therapy and some modifications to spectacles and contact lenses have been discovered to be effective in treating amblyopia in recent years. Modern Treatment- Falling Blocks, Occlu-pad.

With current breakthroughs in amblyopia therapy, the success rate of a multimodal strategy is also improving. The purpose of this review article is to present information on the management of amblyopia. Literature on AMBLYOPIA MANAGEMENT has been taken from PubMed, Scopus, Science Direct, and other internet resources.

Open Access Review Article

Biosynthesis of Polyhydroxyalkanoate by Recombinant Bacteria: A Review

Gamal Gabr, Nahla M. M. Hassan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 218-225
DOI: 10.9734/jpri/2021/v33i60A34478

Polyhydroxyalkanoates (PHAs), a biodegradable polymer, has many industrial and medical applications such as heart valves, scaffold, suture and drug delivery. Because of their structural diversity and close analogy to plastics, PHAs have gained major interest over the world. Natural isolates, recombinant bacteria, and plants have all been found to improve the quality, quantity, and economics of PHA production. Their biodegradability makes them an especially appealing synthetic plastic substitute. PHB biosynthetic genes phbA, phbB, and phbC are grouped and systematised into a single phbCAB operon. In terms of alignment and clustering of the relevant genes, the PHB pathway varies greatly across bacterial genera. In this regard, the enzymes appear to have a high degree of sequence preservation.

The structural studies further improve the mechanism of action of these enzymes and helped in improving and choosing the good candidates for increased production of PHB.

Open Access Review Article

Therapeutic Opportunities for Headaches and Migraines in Pediatric Populations: A Review

Devanshu Singh Raghuvanshi, Richa Chaudhary, Nihaal Singh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 226-232
DOI: 10.9734/jpri/2021/v33i60A34479

Headaches, migraine-like episodes, and other associated conditions are increasingly becoming the most frequent occurrence and a threat to the pediatric population in today’s world.  It has become the most sought-after therapeutic opportunity in the clinical setting in a way that can help to treat, diagnose and minimize its ill effects or side effects in today’s world which has witnessed all severe forms of diseases and hopefully will witness more severe forms because of the everlasting unhealthy lifestyle and prevalent hypertension which can be maternal or paternal and can affect the newborn as well as all the pediatric age groups in today’s world. Severe forms of  Headachin children or pediatric age groups can be a massive challenge for the clinician to identify, diagnose, and provide effective treatment that can be curable in most cases but can be fatal. In pediatric populations, headaches or migraines can result from underlying conditions, pathologies, or effects of maternal and paternal habits or lifestyles that need more attention than the symptom itself. The treatment spectrum ranges from pharmacological interventions to more unconventional options like acupuncture and alternative medicine. All these options are worth considering, as several studies show high efficacy and success rates with each of these conditions and etiology discussed above. In this review, the authors aim to discuss these different therapeutic options and weigh out their pros and cons, which can help in better and effective treatment to control or eliminate this disease.

Open Access Review Article

A Review on Frozen Shoulder: Pathophysiology and Its Associated Diagnosis

Aashriya Jha, Varsha Patond

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 241-248
DOI: 10.9734/jpri/2021/v33i60A34481

Background: Frozen shoulder is a commonly occurring disease of the population. It is also referred to as shoulder capsulitis. It causes pain and stiffness of the shoulder and dominant in left shoulder. Various things are still unclear regarding the treatment and causes of this disease. It is a painful and n quickly healed disease.

Patients show recovery but are often unable to regain their full potential movements. Painful stiffness of the shoulder is an ill-described medical entity, this is hard to evaluate and sensitive to treat. The nomenclature sed and consists of phrinclude cluding frozen shoulder, adhesive capsulitis, focal dystrophy, stiff shoulder, shriveled shoulder, and following. Apart from its idiopathic form, the disease can be initiated with the resource of the usage of trauma, infection, tumor, radiation, systemic and neighborhood metabolic concerns. Patho- anatomically, the common place region denominates an inflammatory vascular proliferation found with the resource of the usage thickening, scarring, and retraction of the joint cover.

Summary: The inflammatory technique frequently begins to evolved on the rotator language and can increase to the subacromial space. Clinical analysis is primarily based totally records and bodily examination. Generally, the onset of ache precedes the belief of a discounted variety of movement with the aid of using weeks or months. In early ranges of ailment, the inflammatory form of ache dominates, the patient's most important criticism is ache at night. In the later stage, variety of movement step by step decreases. Patients no longer frequently whine approximately decreased movement, likely due to its gradual onset.

Conclusion: Treatment options are a mixture of mobilization carrying sports with intra-articular steroids, hydraulic distension of the joint capsule, manipulation below anaesthesia,arthroscopic and/or open arthrosis.The appropriate preference of protocol is really as critical as its correct timing. In the inflammatory phase, competitive invasive protocols are uncommon, but deleterious and therefore need to be taken into consideration. New anti- angiogenic outlets also can moreover enhance beneficial effects and shorten the rehabilitation phase.

Open Access Review Article

Role of Forensic Anthropology in Disaster Victim Identification (DVI)

Alok Sharma, Avinash H. Waghmode

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 257-263
DOI: 10.9734/jpri/2021/v33i60A34483

DNA profiling is one of the most dependable and well-organized methods for recognizing bodies or losing body parts in disaster victim identification (DVI). This necessitates the collection of a post-mortem DNA sample and an antemortem DNA sample from the alleged victim or a biological related people. Collecting an acceptable ante mortem sample is usually effortless, but because of the varying degree of preservation of the human remains after any disaster and very high risk of cross-contamination of DNA, obtaining an adequate standard post mortem sample under cold DVI conditions is difficult. Various post mortem DNA samples from a deceased person in DVI can be obtained from muscle, bone including femur and ribs, teeth, and bone marrow with the slightest possibility of contamination.

DVI (disaster victim identification) has been used to identify deceased people in various famous disasters like the 9/11 attack of the terrorist group al-Qaeda against the United States, Malaysia Airlines Flight 17 from Amsterdam to Kuala Lumpur that was shot down on 17 July 2014 while flying over eastern Ukraine. All 283 passengers and 15 crew members were killed; the 26/11 attack on Mumbai in 2008 led by terrorist organizations caused 166 deaths, excluding nine terrorists.

According to Interpol protocol, four steps for identification are given importance:

1 – Site examination, which lasts for days to weeks.

2 – Post-mortem data include fingerprints, odontology, DNA profiling and physical indication.

3 – Ante-mortem data collected from victim houses.

4 – Reconciliation where specialists identify the victim from the data collected.

Open Access Review Article

Pathways of Renal Involvement in COVID-19 Infection

Catherin Ouseph, Praful Patil

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 274-281
DOI: 10.9734/jpri/2021/v33i60A34485

The causative agent of the highly infectious pandemic COVID-19 is SARS-CoV-2. According to WHO, as of August 18th 2020, the number of confirmed cases was and confirmed deaths was 771,635 from 216 countries. The most affected organ system in COVID-19 is the respiratory system. Later studies proved that the virus caused multiorgan infections. Several studies shows that SARS-CoV-2 causes damage to the renal system and; critically ill patients with associated renal damage show a higher mortality rate as compared to those patients with an unaffected renal system .This review article aims at updating the knowledge about associated kidney failure in covid-19 cases and its impact on the morbidity and mortality. The virus damages the renal system through two different mechanisms: Direct and Indirect pathway. The direct pathway explains how the virus damages the renal system by directly acting upon the target cells in the kidney.SARS-CoV-2 gains its entry by binding to the ACE2 receptors on the target cell. The SARS-CoV-2 progresses its journey and extensively spread the infection, damaging the kidneys leading to the failure of the renal system. The indirect pathway of damage speaks about the secondary damage caused to the renal system due to cytokine release syndrome caused by SARS-CoV-2.This pathway also points out the formation of microthrombi in the glomerular capillaries and also kidney hypoperfusion. AKI in covid-19 patients can occur secondary to multiorgan failure. This review aims to build a foundation concerning the direct pathway and indirect pathway by means of which SARS-Cov-2 infects the kidneys by summarizing the numerous researches carried out till date to update the knowledge gained thus far to aid in building better protocols for covid-19 management and decrease morbidity caused due to renal damage.

