Open Access Case Report

A Rare Case of Lymphatic Filariasis

J. Vijay, N. Anuradha, Viknesh Prabhu, Patel Harshvardhan Anilbhai

Journal of Pharmaceutical Research International, Page 30-32
DOI: 10.9734/jpri/2021/v33i60B34582

Lymphatic filariasis is a parasitic infection caused by Wuchereria bancrofti, Brugia malayi and Brugia timori.Asymptomatic microfilaria, acute lymphatic filariasis, chronic lymphatic filariasis, tropical pulmonary eosinophilia are the different presentations of lymphatic filariasis. Systemic manifestation can involve joint, kidney, heart and nerve. This article is a case report of lymphatic filariasis with a rare presentation of anasarca and nephritic syndrome.

Open Access Case Report

Rehabilitation of a 55-year-old Man’s Inter Trochanteric Fracture: A Case Report

Shivani Uttamchandani, Neha Chitlange, Mithushi Deshmukh

Journal of Pharmaceutical Research International, Page 201-206
DOI: 10.9734/jpri/2021/v33i60B34605

Background: The most common fractures seen in senior osteoporotic patients are intertrochanteric (IT) fractures, which are usually caused by a simple fall in the house. The number of old patients is expected to double by 2040 due to an increase in the number of elderly patients with osteoporosis. Understanding key aspects of IT fracture, therapy such as stability, reduction, and the involvement of posterior medial and lateral walls, will aid in implant selection for a better outcome.This fracture interferes with the normal functioning of the body in day-to-day life. Therefore, physiotherapy rehabilitation after surgery is essential to get back to normal functioning.

Case Presentation: A 55- year-old male patient who came with complaints of pain and swelling in right hip, unable to walk. Patient was under the influence of alcohol when he fell from the bed. He experienced sudden and severe pain in right hip and was unable to stand. His relatives brought him to Acharya Vinobha Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Maharashtra for further management. Dynamic Hip Screw was applied for the fixation of Intertrochanteric Fracture. Further on rehabilitation was started, which aimed to restore mobility, regain full range of motion and develop muscle strength.

Conclusion: The Intertrochanteric fracture of femur is a form of fracture with a high occurrence. The above case presentation concludes that a traditional surgical procedure combined with timely planned physiotherapy rehabilitation contributed to progressive improvement in functional goals, which is an important factor in achieving a good recovery in such post-operative cases.

Open Access Case Report

A Case Report of Capitellum Fracture Treated using Herbert Screw

Vijay Narasimman Reddy, . Mervinrosario, . Kushwanth

Journal of Pharmaceutical Research International, Page 1049-1054
DOI: 10.9734/jpri/2021/v33i60B34712

Capitellar fractures are intra-articular elbow injury & it is an uncommon type of elbow injuries that can cause and affect severe functional limitation if not treated correctly. Various treatment options have evolved over the years, from cast immobilization to closed reduction fixation and now finally open reduction fixation is used as a better treatment option. Open reduction internal fixation provides excellent fixation to the fracture site and helps in achieving a stable joint that help in early mobilization of the elbow joint after trauma. Which also prevents late complications such as myositis ossificans. This is a case report of capitellar fracture, a typical type -1 Hahn-Steinthal fracture of left elbow joint in a 14 year old adolescent male treated using Herbert’s screw fixation. Here after three months of post-op follow-up it shows good interfragmental compression, early mobilization, excellent recovery & Implant removal is rarely necessary.

Open Access Case Report

Case Report on Sacro-Coccygeal Teratoma in 5 Year Old Girl: A Case Report of Late Presentation

Priyanka Rewatkar, Madhuri Shambharkar

Journal of Pharmaceutical Research International, Page 1242-1246
DOI: 10.9734/jpri/2021/v33i60B34738

Introduction: The Sacro-coccygeal teratoma is rare tumour that appears near the distal end of the tailbone in new-borns (coccyx). It's the most common congenital tumour, and it can appear at any time throughout pregnancy. It occurs in about 1/35000 to 1/40000 of all live births. Female new-borns are more likely to have this birth defect than male ones. Sacro-coccygeal teratoma can cause critical disturbance in defecation function of infant although this disease is extremely rare benign tumour. Appropriate early recognition can prevent progression to this devastating outcome. In this case report, we present a Sacro-coccygeal teratoma originating from gluteal region. The case is used to highlight important nursing management, clinical consideration and how to prevent further complications. We describe a Case of Sacro-coccygeal teratoma in 5 year girl child presenting with increased gluteal swelling of 15 days duration. In addition she had difficulty in passing stool and urine and also difficulty in sitting.

Open Access Case Report

A Rare Finding of Abundant Crystals in Thyroid FNAC

Devikala Kumaresan, Mary Lilly

Journal of Pharmaceutical Research International, Page 2063-2066
DOI: 10.9734/jpri/2021/v33i60B34846

Thyroid is a versatile endocrine organ. Fine needle aspiration cytology is the famous technique which is safe, easy to perform, cost effective and more accurate in diagnosing benign and malignant thyroid lesions. Our case shows a rare presentation of numerous calcium oxalate crystals within the colloid in thyroid smear which indicates degenerative and atrophic changes in the follicles, and can also be seen in numerous other benign and systemic conditions which roots the underlying pathology and helps in treatment as well as stays as a unique rare finding.

Open Access Case Report

Bilateral Task-oriented Training and Strengthening Leads to Improvement in Gross Motor Functioning in Patients Post-ischemic Stroke: An Interesting Case Study

Arasha Khan, Rebecca Timothy, Pallavi Harjpal, Rakesh Krishna Kovela, Mohammad Irshad Qureshi, Ragini Dadgal, Snehal Samal

Journal of Pharmaceutical Research International, Page 2527-2531
DOI: 10.9734/jpri/2021/v33i60B34909

Background: A stroke is a medical emergency that requires immediate attention. Early intervention can prevent brain damage and other adverse outcomes. An ischemic stroke occurs when a blood clot stops or narrows in a blood vessel that leads to the brain.

Presentation of Case: In the present case, a 63-year-old retired Zila Parishad worker came to our hospital with complaints of fever and weakness; after six days of medication and hospital stay, his fever subsided, but he developed weakness of the right upper extremity and slurring of speech. Regular investigations were done. MRI revealed Acute Infarct in the Left Frontal Region.

Discussion: Bilateral training is proved to be effective in improving hand functioning in patients post-stroke. This is the application of the movement to both the extremity to gain progress.

Conclusion: The patient was provided with medical, regular physiotherapy management, and speech therapy leading to improvement in his condition. He is still under regular physiotherapy for improvement in his fine motor function.

Open Access Case Report

Acute Fatty Liver of Pregnancy-a Rare but Potentially Catastrophic Cause of Jaundice in Pregnancy

Sharmeen I. Memon, Neema S. Acharya

Journal of Pharmaceutical Research International, Page 3050-3055
DOI: 10.9734/jpri/2021/v33i60B34976

A 27-year-old female primigravida at 36.2 weeks gestational age presented nausea, vomiting, and yellowish discoloration of the eyes. On investigation, she had deranged liver and kidney functions, and USG was suggestive of Coarse Echotexture of the Maternal liver. We diagnosed it as a case of Acute fatty liver of pregnancy followed by Early Caesarean section and intensive supportive management. Active monitoring of Haemodynamic status, Metabolic status, Coagulation profile, Renal, and CNS function resulted in a safe and healthy mother and child.

Open Access Case Report

Adult Idiopathic Hypertrophic Pyloric Stenosis- A Diagnostic Challenge for Surgeons

K. Pranay, R. Anantharamakrishnan, K. Senthil Kumar, P. Varadaraju

Journal of Pharmaceutical Research International, Page 3056-3061
DOI: 10.9734/jpri/2021/v33i60B34977

Background and Objectives: AIHPS (adult idiopathic hypertrophic pyloric stenosis) is an uncommon but clear cut condition in adults, with only 200-300 case reports are recorded in the articlesso far, now A case report of AIHPS treated in our hospital is discussed, as well as a review of the literature.

Methods and Results: The patient had upper abdominal discomfort that started suddenly and was accompanied by nausea, vomiting, and anorexia. The pylorus showed a distinct "cervix sign" during an esophagogastroduodenoscopy (EGD). He next had a partial distal gastrectomy with a Billroth II gastrojejunostomy, which resulted in significant alleviation in his symptoms.

Conclusion: Adult idiopathic hypertrophic pyloric stenosis (AIHPS) is an uncommon condition as it were underreported owing to diagnostic difficulties. After food nausea, vomiting, early satiety, and epigastric discomfort are the most prevalent symptoms of AIHPS, as shown in our case.Endoscopy impression reveals a distinct sign characterised by a fixed, constricted pylorus with a smooth border also known as cervix sign which is in diagnostic favour for AIHPS. Endoscopic dilatation, pyloromyotomy with forethought pyloroplasty, and gastrectomy with a BillrothII gastrojejunostomy have all been recommended as therapies for AIHPS. There is currently no proof that one surgical method is better than another. Before one approach can be established as the standard of care, more study on AIHPS is required.

Open Access Case Report

Cysticercosis of Cheek - A Rare Site

Aanchal Manchanda, Anil Agrawal, Sunita Vagha

Journal of Pharmaceutical Research International, Page 3281-3285
DOI: 10.9734/jpri/2021/v33i60B35006

Cysticercosis caused by Taenia solium is a helminthic infection. It usually resides in animals and humans to complete its life cycle and cause the disease within it. Cysticercosis in humans is acquired by ingestion of eggs or its larvae form. It is caused due to improper sanitation, fecal ingestion by the pigs which is infected with larvae of cysticercus, improper vaccination of pigs and ingestion of raw or uncooked pork and meat by the humans. Most commonly it involves the brain, heart, liver, muscles, lungs and the peritoneal cavity. When there is involvement of the mouth, frequently occurring sites include the tongue, buccal mucosa and rarely floor of mouth. Likewise, most commonly, the skeletal muscle involvement is noted.

It is usually diagnosed by radiological and pathological investigations. Radiologically, USG and MRI characteristically reveals the lesion caused by cysticercosis. Pathologically, the biopsy done of the affected area shows the inhabited cysticercus along with its causative changes in the tissue like edema, congestion and infiltration of Inflammatory infiltrates. Being a parasitic infestation, eosinophilic infiltration around the membrane of cysticercus is commonly noted in the biopsy. This is the presentation of the case report, where there is an occurrence of Cysticercosis in the muscles of cheek, a site with rare occurrence.

Open Access Case Report

Seizures Presenting as ADHD: A Case Report

Anies Siya K. S., Fadi Mohamed Kallan, Julianna Jinson Kolenchery, Vismaya Rachel D'silva, Amit B. Nagdive, Siddharth Sethi

Journal of Pharmaceutical Research International, Page 3352-3357
DOI: 10.9734/jpri/2021/v33i60B35017

ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental disorder that affects a large proportion of children. ADHD is associated with an increased risk of seizures and is characterised by inattention, restlessness, and impatience.

A 6-year-old boy with ADHD presented to the Psychiatry Out-Patient Department with complaints of aggressive behaviour and restlessness. Trademark symptoms such as difficulty in sustaining concentration, not following instructions, running about, not being able to sit in one place, and verbally and physically abusive behaviour were noted in the patient.

Atomoxetine and Risperidone were prescribed for inattention and behavioural misconduct, respectively. Due to lack of improvement and a seizure suggestive incident an EEG investigation was instigated; it showed seizure activity for which Sodium Valproate was initiated for the same. Due to adverse effects, Oxcarbazepine was additionally included. Oxcarbazepine showed the most effective in treatment and progress continued with the intake of the drug. Currently, the boy is showing near total improvement and is on Atomoxetine 20 mg, Oxcarbazepine 600 mg and Sodium Valproate 400 mg, all of the above in divided doses.

This case report aims at highlighting the manifestation of unprovoked seizure activity in a patient previously diagnosed with ADHD with conduct disorder.

Several medical conditions in children mirror ADHD symptoms, making diagnosis difficult. For accurate treatment, it's crucial to rule out a differential diagnosis. With the help of this case, we can shed some light on the lack of knowledge and protocols in the management of hyperkinetic disorders, which has resulted in the spike of misdiagnosed cases across the country.

Open Access Case Report

Well Differentiated Villoglandular Papillary Adenocarcinoma of the Cervix: A Rare Case Report

Anita Sajjanar, Pratibha Dawande, Swetha Bahadure, Sunita J. Vagha

Journal of Pharmaceutical Research International, Page 3843-3847
DOI: 10.9734/jpri/2021/v33i60B35085

The Villoglandular papillary adenocarcinoma (VGA) is a variant of adenocarcinoma of the cervix. It occurs in young women having a favorable prognosis. Pathologically, VGA poses a diagnostic challenge. Here we present a rare case of a middle-aged female patient complaining of bleeding per vagina since1year. Histopathological examination reported it as a well-differentiated villoglandular adenocarcinoma of the cervix. This tumor as a separate entity should be recognised, distinguished from other variants of adenocarcinomas. Because of its good behaviour and favourable prognosis usually itsallow conservative treatment.

Open Access Systematic Review Article

A Systematic Review: The Relationship between Fixed Prosthodontics and Dental Sensitivity

Ghith Fayez Aldhahri, Shaima Abdulaziz Nass, Abdulrahman Abdullah Alrefaei, Ali Hussain Albouri, Hanouf Saad Alqethami, Mahmood Hamdan Abdulla Radhi, Abdulraouf Abdulaziz Alhojaily, Wijdan Ahmed Alghamdi, Ali Mohammed Alqahtani, Mohamed A. Qudaih, Fatima Sultana

Journal of Pharmaceutical Research International, Page 115-119
DOI: 10.9734/jpri/2021/v33i60B34593

Dental prosthetics that are permanently attached (fixed) to the teeth are called fixed prosthetics. Crowns, bridges (fixed dentures), onlays, inlays, and veneers are also referred to as indirect restorations. Professionals in prosthodontics have trained in this area from academic institutions. With fixed prosthodontics, a single tooth or multiple teeth can be restored over areas where teeth are missing. A common oral health issue is trauma-induced tooth hypersensitivity following preparation of the tooth. Dental hypersensitivity is caused by a sudden onset of sharp pain on contact with exposed dentin, usually in response to heat, evaporation, pressure, or cold and is not attributed to any other dental problem or condition." Despite a lack of literature on the subject, post-cementation sensitivity has not been definitively studied. When dentinal tubules are separated during the preparation of teeth, a certain degree of pulpal trauma will result. An important decision is whether to carry out elective endodontic treatment for the tooth's vital abutments or proceed with the pulp preservation procedure.

Open Access Systematic Review Article

The Effect of Dental Care during Orthodontic Treatment: Systematic Review

Laila Mohammed Alanazi, Dalal Jumah Alturaif, Raed Saud Alhuzaimi, Nouf Abdullah Alarwan, Rawan Abdulaziz Almubarak, Aljawharah Alabsi, Sahar Alothman, Manal Alrubayqi, Ghith Fayez Aldhahri, Amatulrehman Bahaziq, Fatima Sultana

Journal of Pharmaceutical Research International, Page 556-563
DOI: 10.9734/jpri/2021/v33i60B34654

The maintenance of stringent oral hygiene practices is imperative during orthodontic treatment in order to prevent plaque from accumulating over braces and other orthodontic appliances, leading to gingivitis inflammation and periodontal disease. Consequently, an orthodontist is responsible for providing advice to patients about oral hygiene to maintain periodontal health and for monitoring plaque control measures. In spite of their orthodontist's recommendation, most orthodontic patients do not follow their recommended instructions on how to maintain a satisfactory level of plaque control. We conducted our systematic review of literature in English. During the initial re-examination phase, there were no filters applied to ensure all studies were available for subsequent screening. Filters like human studies were added later, with English language studies being the only ones added. We found nine articles related to orthodontic treatment, and their relation to dental care, during our literature review. It is essential to maintain good oral hygiene during orthodontic treatment to reduce iatrogenic demineralization and caries. When a patient's DMFS score is high, prophylaxis programs are necessary during orthodontic treatment.