Open Access Review Article

Risk Factors Which Lead to Development of Senile Cataract: A Review

Kingshuk Kumar, Tejas Shegekar, Shubhangi Nagpure

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 293-301
DOI: 10.9734/jpri/2021/v33i60A34487

Maturing processes, including those brought about by various outside factors, have stood out for researchers throughout the last years. Senile cataract is a multifactorial illness. The expense of surgery of cataract medical procedures stays among the highest costing procedures in general public healthcare. Age is an essential element that causes senile cataract morbidity, which double ten every ten years. This article considers some sources which portray research results on impact on cataract development by risk factors like age, sex, race, smoking, alcohol consumption, diabetes (pancreatic), usage of specific drugs, various environmental aspects, including ultraviolet and ionizing radiation; many of which are shown to cause increment or decrease the risk of senile cataract; there is clashing information on specific factors. Depending on etiology, experts spot senile, congenital, traumatic, complicated, and occupational cataracts. Senile cataract (hereafter referred to as “cataract”) is the most prevalent. The layout also contains quantitative data of cataracts and risk, given through odds ratio and advance because of age, alcohol consumption, ionizing radiation, etc. The researchers also express that there is still no finding on whether the dose-effect relationship for cataract evolvement is a non-threshold or threshold. Surgical procedures are the only treatment available. The surgical procedure usually needs less than an hour. The surgeon makes a small incision in the sclera or limbus of the eye, sometimes with a laser. A small tool is put in to break up the cataract and gently suction it out through the opening created. Then they put in the new lens, made of plastic, silicone, or acrylic, and close the incision. Surgical procedures namely phacoemulsification and minor incision cataract surgery (SICS) are widely used for cataract surgeries; the former is the latest development in cataract surgeries and is less time-consuming. If both eyes are affected, two surgeries are done separately.

Open Access Review Article

Surgical Management of Benign Gastric Tumors: A Review

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

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 420-426
DOI: 10.9734/jpri/2021/v33i60A34502

Benign stomach and duodenal tumors are uncommon. Any component of the stomach epithelium, whether glandular, endocrine, or mesenchymal, can develop benign neoplastic tumors. The majority of people with benign stomach and duodenal tumors are asymptomatic for a long time. When symptoms do appear, they are determined by the tumor's size, location, and comorbidities. Endoscopy, computed tomography, and especially endoscopic ultrasonography results are used diagnose. Clinically, it's difficult to tell the difference between benign and malignant stomach tumors. Even benign tumors can undergo malignant transformation, severe obstructive problems, and bleeding. As a result, aggressive surgical resection of the tumors should be undertaken. Laparoscopic resection has become the first option of many surgeons since the development of minimally invasive surgery. According to previous literature, laparoscopic excision of GIST is safe and effective. In this review we’ll be looking at benign gastric tumors, gastrointestinal stromal tumors (GISTs) and their diagnosis.

Open Access Review Article

Synthesis and Anticancer Perspective of Pyridopyrimidine Scaffold - An Overview

Chaithra R. Shetty, C. S. Shastry

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 438-461
DOI: 10.9734/jpri/2021/v33i60A34505

The core pyridopyrimidines are gaining interest in organic and heterocyclic chemistry in recent days, as this scaffold acts as a building block because of its wide range of biological and pharmacological applications like anticancer, antimicrobial, fungicidal, antiviral, CNS, antibacterial, and anti-inflammatory properties. This review mainly emphasizes the evolution in anticancer properties of pyridopyrimidines since 2008 especially the method of synthesis and anticancer activity of synthesized compounds with reporting of active anticancer scaffolds. Important starting materials which are widely used for the synthesis are 2-thioxopyrimidine, ethyl 2-cyanoacetate, 2-amino-3-cyano-4-trifluoromethyl-6-phenyl-pyridine, 2-amino-4,6-disubstituted nicotinonitrile, 2-chloro-3-pyridine carboxylic acid, in which 2-thioxopyrimidine is found to be mostly employed in the synthesis. Pyridopyrimidines which are synthesized from different starting materials, in which the more active compounds are reported here which may help in further discovery/ development of novel molecules.

Open Access Review Article

A Brief Review on Management of Gestational Diabetes

Nikhil Kaushik, Dhara Vaghani, Arpita Jaiswal Singam

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 462-469
DOI: 10.9734/jpri/2021/v33i60A34506

Gestational diabetes mellitus (GDM) is a real pregnancy trap, wherein ladies without as of late dissected diabetes encourage constant high blood glucose during pregnancy. Diabetes in gestation is a condition where highly increase in the blood glucose level at the period of pregnancy and impacts pregnant ladies who haven't been broke down with diabetes.

Diabetes mellitus in gestational period is conceivably most broadly perceived serious the pregnant conditions, with long and short stretch outcomes for mothers, hatchlings & babies. The chiefs & remedies which are wanted to gain most ideal control of glycemia, and while ignoring hypoglycaemia & make sure of fetal and maternal prosperity. This incorporates direct changes, food & treatment, and when considered fundamental; For possible opposing outcomes, simultaneously with fetal and maternal perception was made. The response intends to develop choices for gestational diabetes management treatment pharmacologically. Everyone played out a wide composing different review of examinations, conveyed in the latest fifty year , focusing on  treatment for Gestational diabetes mellitus pharmacologically, overseeing security & ampleness, for maternal & fetal unpleasantness results; similarly like disillusionment & accomplishment in developing legitimate control of glucose and metabolic conditions . Medical treatment orally is a secured & convincing treatment system for GDM and in specific conditions may fill in as first-line treatment while supporting changes misfire. Right when oral experts disregard to set up control of glucose then imbuements of insulin are added supposedly. Choosing oral treatment which is the best in unsure, disregarding the way that it seems, by all accounts, to be that metformin is fairly better compared to glyburide, in specific perspectives. Concerning parenteral treatment, all recorded insulins in the specified article need to be considered both ensured & practical so that the treatment of high blood glucose can be treated in pregnancy. Fundamentally, a prevalent security profile, with near feasibility is recorded for most analogs. As GDM normality climbs, there is a prerequisite for powerful noticing and treatment for patients.

Open Access Review Article

Overview of Congenital Hepatic Fibrosis in Pediatrics: A Review

Ahmed Abdelsamie Fadl, Sarah jamal almujil, Ahmed Saeed S. Banheem, Nasser Naif Alsuhaymi, Mansour Hemaid Alhelali, Dhiyaa Hassan A. Aldukhi, Khalil Rafed B. Alsaedi, Naif Mohammed Al-Wagdani, Ebtesam Ali S. Almadi, Khalid Mohammed A. Aladhadh, Fahad Amrh AlAjmi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 470-477
DOI: 10.9734/jpri/2021/v33i60A34507

Congenital hepatic fibrosis is a rare developmental illness caused by a ductal plate malformation, often known as ciliopathy or fibrocystic liver disease. Hepatosplenomegaly and portal hypertension are two symptoms. The disease affects 1/10000–20000 people. frequently associated with a variety of illnesses caused by genetic abnormalities, such as autosomal recessive polycystic kidney disease (ARPKD) and Caroli syndrome. There hasn't been a way to stop or reverse the progression of congenital hepatic fibrosis until now. Clinical trials of anti-fibrotic medicines such as colchicine, interferon gamma, angiotensin II receptor blockers, pirfenidone, and ursodeoxycholic acid found no significant benefit. The only known cure for CHF is liver transplantation, which is recommended when the condition has progressed to the point when symptoms of liver failure have appeared. In this article we will be making overview of the disease. It’s symptoms and diagnosis, different treatment method, and we will compare some of the articles published about the disease.