Open Access Systematic Review Article

Management of Hypertension through Shodhana & Shamana Chikitsa: A Systematic Review

Vaishnavi Paraskar, Punam Sawarkar, Gaurav Sawarkar

Journal of Pharmaceutical Research International, Page 822-835
DOI: 10.9734/jpri/2021/v33i60B34685

Hypertension or high blood pressure is a complex disease that may affect other organs resulting in renal dysfunction, neuropathy, cerebral disorders, and many other complications. These are further complicated due to the side effects of established antihypertensive medicines used for it’s treatment. A significant rise in cases of hypertension has been noted in the era of modernization.  Some alternative or adjuvant modalities require time for the prevention and management of hypertension. As per two basic modules of Ayurveda, i.e., Hetu, Linga, it is easy to correlate the Hypertension with multiple terminologies such as  Shonitdushti, Raktavruuta Prana or Vyanavrutta Prana, etc. Using these principles of Ayurveda, treatment of hypertension is possible safely at a primary stage. Also, it can be used as an adjuvant in the management of advanced-stage disease.  This meta-analysis reflects on Ayurvedic interventions like Shodhana or Shamana Chikitsa used to manage hypertension. This analysis included 14 clinical studies conducted on 995 participants at different places. Shodhana & Shamana Chikitsa were found to play a primary or adjuvant role in the effective management of hypertension. This study dictates the need for scientific multi-centric research on hypertension. 

Open Access Systematic Review Article

Radiological and Laboratory Modalities for Diagnosis of COVID-19: A Systematic Review

Bhavesh Modi, Komal Shah, Mahalaqua Nazli Khatib, Deepak Shukla, Abhay Gaidhane, Deepak Saxena

Journal of Pharmaceutical Research International, Page 865-878
DOI: 10.9734/jpri/2021/v33i60B34689

The world has witnessed the dreadful COVID-19 pandemic and the rapid rate of its spread across countries. The key measures in pandemic control includes early detection of cases, isolation of cases to prevent spread and appropriate management of confirmed cases. The present diagnostic criteria for COVID-19 in India is based on RT-PCR. This technique has its own limitations. There are ongoing debates to the cost, time taken and type of diagnostic sensitivity and predictive values of RT-PCR. Researchers across globe have been exploring alternative methods to enhance the mainstay of protocols for identifying suspected cases of COVID-19. With media news of too many asymptomatic positive results from community in New Delhi, Ahmedabad and other places in India, along with prompt withdrawal of antibody based tests by ICMR after questions on validity, such test raises concerns and urgent need for exploring the need for rethinking the diagnostic algorithm. This is a systematic review to explore possibility of novel diagnostic approaches for a suspected case of COVID-19 with an objective to early detection of case and using appropriate methods to halt the chain of transmission.

Open Access Systematic Review Article

Effect of Mulligan Mobilization on Proprioception in Osteoarthritis of Knee Joint - A Systematic Review

Makesh Babu Subramanian, Preethi Rajesh, . Sudhakar

Journal of Pharmaceutical Research International, Page 1027-1034
DOI: 10.9734/jpri/2021/v33i60B34709

Background: Osteoarthritis (OA) of the knee is a degenerative disorder that affects the joint which causes pain, stiffness, swelling, muscle weakness, and functional impairments. Proprioception in the OA knee seems to be impaired when compared with the normal counterparts. Manual therapy is one of the hands-on therapies delivered by physiotherapists. However, there is not much information on how manual therapy affects joint proprioception, although some studies show a positive response. Mulligan’s mobilization technique is common for spinal and peripheral joints to correct positional faults.

Aim: To systematically identify and to evaluate the effects of mulligan mobilization on the proprioception of the OA knee.

Methods: Various electronic databases like PubMed Central, Medline, Google Scholar, ProQuest and CINAHL are searched from 2001 to 2021. Multiple search criteria were used in the search of relevant articles based on the selection criteria used. Four articles that fit the criteria were taken based on the PEDro Scores of above 5. The two specialists analysed all the papers. The articles which cover mulligan’s mobilization and proprioception of the knee were only selected.

Results: Four articles that fit the criteria were reviewed which demonstrated baseline comparability and reported point estimates and measures of variability.

Conclusion: This systematic review has concluded that the knee joint proprioception was improved with applying the Mulligan’s manual therapy, whereas the neurophysiological activity is not well understood.

Open Access Systematic Review Article

Prevalence of Untreated Mesio-Buccal 2 Canal in Maxillary First Molars Reported in KSA Since 2010: A Systematic Review

Laila Mohammed Alanazi, Sahar Alothman, Amal Taha Alsomaly, Abdulelah Khalid Alanazi, Abdulmohsen Khalid Alanazi, Saleh Mohammed Alghufaili, Wesam Yousef Alibrahim, Shahzeb H. Ansari, Fatima Sultana

Journal of Pharmaceutical Research International, Page 1174-1178
DOI: 10.9734/jpri/2021/v33i60B34729

Several aspects are involved in the success of an endodontic therapy. Because root canal treatment is so complicated, it can't be evaluated using two-dimensional radiographs. Endodontic failure can occur if any section of the canal is overlooked and left untreated. The root canals of the first and second molars are the most complicated of all the maxillary teeth. Locating the mesio buccal (mb2) canal in the maxillary teeth for endodontic treatment is difficult. The mb2 canals are located utilizing three-dimensional technology and cone beam computed tomography (CBCT). The primary goal of this research is to conduct a systematic evaluation of publications that have reported on the occurrence of mb2 canal in maxillary first molars. Many studies in Saudi Arabia have found that the incidence of mb2 in maxillary first molars ranges from 23.3 percent to 70.6 percent, and that the incidence in maxillary second molars is about 19.8%. A few studies also found that direct viewing of the root, followed by troughing, was used to find an mb2 canal that was not visible on a CBCT scan.

Open Access Systematic Review Article

Benign Paroxysmal Postural Vertigo (BPPV): A Review

Arju Fatema B. Lakhani, Sakshi K. Katariya, Sagar Gaurkar

Journal of Pharmaceutical Research International, Page 1437-1446
DOI: 10.9734/jpri/2021/v33i60B34764

Background: Benign paroxysmal postural vertigo is considered as the most frequent cause of vertigo worldwide because of which various times patient suffers the most dreaded complication which is not just because of vertigo but is due to the loss of balance during activities (such as driving and crossing the road,even while climbing up the stairs) and which is often misdiagnosed as a neurologic condition which further worsen the prognosis. This can be avoided by a simple OPD based manoeuver (series of movements) as a diagnostic procedure in most cases. Once diagnosed another series of movements (manoeuver) can be performed to afford symptomatic relief.

Objective: To create a complete systematic review of the prevalent reason of dizziness  i.e. benign paroxysmal postural vertigo (BPPV) along with its historic background, diagnostic modality (associated with various manoeuvers ). Also, alternative methods of management considering their success rate and prognosis associated with precautions and primary measures (I.e prevention or decrease of risk factors, precautions and even to educate the patient about the disease.

Methodology: This article is reviewed from data taken from various articles found on various search engines like Google Scholars , PubMed , Research Gate along with the data taken from various books on he respective topics. Also,  the data searched from various search engines using the terms like BPPV, Vertigo, VOR, Dix - Hallpike Maneuver, Posterior Semicircular Canal, Superior Semicircular Canal.

Conclusion : BPPV is a simple disorder that can be misdiagnosed if the history is not taken properly or examination is not done correctly, it can severely affect the patients day to day activity and can be a very problematic condition if the attack is precipitated while activities like driving  or  crossing the road, or even climbing,which can lead to dreaded complications. Henceforth it is a great topic of concern to resolve this disease which can be usually resolved by a simple OPD based management and can bring a great difference in the patient’s life for GOOD.

Open Access Systematic Review Article

A Systematic Review: Prevalence of C Shaped Configuration in Upper-maxilaryand Lower-mandibular First Premolar

Nadia Buraik, Abdulaziz Abdullah Alnafjan, Fahad Khalid Almana, Amani Essam Najjar, Abdulelah Mesfer Alrubayqi, Roqiah Zaki Alkhamis, Amirah Abdulaziz Alotaibi, Mohammed Thafar Aldosari, Dalal Jumah Alturaif, Laila Mohammad Alanazi, Ahmed M. Elmarakby, Fatima Sultana

Journal of Pharmaceutical Research International, Page 1497-1507
DOI: 10.9734/jpri/2021/v33i60B34771

In most cases, the C-shaped pattern is found in mandibular second molars. Additionally, C-shaped canals can also occur in mandibular premolars, maxillary molars, and mandibular third molars. It poses challenges like debridement, obturation, and possibly the outcome of root canal treatment. The purpose of this study is to make a systematic review of studies related to the prevalence and morphology of C shaped canals in premolar teeth. Using pre-designed forms, data were extracted from online databases such as Medline and PubMed Central. We extracted citations and characteristics of studies, such as names of authors, date of publication, country, title, definition of C shaped canal configuration, and classification of C shaped canal configuration in upper and lower first premolars. Even though they are rare, mandibular premolars are also known to have C-shaped canal systems. Approximately 10-18% of mandibular first premolars have C-shaped canals, according to studies. Treatment is more challenging for patients with C-shaped canals. The frequency of C-shaped configurations in premolar teeth is likely to be affected by regional characteristics and gender of the population. Having these factors in mind before surgery allows dentists to better plan, coordinate, and perform complex morphologies.

Open Access Systematic Review Article

A Brief Study on Diabetes Mellitus: Pathophysiology and Diagnosis

Harsh Verma, Swarupa Chakole, Guddi Laishram

Journal of Pharmaceutical Research International, Page 1675-1681
DOI: 10.9734/jpri/2021/v33i60B34793

Background: This article reviews published articles and existing diagnostic and therapeutic techniques relevant to adolescents with obesity and diabetes mellitus.

Obesity, in addition to DIABETES MELLITUS, is a crucial risk factor for the occurrence of future chronic and noncommunicable diseases.

Obese and overweight teenagers are more prone to acquire Adult Onset Diabetes, formerly rare among the younger population. However, a global trend of Adult Onset Diabetes was noted in the late 1990s and early 2000s. In the United States and the United Kingdom, and other developing and developed countries, this is particularly true. Adult Onset Diabetes is nearly as common as Insulin Dependent Diabetes in some locations. There has been a significant surge in the prevalence and severity of obesity in several population groups in teenagers.

Objective and Methodology: To read and review the existing literature on the prevalence of Diabetes Mellitus and obesity in adolescence. About 15 articles and literature were studied using the PubMed and Google Scholar search engine to produce a detailed review article on the topic of interest so chosen.

Results and Conclusion: After reviewing the articles, we can agree that TYPE-2 DIABETES MELLITUS is linked easily to young adults who are obese, that is, having a Body Mass Index of more than 30 or more than 30. TYPE-2 DIABETES MELLITUS   causes destruction of receptors for insulin which results in an increased level of glucose, causing various diseases. Obesity in young adults is a critical factor in the occurrence of Adult Onset Diabetes which makes them at risk of developing severe diseases in the 3rd or 4th decade of life.

Open Access Systematic Review Article

Role of Medicinal Plants in the Management of Diabetes Mellitus: A Review

Navjot Sharma, Kundan Singh Bora

Journal of Pharmaceutical Research International, Page 2196-2207
DOI: 10.9734/jpri/2021/v33i60B34864

Diabetes mellitus is a worse metabolic condition in which level of glucose and lipid increased in blood circulation due to insufficient insulin functionality that may lead to worse the complication like atherosclerosis, dyslipidemia, gangrene, limb amputation, kidney failure, and many more. Furthermore, high concentration of glucose in blood stream can directly produce reactive oxygen species which ultimately more worsen the conditions like dyslipidemia, atherosclerosis etc. This disorder is expected to affect 9.3% of the global population in 2019, increasing to 10.2%  by 2030 and increasing 10.9 % by 2045. Medicinal plants are used as medicine to treat many ailments since a long time ago. But now they have been rediscovered with having specific constituents to treat diseases and many more yet to discover. There are so many active phytoconstituents of plants which are being extracted, purified, tested and formulated for patient convenience. In the present review, various plants used to treat diabetes mellitus due to have negligible side effects as compared to allopathic treatment (oral hypoglycemic drugs) are described. Many plants with hypoglycemic effect of many plants have been reported, and the mechanisms of action of these plants with these hypoglycemic behaviors are being examined through in vitro and in vivo studies. Some of these 22 medicinal plants and their active constituents related to antidiabetic activity are discussed in this review.

Open Access Systematic Review Article

Ischemic Stroke in COVID-19: A Systematic Review

Ganna Trepet, Nataliia Radzikhovska

Journal of Pharmaceutical Research International, Page 2412-2420
DOI: 10.9734/jpri/2021/v33i60B34893

Aims: To determine an association between inflammatory and coagulation markers in a COVID-19 patient with ischemic stroke.

Study Design: We performed a systematic review of 4 databases using the keywords “ischemic”, “stroke”, “COVID-19”,” Virus”

Place and Duration of Study: December 2021 - January 2022.

Methodology: Randomised control trials, observational studies, and systematic reviews were evaluated to ascertain the correlation between inflammatory and coagulation markers in COVID-19 patients with Ischemic stroke. Searches were conducted using Cochrane/EMBASE, PubMed/Medline, and PEDro between (2020-2021).

Results: Of the inflammatory markers, white blood cells (WBC) and platelets did not vary considerably outside their normal ranges. All markers of hypercoagulability were elevated, but only Prothrombin Time corresponded with C-reactive protein (CRP).

Conclusion: Inflammatory markers were not useful in forecasting the development of acute ischemic stroke, but CRP levels may be a possible marker to further research. D-dimer is a tried and true lab test that should be part of management guidelines in the ongoing COVID pandemic.

Open Access Systematic Review Article

A Systematic Review on Association between Dietary Acrylamide and Cancer Risk

Suman Rohilla, Tripti Arora

Journal of Pharmaceutical Research International, Page 2769-2776
DOI: 10.9734/jpri/2021/v33i60B34940

Acrylamide is a yellowish, odorless solid that is water-soluble and is used in a variety of organic solvents and organic chemical compounds. It is used as a precursor or substitute for water-soluble thickeners in a variety of applications. It is very toxic and hence carcinogenic, and it is administered as a watery solution. Aside from exposure to the industry and cigarettes, food appears to be the most common source of human exposure. Cancer has remained the second-leading cause of death, with a global increase in the number of cases. Increasing the cancer burden necessitates the use of cancer preventive methods. Because of the present results of several future investigations, specialists have conducted a new meta-analysis on the usage of acrylamide-related illness incidence in various areas. Authors discovered 32 publications on their own. The researchers conducted a meta-analysis utilizing corrected or spontaneous modeling, based on the heterogeneous method, to assess the overall chance for each cancer site for highest versus  lowest consumption levels, including an increase in nutritional acrylamide by 10 mg/day. Acrylamide has been classified by the International Agency for Research on Cancer as a human category 2A carcinogen, based on evidence of acrylamide carcinogenicity in animals.