Open Access Review Article

An Overview of Low Vision Aids

Riddhi Lele, Shashank Banait

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 478-483
DOI: 10.9734/jpri/2021/v33i60A34508

Low vision is something that will cause hindrance in one’s daily activities. These problems are on the rise amongst the Indian population nowadays. Low vision is one of the emerging problems which needs immediate attention. Blindness is one of the most critical aspects of low vision. In a survey conducted at the national level in 1989-90, approximately 12 million people of India accounted for about 1.5% who were blind presented with a visual acuity of about <6/60 in the eye with better vision. Visual impairment possesses a financial burden, which is why we cannot pay attention to it . Funding by the government in this sector should be the thing which should be taken care of. The rehabilitative purpose of low aids is to help people perform their daily chores without any disturbances. Low vision aids are different depending on different age groups of the population. Spectacles are commonly used measures to correct low vision, but they are not socially acceptable. There is a stigma still associated with spectacles, so the person wearing them feels insecure about it. Low vision is not always necessarily associated with any disease of the eye. Negligence associated with low vision causes an increase in the number of blind cases overall. Depending upon the type of visual loss, appropriate corrective measures can be brought into force. In the current scenario, covid-19 is also one of the leading causes of the growing number of eye diseases globally due to the online platforms used.

Open Access Review Article

Bullous Disease of Diabetes (Bullosis Diabeticorum)

Mohammed Salah Hussein, Shatha Saeed Mohammed Alqahtani, Amani Hussain Almutawa, Batool Mesfer Alqahtany, M. Albulushi Amer Ismail, Ayat Hussain Almutawa, Alaa Saleh Alharbi, Elaf Saad Almutairi, Maab Jassim Alhashim, Sarah Naif Aldawish, Hassan Ali A. Almohaishi, Hamed Hamad B. Alharbi, Mohammed Nabil A. Almuhanna, Dhiyaa Jaber Alfaraj, Abdulrahman Saud Saeed Alsharari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 552-557
DOI: 10.9734/jpri/2021/v33i60A34518

Acanthosis nigricans, acrochordrons, diabetic dermatopathy, necrobiosis lipoidica, and bullous diabeticorum are some of the cutaneous symptoms of diabetes. Bullous illness (bullosis diabeticorum) is a blistering, non-inflammatory condition of the acral skin. Diabetes bullous illness is more common in people who have had diabetes for a long time or who have many comorbidities. Although the actual cause is uncertain, it is likely to be multifactorial. Neuropathy, nephropathy, vasculopathy, and UV (ultraviolet) light are all suggested to have a role. BD is most likely caused by the various problems that come with poorly managed diabetes. The exact number of people who have BD is unknown. The majority of case studies in the literature were based on a small number of cases. Bullous diabeticorum is a restrictive diagnosis, which necessitates a histological study that includes direct immunofluorescence to rule out other vesicobullous illnesses. In terms of BD management, no strong consensus has formed. The blisters have historically been thought to be self-limiting, with bullae resolving in 2 to 6 weeks if left untreated. In some cases antibiotic may be used. In this article we’ll be looking at Bullosis Diabeticorum. Its etiology, epidemiology, diagnosis, and treatment.

Open Access Review Article

Handling of Medical Devices: Reforms and Regulations

M. Charmila, M. P. Venkatesh, G. Ramya Shree

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 565-572
DOI: 10.9734/jpri/2021/v33i60A34520

With the evolving technology and changing regulations, the medical device sector is set to grow quickly soon. Even though they are an integral part of patient care they present several unique problems which are not sufficiently addressed by the device manufacturer or the medical community in general. Medical device is widely used by professionals in a clinical setup, by patients, family members at home. As step towards better understanding the rules, regulations, and the required reforms for the safe use of medical devices various measures taken by different regulatory authorities to ensure the minimization of use error are discussed. Human factor engineering and ergonomics are considered while designing a medical device. It is evident that all the stakeholders involved contribute to the safety of the medical device keeping in mind the welfare of the patient but is that enough and what can be done is discussed in this review work.

Open Access Review Article

Review on Tauopathies: Clinicopathological Aspect

Sonaakshi Kushwaha, Anil Wanjari

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 573-579
DOI: 10.9734/jpri/2021/v33i60A34521

A group of neurodegenerative diseases that differ in their morphology, biochemistry, and clinical presentation are Tauopathies. They are distinguished by aberrant tau protein accumulation in the brain. Currently, there is no conclusive method for preventing or curing tauopathies, but new scientific advancements have transformed this gloomy picture. Evidence from genetic research, experimental animal models, and molecular and cell biology has offered insight into the illnesses' underlying causes. Advances in radiology and biochemistry, notably in PET imaging, may offer critical biomarkers for clinical diagnosis and therapy. Tau, in addition to its role as a microtubule-associated tau protein, is involved in gene regulation, signal transduction, and metabolism. Experimental models allow for the development of novel diagnostic and treatment methods. Tauopathies are a set of disorders that can present with a wide range of clinical signs. It is still difficult to distinguish this disease from other protein-pathologies. In the last year, there has been a lot of interest in cerebrospinal fluid biomarkers and radiotracers. Although the accuracy of diagnosis in non-disease Alzheimer's tauopathies remains debatable, PET tau tracers may be utilised to identify disease process. Although primary tauopathies are uncommon and diverse conditions, their combined incidence, as well as the importance of tau malfunction in Alzheimer's disease and secondary tauopathies, make tauopathy research a top priority since it might assist many people.

Open Access Review Article

A Systemic Review of Pathological Findings in COVID-19 and Its Mechanism of Disease

Aishik Chanda, Shruti Dehankar, Abhishek Kumar, Samarth Shukla, Sourya Acharya

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 597-606
DOI: 10.9734/jpri/2021/v33i60A34523

The Severe Acute Respiratory Syndrome (SARS) coronavirus 2 (SARS-CoV2) has spread worldwide at a rapidly alarming pace and has resulted in the coronavirus disease 2019 (COVID-19) pandemic. The virus has more intensive and prolonged standing effects in the host body post-infection than the other related groups of viruses. The disease has caused an unforeseen need for the availability of intensive support because of the resulting critical respiratory distress and consequent multi-organ failure. What starts as an elegant fever with cough and headache, with body pain, runny nose, sore throat, quickly develops into loss of perception of taste and smell, with nausea, diarrhea, troubled breathing, chills; and finally results into grievous damage to the vital organs of the body, such as heart, lungs, liver, kidneys, blood vessels, and even brain, necessitating the need of urgent and competent availability of critical care infrastructure. It is now the disease with the highest number of affected individuals recorded in the modern era. And, not only does the infection of Covid inflict highly significant morbidity and mortality rates amongst the population, but there have also been multiple and significant strains to the overburdened health care system and also, massively on the economy.

Here in this article, our focus will primarily be upon the systemic pathology in the various organ systems and how the coronavirus has been affected. We shall discuss the Respiratory System, the Cardio-Vascular System, the Renal System, Central Nervous System, and the pathophysiology involved herewith after covid infection.