Open Access Case Study

Oral Candidiasis with Subcutaneaous Emphyema Associated With Sari Following Post COVID 19: A Case Report

Shiwani Padmakarrao Dandade, Vaishali Taksande

Journal of Pharmaceutical Research International, Page 58-63
DOI: 10.9734/jpri/2021/v33i60B34586

Background: Over the last few decades, the covid 19 has increased all over the world. More issues are likely to be observed as covid 19 rate increases. The major cause of morbidity and mortality is infection. Oral Candidiasis With Subcutaneaous Emphyema and SARI are very rare complications in Covid 19 patient. The final cause is infection, but sometimes it causes due to allergic or inflammatory reaction of the drugs. If it occurs after post covid 19 then creates very serious issues with the peoples health.

Case Presentation: Here we are mentioning a very rare case of Oral Candidiasis With Subcutaneaous Emphyema and SARI after Covid 19 positive patient. In this case, on physical examination and investigation, it was found that, after covid 19 patient has developed Oral Candidiasis, Subcutaneous Emphysema , severe breathlessness, cough, fever, nausea, vomiting, throat infection and loss of appetide. To overcome this sudden issue, emergency exploratory medical and surgical treatment was done. During Covid 19 treament her HRCT Score was 21/25 and the infection was severe. There was no any sign of oral candidiasis, subcutaneous emphysema, or tissue or organ damage or no any other abnormality was detected during Covid 19 tratment. No bacterial growth or fungal growth observed on investigation. After some days and treatment of covid 19 the patient was developed a Oral Candidiasis and Subcutaneous Emphysema and SARI. The working diagnosis was finalized by doctors i.e. Oral Candidiasis With Subcutaneaous Emphyema and SARI. After expert medical management and excellent nursing care patient was discharged with full recovery.

Conclusion: In this study, we mainly focus on expert medical management and excellent nursing care helped in managing the complicated case very nicely. All the patient response was positive for conservative and nursing management and after treatment the patient was discharged without any complications and satisfaction with full recovery.

Open Access Case Study

Documentation, Clinical Validation, Safety Assessment and Efficacy of Siddha Treatment in COVID 19 SARS-CoV-2: A Case Series

J. Jeyavenkatesh, P. Saravanapandian, C. Yogeswari, S. Roja Ramani, R. Shanmuga Priya

Journal of Pharmaceutical Research International, Page 131-141
DOI: 10.9734/jpri/2021/v33i60B34595

Aims: To evaluate clinical validation, safety assessment and efficacy of Siddha line of treatment in COVID-19 patients.

Presentation of the Case: Open labelled, interventional, prospective cohort study conducted in Covid ward, Kokila Siddha Hospital and Research Centre, Madurai between June and Aug 2021. Among 22 registered in the trial 5 (22.72%) developed breathing difficulty, treated with oxygen support, 10 (45.5%) were male, 12 (54.5%) were female. At the time of admission, maximum 9 (40.9 %) had fever, followed by dry cough 18 (81.8%), dyspnea 8 (36.4%), malaise 16 (72.7%), anorexia 8 (36.4%), headache 4 (18.2%), Type-2DM 5 (23%), and 2 (9%) had hypertension as comorbidity. Hematology, LFT, RFT, D-Dimer, PTT, CRP were taken before and after 5 days of treatment.

Discussion: The mean hospital stay was 7 days and discharged on a minimum of 4th day and a maximum of 16th day. The mean hospital stay for hypoxic patients was 10 days. Paired sample test analysis has been carried out to find a significant difference in the counts of lymphocytes, ESR, CRP and PTT after the administration of the intervention.

Conclusion: The medications chosen according to the pathology of Kaba suram and administered starting on first day of admission, depending on the stage and severity of the infection. Patients were provided with appropriate food, exercise, therapy in conjunction with medications and found the patient's condition has not deteriorated further. It is reasonable to conclude that the treatment of COVID-19 with selective Siddha medications stopped the disease progress more critical.

Open Access Case Study

Case Report on Ebstein Anomaly

Saleha Shahid Ansari, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 188-191
DOI: 10.9734/jpri/2021/v33i60B34603

Introduction: Ebstein anomaly, also known as Ebstein malformation, is a congenital (existing at birth) heart defect that affects a small percentage of people. The tricuspid valve (the valve that connects the chambers on the right side of the heart) does not close properly in people with Ebstein abnormality [1].

Patient History:  A 25-years female patient was admitted in Acharya Vinoba Bhave Rural Hospital in medicine ward. She was admitted with the complaint of breathlessness on exertion, and weakness since 2 months. patient is a known case of severe ASD since birth. After coming to the ward all investigations done like blood test, ECG, 2D Echo, chest x-ray etc. then final diagnosis is conformed as severe ASD with Ebstein anomaly.

Past History: Patient is a known case of ASD. And not having any other history of communicable disease, asthma, tuberculosis.

Management: Tablet- Lasilactone (20/60)) A diuretic, Tablet- Neurobion Fort, Tablet- Pan 40mg a antacid are prescribed the doctor .

Nursing Management: vital sign checked and documented, comfortable position given as patient having breathing difficulty. Fowlers position given. intake and output of patient recorded. Assessed the patient for anxiety, depression.

Conclusion: Patient was admitted to the hospital with the major complaints of trouble breathing and generalised weakness, and her situation was critical. Immediate treatment was initiated by a member of the health team, and all available treatments were administered, and the patient's condition has improved.

Open Access Case Study

Case Report on Subacute Sclerosing Panencephalitis

Sweta Chavhan, Archana Maurya, Amruta Kothe

Journal of Pharmaceutical Research International, Page 214-218
DOI: 10.9734/jpri/2021/v33i60B34607

Introduction: Subacute sclerosing panencephalitis (SSPE), frequently referred as Dawson disease, is a kind of sclerosing  panencephalitis, and is an uncommon long-term, continuous cerebral inflammatory condition triggered by a gradual infection with particular faulty types of hyper mutated measles virus.

Main Symptoms and/or Important Clinical Findings: Patient came with the complaint of gait abnormalities, sudden fall while walking, loss of speech, staring look, abnormal smile and loss of bladder control, hemiplegia and contracture of all four limbs, seizures, Grade III Malnutrition.

The Main Diagnoses, Therapeutic Interventions, and Outcomes: Patient undergone investigation i.e. Blood Test: Hb- 9.8 gm%, TLC- 14,700/mm, Platelet- 2.24 lacs /cu.mm, Total Protein- 8.4 g/dl, HCT- 29.8, Serum Bilirubin- 1.0mg/dl, ALP- 99IU/L, Serum Urea-32mg/dl,SerumCreatinine-0.5mg/dl,SerumSodium-153meq/L,SerumPotassium-.2mmol/L. .CSF igg Measles test was done EEG which revealed burst of periodic complexes with well-preserved back ground activity. Doctor manages with Tab. Valparin 200mg BD, Tab. Frisium 5mg BD, Tab. Baclofen10mgBD,Tab. Samion D3 OD, Syp Q-Carni 5ml BD, Tab. Augment375mg BD.

Outcome: After treatment, the child showed some improvement. The patient was admitted to Pediatric Ward No- 22, AVBRH with known case of Subacute sclerosing panencephalitis (SSPE) and he had complaint of swelling over right jaw with caries tooth since4month.

Open Access Case Study

Erythema Dyschromicum Perstans: The Spotty Possibility – A Rare Case Report

M. Naga Meena Lochini, F. K. Jasima Nilofer, S. Mary Lilly

Journal of Pharmaceutical Research International, Page 219-222
DOI: 10.9734/jpri/2021/v33i60B34608

Erythema Dyschromicum Perstans (EDP) / Ashy Dermatosis are a less common dermatological disorder with an unknown etiology. It is characterized by asymptomatic, grey, symmetric and confluent macules all over the body. Herein, we report a case of a 50 years old man who presented clinically, with diffuse, patchy pigmentation having ill-defined, erythematous borders involving bilateral arms and forearms. Histopathological examination of the lesion biopsy demonstrates vacuolar degeneration of the basal cell layer, dermal perivascular mononuclear cell infiltrate and increased epidermal melanin pigment and presence of dermal melanophages. For the present case, treatment with Clofazimine has proven to be effective.

Open Access Case Study

Case Report on Nursing Management of a Client with Peripheral Arterial Disease

Vishakha Meshram, Vaishali Tembhare, Achita Sawarkar, Madhuri Shambharkar, Arati Raut, Prerana Sakharwade

Journal of Pharmaceutical Research International, Page 223-229
DOI: 10.9734/jpri/2021/v33i60B34609

Peripheral artery disease is a frequent cardiovascular ailment in which constricted arteries restrict blood flow to our limbs. When we have Peripheral Artery Disease in our limbs, our legs haven't had enough flow of blood to increase production. The capillaries that nourish the lower legs narrow and stiffen in peripheral vascular disease, making walking harder. Reduced blood flow can cause cartilage and necrosis in the limbs. Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for single lesions. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures, and risk factor control.

A 65-year-old man was admitted to the hospital with the following symptoms: worsening left severe calf pain, fatigue, cramping, aching, pain in the legs or arms that worsens when walking or using the arms, tightness in the muscles of the legs that worsens with exercise and improves with rest. He has a diabetes mellitus history. The lower extremity pulse was diminished or absent on physical examination, but all other vital signs were typical. Pulses in the left dorsalispedis and posterior tibialis could not be felt. The results of the cardiac examination were average. The patient has numbness in one leg, pain in both legs, decreased energy in both upper and lower limbs, ulceration, gangrene in the lower extremities, Hair loss, weakness, and dependent rubor (redness caused by swelling) present. He had audible bruits, a nonhealing lower extremity wound, and a delayed capillary refill, so he started treatment as soon as possible.

The primary focus of this study is on professional management and outstanding nursing care, which may provide the holistic care that peripheral arterial disease necessitates while also effectively managing the challenging case.

Open Access Case Study

Case Report on Benign Spindle Cell Tumour

Manisha P. Mandaokar, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 263-266
DOI: 10.9734/jpri/2021/v33i60B34615

Introduction: It's an extremely uncommon cancer. First, the epidermis, soft tissues, and connective tissues are impacted. Breast benign spindle cell lesions include a wide range of tumor-like or malignant fibroblastic and myofibroblastic entities. They should be made up entirely of Spindle cells (pure spindle cell lesions) are defined as lesions with no mixed epithelial component.

Clinical Finding :

Most Common Symptoms Of Spindle Cell Sarcoma.

  • • Bone ache. The most frequent sign of spindle cell sarcoma is bone discomfort. The most often afflicted bones by spindle cell sarcoma are those of the...
  • Swelling And Tenderness.
  • Reduced Mobility.
  • Fatigue And Malaise.
  • Lump Or Mass.

Diagnostic Evaluation: HB-6.7, TLC:-16, 200, PLT:-15, 000, MCV:-67.0, SR. BILIRUBIN:-0.7

Therapeutic Intervention – Tab. Allopuraznol 300mg BD, Inj. Emset:- 1.8mg TDS.  Inj. Pantop 12mg BD, Inj. Ceftraxon 20ml NS 1 mg BD.

Outcome- Spindle cell tumours are uncommon cancers that develop in the peripheral and deep tissues of the body. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis. According to a CT scan, a massive tumour encompassed the whole abdomen and pelvis.

Conclusion: The patient is admitted to Acharya vinoba bhave rural hospital sawangi (meghe) wardha, under the USG department, where he will get ongoing medical and nursing care, and his health is currently stable and under monitoring.

Open Access Case Study

Case Report on Sickle Cell Anemia in Children

Subodh Itkalwar, Ruchira Ankar, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 321-324
DOI: 10.9734/jpri/2021/v33i60B34622

Introduction: Sickle cell anemia is a kind of severe hemolytic anemia caused by the sickle haemoglobin (HbS) gene, which results in a faulty haemoglobin molecule. The term "sickle cell disease" refers to a set of genetic illnesses affecting red blood cells. People with sickle cell disease have irregularly formed red blood cells, which might be troublesome since they don't stay as long as healthy blood cells once they reach the state of blood arteries.

Clinical findings:

  • Progressive Anemia
  • Mild jaundice
  • Fever
  • Headache
  • Growth retardation
  • Superaded bacterial infection
  • Enlarge hurt

    Non healing ulcer
  • Organ failure
  • Abdominal pain with distension
  • Joint pain

Diagnostic Evaluation: Abdominal pain, fever, Hb (8.5 gm%), Abdomen swelling, Increase abdominal girth, pain in joint and irritability.

Ultrasonography:  Abdominal USG.

Therapeutic Investigation: Inj. Ceftriaxone 1mg BD, Inj pantoprazole 20mg OD, Inj. Neomole 30ml SOS, Inj. Tramadol 0.4mg TD S, Cap. Hydra 500mg OD, syr. syncoria 5ml OD, Tab. Folic Acid 5mg OD.

Outcome: All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia.

He showed significant progress after receiving therapy, and the treatment was kept ongoing until my last date of care.

Conclusion: A male child of 8 yrs was brought to AVBRH on by his parents with a complaint of abdomen pain with distension, Pain in joints, irritability and he was admitted to pediatric ward. All the investigation of the patient is done and the patient is diagnosed as sickle cell anemia. He improved dramatically after receiving therapy, and the treatment was continued until my final date of care.

Open Access Case Study

Case Report on Cellulitis

Minal Ughade, Prerana Sakharwade, Darshana Kumari, Archana Taksande, Sheetal Sakharkar, Vaishali Tembhare, Ruchira Ankar, Achita Sawarkar

Journal of Pharmaceutical Research International, Page 334-338
DOI: 10.9734/jpri/2021/v33i60B34624

Introduction: Cellulitis is a bacterial infection that causes an inflammatory condition of the skin that affects the dermis and subcutaneous tissues. 2016 (Lee and Levell). Cellulitis of the lower limbs is a potentially dangerous condition (Halpern et al, 2008). Rubor or erythema, which is warm to the touch and often combined with a degree of localised oedema, is the most common symptom. However, because diagnosis is dependent exclusively on clinical data, it is commonly misdiagnosed [1]. There are a number of different illnesses that have symptoms that are similar to cellulitis. The purpose of this page is to provide information on the clinical symptoms of lower limb cellulitis as well as treatment options ensuring that practitioners are capable of making an accurate diagnosis and developing successful treatment programmes [2].

Clinical Findings: Fever, pain over right lower leg, wound present right dorsal foot, weariness, malaise, and swelling were the patient’s main complaints.

Diagnostic Evaluation: Haemoglobin 14.7%,total RBC count 4.77, total WBC count 16100, platelet count 1.56, KFT – UREA -57 CREATININE -2.0 potassium- 4.6, LFT ALKALINE PHOSPHATE -105, ALBUMIN3- 0 TOTAL BILIRUBIN- 1.4 micro report is normal. His liver function and coagulation studies were normal. A diagnostic work-up that includes blood cultures, dengue, malaria smear, typhoid, and other tests. The following tests were sent: leptospirosis, monospot and stool investigations, and Clostridium difficile PCR [3].

Therapeutic Intervention: Four primary analgesic drugs, antibiotics drug in penicillin.

Conclusion: My patient, a 65-year-old man, was hospitalised to the  Hospital's medicine ward on June12, 2021.Fever, pain over right lower leg, wound present right dorsal foot, fatigue, malaise, and edema were among the symptoms that the patient had. His health improved when he received appropriate treatment. The patient was follow up after 1 weak [4].

Open Access Case Study

Case Report on Alcohol Dependence Syndrome

Suhani Nagdeote, Shalini Lokhande

Journal of Pharmaceutical Research International, Page 360-363
DOI: 10.9734/jpri/2021/v33i60B34628

Introduction: Alcohol dependence is psychiatric problem in which a person is psychologically and physically dependent upon alcohol consumption.  “A chronic disease in which a person craves that contains alcohol and is unable to control his or her drinking”.

Clinical Finding: Without drink patient feel discomfort, anxious, loss of appetite, sleeping disturbance.

Diagnostic Evaluation: Blood test: Amylase – 31U/L, RBS (glucose-plasma-random) – 92mg%, CBC Investigation (Hb -13%, MCV – 84.3fl, MCH – 29.7picogm, total RBC count – 4.55millions/cu.mm, total WBC count – 6200cu.mm, monocytes – 04%, granulocytes – 70%, lymphocytes – 25%, eosinophil – 01%, total platelets count – 3.38lac/cu.mm).

Therapeutic Intervention: Inj. Lorazepam 4mg × TDS, Inj. Thiamine 200 mg × TDS , Inj. Neurbion fort × OD, Inj. Pantop  40mg × OD, Inj. Emset, Inj. Avil, Tab. Paracetamol 500 mg × S0S.   

Outcome: After treatment, patient shows improvement. His increase appetite, decrease the feeling of discomfort.

Conclusion: My patient was admitted to psychiatric male ward in AVBRH with a known case of alcohol dependence syndrome and he had complain related to disease condition and after taking appropriate treatment  his condition was improved.

Open Access Case Study

Prosthetic Rehabilitation of a Hemimandibulectomy Case by Non-Surgical Approach- A Case Report

Mirella Vaz, Mridula Joshi, Mahesh Ghadage, Gunjan Daphale

Journal of Pharmaceutical Research International, Page 411-419
DOI: 10.9734/jpri/2021/v33i60B34636

Hemimandibulectomy can have several consequences such as disoriented masticatory cycle, eccentric occlusion, distorted speech and facial disfigurement depending on the severity of the defect. It is challenging for the prosthodontist to rehabilitate the patients in whom osseous reconstruction has not been carried out. This clinical report describes the Prosthetic management of a patient who had undergone hemimandibulectomy due to moderately differentiated squamous cell carcinoma involving left buccal mucosa, gingivobuccal sulcus and retromolar trigone. A non- surgical approach was carried out to rehabilitate this patient, which included the fabrication of a maxillary guide flange prosthesis for correction of the frontal plane rotation and a twin occlusion prosthesis for ease of mastication. The appearance of the patient was improved drastically by the fabrication of an extraoral prosthesis.

Open Access Case Study

Post Mastectomy and Radiation Therapy - Complex Regional Pain Syndrome -A Case Report

Jeshnu Prakash Tople, S. Krishnendu

Journal of Pharmaceutical Research International, Page 508-512
DOI: 10.9734/jpri/2021/v33i60B34647

Complex regional pain syndrome which is a rare syndrome following an injury or trauma, is an extremely painful condition. Diagnosis of this condition is not easy. They present with various symptoms like allodynia, hyperalgesia, asymmetry of temperature and sweating ,restricted range of motion. Identifying and treating this condition at earlier stage is important. There are different treatment options like pharmacological (NSAIDs, Anticonvulsants, Antidepressants, neuromodulators) and interventional techniques like Stellate ganglion block, Thoracic Sympathetic Ganglion block, Lumbar sympathetic block, Neurostimulation.

In this case report we present a case of 52 year old female post mastectomy and radiation therapy developing CRPS of left upper limb, which was diagnosed and managed successfully with diagnostic thoracic sympathetic ganglion block followed by therapeutic radiofrequency ablation.

Open Access Case Study

A Case Report on Nursing Care of Craniopharyngioma

Pornima Dnyaneshwarro Zade, Prerana Sakharwade, Samruddhi Gujar, Achita Sawarkar, Jaya Khandar, Archana Dhengare, Kavita Gomase, Pooja Kasturkar

Journal of Pharmaceutical Research International, Page 550-555
DOI: 10.9734/jpri/2021/v33i60B34653

We present a case of a rare craniopharyngioma in the left temporal lobe that developed after no prior brain trauma or surgery. Craniopharyngiomas are slow-growing benign tumours that affect the sellar and parasellar portions of the central nervous system. The incidence of this tumour is roughly 2/100,000. The majority of individuals experience neurological (headaches, visual abnormalities) and endocrine (growth retardation, rapid puberty) disorders over time 13.

Case presentation: After undergoing biopsy, M.R.I., and C.T., a 45 year old man was admitted to Acharya Vinoba Bhave Rural Hospital on 13/02 2021 with the main complaint of blurring of vision in right eye, headache, polyurea since 5 month, polydipsia, and altered behavior since 2 month. After a C.T. Scan, the patient was diagnosed with a craniopharyngioma.

Conclusion: The patient was admitted to Acharya Vinoba Bhave Rural Hospital with blurred vision in the right eye, headache, polyurea, polydipsia, and altered conduct as his known causes. Going to follow all of the tests, the patient was diagnosed with a craniopharyngioma still the patient requires medical attention and appropriate nursing care.

Open Access Case Study

Case Report on Tricuspid Atresia

Himanshu Jawanjal, Savita Pohekar

Journal of Pharmaceutical Research International, Page 564-569
DOI: 10.9734/jpri/2021/v33i60B34655

The absence of the tricuspid valve is one of the more unusual types of congenital heart illness. Before the introduction of heart surgery, it was only of scholarly interest, However, now that such conditions may be alleviated medically, the problem has taken on more significance, and every effort must be made to identify the anatomical weakness in cases of congenital cardiac disease.[1]

Clinical Findings:  Cyanosis, feeding difficulties, cyanosis, shortness of breath and fast breathing, sluggish development, and a heart murmur are the most common symptoms.

Therapeutic Intervention: Tab .Lasix 40mg OD, dioxin drop0.5ml, Furoped drop 0.5 ml ,Syp A-2.5ML

Outcomes:  After treatment, the patient shows improvement. His breathing difficulty and heart rate arebeing improved.

Conclusion: My child was admitted to the AVBRH's pediatric ICU with cyanosis of blurred vision and breathing difficulties. His condition has improved upon obtaining adequate therapy.

Open Access Case Study

Urolithiasis Presenting as Right Flank Pain

Vipul Umare, Shabanam N. Sheikh, Roshan Umate, Chetan Mahatme

Journal of Pharmaceutical Research International, Page 777-781
DOI: 10.9734/jpri/2021/v33i60B34679

Introduction: Urolithiasis is a term that refers to the formation of calculi or stones in the urinary tract. Calcifications arise in the urinary system, generally in the kidneys or ureters, but they can also damage the bladder and/or urethra. It's a prevalent ailment that leads to a high number of hospital visits. It is generally avoidable by modifying risk factors, and there are a variety of treatment methods available. Clinicians should be aware of the signs, symptoms, potential consequences, and therapeutic suggestions. In urolithiasis, diagnostic imaging techniques such as double-contrast cystography, ultrasonography, radiography, and, potentially, computed tomography are used.

Presenting Complaints and Investigations: A 50-year-old male was admitted in AVBRH on 13/02/2021 with chief complaints of severe pain in the side, which spread to the lower abdomen and groin, pain in urination, nausea, vomiting for 15 days. Investigations included hematology and radiological  tests including Hemoglobin 7.5 gm/dl, Sodium: 19.1 mg/dl, creatinine: 5.4 mg, calcium: 11.5 mg/dl. Urine analysis, cystoscopy, ultrasound, KFT, LFT were carried out.

Main Diagnosis: Urolithiasis.

Therapeutic Interventions: Included Tab. Ibuprofen, Syp. Cystone.

Conclusion:  Urolithiasis is harder to treat in the aged since they have more complications and become less likely to show with classical renal colic complaints. This could result in a later presentation with larger, more complicated stones. Individuals with significant back and flank discomfort should consider acute care and preventive efforts in patients with renal calculi, as it might lead to hydro nephrosis and kidney failure.

Open Access Case Study

A Case Report on Malaria

Dhanshree A. Selukar, Sonali Kolhekar, Darshana Kumari, Ruchira Ankar, Sheetal Sakharkar, Savita Pohekar, Achita Sawarkar, Pradnya Sakale

Journal of Pharmaceutical Research International, Page 1100-1103
DOI: 10.9734/jpri/2021/v33i60B34720

Introduction: Malaria is caused by the parasitic protozoan Plasmodium. It is a vector-borne disease which is transmitted from person to person via bites from infected mosquitoes. Following a mosquito bite the parasites multiply in the liver and subsequently infect red blood cells. It is a mosquito-borne illness. Fever or flu symptoms include shivering chills, headaches, and muscle pains. Anemia, jaundice, nausea, and diarrhea are some of the symptoms of malaria.

Main Symptoms and Important Clinical Findings: A 24-year-old woman was admitted in. Acharya vinoba bhave rural hospital with chief complaint of stomach pain as her primary complaint. Then after several days Fever, pain, fatigue, headache occur. Several diagnostic evaluations done which shows total Red blood cells count: 4.8 million cu mm; white cell count: 11.810 cells mm3; lymphocytes: 11.2% platelets drop on smear, RBCs are moderated.

The Main Diagnoses, Therapeutic Interventions, and Outcomes: 24 years old women admitted in Acharya vinoba bhave rural hospital with the chief complaint of stomach pain, fever, fatigue, headache and after all investigation she has diagnosed as malaria. Doctor manage with Iv fluids, cap. Doxycycline 100 mg, tab.dolo 650 mg, tab.larigo 650 mg, emset 4 mg injection Once a day, she was also given the Calcium Tab. Her condition has improved as a result of the treatment. The fever and agony had subsided.

Conclusion: My patient was admitted to Acharya vinoba bhave rural hospital with a known case of malaria and a fever and discomfort complaint. Her condition improved after she received proper therapy.

Open Access Case Study

Effect of Neurodevelopmental Therapy on Functional Recovery in a Patient with Subacute Stroke: An Interesting Case Report

Maitri Thamke, Rakesh Krishna Kovela, Mohammed Irshad Qureshi, Ragini Dadgal, Rebecca Timothy, Snehal Samal

Journal of Pharmaceutical Research International, Page 1457-1461
DOI: 10.9734/jpri/2021/v33i60B34767

Stroke is defined as a clinical illness characterised by a sudden onset of cerebral impairment that lasts more than 24 hours or results in death with no obvious explanation other than a vascular origin.Every year, around 800,000 people have a stroke, or one every 40 seconds. Strokes are caused by difficulties with the brain's blood supply: either the blood supply is cut off or a blood artery within the brain bursts, killing brain tissue. A stroke is a medical emergency that requires immediate medical attention. Present case report is of a 39-year-old male with right side weakness. Patient’s right upper limb recovery stage was 1 going towards 2, and lower limb recovery stage was 2 going towards 3 on first day of assessment. Patient was treated with Neurodevelopmental therapy combined with conventional physiotherapy for a period of 8 weeks. Balance, Gait parameters and tone evaluated on day 1 and on last day of treatment. There was tremendous improvement in balance and gait parameters along with normalisation of tone. Thugs wee would like to conclude that early NDT along with conventional therapy can improve gross motor function in patients with subacute stroke.

Open Access Case Study

Effect of Threshold Inspiratory Muscle Training Device on Inspiratory Muscle Strength in Upper Abdominal Surgery Patient: A Case Report

Neha Arya, Vishnu Vardhan

Journal of Pharmaceutical Research International, Page 1474-1479
DOI: 10.9734/jpri/2021/v33i60B34769

Background: Surgical care plays a crucial role in the treatment of a wide spectrum of ailments, as well as in the relief of human suffering. Gastrectomy, pancreatectomy, hepatic resection, cholecystectomy, and splenectomy were among the upper abdominal surgeries performed. The maximum inspiratory pressure (PImax) is an important metric for assessing the strength of the inspiratory muscles. Respiratory muscle training device increase the capacity for activity, strength, and endurance of respiratory muscles. Pressure Threshold IMT devices are typically spring-loaded handheld devices that is obstructed at various intensities. As a result, the current study aims to show the effect of Inspiratory Muscle Training in patients undergoing Upper Abdominal Surgery. Materials and Methods: On Day 1, maximal inspiratory pressure (PI Max) was measured by a Hand held pressure manometer before intervention. Threshold Inspiratory Muscle Training device was administered on Day 1, and continued for one week two sessions per day. Post treatment maximum inspiratory pressure. (PImax) was measured. Each session lasted 15 minutes, including breaks.

Conclusion: The study concluded that Threshold inspiratory muscle training device shows improvement in Maximal Inspiratory Pressure in upper abdominal surgery patient.

Open Access Case Study

Impact of Short-term Exercise Program on Functional Independence in Patient with Hydropneumothorax: A Case Study

Vaishnavi Chawake, Vaishnavi Yadav, Moli Jain, Tasneem Lakkadsha, Pallavi Bhakaney

Journal of Pharmaceutical Research International, Page 1490-1496
DOI: 10.9734/jpri/2021/v33i60B34770

Background: Hydro-pneumothorax is a rare variant of pneumothorax. It occurs when both free fluid and air is present within the pleural space. The goal of the treatment is to relieve the pressure on the lung, allowing it to re-expand. Treatment options may involve solely observation or needle aspiration or intercostal tube drainage (ICD), along with antibiotic cover, all of this anchored with physiotherapeutic management.

Case presentation: A 54 years old male visited hospital with complaints of dyspnea (MMRC grade II), dry cough and high-grade fever since one month along with a history of chronic alcohol consumption and tobacco chewing since more than 10 years.

Investigations: Laboratory investigations include Chest X-ray which showed fairly large opacities with fluid level in right side. The costo-phrenic angle on the right side was obliterated, multiple small patchy opacities are also seen in right lower zones. Along with these findings, there was contralateral mediastinal shift.

Treatment: Physiotherapy intervention included patient education, breathing retraining, airway clearance techniques, positioning, walking program with supplemented oxygen and psychological support. Outcome measures have shown improvement in functional independence and performance of activities of daily living.

Conclusion: Physiotherapy management showed efficient results in improving the lung function, quality of life, inducing relaxation and early return to pre-disease life in patient with hydro pneumothorax.

Open Access Case Study

Early Mobilization is the Key towards Early Functional Independence in a Patient Undergone Aortic Valve Replacement: A Case Study

Gunjan Ingale, Vaishnavi Dilip Yadav, Moli Jai Jain, Vishnu Vardhan

Journal of Pharmaceutical Research International, Page 1508-1513
DOI: 10.9734/jpri/2021/v33i60B34772

Heart disease due to valvular anomaly has increased prevalence along with increasing age. Rheumatic heart disease is a condition in which the heart valves have been permanently damaged post rheumatic fever. We report a patient with Aortic valve replacement using TTK CH 25 prosthetic valve who underwent post-operative physiotherapy which comprises 2 weeks of phase I cardiac rehabilitation, a home exercise program after discharge, and follow-up after 2 weeks. During follow up patient has a high level of independence, improvement in quality of life, lung function, and symptoms. This case report aims to highlight the significance of prompt diagnosis; treatment and most importantly rehabilitation incorporating early mobilization to get the patient back to his functional state. A scheduled exercise program benefits the patient and also minimizes complications after surgery.

Open Access Case Study

Physiotherapeutic Rehabilitation of a 48-Year Male with Buccal Mucosa Carcinoma of Squamous Cell: A Case Report

Shrutika H. Wankhade, Shubhangi Patil, Rupali Thorat

Journal of Pharmaceutical Research International, Page 1538-1543
DOI: 10.9734/jpri/2021/v33i60B34776

Buccal mucosa carcinoma of squamous cell is an uncommon kind of oral cavity cancer that is known to be dangerous. It's also linked to a high probability of local regional recurrence, and it's more likely in persons who chew tobacco and/or smoke, whether or not they drink alcohol. A 48-year patient is an elderly man who works as a farmer, mesomorphic built with right-hand dominance came to the tertiary care hospital with complaints of painful ulcers in upper left Jaw's front portion, which was relatively small initially and further increases to 6 x 4 cm approx., since last 4 months. Patient was complaining of pain, difficulty in mastication and manipulations etc. He has history of kharra chewing and tobacco chewing since last 10 years. With these complaints patient has come to the oral surgery department with buccal mucosa skin involvement and underwent surgery as compartmental resection of lesion, Modified Radical neck dissection and segmental mandibulectomy. Following surgical procedure patient has complaints of discomfort, limitation of movements at the operated site, chest pain, and limited mouth opening. For these complaints, programmed physiotherapy treatment was given to the patient which mainly concentrates on mouth opening and increasing range of motion of affected side.