Open Access Review Article

Estimation of Cephalic Index of Population of Central India

Aditi R. Gupta, Swapnil Patond

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 614-622
DOI: 10.9734/jpri/2021/v33i60A34525

Cephalic Index is otherwise called cranial list or broadness file. The cephalic index is given as the breadth, which is multiplied by 100 divided by the length. Assessing varieties in cephalic records across parents, children, and family members can uncover if hereditary qualities are passed down hereditarily. The research included 480 subjects (296 male and 184 females). Most of the people were Mesocephalic. 43.58 percent of males and 42.93 percent of young females had a mesocephalic head. Males had an average cephalic index of 81.24, while females had a regular cephalic index of 80.31.

Somatometric estimations, for example, the face and cephalic records, are used in human criminological sciences. These lists utilized a human's sex and racial populace to compute their singular character. This exploration aims to give benchmark data to cephalic records and face files in the Central Indian population, contrasting these outcomes with past research. This review will be helpful to legal specialists, anatomists, and others in related disciplines.

The cephalic index (CI), in some cases called the cranial list, is the proportion of the head's maximal expansiveness to length. The motivation behind the review was to research the anthropometry of cranial qualities. The review's objective was to check out the anthropometry of cranial qualities utilizing google structures circled in the school gatherings. Experts in scientific science will see the data as advantageous, just as in clinical, medico-legal, anthropological, and excavation settings.

Open Access Review Article

Evolution of Antimicrobial Resistance in the Era of COVID-19

Aditi Deepak Gupta, Praful S. Patil

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 633-642
DOI: 10.9734/jpri/2021/v33i60A34527

Antimicrobial resistance is a slow-growing phenomenon that could even be a reason for a future pandemic. Due to inappropriate diagnosis and consumption of antibiotics, the bacteria have become resistant to the antibiotics used. In the era of COVID-19, this blind consumption of antibiotics has rapidly increased due to the period of quarantine and fear of the disease. Ligue to the fear of the pandemic, especially in ru, rural areas, many patients avoid going to the hospital and consuming antibiotics without any prescription. Various retrospective studies have shown a relationship between bacterial co-infection and AMR, which is increased in the era of COVID-19. Also, the secondary bacterial infections associated with the pandemic of COVID-19 have added to the risk of antimicrobial resistance. The viral effect on the respiratory system is favorable for bacterial infection, as in the case of COVID-19 affecting the respiratory tract followed by co-bacterial infection in some cases. COVID-19 has affected AMR in many aspects. Proper antibiotic resistance tests should be performed before prescribing any antibiotics to the patient to reduce the chances of AMR, especially in such an obnoxious situation of COVID-19. This crucially calls for a brand new and effective plan of action to attenuate the influence of the pandemic on antimicrobial resistance. Statistics of various countries in matters of antimicrobial resistance have shown an increase in AMR due to the concentration of health workers, researchers, and population on the pandemic associated with COVID-19. This calls for the necessity to aware the population worldwide about antimicrobial resistance and how it could be a hidden menace in the future and could probably prove to be a matter of concern as it would worsen the condition of the patients in a particular disease and would decrease the various possible aspects of the treatment especially in case of treatment based on antibiotics.

Open Access Review Article

Surgical Site Infections in Gynaecological Surgeries

Akshaya Iyengar, Shiven Nayyar, Vedika Jajoo

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 654-663
DOI: 10.9734/jpri/2021/v33i60A34529

Surgical contaminations are one of the utmost familiar medical management related contamination within the economically developing nations. Gynecologic tactics constitute a completely distinctive venture within which the infectious pathogen arising out of pores and the underlying skin or the vagina and endo-cervix can also relocate up to the area of surgery and may bring about vaginal cuff cellulitis, cellulitis of the  pelvis, and abscesses of the pelvis. Numerous organisms along with operation threat elements were recognized as dangers that grow infectious sequelae after pelvic surgical treatment. The full-size use of antibiotic prophylaxis has decreased however now no longer removed severe postoperative infections; the common anticipated SSIs price being three–15% after c-section. Those costs are multiplied by the existence of various threat elements like surgical infection, which is compounded by untimely rupture of membranes, obstructed labour, chorioamnionitis, large obesity, extended duration of surgery, emergency surgeries, and immunodeficiency, all of that are not uncommon within aid-deficient nations. Other factors linked to physician ability, such as poor operation skills, insufficient hemostasis, and the presence of a useless region, lead to increased injury contamination. Working at the pinnacle, such as those medical conditions that occur during pregnancy and malnutrition, also contribute significantly to the problem.

SSIs as the most common motive concerning hospital-acquired contamination in obstetrics, although the present contemporary era, remains as chief residence fitness hassle within growing nations. We may even evaluate the definitions, microbiology, pathogenesis, diagnosis, and control of pelvic SSIs after gynecologic surgical procedures.

Open Access Review Article

Vaccine Regulation, Licensing and Approval in USA

S. Shashank, M. P. Venkatesh

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 664-673
DOI: 10.9734/jpri/2021/v33i60A34530

Vaccines are the foremost effective public and personal preventive health interventions, leading to vital reductions in vaccine-preventable diseases and in substantial price savings to the United States health care system. A vaccine is a biological preparation that will increase the immunity to a particular illness. Vaccine development is commonly found to be difficult and needs sharp understanding and information of recent developments by physicians and experts to confirm that safe and effective vaccines are manufactured with minimum risk. A strict regulative method to see the safety, efficacy, and quality should be achieved throughout the event of vaccine development for its authorization. The Office of Vaccines Research and Review at the CBER of the US-FDA is the federal administrative body charged with guaranteeing the safety, purity, and efficacy of vaccines within US. The licensing rules are published in the Title 21 CFR Part 60. Current authority for the regulation of vaccines is in Section 351(a) of the Public Health Service Act (PHS). Vaccine licensure, development of recommendations to be used, and implementation of these recommendations resulting in uptake, community protection, and result on illness burden represent a posh system that needs collaboration within the areas of basic science, public health, vaccine delivery and outcome observance, and public perception.

Open Access Review Article

Herpes Zoster in Immunosuppressed Patients

Akshad Wadbudhe, Smita Damke

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 674-680
DOI: 10.9734/jpri/2021/v33i60A34531

Herpes zoster (HZ) is a disease caused by the activation of the virus in the latent phase. The name of the virus is varicella-zoster virus (VZV). This virus remains in the dorsal root ganglia, the collection of neuronal cell bodies. It is known as reactivation because it is a secondary infection. The main or the old infection is chickenpox; it generally occurs in the early stages of life. This secondary infection is caused in the later stages of life in old age patients; if the patient is immunocompromised, this type of infection can cause death or make the patient unconscious. But in the world, many people have a variety of standard or uncommon signs and symptoms of this disease based on their body, diet, area, or even genetic features.

This Herpes Zoster acts on the immune response called cell-mediated immunity and decreases it rapidly with the advance of age of the person. In the coming years, the incidences of this disease are gradually increasing because of the weakening of the immune system. The incidences also happened in people with defective immunity of cell-mediated type or due to the abuse of certain drugs.

The herpes zoster is caused to the immunosuppressed patient more quickly than the average population. As there is no immune system to defend the body, some secondary infections can also be induced in these conditions and lead to death. This multiple infection can make a differential diagnosis.

This review explains and understands the herpes zoster virus causing different complications in the body and other clinical things related to immunocompromised patients.

Open Access Review Article

A Persistence Search for the Most Appropriate Process of PET Recycling: A Review

Neelam Thakur, Kritika Rajput, Navneet Kaur, Pankaj Mehta

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 681-688
DOI: 10.9734/jpri/2021/v33i60A34532

One of the most serious threats to the environment in today’s world is plastic pollution. The reason for widespread of plastic is its poor disposal management, indiscriminate use of plastic and its related products. There was a tremendous increase in the production of plastic from the start of 21st century due to its high demand which tripled the waste in these two decades. This review papers aims at providing the understanding of various techniques used for PET plastic degrading process and currently used in large scale that is quite detrimental to the environment. Further, the recent discovery of the bacteria eating enzyme provided a shaft of light in waste green recycling process. Adding to this, there is an outline provided for bioengineering of the most preferred enzymes for hydrolysis process result is compared that which one is more efficient one. Comparing them and trying to exploring the potential of various mutated enzymes for hydrolyzing of plastic waste formulated by various researchers to identify the Nobel PET catalyst which can solve the massive environment crisis when used in large-scale.

Open Access Review Article

Oxytocin Regimens for Labour Augmentation and Its Effect on Perinatal Outcomes: A Narrative Review

Neema Acharya, Priyanka Singh, Monisha Singh, Priyanjali Sinha

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 689-693
DOI: 10.9734/jpri/2021/v33i60A34533

Background: The issue of childbirth, stimulation of labor is very important for successful childbirth and the birth of healthy babies. Obstetricians play main role in providing and rising Maternal and Child Health (MCH) care facilities. One amongst the goal of MCH care is safe delivery with smart feto-maternal outcome. The hormone plays vital role to cut back rates of caesarean birth once used for management of dystocia. Interventions with oxytocin particularly at high doses would lead to adverse effects on fetal heart rate and uterine tachsystole which occurs due to reduction in blood flow during contraction in intervillousspaces. The purpose of use of oxytocin is for physiological birth and for successful delivery practices. For augmentation of labour hormone regimens are low-dose (1-3 milli units/min) and high dose (4-7 milli units/min). Studies have shown high-dose of hormone causes hyperstimulation to womb. It's been mentioned that there's decrease in induction to delivery time at meta-analysis.

Augmentation of labour is that the method of accelerating the frequency of contractions to facilitate a labour. The principal methodology for achieving augmentation of labour varies in the use and approach. Oxytocin is widely used for each induction and augmentation of labour. Interventions with oxytocin particularly at high doses would lead to adverse effects on fetal heart rate and uterine tachsystole which occurs due to reduction in blood flow during contraction in intervillous spaces. The purpose of use of oxytocin is for physiological birth and for successful delivery practices. These results reinforce the need to reflect on a change in care during delivery. Thus,this will help health care professional for better understanding on use and its effect during labour which will help in proper decision making for augmentation of labour.

Open Access Review Article

Assessing the Role of Vitamins for COVID-19 Treatment

Abhishek Borkhade, Anupama Sawal

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 710-717
DOI: 10.9734/jpri/2021/v33i60A34537

Acute SARS-Covid-2, also known as a coronavirus (COVID-19), seemed in Wuhan metropolis, China, in December 2019. On March 11, 2020, a global epidemic was announced. As the sector responds to the COVID-19 virus, the less critical clinical remedy, commentary has been shifted to various methods that can help toughen the immune system to fight against various viral and bacterial infections. Considering that the Corona contamination considerably impacts the body defense with many irritative and harmful responses, medicinal corporations are working to develop unique tablets and vaccines in opposition to the Coronavirus, which is beneficial for people to fight corona disease. A properly balanced diet can play a chief role in keeping typical fitness to control persistent infectious illnesses. A nicely balanced diet or food regimen includes nutrients A, B, C, D, E, and vit. K can help with numerous infectious illnesses. This research aims to talk over and gift with the ultra-modern records of the position of nutrients inside the COVID-19 treatment, as these nutrients play an essential role in covid treatment. Deficiency of these nutrients can cause a decrease or low resistance of immune working, which is one of the principal reasons that purpose terrible immune device. that is a story evaluation of the capabilities of Corona virus and facts of getting use vitamins as precautionary measures to convey down the incidence and dying of sufferers struggling with COVID.

Open Access Review Article

Gene Editing: A Double-Edged Sword

Akshara K. Raut, Tripti Waghmare

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 727-735
DOI: 10.9734/jpri/2021/v33i60A34539

This essay is about intrinsic planning parts that can alternate the enlarge of the particle that regulates our herbal cycles, the genome. Since the 1990s, first-class enchantment has been a focal factor of research. It commenced with the genome undertaking and will proceed to be an ambassador for the foreseeable future. The functions are many, and they are anticipated to have a significant speculative effect as properly as extraordinarily extreme hazards. The genome altering development trends have opened up the technique to truly zero in on and exchange genomic progressions in nearly all eukaryotic cells, whether or not they are planned or bacterial nucleases. Genome editing has loosened up our capacity to grant an explanation for the role of inherited qualities in infection with the aid of accelerating the development of increased right smartphone and models of animal of psychotic cycles, and it has begun to exhibit extraordinarily top achievable in a variety of fields, ranging from indispensable look up to utilized biotechnology and biomedical research. The late boom in the development of programmable nucleases, such as zinc-finger nucleases (ZFNs), file activator-like effector nucleases (TALENs), and assembled reliably interspaced quick palindromic repeat (CRISPR)– Cas-related nucleases, has accelerated the transition of fee from idea to medical practice. We observe the purposes of their subordinate reagents as quality-changing units in a range of human illnesses, and anticipated future medicines, which focuses on eukaryotic cells and animal models, in this evaluation of modern-day advances in the three critical genome-modifying propels (ZFNs, TALENs, and CRISPR/Cas9). Finally, we have a framework for clinical primers to use genome adjusting phases for sickness therapy, as nicely as some of the difficulties encountered throughout implementation.

Open Access Review Article

Therapeutic Role of Element Anhydrase Inhibitors in Treatment of Glaucoma: A Review

Akshata Kadu, Sarju Zilate

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 745-750
DOI: 10.9734/jpri/2021/v33i60A34541

Eye disease may be a cluster of inveterately progressive disorders of the nervus opticus. during this article, I gift the medicine, Pathophysiology, risk factors, ophthalmic examination, and therapeutic role of carbonaceous anhydrase inhibitors in treating eye disease. In European countries, the prevalence of eye disease is a pair of.93% among persons aged 40-80 years, reaching ten you tired of persons over ninety years old-time. There is a unit many differing types of eye disease, and that they are classically divided into classes of open-angle and closed-angle eye disease. Use of topical selective or nonselective beta-blockers is used in the treatment of eye diseases. Second-line drugs of alternative embody alpha – agonists and topical carbonaceous anhydrase inhibitors. Parasympathomimetics drugs, most ordinarily alkaloid, area unit thought-about third-line treatment. For patients, the United Nations agency doesn't reply to antiglaucoma remedy, optical laser incisional and trabeculoplasty surgery area unit more ways that may be accustomed lower the pressure. The inhibitors area unit used medication in the treatment of symptom coronary failure, brain disease, and hypoxia conjointly. A Corollary of Friedenwald's construct of hydrogen carbonate secretion within the formation of liquid body substance is that inhibition of the protein carbonaceous anhydrase could be expected to decrease the speed of secretion and lower IOP. The carbonaceous anhydrase matter, Diamox (acetazolamide) is employed in the treatment of eye disease. Preliminary trials of Diamox in rabbits created a definite lowering of pressure to once ten to one hundred mg. carbonaceous anhydrase inhibitors diminish ocular high blood pressure in glaucomatous patients by reducing the hydrogen carbonate formation.