Open Access Case Study

Physiotherapy Intervention in Post Hysterectomy Patient with Urinary Incontinence: A Case Report

Gunjan Ingale, Shubhangi Patil, Rupali Thorat

Journal of Pharmaceutical Research International, Page 1652-1658
DOI: 10.9734/jpri/2021/v33i60B34790

The uterus and cervix are removed during a total abdominal hysterectomy. The majority of hysterectomies are performed to address fibroids, endometriosis, adenomyosis, pelvic organ prolapse, and malignancy. The second most common procedure on the female genital system is hysterectomy. Patients who have this treatment are at risk for problems that can be avoided with preventative interventions such as physiotherapy. A 48 year old who had undergone total abdominal hysterectomy with bilateral salphingo opherectomy was referred for physiotherapy. Patient complained of pain in lower abdomen and difficulty in bed mobility and constant dripping of urine. Apart from medicinal intervention, physiotherapy was given for six days a week along with pain management activities, respiratory exercises, home exercise program and ergonomic advice for 4 weeks. A comprehensive rehabilitation plan including home exercise regimen can help in early recovery and restoration of daily activities rapidly and improve the quality of life of the patient.

Open Access Case Study

Case Report on Fibroid Uterus

Harshada Bhoge, Archana Maurya

Journal of Pharmaceutical Research International, Page 2184-2187
DOI: 10.9734/jpri/2021/v33i60B34862

Uterine fibroids are also known as leiomyomas or myomas are muscular tumors that can form on the uterus. They seldom become malignant, and having them does not increase your risk of uterine cancer. Fibroids come in a variety of sizes, shapes, and locations. They can be found inside your uterus, on the surface, or in the uterine wall. They may also have a stalk or stem-like structure that connects them to the uterus.

Main symptoms and/or important clinical findings: Constipation, backache, or leg discomfort since 4 month, monthly bleeding for more than a week since 4 month, pelvic pressure or discomfort since 4 month, frequent urination since 4 month, difficulties emptying the bladder.

Nursing perspectives: fluid replacement that has been administered, i.e. DNS and RL checked vital signs and blood pressure every hour, kept an intake and output chart, and made sure the patient had enough rest and sleep. Medication was administered in accordance with the doctor's orders.

Open Access Case Study

Case Report on Congestive Cardiac Failure with Pneumonia with Bronchial Asthma

Chaitanya Gabhane, Manjusha Mahakarkar, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 2208-2212
DOI: 10.9734/jpri/2021/v33i60B34865

Introduction: Congestive cardiac failure is a pathophysiologic state when the heart is not able to maintain its cardiac output to meet the demand of metabolizing tissues. Pneumonia is the inflammation of parenchyma of lungs. Bronchial Asthma is a diseases of airway produced by hypersensitivity inflammatory response of tracheobronchial tree to a variety of stimuli resulting in reversible narrowing of the air passages.

Clinical Finding: Patient having pain in chest since 2-3 days and it radiating to back and shoulder. Patient is experiencing breathlessness even at rest stage. Patient is also having a diagnosis of Asthma since 1 year.

Diagnostic Evaluation: Patient had undergone the Respective Diagnostic evaluation. Complete Blood Count, MRI, chest X- ray and 2D Echo.

Therapeutic Intervention: Patient have been prescribed the following Medication. Inj. Lasix 400mgX BD, Inj. Sodabicarb in 100ml saline stat, Inj. Doxy 100mgX BD, Inj. Piptaz 20mgX BD, Inj. PAN 40mgX TDS, Tab. Flucon 150 mg X OD.

Outcome: After the providing the nursing care the pain level in chest had been minimized and patient is not having any breathlessness in resting stage and his condition also has been improved after the care provided.

Conclusion: The patient was admitted in Medicine Intensive Care Unit [MICU] AVBRH, Sawangi (Meghe), Wardha with the known case of Congestive Cardiac failure with Pneumonia and Bronchial Asthma. After providing appropriate nursing care his condition has been improved.

Open Access Case Study

Anaesthetic Management of Left Cerebellopontine Angle Acoustic Nerve Schwannoma in Sitting Position with Intraoperative Electromyographic Facial Nerve Monitoring

Wankhade Prachi, Roshan Nisal, Swathi Reddy, Neeta Verma, Jui Jadhav, Nikhil Bhalerao

Journal of Pharmaceutical Research International, Page 2325-2331
DOI: 10.9734/jpri/2021/v33i60B34880

A case of left cerebellopontine angle acoustic nerve schwannoma in sitting position with electromyographic(EMG) monitoring for facial nerve was managed. The 40 year old male, ASA II, presented with complaints of difficulty in walking, left sided hearing loss, diminution of vision since 3 years and Magnetic Resonance Image (MRI)suggestive of left CPA acoustic nerve schwannoma. Patient was operated under general anaesthesia in sitting position with Mayfield clamp on head without using muscle relaxant as the plan was to use EMG monitoring during tumor resection. Anesthesia was maintained with sevoflurane and propofol and no muscle relaxant was used, yet patient was immobile. Throughout the procedure haemodynamic stability was maintained with noradrenaline injection. Procedure was uneventful with complete excision of tumor and without damaging the facial nerve. Excision of this deep-seated tumor in sitting position without using muscle relaxant is very difficult to manage. This surgery was very challenging from anaesthetic point of view as sitting position itself increases the risk of complications and avoiding movement of patient with Mayfield clamp without using muscle relaxant was a tough job.

Open Access Case Study

Case Report on Intra Arterial Thrombosis

Sagar Anilrao Ingale, Darshana Kumari Wankhede, Sonali Kholhekar

Journal of Pharmaceutical Research International, Page 2363-2366
DOI: 10.9734/jpri/2021/v33i60B34885

Introduction: A thrombosis is a blood clot in an artery that can be highly harmful because it stops blood from reaching essential organs. Arteries are blood vessels that convey blood from the heart to the rest of the body and the heart muscle.

Clinical Finding: pain in left lower abdomen and as well as thoracic region also and pain in lower limb extremities are also occurred, pulse is 78 beats/ min, and temperature is 98.6°F or 37°.

Diagnostic Evaluation: Blood test:- Hb –14.3 gm%, total RBC count – 4.84 millions/cu mm, RDW – 13.3%, HCT -42.4%, total WBC count –7100/cu mm, monocytes – 03%, granulocyte –70%, lymphocyte – 25%.

Peripheral Smear: RBC:- normocytic normochromic, Platelets:- adequate on smear, No hemiparasite seen Ultrasonography: There is no sonography report founded.

Therapeutic intervention: Inj. Ceftraxine- 19 mg, inj. Hydrotrsol – 100 mg, inj. Heparin – 5000 IV –TDS , tab. Ecosprin – 100 mg –OD, tab. Clopitab- 75 mg – OD.

Outcome: After treatment, the patient has improved his fever, pain in the chest, and lower extremities pain have all been reduced.

Conclusion: Patient was admitted to cardiology ward in hospital with known case of arterial thrombosis and he had complain of fever chest pain and also pain in lower limb. After getting appropriate treatment his condition was improved. Smoking, overweight, and drinking are additional factors that promote intra-arterial thrombosis. After getting therapy, patient's condition significantly improved, and the treatment was continue until final day of care.

Open Access Case Study

Case Report on Seizures Disorder

Prasad G. Gade, Manjusha Mahakarkar, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 2374-2378
DOI: 10.9734/jpri/2021/v33i60B34887

Introduction:  Seizures are periods of aberrant motor, sensory, autonomic, or mental activity caused by discharge from brain neurons [1]. Epilepsy is defined as the two or more unprovoked seizures that occur more than 24 hours apart [2]. There are three types of seizures: focal, generalized, and unknown. Generalized seizures arise in bilaterally dispersed networks and rapidly activate them [3]. The origin of focal seizures is assumed to be in one hemisphere of the brain. Epileptic spasms are an example of the unknown kind [4].

Main symptoms:  The signs and symptoms of a seizure can range from minor to severe; these are as follows; perplexity, stare, Jerking motions of the arms and legs, Loss of awareness, Fear, anxiety, and other cognitive symptoms.

Diagnosis: The initial step for a physician is to rule out alternative possibilities, such as nonepileptic seizures. These might seem like seizures, but they're usually caused by other things like low blood sugar or high blood pressure, changes in heart rhythm, or mental stress.

Therapeutic Intervention: Tab. Levetiracetam 500mg * OD, Tab. Carbamazepine 200mg * TDS, Tab. Escitalopram 10mg * OD, Tab. Neurobion forte 1mg * OD.

Outcome: After treatment the patient show improvement. His temporary confusion got reduced, he is now aware to many things.

Conclusion: My patient was Admitted to AVBRH with a known case of Seizures Disorder and he had a complaint of temporary confusion and he was not aware to his surroundings. After getting appropriate treatment his condition was improved. 

Open Access Case Study

Mucormycosis with Ca Breast Cancer

Shivani R. Dethe, Priyanka Telang, Rupali Thorat

Journal of Pharmaceutical Research International, Page 2387-2392
DOI: 10.9734/jpri/2021/v33i60B34890

Mucormycosis is an extraordinary fungal contamination because organisms of Mucorales frequently happening in immunologically or diabetics compromised patients. Best case of number one Mucormycosis of breast is mentioned withinside in the English literature. We can explain another patient of Mucormycosis which is located in breast of patient with no fundamental disease and is well treated with intravenous antifungal therapy & mastectomy. Today, Breast cancer is usually diagnosed life-frightening cancer in women and can cause cancer death in women. Since past two decades, breast cancer research had led to remarkable advances in consideration of the disease, arising in less toxic as well as most effective diagnosis. Improved public understanding and better protection had show to early diagnoses at phases likely to complete surgical incision and healing therapy. As a result, cancer of breast survival rates has increased dramatically ,especially among young women. This article discusses the causes, types, clinical symptoms, and various non-pharmacological (such as radiation therapy and surgery) and pharmacological (including gene therapy, chemotherapy, etc.) approaches to breast cancer.

Open Access Case Study

Case Report on Ectopic Pregnancy with Septicmia

Neha lacharwar, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 2427-2431
DOI: 10.9734/jpri/2021/v33i60B34896

Introduction: Ectopic pregnancy is a complication of pregnancy in which the embryo implants outside the uterus. Abdominal discomfort and vaginal bleeding are common signs and symptoms, but only around half of the women who are affected experience both. The discomfort can be severe, dull, or crampy. If there is bleeding into the abdomen, pain may radiate to the shoulder. A rapid heart rate, fainting, or shock may occur as a result of severe bleeding. The foetus, with a few exceptions, is unable to live. Obstetricians and gynaecologists face a number of obstacles when dealing with emergencies in Jehovah's Witnesses.

Main symptoms and/or important clinical findings: She is a 20-year-old woman who had an emergency diagnostic laparotomy for a ruptured ectopic pregnancy with pyosalpinx and septicemia on February 14, 2021. Her diagnostic Ultrasonography has been completed. A complete blood investigation has been completed. She was moderately symptomatic before 8 days, when she was primigravida with 2 months of pregnancy, and then she got abdomen cramps that worsened with time.

The main diagnoses, therapeutic interventions and outcomes: She is a 20-year-old woman who had a post-surgical case of Explore Laparotomy For Ruptured Ectopic Pregnancy with pyosalpinx and septicemia, as well as acute abdominal pain. Her treatment began on the day of admission with IV fluids, antibiotics and injectables. Started, advised for Zonac suppository PR, and finished all necessary research. 

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

Conclusion: Although it is rare for an ectopic pregnancy to go past the first trimester, it does happen. Thus, it is necessary to rule out ruptured ectopic pregnancy in all cases of surgical abdominal urgency during pregnancy, as it is life-threatening to the mother if proper diagnosis and care are delayed. Despite the fact that early intervention saves lives and minimizes morbidity, ectopic pregnancy still accounts for 4 to 10% of all pregnancy-related deaths and is associated with a high rate of ectopic site gestations in subsequent pregnancies.

Open Access Case Study

Case Report on Nursing Management of a Client with Hiatus Hernia

Sarthak Meghe, Vaishali Tembhare, Ruchira Ankar, Sheetal Sakharkar, Archana Dhengare, Swapana More, Prerana Sakharwade, Khushbu Meshram

Journal of Pharmaceutical Research International, Page 2459-2463
DOI: 10.9734/jpri/2021/v33i60B34900

A hiatus hernia occurs when a portion of the stomach protrudes into the chest cavity. It enters through the same entrance through which the food tube (oesophagus) travels to the stomach. A case of an 39-year-old male with a history of diabetic presented to the emergency room with acute onset shortness of breath, epigastric pain and chest pain. The stomach bulges up into the chest through that opening in a hiatal hernia (also known as a hiatus hernia). The client was having burning sensation in epigastric region since from 2-5 year, acid reflux after taking food, heartburn, nausea, regurgitation, vomiting, and abdominal pain and irritation. After the physical examination, history collection and investigations he was diagnosed as case of hiatus hernia.The study's main focus is on professional management and excellent nursing care, which may be able to give the holistic care that hiatus hernia requires while also efficiently treating the difficult case. Following a complete recovery, the patient's multidisciplinary health care team works together to help the patient reclaim his or her prior level of independence and contentment.

Open Access Case Study

Case Report on Cervical Dysplasias

Pragati Dhawale, Vaishali Takshande, Kavita J. Gomase

Journal of Pharmaceutical Research International, Page 2489-2493
DOI: 10.9734/jpri/2021/v33i60B34904

Introduction: Cervical dysplasia is a precancerous disorder in which abnormal cell growth occurs on the cervix's surface lining or endocervical canal, which connects the uterus and the vaginal canal. Cervical intraepithelial neoplasia is another name for it (CIN). Clinical finding:-Abdominal pain, weight loss, fever (Temperature – 101oF).

Diagnostic Evaluation: Blood test: HB- 10.8 gm%, Total RBC count- 4.15 millions/cu mm, RDW –13.1%, Total WBC count-6100 /cu mm, Total platelets- 2.381ACS/MM3.

Cytopathology Examination: Cervical cytology Smear shows only scattered superficial and intermediated squamous cell with few neutrophils. Colposcopy Examination: Moderated dysplasia, chronic cervicitis. Colposcopy finings- cervical erosion seen on post lip,-Mosaic pattern of blood vessels seen on green filter, Aceto white areas seen at 7o’clock position, Less iodine uptake at 7o’ clock and 12o’clock positions, aceto white areas reduced as compared to previous colposcopy.

Therapeutic Intervention: Vaginal hysterectomy lateral Sphincterotomy I/V/O Cervical Dysplasia Inj. Gentamacine 80 mg iv 12 hrly, Inj. Ctax 1 gm IV 12hrly, Inj. Pan 40 mg iv 12 hrly, Inj Metro 100 ml /8 hrs, Inj. Neomal 100 ml Iv 12 hrly, Inj Pause 8 hrly, zonac suppository TDS, Tab-Gabapentin 300 mg HS, Glucose powder, protein powder 2tbsp BD with milk.