Open Access Review Article

A Review on Hyperglycemia: Symptoms and Risk Factors

Megha Goyal, Divasha Choudhary

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 756-762
DOI: 10.9734/jpri/2021/v33i60A34543

Background: The term "hyperglycemia" is derived from the Greek hyper (top) + glykys (sugar/sugar) + haima (blood). Extra sugar varies from one hundred and twenty-five mg / dL and is faster and more noticeable than one hundred and eighty mg / metric unit a couple of hours after meals. The patient has decreased resistance to aldohexose, or prediabetes, with rapid plasma aldohexose 100 mg / dL one hundred and twenty-five mg / dL. The patient is diagnosed with diabetes mellitus, more noticeable than one hundred and twenty-five mg / metric dose units. As long as the symptom is not treated, it will create a variety of dangerous complications that include pain in the care, kidneys, nerves, heart, and vascular structure.

Objectives: To define the number of children in the past to assess whether symptoms have been given or not and whether this is often associated with a PIM pair difficulty index.

Methods: Recurrent analysis, patients between one month and fifteen years The World Health Organization recognizes care for septic shock, between the month of the Gregorian calendar 2008 and Oct 2010. -aldohexose> 126 mg / dl. Patients were diagnosed according to age, gender, illness, and glucose levels when treated, 24, forty-eight, and seventy-two hrs

Results: Out of 25 patients, 16 PF had symptoms,  one patient had a glucose level> 200 mg /dl, and only one patient needed a hypoglycemic agent, usually between seventy-two hours and admission.

Conclusions:  The World Health Organization's gift of septic shock occurs at a lower rate, and people have developed the World Health Organization, a self-administered gift of traditional blood sugar levels of 72 hours while not requiring hypoglycemic agent administration. Patients with symptoms had a higher mortality rate of PIM pairs, thus increasing mortality.

Open Access Review Article

Ocular Trauma in Pediatric Population

Indrayani Jadhav, Nidhi Sohrot, Sohan Lohiya

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 769-775
DOI: 10.9734/jpri/2021/v33i60A34545

Pediatric ocular trauma is the main challenge for ophthalmologists. It is the most crucial cause of monocular blindness. Thus, it is the main problem in public health management. This study is aimed to determine the clinical characteristics and visual consequences of ocular trauma. The ocular trauma with further complications can result in blindness.  An immediate evaluation of the potential damage may be impossible because of vitreous hemorrhage or may be ill-advised because of hyphema or damage to other ocular or orbital structures. Books like Comprehensive Ophthalmology by Dr. A K Khurana and various articles, WHO (World Health Organization) website, etcetera were referred for this review article. Trauma in pediatric age groups is more prevalent than that in adult age groups. The so, the male gender is more prone to such injuri females. This study concludes that trauma to eyes the is the leather dying cause of ocular morbidity, which can be avoided by simple measures. First aid and early treatment can cause a significant decrease in loss of vision due to ocular trauma. Thus, a little awareness in parents and guardians can help decrease loss and blindness in the pediatric population. Eye injury, if occurred in a closed eye, causes contusion or lamellar laceration, and if that happens in an open eye, then it can lead to rupture, perforation, or penetrating injury to the eyeball. Troma to the eyes is the leading cause of ocular morbidity, which simple measures can avoid. First aid and early treatment can cause significant decrease in loss of vision due to ocular trauma. Thus, a little awareness in parents and guardians can help decrease loss and blindness in the pediatric population.

Open Access Review Article

Evaluation and Management of Mallory – Weiss Syndrome: A Review

Mohammed Salah Hussein, Fatimah Ali Alfaraj, Abdulrahman Dhafer Alshabwi, Aljawhara Abdullah Altheyab, Khulood Tariq Alhasan, Omar Mohammed Alghamdi, Manal Abdulla Jaafar Saleh Ahmed, Amal Ali Alamri, Mohammed Tariq Alhabeeb, Abdelhalim A. Elsherif, Lojain Saoud Zaki

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 788-794
DOI: 10.9734/jpri/2021/v33i60A34548

Upper gastrointestinal bleeding is a symptom of Mallory-Weiss syndrome, which is caused by longitudinal mucosal lacerations (known as Mallory-Weiss tears) near the gastroesophageal junction or gastric cardia. Mallory-Weiss syndrome is rather prevalent, accounting for 3 to 10% of all upper gastrointestinal bleeding episodes. In mild circumstances, the disease may be asymptomatic. Hematemesis is the presenting symptom in 85 percent of patients. Blood is present in varying amounts, ranging from blood-streaked mucous to huge bright red haemorrhage. Other symptoms such as melena, dizziness, or syncope might occur as a result of heavy bleeding. The majority of the time, the bleeding is little and ends on its own. Endoscopy is frequently used to confirm the diagnosis of MWS. Although most patients may be treated with monitoring or conservative medicinal treatment, certain cases require endoscopic or surgical treatment. Despite the fact that MWS is a common cause of nonvariceal upper gastrointestinal bleeding (NVUGIB), little research has been done on it. This article discusses MWS Etiology, epidemiology, evaluation and management.

Open Access Review Article

Incidence of Corneal Inflammation of Varying Severity among Contact Lens Wearers

Yusuf Osmani, Krishna Kela, Mona Sune

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 795-800
DOI: 10.9734/jpri/2021/v33i60A34549

The human cornea is an avascular, transparent tissue that permits or allows light rays to enter or reach the retina. The cornea is made up of several layers, each of which plays an important role in preserving the transparency and power of cornea. The epithelium, Bowmans layer, Descemet’s membrane and endothelium are the layers of the cornea. This study aimed to discover the incidences of severe and non-severe corneal inflammation amongst wearers of modern technology touch lenses. Studies on touch lens users providing with a corneal ulcer/infiltrates were reported. On the basis of severity, a medical severity matrix was utilized among cases of severe and non-severe corneal inflammation. There was a large distinction in severe corneal infection among ew-hydrogel and ew-silicone hydrogel. When it comes to evaluating touch lens-related corneal inflammation, a medical severity matrix is available in hand. Wearers of contact lenses who sleep with them have a appreciably low risk of severe corneal inflammation than those who simplest  put on lenses for the duration of the day. Those cases who everyday sleep with lenses have a 5-fold lower risk of severe corneal inflammation as compared day-to-day hydrogel lenses for prolonged utilization.

Open Access Review Article

Psychological Problem in Geriatric Age Group

Ujwall Thakur, Vijay Babar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 809-815
DOI: 10.9734/jpri/2021/v33i60A34551

The proper definition of geriatrics is not easy to define. It can be said it is the health care / medical care provided to the elderly age group people of the society. Old/elderly is also preferred over the geriatric term but is not that precise, sixty-five years is said to be the age group coming into the geriatric group, but some of the people do not need any medical care until the age of seventy- seventy years. Biological or physiological impairment, as well as socioeconomic circumstances, can affect functional status. Their functional ability determines the elderly's capacity to stay at home. Doctors should reasonably expect to care for an increasing number of elderly people with complex medical and psychosocial issues. As a result of these challenges and issues, difficult ethical dilemmas may arise. As a result, practitioners should be aware of ethical difficulties that arise frequently when caring for older patients. Poor patient-clinician communication can lead to ethical difficulties; as a result, we present practical guidelines for better communication. People were more likely to develop physical disabilities, despair, and cognitive impairment as they got older, especially those in the 80-89 age bracket. Current data for India's old provide a foreshadowing of a new challenges if programme managers and policymakers do not take prompt action in this area. There is a need to raise awareness of the medical and socioeconomic difficulties that India's elderly confronts and initiatives for improving their quality of life.