Outcomes: After treatment the patient shows improvement. Her abdominal pain and fever were relived and the surgery precancerous cells are removed, Patient condition was improved.

Conclusion: My patient was hospitalized to AVBRH gynecology unit with abdominal pain, fever, weight loss. After receivingproper therapy, her condition has improved.

Open Access Case Study

Effect of Early Proprioceptive Neuromuscular Facilitation on a Hemiplegic Patient Post-Hemorrhagic Stroke: A Case Report

Shifa Sheikh, Snehal Samal, Rakesh Krishna Kovela, Ragini Dagal, Rebecca Thimoty, Pallavi Harjpal

Journal of Pharmaceutical Research International, Page 2494-2499
DOI: 10.9734/jpri/2021/v33i60B34905

Background: Stroke is the sudden loss of neurological function caused by an interruption of blood flow to the brain. Hemorrhagic stroke occurs when a blood artery ruptures in the brain, causing bleeding into the brain leading to hemiplegia. Hemiplegia is a paralysis of the face, arm, and leg on one side. 

Aim: To study the effect of early Proprioceptive Neuromuscular Facilitation on a post-Hemorrhagic stroke hemiplegic patient

Presentation of case: In the present case report, a 75-year-old male was admitted into the hospital with a history of dizziness and weakness of the right upper limb and lower limb along with slurring of speech. After doing CT scan, left Intraparenchymal bleed in the Corona Radiata were present and based on his symptoms and investigatory findings he was diagnosed as a case of right hemiparesis. He was under medical and physiotherapy management. Goal seeking limb was provided to the patient in the ICU and was continued in the ward. The early physiotherapeutic intervention proved to be effective for the positive outcome of the patient. After 20 days of treatment, there was a enormous improvement in the bed mobility of the patient. Speech therapy was also provided to the patient.

Discussion: Early physiotherapy rehabilitation will increase the decreased ranges of movement of all joints, help in improving the daily living activity of the patient, thus enhancing the confidence of the patient.

Conclusion: Thus, we conclude by this case report that early rehabilitation enhances the condition and later on the quality of life of the patient.

Open Access Case Study

Identification of Osteogenesis Imperfecta Type VI: A First Case Report from a Pakistani Family

Asia Parveen, Amina Arif, Shafia Arshad, Muhammad Shafeeq Ur Rahman, Faheem Ahmed Siddiqui, Muhammad Awais

Journal of Pharmaceutical Research International, Page 2532-2539
DOI: 10.9734/jpri/2021/v33i60B34910

Background: Osteogenesis imperfecta type VI (OI type VI) is a rare autosomal recessive disease of bone mineralization characterized by multiple bone fractures after six months of age, without a history of other extra-skeletal complications. SERPINF1 (serpin inhibitor clade F1) is the causative gene for this abnormality, having a chromosomal location 17p13. Many cases have been reported from different populations of the world. No case has been reported from the population of Pakistan related to this deformity. 

Case Presentation: In the current study, we presented a case of Osteogenesis imperfecta type VI. The patient's clinical findings indicated her with short stature and progressive distortion of the skeleton, without the record of other complications like hearing problems, dental anomalies, and abnormal vision. She was 16 years old, could not walk due to deformation and weakness of lower limbs. At the time of Patient’s radiological examination, history of multiple fractures of long bones was reported. The radiological findings showed the condition of kyphoscoliotic impairment                          in the cervicodorsal spine. Long bones showed bowing and relatively decreased bone mineralization. Patients' sequencing data indicated a new homozygous frameshift mutation c.262_263insCCCTCTC (p. Ala91Profs*23) in SERPINF1 responsible for splice site changes in PEDF protein.

Conclusion: This identified mutation was the first report from Pakistan, and an increase in the pathogenic variants in SERPINF1 caused OI type VI.

Open Access Case Study

Positive Outcomes of Inpatient Rehabilitation in a Snake Bite Patient with Pulmonary Complications: A Case Report

Radhika Rathi, Vishnu Vardhan, Moli Jai Jain, Vaishnavi Yadav, Rashmi Walke, Pallavi Bhakaney, Ruhi Kumbhare

Journal of Pharmaceutical Research International, Page 2540-2543
DOI: 10.9734/jpri/2021/v33i60B34911

Snake bites are a common medical emergency and workplace danger, particularly in tropical India, where farming is a key source of income. We report case of 55 year old female patient reported to medicine department on 25\09\2021 with an alleged history of snake bite over her right ankle in evening when she was the working in the farm. She undergone 2 weeks of In-hospital rehabilitation along with medical management and had shown positive outcomes. This case report’s purpose was to focus on the significance of prompt surgical treatment and essential physiotherapy rehabilitation to attain the functional goals with to respect to patient and its prognosis.

Open Access Case Study

Carcinoma of Breast Expressing Human Epidermal Growth Factor Receptor 2: Case Report

Prashik Moon, Kavita Gomase, Pooja Kasturkar, Shalini Moon, Vaishali Taksande, Prerana Sakharwade, Achita Sawarkar

Journal of Pharmaceutical Research International, Page 2577-2580
DOI: 10.9734/jpri/2021/v33i60B34917

Introduction: Breast carcinoma is a systemic disease in which micro metastasis of abnormal cells which can form the secondary malignant cells. Breast carcinoma is the rapid and uncontrolled growth of abnormal cells. Breast cancer is cancer of breast that develop from breast tissue.

Case History: Clinical findings – patient 49 years old female, having pain in right upper quadrant  of right breast, irritation and discomfort in breast, swelling in lower area of breast. Biochemical, Hematological and rediological investigation are decrease.

Investigation: Physical examination -lump is found on right breast which is non tender and slightly movable. USG and Mammography shows A suspicious retroareolar lump in the right breast and two foci pleomorphic macro calcification in right breast, Histopathology – shows both the masses are malignant but in biopsy metastasis not detected.

Therapeutic Intervention: Symptomatic treatment -tab acetaminophen -tab – hydrocortisone. Lumpectomy On the left breast and mastectomy done on right breast. Radiation therapy and Chemotherapy is given before and after surgery and Chemotherapy was continue after the surgery. Hormonal therapy also given for HER2 + receptor .all the complications of chemotherapy is managed by quality nursing care.

Outcome: After all pharmacological, surgical and medical intervention and quality nursing care, patient is now in stable condition. During treatment her treatment response is good and she can very effectively cope up with her disease condition and she is able to do her daily activities effectively.

Open Access Case Study

Advanced Physiotherapy Rehabilitation in Patient with Low Back Pain- A Case Report

Alpriya Pathan, Ragini Dadgal, Neha Chitale, Rakesh Kovela, Irshad Qureshi

Journal of Pharmaceutical Research International, Page 2613-2617
DOI: 10.9734/jpri/2021/v33i60B34921

Low back pain is a common condition due to many possible causes. The causes include improper lifting, improper posture, lack of regular exercise and fracture. Low back pain is experienced by everyone at least once in their lifespan. Proper management of low back pain is very important to prevent further complications. Low back pain can be managed by medication, surgery or by physiotherapy depending upon the cause. Physical therapy is one of the treatment for various low back pain. To manage low back pain the cause plays a major role, the therapist should take some efforts to know the cause and treat accordingly. Manual therapy is very useful for improving range of motion and tightness of the muscle.

Open Access Case Study

Rehabilitation in Operated Case of Neck of Femur Fracture: A Case Report

Anisha K. Sawra, Swapna Jawade, Neha Chitale

Journal of Pharmaceutical Research International, Page 2625-2629
DOI: 10.9734/jpri/2021/v33i60B34922

Femoral neck fracture is a common and hazardous condition of the elderly, whose morbidity is constantly increasing with population ageing and has become a serious social burden. Prosthetic joint replacement can successfully relieve pain and restore joint function. As a result, an increasing number of doctors consider it a primary treatment option for displaced femoral neck fractures in the elderly. Patients and society, however, are burdened by the lengthy procedure and hefty cost. The surgery technique for femur fracture neck fractures should be redefined as medical technology advances. Individual therapy options should be determined by the therapeutic indication and the clinical status of the patient. Personalized therapy techniques for elderly patients with femoral neck fractures should be established. The fractures causes radiating pain to the knee. Inability to bear weight. Shortening or sideways rotation of affected leg. It causes external rotation deformity, shortening, unable to ambulate, echymosis, restricted movements. The main cause of femoral neck fracture is a medical condition called osteoporosis which causes the bones to become thin and weak due to loss to bone mass. A femoral neck fracture can tear the blood vessels and cut off the blood supply to the femoral head. If the blood supply to the femoral head is lost, in bone tissue avascular necrosis may occur, leading to the eventual collapse of the bone.

Open Access Case Study

A Case Report on High Contagious and Rapid Spread of Severe Acute Respiratory Syndrome (SARS) in Hypertensive Client: An Agent of Emerging and Reemerging Infection

Amruta Kothe, Savita Pohekar, Pragati Alnewar

Journal of Pharmaceutical Research International, Page 2765-2768
DOI: 10.9734/jpri/2021/v33i60B34939

Introduction: Severe acute respiratory syndrome (SARS) is a potentially life-threatening. Severe acute respiratory syndrome (SARS) is the rapidly progressive respiratory illness which may be due to the pathogens that have potentials for large scale epidemics. MERSCOV AND H7N9 (Avian influenza) has been described by SARS. The causative organism of a SARS yet not being identified or it cannot be easily established. SARS increases morbidity and mortality which is associated with the COVID -19. COVID-19 can be complicated by severe acute respiratory syndrome (SARS) and may often cause multisystem involvement is encountered. SARS patients had mandatory needs of intensive care unit hospitalization and mechanical ventilation.

Main Symptoms and/or Important Clinical Findings: A 50 years old female was admitted in A.V.B.R.H. with chief complaints of cold, cough (dry, non-productive, non-bloody), vomiting, loose stool, breathlessness since 3 days. The patient was hypertensive for which she was taking Tab Amlo. After undergone certain investigation like complete blood test, HRCT, ECG and diagnosed as SARS and shifted to Intensive care unit.

The Main Diagnoses, Therapeutic Interventions, and Outcomes: A 50 years old female with severe acute respiratory syndrome (SARS) with chief complaints of cold, cough (dry, non-productive, non-bloody), vomiting, loose stool, breathlessness, the doctors manage her initially withantibiotic, steroids, vitamin C, multivitamin and anticoagulant and adequate nursing management.

Nursing Perspectives: The nursing interventions initiated for managing present case aremonitor the vital sign i.e., blood pressure, pulse, respiration, temperature, maintain oxygen level and intake output. BIPAP site observed and ensure that the patients is comfortable. Patient assessed for GCS, Glucose level and sign of cyanosis, monitoring the ESR, D-DIMER, RT PCR, FERRITIN other investigations like HRCT.  

Conclusion: In the Present case the patient of 50-year-old female with severe acute respiratory syndrome (SARS) it has been managed with the therapeutic treatment, right now the patient condition is worsened.

Open Access Case Study

Non-healing Ulcer on the Foot as Cellulitis: A Case Report

Pranay Tadas, Pooja Kasturkar, Ruchira Ankar, Trupti Uke, Kavita Gomase, Achita Sawarkar, Prerana Sakharwade, Sheetal Sakharkar

Journal of Pharmaceutical Research International, Page 2973-2976
DOI: 10.9734/jpri/2021/v33i60B34966

Introduction: Cellulitis is a serious bacterial skin infection. The skin is swollen and red, and it feels warm and uncomfortable to the touch. Cellulitis is most commonly found in the lower legs, although it can also appear on the face, arms, and other regions of the body. Bacteria enter the body through a crack or break in the skin. The infection can spread to your lymph nodes and bloodstream if left untreated, creating a major health danger. It is rarely passed down from one generation to the next.

Clinical Findings: The patient presented with a non-healing ulcer for 30days, due to the insect bite 1month ago on right foot which is being developed into non-healing ulcer on right foot. A 20x6cm wound over the right foot was seen on a plain film radiograph of the knee. It consists of necrotic debris, underlying tendons exposed, peripheral cold and pigmentation. Foul smelling is not present. Based on the appearance of the spreading erythema and radiographically confirmed findings, cellulitis was diagnosed. 

Diagnostic Evaluation: Blood test- Hb-8.6gm%, MCV-91.1fl, MCH-30.9Pico-gm, MCHC-33.9%, Total RBC Count-2.78 millions/cu.mm, RDW-16.8%, HCT-25.3%, Total WBC Count-7400 cu.mm, Monocytes-04%, Granulocytes-75%, Lymphocytes-20%, Eosinophills-01%, Basophills-00%, Total Platelet Count-2.06lacs/cu.mm Peripheral Smear: RBCs-Normocytic hypochromic Platelets Adequate on smear, No Haemoparasite seen.

Therapeutic Intervention: Inj. Ceftriaxone 1gm IV BD; Inj. PAN 40mg IV OD; Inj. Emset 4 mg IV TD; Inj. Neomal 100 ml IV TDS; Inj. MVI IV OD; Tab. Dolo 650 mg TDS; Tab Limcee 500 mg OD; Cap. Becosute OD; Protein powder; Tab Shelcal 500 mg OD; Tab. Duphalac 15 ml. 

Conclusion: My patient was admitted to Surgery Ward, A.V.B.R.H with a known case of Cellulitis and he had a complaint of non-healing-ulcer over the right limb. After getting appropriate treatment his condition was approved.

Open Access Case Study

Physiotherapy Rehabilitation in Idiopathic Chronic Osteomyelitis: A Case Report

Ghanishtha Burile, Swapna Jawade, Neha Chitale

Journal of Pharmaceutical Research International, Page 2985-2989
DOI: 10.9734/jpri/2021/v33i60B34968

Osteomyelitis is an infection-related inflammation of the bones and bone marrow. Generally   in the legs, arms, spine. Foot and ankle osteomyelitis can be excruciatingly painful for patients and a difficult management challenge for orthopedic surgeons. Acute staphylococcal osteomyelitis had a 50% death rate in the pre-antibiotic era. Osteomyelitis of the foot and ankle can occur due to a variety of reasons, with diabetic foot infections being one of the most common. Osteomyelitis is a bone marrow inflammation which progression, involving the cortical plates and frequently periosteal tissues, along with the majority of cases occurring after bone trauma or surgery, or as a result of vascular insufficiency. Chronic nonbacterial osteomyelitis is an autoinflammatory disease that primarily affects children and adolescents and is characterized by recurrent or persistent osteitic foci. The symptom is bone pain, which may or may not be accompanied by soft tissue tenderness. Chronic osteomyelitis is related with avascular necrosis of bone along with the establishment or formation of sequestrum (dead bone), and surgical debridement, in addition to antibiotic therapy, is required for cure. Physiotherapy has effect in improving the quality of life of the patient with osteomyelitis.

Open Access Case Study

Case Report on Hemolytic Uremic Syndrome

Nilima Manmode, Vaishali Tembhare, Seema Singh, Ranjana Sharma, Ruchira Ankar, Savita Pohekar, Usha Waghamare

Journal of Pharmaceutical Research International, Page 3313-3316
DOI: 10.9734/jpri/2021/v33i60B35011

Background: In the United States, the hemolytic–uremic syndrome of childhood typically follows gastrointestinal infection with Escherichia coli O157:H7.  It is presumed that the absorption from the gastrointestinal tract of Shiga toxins 1, 2, or both (formerly called Shiga-like toxins) produced by E. coli O157:H7 causes microangiopathic hemolytic anemia as a result of endothelial-cell injury. Shiga-toxin–producing E. coli belonging to serotypes other than O157:H7 can also cause the hemolytic–uremic syndrome. However, even though such organisms have been implicated as causes of sporadic cases or outbreaks of gastroenteritis, they are not believed to be important causes of the hemolytic–uremic syndrome in this country. Hemolytic uremic syndrome (HUS) is a kidney disease characterized by damaged and inflamed small blood vessels. As a result of the damage, clots in the vessels may form. Clots impede the filtration function of the kidneys, causing renal failure, which can be deadly.

Clinical Finding:  Hemolytic uremic syndrome, nephropathy and thrombocytopenia, pallor, jaundice, edema. After eight hours of stomach and left-flank pain, vomiting, and dysuria, a previously healthy six-year-old girl was seen. The day before, an enema had been used to alleviate constipation. The child had not had diarrhoea during the two weeks before evaluation. On examination, the patient had an oral temperature of 39.8°C, a pulse rate of 120 per minute, and a blood pressure of 111/59 mm Hg. There was tenderness of the suprapubic area and left costovertebral angle. The white-cell count was 23,400 per cubic millimeter (58 percent neutrophils, 23 percent band forms, 9 percent lymphocytes, and 10 percent monocytes), the hematocrit was 40 percent, and the platelet count was 293,000 per cubic millimeter. Urine obtained by catheterization had a specific gravity of 1.028 and a ph of 5, and dipstick analysis was positive for leukocyte esterase (++), protein (++), ketones (++), and blood (+++). The urinary sediment contained 21 to 100 red cells, more than 100 white cells, 1 to 5 renal tubular cells, and 1 to 5 granular casts per high-power field. Many bacteria were observed by microscopy. The left kidney showed attenuation of fat and a possible collection of fluid on abdominal ultrasonography; the right kidney was normal. Before starting ceftriaxone medication, blood was taken for culture.

Diagnostic Evaluation: HB-5.7 g/dL, total protein-7.4 g/dL, total Alcaline phosphatase -123 U/L , total platelet count-2,93,000 per cubic millimeter, total bilirubin-3.2 mg/dl, WBC 23400 per cubic meter, CRP 5.58 mg/L, Sodium level 136 mg/dl, potassium level 3.92mg/dl.

Therapeutic Intervention: Tab Amlodepin 10 mg BD, Tab Prednisolone 10 mg TDS, Tab Envas 2.5 mg OD, Metropenum 340 mg BD, Inj. Pantop 20 mg OD.

Outcome: The medication has started for thrombocytopenia, the patient is on dialysis and If is given to patient for movement of body because of patient is obese. The patient was sent home after 20 days of hospitalization. Three weeks later, a voiding cystourethrogram was normal, and six weeks later, ultrasonography revealed that the focal abnormality in the left kidney had disappeared. The patient's blood urea nitrogen and serum creatinine concentrations, iothalamate clearance, and blood pressure are all normal two years later, and her urine is protein and blood-free. She has not experienced a recurrence of a urinary tract infection or hemolytic–uremic syndrome.

Conclusion: The atypical hemolytic uremic syndrome is an uncommon condition that must be diagnosed with a high index of suspicion. It's an exclusionary diagnosis. A better outcome will be achieved if the disease is detected early and treated promptly. In all patients with thrombotic microangiopathy, the atypical hemolytic uremic syndrome should be evaluated.

Open Access Case Study

Case Report on Management of Abnormal Uterine Bleeding with Anemia

Pallavi Raut, Khushabu Meshram, Sonali Kolhekar, Prerana Sakharwade, Jaya Khandar, Savita Pohekar, Samruddhi Gujar

Journal of Pharmaceutical Research International, Page 3348-3351
DOI: 10.9734/jpri/2021/v33i60B35016

Introduction: The most prevalent condition seen in the gynecology outpatient department is abnormal uterine bleeding (AUB). AUB can be caused by a variety of conditions 1. A 42 year female who have chief complaints of abnormal uterine bleeding   is bleeding from the uterus that is longer than usual or that occurs at an irregular time. several characteristics of underlying hereditary or acquired blood disorders increase the "anticipated" hormonal imbalance at this age, hence worsening the morbidity of the underlying condition axis .Despite the fact that blood problems can cause AUB, uterine structural and/or endocrine abnormalities are frequently missed when a blood illness is present [1]. Hematologists and gynecologists, as well as adolescent medicine experts, must work to get her to treat a complex etiology [2,3].

Patient History: A 42 year old female was admitted in AVBRH in gynec ward sawangi meghe wardha with chief complaint of abnormal uterine bleeding since 2 month, abdominal pain since 1 week, weakness.

Medical Management: Patient treated with anticoagulant, antibiotic, iron supplement.

Nursing Management: Administrative IV fluid monitor vital sign, and medication given by doctor’s order.

Conclusion: Women should be asked about their previous menstrual cycle, regularity, desire for reproduction, contraception, and sexual health by their primary care providers. If abnormal uterine bleeding is detected at the primary care level, additional history, examination, and testing can be undertaken, and appropriate consultations can be scheduled. Timely treatment and management of abnormal uterine bleeding with anemia.

Open Access Case Study

A Case Report on Pyloric Stenosis in Infants

Bhushan M. Petkar, Khushbu Meshram, Jaya Khandar, Pooja Kasturkar, Prerana Sakharwade, Vaishali Tembhare, Shital Sakharkar

Journal of Pharmaceutical Research International, Page 3358-3362
DOI: 10.9734/jpri/2021/v33i60B35018

Introduction: Pyloric stenosis also known as pylorostenosis or specifically as infantile hypertrophic pyloric stenosis (IHPS) is the tapering (stenosis) of the opening from the stomach to the first part of the small intestine (duodenum). The term “pylorus” indicates “gate”. The thickened pylorus is feels as an olive shaped abnormal mass in the upper right hypochondriac and epigastrium region of the infant’s abdomen.

Clinical Findings: Frequent vomiting after feeding which is projectile,non-bilious, in nature. Continual hunger, dehydration, alterations in bowel movements, weight issues.

Diagnostic Evaluation: History collection (family history), physical examination (olive shaped mass) at epigastrium, hematological test (CBC), biochemistry test (KFT) (electrolyte imbalance). Ultrasonography (USG) abdomen:- thickened pylorus (<3mm), narrowed pyloric lumen, gastric content can not pass to duodenum, superior mesenteric artery and superior mesenteric vein located without altered position.

Therapeutic Interventions: Inj. Cefotaxim 1gm 1.4ml IV × BD (Antibiotics), Inj. Pantodex 40mg 2ml IV × OD (proton-pump-inhibitor), Inj. Temfix 100ml 50ml IV ×BD (antipyretic analgesic), IV Fluids.

Surgical Interventions: Fred-Ramstedt’s Pyloromyotomy.

Outcome: After treatment, infant show improvement. His frequent vomiting has been stopped and hunger problem resolved, baby starts gaining weight after surgery.

Conclusion: My patient was 1 month 10 days old when he was admitted to the paediatric intensive care unit (ICU) with the chief complaint of frequent vomiting, persistent hunger, weight loss, and dehydration. After a thorough physical examination and a variety of tests, he was diagnosed with infantile hypertrophic pyloric stenosis.

Open Access Case Study

Carcinoma of Breast: A Case Report

Pratiksha Thakare, Ruchira Ankar, Ranjana Sharma, Samruddhi Gujar, Shakib Sheikh

Journal of Pharmaceutical Research International, Page 3381-3385
DOI: 10.9734/jpri/2021/v33i60B35021

Background: In Indian women, breast cancer is the most frequent type of cancer. Breast cancer affects 30 out of every 100,000 women in India.

Case Report: A female patient of 70 years old was admitted to Female surgery Ward-33, Unit-3, AVBRH on 19th January with a chief complaint of lump in upper outer quadrant of the right breast, hardness and non-tenderness of right breast since 2 months. The patient was ok. She had complained of a lump in the upper outer quadrant of her breast for 2 months, and it had appeared gradually. During a physical examination, some clinical findings were obtained i.e., lump in a breast was gradually progressive, and non-tenderness and a nonmobile lump in upper outer quadrant of right breast, no history of fever, nausea vomiting, bloody discharge from a nipple. After that patient was undergone on the routine investigation in that Haemoglobin- 8.4gm% was decreased, Total Red Blood Cell count 2.88 cumm decreased, Total Leucocyte Count -17800 cumm increased. Fine needle aspiration cytology show metastasis of breast and ultrasonography shows an irregular strangulated hypoechoic mass of approximately 3.5*1.9 cm at the outer upper quadrant of the right breast. After histopathology report revealed that patient having metastasis of right breast and she was undergone on treatment of chemotherapy.

Conclusion: This case report was of great relevance for academics, its provided to improve knowledge about breast cancer, to encourage the practice of BSE making women aware of the importance of this exam.

Open Access Case Study

Case Report on Acute Pancreatitis

Sonal Hadke, Sheetal Sakharkar, Arati Raut, Archna Dhengare, Samrudhi Gujar, Swapna Morey, Archana Taksande, Darshna Kumari, Khushbu Pande

Journal of Pharmaceutical Research International, Page 3394-3398
DOI: 10.9734/jpri/2021/v33i60B35023

Introduction: Upper-abdominal pain is frequently caused by acute pancreatitis. A diagnosis based purely on symptoms and signs is difficult because its clinical features are similar to those of a range of other acute diseases. Acute pancreatitis is diagnosed using two of the 3 criteria given below: Stomach pain, increased serum lipase and/or amylase levels, and abnormal abdominal image processing are all signs of pancreatitis. When it comes to diagnosing acute pancreatitis, lipase has been demonstrated to have good specificity and sensitivity. Pain in the stomach that appears to originate from the pancreas When it comes to diagnosing acute pancreatitis, abnormal abdominal imaging and/or serum lipase and/or amylase values larger than three times the upper period of normal Lipase have been proven to have good sensitivity and accuracy.

MAIN Symptoms And / OR Important Clinical Findings: For 5 days, I had abdominal pain, difficulty swallowing, decreased appetite, generalized weakness, fever, and loose movements.

Diagnostic Evaluation: He is a male patient who is 22 years old. And all diagnostic testing has been completed. Contrast-enhanced computed tomography of the abdomen, ultrasonography, complete blood count: 12.8 gm/dl.

Therapeutic Intervention: Patient was treated injection meropenem 500 milligram thrice a day,  injection Levoflox 500 milligram one time a day, injection pan 40 milligram one time a day,  injection Emeset 4 milligram thrice a day, injection Tramadol 100 milligram thrice a day, injection Thiamine 100 milligram thrice a day, injection mucomix 600 milligram twice a day, injection Doxy 100 milligram twice a day, Injection Hydrocort 100 milligram thrice a day, Syrup, Kesol 2TSP thrice  a day.

Outcome: The patient’s overall condition gotten better.

Nursing Perspectives: Changing the fluid dextrose normal saline and ringer lactate were set up in the first place. On an hourly basis, keep track of your vital signs and blood pressure. Maintaining the patient’s intake and output chart, as well as providing adequate rest and sleep. Administered drugs as directed by the doctor.

Conclusion: During the past five days, patients complained of abdominal pain, nausea and vomiting after each meal, difficulty swallowing, decreased appetite, generalised weakness, fever, and loose movements at Acharya Vinoba Bhave Rural Hospital. These symptoms were eased with proper treatment, and the patient is currently in good health.

Open Access Case Study

Case Report on Management Hydrocephalus as a Complication of Meningitis in Infant; Nurse Prospective

Manjari Ingle, Savita Pohekar

Journal of Pharmaceutical Research International, Page 3407-3411
DOI: 10.9734/jpri/2021/v33i60B35025

Introduction: Hydrocephalus is one of the commonest complications of meningitis in children with the disease. It is more severe in children than in adults. Fewer cases cause chronic Meningitis. Finding and treating the culprit organism is quite tough. In patients with chronic meningitis, complications such as hyponatremia, hydrocephalus, and neurological impairment should always be identified early and treated with a multidisciplinary team approach. We came across a case of severe brain damage due to Escherichia coli that progressed to meningitis which further also cause hydrocephalus, which she was treated for numerous times before being returned home with some neurological disability.

Clinical Findings: A 1.5 month old female child was brought to A.V.B.R. Hospital Sawangi (meghe) wardha on date 18th November 2021 by her parents with High fever, refusal of feed, seizures like activity, bulging fontanel.

Diagnostic Evaluation: Hb: 10.7, TLC : 21,500 . platelet: 5.1 eql CBC , elevated WBC count of 23,511/ul KFT and LFT are normal ,  Brain MRI showed restricted diffusion, Lumbar Puncture was also performed same day E.coli gram negative bacteria are present in CSF collection

Therapeutic intervention: Injection Ceftriaxone 650 mg 6 hourly intravenous, Injection Pan 15 mg 24 hourly intravenous, Injection Emeset 2 ml 4 hourly intravenous  DNS with injection KCL 3.8 ml 8 hourly intravenous.

Outcome: After treatment of 6 days the child show improvement like fever and seizers decreased.

Conclusion: After proper treatment like medication, monitoring vitals and also by continous observation her condition was improved.

Open Access Case Study

A Case Report On: Guillain – Barre Syndrome

Ayushi Hedau, Sheetal Sakharkar, Ruchira Ankar, Arati Raut, Samrudhi Gujar, Archna Dhengare, Shalini Lokhande, Khushbu Pande, Prerna Sakharwade

Journal of Pharmaceutical Research International, Page 3418-3422
DOI: 10.9734/jpri/2021/v33i60B35027

Introduction: Guillain berry syndrome is also called as landry’s paralysis. It is the disorder included in the peripheral neuropathy. In guillian berre syndrome, the patient’s body’s immune system attacks on the nerves. This condition may also triggered by the bacterial infections as well as some of the viral infections. GBS is a rare syndrome approximately there were only 1-2 cases per 1,00000 people annually. Men are more likely affected than that of womens. This syndrome is names after a French physicion Gorgous Guillian and Jean Alxzandre Barre and strohl who described it in 1916.

Clinical Findings: weakness, difficulty in breathing, difficult to hold the breath till 5 second, fatigue, elevated blood pressure, difficulty in speaking.

Pheripheral Smear: RBCS _ normal range, atrophy is seen.

Ultrasonography: Enlargement of vagus nerve.

Therapeutic Interventions: DNS 380 ml intravenous, plasma exchange theraphy, inj. Ceftriaxone, syrup Phenytoyin 9.5 ml. syrup rdpen 10 ml. syp calcimax 10 ml, tab folic acid 5 mg, tab limcee 500 mg, tab baclofenac 10 mg, NEB 3% NACL, inj pantop 15 mg.

Outcomes: After the treatment, the child shows improvement. His weakness and fatigue ger relieved and pain in muscle had relieved.

Conclusion: A 5 years old male child was admitted in the prdiatric ward no. 18 , Acharya Vinoba Bhave Rural Hospital on date 31 july 2021 with a case of Guillian Barre Syndrome (GBS). He had the complaint of weakness, fatigue, lack of co-ordination, difficulty in swallowing .After getting an appropriate treatment, the patient’s condition has improved than that of previous.

Open Access Case Study

The Effects of Plasma Exchange on Diffuse Alveolar Hemorrhage in Severe Vasculitis – A Case Study

Monali Rajendrakumar Sahu, Tanvi Dilip Wairagade, Sonali Dilip Wairagade, Ranjit S. Ambad, Parikshit Muley

Journal of Pharmaceutical Research International, Page 3423-3428
DOI: 10.9734/jpri/2021/v33i60B35028

Introduction: Rapidly progressive glomerulonephritis (RPGN) and widespread alveolar hemorrhage define ANCA-associated vasculitis (AAV), a rare, life-threatening illness (DAH).