Open Access Review Article

A Recent Update on Oral Anticoagulants

Jijnasha Mishra, Shreem Deolia, Sunil Kumar

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 834-840
DOI: 10.9734/jpri/2021/v33i60A34555

Atrial Fibrillation is very common among Americana; it is the irregular rhythm of the heart usually present with or without symptoms. It causes the formation of clots, clots go to the brain and cause a stroke. Anticoagulants have been known for a few decades to cause abrupt decrease around 50%) in the rate of stroke and prevent clotting at the required location and can cause bleeding. Anticoagulants aims for the safeguard and therapy of thromboembolism to prevent stroke. Previously used Anticoagulants are Warfarin, low molecular weight heparin and heparin. There were shortcoming of the drugs like parenteral route of administration, requires frequent monitoring due to variability in response, the onset of action is slow and there is bleeding in response to the drugs .In addition to heparin and vitamin k antagonist, anticoagulants that act on enzymatic agility or vigor brought about by of thrombin and factor Xa was exquisitely formulated. Implementation of the foresaid oral Anticoagulants requires knowledge of necessitate the comprehension of discrete indication, contraindications, characteristics. Research and repeated clinical trials have led to acceptance of few newer drugs which are working classically styled but better than Warfarin. In the last few years, Pradaxa (dabigatran), Xarelto (rivaroxaban), and Eliquis (dabigatran) have all been authorised by the FDA (apixaban). All three are ‘blood thinners,’ like warfarin, that lessen the overall risk of stroke associated with atrial fibrillation while also causing bleeding.

Open Access Review Article

Point of View about Corona Pandemic: An Approach towards Health Perspectives

Anmol Singh, Bharat S. Sudame

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 848-854
DOI: 10.9734/jpri/2021/v33i60A34557

It's been about a half year since there's been a word that's spread throughout the globe faster than wildfires, and it's not only the most talked-about topic, but also the most feared; yes, it's "crown." Hearing the word itself strikes dread in all individuals around the world. So what is this crown or COVID-19 truly? Coronavirus is an irresistible sickness brought about by the newfound strain of Covid, the SARS-CoV-2. Covid was accounted for from china in late December and early January from the province of Wuhan in China. Covid was found in the absolute most punctual known cases connected to Wuhan’s discount wet food market. The word crown got its fear of India on 30th January 2020 in Kerala. The patient was an understudy, concentrating in the city of source, and had returned to the nation because of the pandemic. Since January, this infection has been spreading and is accounted for everywhere in the world. Crown has become a dread that has not saved anybody from its effect. The everyday existence surprisingly around the globe has been affected since. This infection is a freak type of crown that is novel Covid covid19. Covid pandemic has instructed us that there are different exercises to be scholarly in the current pandemic circumstance. Crown has carried our thoughtfulness regarding how much progress should be around us. An alternate view and viewpoint have become known about our nation's current medical services plan. The establishment of medical care framework with medical services suppliers has come to stake. Ample opportunity has already passed that we investigate the current wellbeing administrations and strengthen them at the center level. Natural selection is one of the oldest adages in clinical research, and it has stayed consistent in situations like this. In the current circumstances, endurance has become an essential component.

Open Access Review Article

Review of the Literature on Existing Management of Dry Eye Disease

Isha Chandrakar, Shruti Sanghavi

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 878-884
DOI: 10.9734/jpri/2021/v33i60A34561

Dry eye disease (DED) is a multifactorial disease in which the tear film’s homeostasis is lost, along with other ocular symptoms such as tear film instability and high osmolarity, neurosensory abnormalities, and ocular surface inflammation and damage. DED is a condition of lacrimal apparatus which is responsible for tear production. The tear film is a mixture of mucin, aqueous (water and solutes like NacI, sugar, urea, proteins,), lipids secreted by goblet cells, lacrimal glands, and meibomian glands, respectively. It keeps the eye moist, provides oxygen to the cornea, and has antibacterial properties. The lipid layer prevents the evaporation of the aqueous. DED is categorized into (i)Aqueous-tear deficiency, characterized by a deficiency of lacrimal glands to secrete tears, (ii)Evaporative DED, associated with increased tear loss by evaporation because there is a deficiency of the meibomian glands. The mechanism of DED might be loss of tear through evaporation or insufficient aqueous production or a combination of the two. DED is a widespread eye problem, which is often left untreated. It causes irritation, itching, dryness, foreign body sensation, and discomfort; severe case causes conjunctival congestion, keratinization, erosion of the corneal epithelium, and plaque formation. If left Univision- threatening vision-threatening, leading to complications like corneal ulceration and perforation. Various clinical tests are used to diose DED, including tear breakup time, tear osmolarity, Schirmer test, Rose Bengal staining, and expression of inflammatory markers. There is no cure for DED at present. The following modalities are used for its treatment:

  1. use of punctual and canalicular plugs,
  2. artificial tear products like polyethylene glycol/propylene glycol with guar HP,
  3. consuming food rich in omega-three fatty acids, antioxidants zeaxanthin, and lutein,
  4. Use of anti-inflammatory drugs, mucolytics, secretagogues.
  5. Reducing or avoiding mild risk factors like prolonged reading, prolonged use of contact lenses, excessive screen time, etc.
  6. Treatment of causative disease.

 Appropriate management and establishing reasonable patient expectations are necessary to ensure patient satisfaction and adherence to the treatment.

Open Access Review Article

Dermatofibrosarcoma Protuberans: A Systematic Review of the Literature

Alaa Alnooh, Yasser Al-Qubaisy, Nujud Alshammari, Ibrahim Alhowshan

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 885-891
DOI: 10.9734/jpri/2021/v33i60A34562

Background: Dermatofibrosarcoma Protuberans (DFSP) is a rare slow growing cutaneous soft tissue sarcoma, that is characterized to be locally invasive with high recurrence rate. However, it has poor metastatic capacity.

Objective: We are conducting this literature review to gather evidence-based medicine knowledge regarding Dermatofibrosarcoma Protuberans. Moreover, this study highlights the gaps of knowledge in regard to this disease entity.

Methods: The literature search was conducted by searching the keywords “Dermatofibrosarcoma Protuberans” and “soft tissue sarcomas” in PubMed and Web of Science databases.

Results: 1,769 potentially relevant results showed matched titles, of which 13 articles met the requirements and were included in the literature review.

Limitations: Vague nonspecific clinical manifestations, makes it challenging to establish an early diagnosis and seek an appropriate counseling.  In addition, it is difficult to diagnose due to the slow growing behavior and the tumor’s benign appearance. As a result of all of that there is no enough cases reported in the literature.

Conclusion: This review highlights the need of high index of suspicion to help reach an early and proper diagnosis and to raise awareness. Dermatofibrosarcoma Protuberans needs a specialized center in order to identify and recognize the disease. The knowledge and awareness of the disease is low since it is rare.

Open Access Review Article

Optimization of Diagnosis and Surgical Treatment of Involutional Entropion of the Lower Eyelid

. Anshu, Pradeep G. Sune

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 892-897
DOI: 10.9734/jpri/2021/v33i60A34563

Background: Rolling inwards of the lid margin is called entropion, and is produced by a disparity in length and tone between the anterior skin muscle, and posterior tarso-conjunctival laminae of the eyelid. Involutional, cicatricial, spastic, or congenital are some of the classifications involutional entropion there is general instability of the lid structures with age .A weakness of the posterior retractors of the lid occurs, together with a laxity of the medial and lateral canthal ligaments,  accompanied by a loss of posterior support ,as atrophy of the orbital fat leads to enophthalmos. The current treatment modalities for this condition are surgical in nature, although non-surgical temporary medical treatment are also used. It's a commonest types of eyelid asymmetry. Corneal and conjunctival damage may lead to abrasions, scarring, corneal thinning, or corneal neovascularization due to this misalignment. Unilateral or bilateral entropion is possible. Involutional entropion of lower eyelids are common, but cicatricial upper eyelids are common.  Entropion of lower eyelid is a much more prevalent than entropion of the upper eyelid.

Objective: The purpose is to review the scientific literature on diagnosis and surgical management of involutional entropion of the lower eyelid.

Methodology: The data were collected from the various electronic data bases like google scholar, PubMed and various books.

Conclusion: After reviewing the articles, we come to the conclusion that the signs and symptoms of involutional entropion are easily manageable by given treatment.

Open Access Review Article

A Literature Review in Understanding the Physio-Pathological Facet of COVID-19

Pramod Kumar Singh, Darishisha L. Suting, Sikha Lekharu

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 927-932
DOI: 10.9734/jpri/2021/v33i60A34568

In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed as COVID-19 and is transmittable between humans that has caused a pandemic worldwide. An early clinical report showed that fever, cough, fatigue, sputum production, and myalgia were initial symptoms, with the development of pneumonia as the disease progressed. COVID-19 basically involved the pulmonary system at the onset, thereby involving the other organs like gastrointestinal system, cardiovascular System and nervous system is based on virulence. Increases in the level of serum liver enzymes D-dimer, cardiac troponin I, and creatinine have been observed in severely ill patients, indicating that multiple organ failure had occurred in these cases.  Here, we review the current knowledge about this disease in relation to its various aspects and make comparison systemic-wise for better understanding of the systemic physio pathological aspect of Covid-19 that may help in contributing towards finding the solution that is needed at present.

Open Access Review Article

COVID 19: Sharing Experience of Health and Treatment Diagnosis in India

V. Sharanya, Swaroopa Chakole, Rupa A. Fadnavis

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 933-939
DOI: 10.9734/jpri/2021/v33i60A34569

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, discovered in the year 2019. It originated in Wuhan, Hubei Province in China. It became the 5th documented Pandemic after the Spanish Flu in 1918. The symptoms are typical of Influenza like Illness, which includes fever, cough, cold, sore throat, headache, generalised body pain, loss of taste and smell sensations. It ranges in severity causing Pneumonia – all caused by the virus known as Corona virus. The pandemic did indeed cause a havoc as it was declared as a Public Health Emergency. It not only had an impact on lives of people but had a worldwide impact on varied sections of society, not limited only to healthcare but also the economy, psychology, travel and tourism, to just name a few. There was even a certain stigma associated with contracting the virus and having to stay in complete Home Isolation from the World. It not only had pronounced effects on the physical well-being of an individual, but also on one’s mental make-up.  It has been a constant learning curve across different walks of life, that placed Hand Hygiene, Mask Wearing and Social Distancing at the epicentre of the prevention of such a Communicable Disease. This article is a reflection of my experience, battling with Corona Virus. – a deadly Pandemic of the 21st Century.

Open Access Review Article

Diabetes Mellitus: Worst Comorbidity to have in COVID-19 Pandemic

Kritarth Sengupta, Bharat S. Sudame

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 948-955
DOI: 10.9734/jpri/2021/v33i60A34571

Background: Diabetic patients have shown the worst clinical manifestation of the COVID-19. They are at higher risk of being infected and producing severe clinical outcomes, challenging to manage. Also, the share of the diabetic patient among case fatalities is large.

Summary: COVID-19 is a disease pandemic that has spread worldwide. All sections and age groups of people worldwide have been affected by the pandemic. Diabetes mellitus is the worst disease to have in OVID-19, as studies have shown some adverse clinical outcome that needs sophisticated medical attention. In lack of resources and overwhelmed infrastructure, the availability of these is tricky.

Conclusion: More study is needed about the bidirectional relationship between COVID-19 and diabetes mellitus so that a clearer picture can be emerged out of the fogged situation. Diabetes is already grappling the world, which is suggested by increasing the number of diabetic patient’s number worldwide. Especially in COVID-19, it has become a challenge to contain the disease along with all these comorbidities. The immunosuppressive state brought about by various underlying medical conditions like diabetes mellitus is suitable ground for novel coronavirus to propagate itself.

Open Access Review Article

An Overview on Tuberculosis and Worldwide Steps to Combat TB Including Awareness Programme in India

Bhoyar Vidyadevi, Belgamwar Veena, Pardeshi Chandrakantsing, Pramod Ingle

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 956-971
DOI: 10.9734/jpri/2021/v33i60A34572

Objectives of current review is to collate history of Tuberculosis (TB), overview of the current literature on epidemiology, world health organisations (WHO) recent strategic plan to overcome and eliminate TB from the root, and to determine current knowledge gaps for control of TB. This study is a review, a descriptive approach of state-of-science for better treatment strategies for TB. The article finds that to reach to end TB goal, WHO, we have to follow the guideline of who about TB control, along with that the Indian government also maintained awareness program. Current findings on TB suggest that with the development of science and technology, researches being conducted to minimise the drug resistance tuberculosis, as well as WHO sets new strategy to fight against TB, which could potentially change the casual outlook of the people towards their health habits, health issues, and will help them in future to tackle from this deadly killer disease.

Open Access Review Article

The Effect of Longitudinal Gastric Resection in Morbid Obesity Surgery on the Course of Insulin-Dependent Diabetes and Gastroesophageal Reflux Disease

Marat Borisovich Uzdenov, Elvira Nazimovna Sherifova, Sergey Ismailovich Kubanov, Aila Azretovna Uyanaeva, Viktoriia Sergeevna Rudiakova, Maryam Bashirovna Balaeva, Kavsarat Kamaldinovna Atagishieva, Svetlana Nikolaevna Shikhina, Angelina Sergeevna Miroshnichenko, Alina Yurievna Maslova

Journal of Pharmaceutical Research International, Volume 33, Issue 60A, Page 977-982
DOI: 10.9734/jpri/2021/v33i60A34574

Longitudinal resection of the stomach is a relatively new type of gastroplasty within the framework of bariatric surgery, which is gaining popularity worldwide today not only as a method of getting rid of excess subcutaneous fat, but also from a range of serious chronic diseases together. The potential of longitudinal gastric resection turned out to be promising, and if the first performed longitudinal gastric resection in 1988 was only a restrictive stage of biliopancreotic bypass surgery, then since the 2000s, laparoscopic longitudinal resection has been started as a deliberately first stage in patients with morbid obesity with high operational risk. To date, longitudinal gastric resection has become increasingly used in particularly difficult cases in the form of independent surgical intervention, for example, in the elderly, teenagers, people with cirrhosis of the liver and other severe pathologies. At the initial stages of the formation of this type of treatment, different surgeons did not have a common opinion on many issues related to the technique of this operation. And therefore, to date, the data on the longitudinal resection of the stomach of many years ago are contradictory. They do not create a holistic view of the effectiveness of surgical intervention, especially in the long term. According to IFSO (The International Federation for the Surgery of Obesity and Metabolic Disorders) data, in 2012, longitudinal gastric resection accounted for 27.8% of all bariatric operations, which even then overtook the gastric banding operation in terms of the number of operations. Over the past 20 years, a little more than 250 thousand such operations have been performed worldwide, and the frequency of performing longitudinal gastric resection increases every year.

The purpose of this article is to reveal the statistics of the effectiveness of longitudinal gastric resection.