Case Presentation: An elderly female came with lower limb weakness and oliguria had features suggestive of RPRF and fluid overload. She developed hemoptysis with respiratory failure despite hemodialysis and intravenous steroids. The diagnosis of patients was pulmonary-renal syndrome– DAH in the setting of ANCA and based on the HRCT chest and positive p-ANCA report. She had excellent responses to intravenous pulse steroids, cyclophosphamide, and plasma exchange. 

Conclusion: Based on observation showed the importance of immediate intervention in potentially fatal disease DAH in AAV.

Open Access Case Study

Case Report on Chronic Renal Failure in Adults

Deepika Uikey, Pooja Kasturkar, Ruchira Ankar, Trupti Uke, Kavita Gomase, Achita Sawarkar, Prerana Sakharwade, Sheetal Sakharkar

Journal of Pharmaceutical Research International, Page 3437-3441
DOI: 10.9734/jpri/2021/v33i60B35030

Introduction: CRF is either the presence of kidney damage for 3 months or longer. Kidney damage is defined as either pathologic abnormalities or markers of damage including abnormalities in blood or urine test or imaging studies. Chronic disease are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic disease such as heart disease, cancer, and diabetes are the leading causes of death and disability in the individual. As renal function declines, the end products of protein metabolism (normally excreted in urine) accumulate in the blood. Uremia develops and adversely affects every system in the body the greater the buildup of waste products, the more pronounced the symptoms. The rate of decline in renal function and progression of end stage kidney disease is related to the underlying disorder.

Main Symptoms of CRF: The main signs and symptoms-Fever/cough/cold/abdominal pain/vomiting/loose stool/edema/giddiness/back pain. Abnormal blood loss in urine test, high blood pressure, weight loss for no reason, low red blood cell count (anemia), nausea, metal taste in your mouth, loss of appetite.

Diagnostic Evaluation: blood test: Hb-6.5gm%, total RBC count-3.5million/cu mm, HCT-28.4%, total WBC count-9.6/cu mm. monocytes-03%, granulocytes-85%, lymphocytes-10%,calcium-9.1mg/day, creatinine-urine test-71.8mg/dl, KFT- urea-111mg/dl, cretinine14.0, sodium 134mmol/l, potassium-6.5(pl. repeat), magnesium-2.4mmol/l, phosphorus-7.3mmol/l, RBS glucose-plasma random -222mmhg, uric acid -8.1mg/dl, urinary protein- 905mg/dl, bloodpressure-140/90mmhg.

Therapeutic interventions: inj. Levoflox 500mg IV OD, inj. ctri 1gm IV BD X 5days, inj. Pan 40mg IV OD, inj. Emset 4mg IV OD, inj. Insulin m(30/70) 18u(BFF)-0-12u(BD) inj. EPO 10000 IU SC post dialysis once per week, tab. Nicardia 20mg TDS, tab. Febuxostat 40mg OD, tab. Shelcal 500mg OD, tab. autrin OD, tab. Sevelamer 400mg BD, tab. Envas 5mg HS, tab. met XL 25mg                       OD.

Outcome:  after treatment, the adult show improvement. His abdominal pain were relieved and his diabetes and hypertension were in control.

Causes:  Due to some disease of infection the kidney can’t do its works properly, the main cause of chronic renal failure is High blood pressure Blocked urinary tract. The chief causes of CRF include obstructive uropathy, primary glomerular diseases, reflux nephropathy and hypoplastic or dysplastic kidneys. Progressive hyperperfusion and hyerfilteration causes increasing glomerular injury and further renal damage. Symptoms of CRF is between 10-25% of normal. The four main causes of CRF are high blood pressure, chronic glomerulonephritis, high blood sugar, polycystic kidney disease.

Conclusion:  My patient was a known case of chronic renal failure and he had complaint of irritation abdominal pain, back pain, giddiness. After getting proper treatment his condition was better than previous condition.

Open Access Case Study

A Case Report on Cesarean Section under Spinal Anesthesia in a Patient of Takayasu’s Arteritis

Krishnendu S., Aruna Chandak, Vijay Chandak, Parag Dongre

Journal of Pharmaceutical Research International, Page 3553-3556
DOI: 10.9734/jpri/2021/v33i60B35046

Takayasu's arteritis (TA) is a chronic inflammatory illness of the major arteries that is extremely rare. It mainly affects women of reproductive age which increases the risk of cardiovascular problems such hypertension and congestive heart failure. In this study, we discuss the case of a pregnant woman with TA who was diagnosed and managed successfully at a tertiary care facility with a good outcome. As a result, comprehensive care for TA patients has been shown to be critical in achieving optimal maternal and fetal/neonatal outcomes.

Open Access Case Study

Case Report on: Appendicitis

Jaya Khandar, Achita Sawarkar, Madhuri Shambharkar, Prerna Sakharwade, Khushbu Meshram, Sheetal Sakharkar, Samruddhi Gujar, Pooja Kasturkar

Journal of Pharmaceutical Research International, Page 3604-3607
DOI: 10.9734/jpri/2021/v33i60B35053

Introduction: Acute appendicitis (AA) is the most common surgical infection, with a 7–8% lifetime risk. The mortality rate following appendectomy is quite low, ranging from 0.07 to 0.7 percent in patients without perforation to 0.5 to 2.4 percent in patients with perforation, which is an acute inflammation of the appendix. It affects people of all ages, with the majority of cases occurring between the ages of 10 and 30, and both boys and females are afflicted equally. Appendicitis is substantially less common in developing nations, particularly regions of Africa, and among lower socioeconomic levels. After being diagnosed with appendicitis, a 24-year-old male was taken to AVBRH with complaints of pain in the right iliac fossa, nausea, and vomiting. The findings of the examination were consistent with acute appendicitis. His systemic health remained unaffected, and testing such as blood tests, urine samples, and abdominal ultrasounds were inconclusive. Acute appendicitis (AA) is the most common surgical condition, and in the vast majority of cases, appendectomy is the treatment of choice. An accurate diagnosis is essential for lowering the rate of negative appendectomy. In the case of a complex appendicitis, management can be tough. The diagnostic process must be improved in order to reduce the negative appendectomy rate and the danger of misdiagnosis. The diagnosis of acute appendicitis was primarily relied on symptoms, signs, and laboratory evidence prior to the widespread use of CT scans.

Open Access Case Study

A Case Report on Stoneman Syndrome

Sakshi Janardhan Patil, Khushbu Meshram, Pooja Kasturkar, Prerana Sakharwade, Jaya Khandar, Sheetal Sakharkar

Journal of Pharmaceutical Research International, Page 3737-3740
DOI: 10.9734/jpri/2021/v33i60B35070

Fibrodysplasia ossificans progressive is a debilitating autosomal dominant disease characterized by postnatal progressive heterotopic which tissue that connects things together ossification and congenital deformities of the big toes. Fibrodysplasia ossificans progressiva affects about one out of every two million newborns born world wide.

Almost ninetypercent of people with fibrodysplasia ossificans progressiva are misdiagnosed and treated wrongly, resulting in ineffective treatments. Approximately 700 cases have been identified so far around the world. Clinical examinations, radiographic evaluations, and ACVR1 gene mutation testing are all considered confirmatory approaches for early illness diagnosis.

Case Presentation: We're reporting on the case of a 45-year-old man who was admittedt in our facility.

He had clinical and radiological evidence of fibrodysplasia ossificans progressing, as well as multiple painful lumps on his back due to hard masses and rigidity of his shoulders, neck, and left hip.His left hip ossification was surgically removed, but he experienced an increased ossification reaction and early impairment as a result.

Conclusion: Fibrodysplasia ossificans progressive is an uncommon and severe illness that, if misdiagnosed, can result in inappropriate surgical intervention and early paralysis with disastrous consequences.

We need to educate clinicians and patients' families concerning the disease, as well as its symptoms for early detection and how to prevent flare-ups, in order to improve quality of life.

Open Access Case Study

Case Report on Wilm’s Tumor in Children

Saurabh Borkar, Archana Maurya

Journal of Pharmaceutical Research International, Page 3758-3762
DOI: 10.9734/jpri/2021/v33i60B35073

Introduction: Wilms tumor is the most frequent kind of kidney cancer in kids. It is responsible for around 6% of all tumors in children. In children under the age of 15, the incidence is 7.6% cases per million, with 75% of cases occurring before the child reaches the age of five. A variant term for wilms tumor is nephroblastoma. It is most widespread between the ages of three and four, after which it becomes much less frequent.

Clinical Findings: Wilms tumor in children produces one or more of the following signs and symptoms:

  • Abdominal pain
  • Increasing abdominal girth
  • Lack of appetite
  • Fever
  • Blood in the urine
  • Nausea or vomiting.
  • Constipation
  • Shortness of breath

Diagnostic Evaluation:  Increase abdominal girth, pain, fever, vomiting, cried at the time of urination, hematuria, black stool, pallor, hypertension and moderate microcytic anemia (Iron deficiency).

Ultrasonography: Splenomegaly

Therapeutic Investigation: X- ray of abdomen and chest, IVP, USG, MRI, CT scan, renal function test and urine analysis, liver function test bone marrow study, and histology

Outcome: After treatment, the child shows great improvement, his fever, abdominal pain, blood in urine is minimized and his Hb level is increased from 9gm% to 11.1gm%.

Conclusion: A female child of 11 years from admitted to pediatric ward no .22, Acharya Vinoba Bhave rural hospital Sawangi ( Meghe) wardha on 28/9/2020 with a rare case of Wilms tumor. She is 30kg and his height is 142cm. She was admitted to the hospital, where all investigations and treatments began. She improved dramatically after therapy and continued to do so until my last day of care.

Open Access Case Study

Management of Bullous Pemphigoid with Diabetes Mellitus: Case Report

Kunal D. Thakre, Kavita Gomase, Pooja Kasturkar

Journal of Pharmaceutical Research International, Page 3878-3882
DOI: 10.9734/jpri/2021/v33i60B35090

Introduction: The most frequent acquired autoimmune sub epidermal blistering condition is bullous pemphigoid (BP). BP mostly affects older persons between the ages of 60 and 80. It is an uncommon autoimmune condition that affects both men and women, with a greater prevalence in women.

Complaints and investigations are underway: A 50-year-old female patient presented to the dermatology department with the primary complaint of fluid-filled sores all over her body that had been present for 8 months. She also complained of lesions with mild to severe itching, irritation, and sometimes burning feeling over lesions for 8 months, and she was a known case of Diabetes Mellitus (DM) type 2 for which she was taking medicine from 8 to 10 years. Following a general physical examination and research, a case of BP with DM 2 was identified.

The major diagnosis, treatment intervention, and results are as follows: After a physical examination and investigation, the doctor diagnosed a case of Bullous Phemphoid with a verified case of DM type 2. Inj. Insulin Mixtard 22U/16U, Tab. Defcort 12 Mg 2-1, Tab. Glicazide 80 Mg BD, Tab. Nicoglow 250 Mg OD, Tab. Cyclophosphamide BD (50 Mg -25 Mg), Cap. Doxepin 10 Mg BD, Tab. Dailyshine 60000IU (Once A Week), L/A Omate –F OD, vitamin B, calcium, iron The entire course of treatment was completed, and the outcome was satisfactory.

Conclusion: She responded to medication as well as physician counselling. Her itch has subsided, and some of the lesions have healed.

Open Access Study Protocol

Application of Visagism Concept to Assess the Co-Relation between the Temperament and Smile Esthetics: A Clinical Study

Poorvi Jain, Surekha Godbole, Seema Sathe Kambala, Chetan Mahatme

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2021/v33i60B34577

Background: Ability of a person to express a wide range of emotions with the movement of teeth and lips is called as a smile. Dentogenic concept considers gender, personality, age in harmonizing shapes of teeth with the face. Personality is unique for an individual. Unveiling personality traits, desires of the individual, translating them into natural tooth shapes to maintain the psychodentofacial harmony poses a major challenge to the clinician in designing a smile. Visagism is a novel concept that helps the dentists in providing restorations that involve esthetics psychological and social features of the created image, which influences the individual’s emotions. It involves the customization of an image.

Aim and Objectives: To assess the co-relation between the smile esthetics and mental temperaments or personalities through the application of the concept of visagism.

Methodology: A Digital camera (DSLR) for capturing the photographs and smile designing software will be used. Each subject will be instructed to occlude the teeth while capturing photographs. A validated questionnaire study will be conducted that will help to discover temperament of the subject. The answers will be evaluated and maximum score of the responses out of the list will be dominant temperament in that individual.

Expected Outcome: Co-relation between this study might help clinicians to accurately assess the correlation between the temperament and the smile esthetics and eventually develop proper customisation of a smile with respect to the personality of the patient.

Conclusion: If computer-assisted smile design and application of visagism concept would be accurate and reproducible, this might help and improve the planning of smile designing, the oral rehabilitations.

Open Access Study Protocol

Comparative Evaluation of the Efficacy of Hydrocortisone Suppository and Durvadi gudavarti in Raktarsha: A Management Protocol

Biswas Nitin, Jajoo Suhas, Jaiswal Reena, S. R. Kapse

Journal of Pharmaceutical Research International, Page 12-18
DOI: 10.9734/jpri/2021/v33i60B34579

The most common diagnosis for any anorectal complaint particularly of rectal bleeding in adults is haemorrhoidal disease. Regardless of grading conservative treatment is used primarily in symptomatic haemorrhoids. In Ayurveda, Sthanik Chikitsa (Local application) in the management of Arsha (Hemorrhoids) includes pralepa/pratisaran (Paste application). Instead of applying the lepa in the clinics by the clinician/proctologist, those formulations could be developed into Gudavarti (traditional suppository) & used in the management of Raktarsha (bleeding piles) for better compliance. Hence, development of ‘Durvadi Gudavarti’ using the indigenous medicinal herbs mentioned in Charaka Sanhita (Classical Ayurveda text) for pratisaran/pralepa in Raktarsha & its efficacy will be evaluated.

Objectives: To study & compare the efficacy in patient treated with standard- Hydrocortisone suppository group & interventional- Durvadi Gudavarti group in the management of Raktarsha (Bleeding piles).

Methodology: 130 patients of 2nd grade hemorrhoids will be selected and will be allocated into two equal groups by computer randomization. Experimental group will be treated with Durvadi Gudavarti & control group with Hydrocortisone based suppository for 2 weeks. Following Symptoms- PR Bleeding, Anal Pain, Prolapse of Pile mass/Lump, Anal pruritus, Mucous discharge & Constipation will be assessed subjectively and Size/ (Volume in cubic millimeter) of pile mass will be the objective parameter for study. Clinical evaluation will be done at Baseline and 3rd, 5th, 10th, 15th day after treatment onset. Proportion of patients that would respond clinically on 10th day will be the main end point, determined via disappearance of the clinical symptoms & more than or equal to 50 % reduction in the initial size of pile mass/lump. Time to response & need for any oral/ parenteral medication for pain, bleeding and constipation would be the secondary variables. Side effects (type, duration & severity) will be registered carefully.

Expected Results: Durvadi Gudavarti contains indigenous herbs having anti-inflammatory, analgesic, haemostatic, wound healing, astringent, & laxative properties. Hence, it is expected to be as efficacious as Hydrocortisone suppository with lesser side effect in the management of Raktarsha. Results will be assessed on the basis of clinical assessment criteria using proper statistical values and tools. Changes will be observed in objective outcomes.

Conclusion: Durvadi Gudavarti will be efficacious in the management of Raktarsha.

Open Access Study Protocol

Evaluation of Antimicrobial Efficacy of Triphala Oral Spray in Patients Undergoing Orthodontic Treatment- A Randomized Clinical Trial

Nishi Malviya, Nilima Thosar, Nilesh Rathi, Monika Khubchandani, V. G. Meshram

Journal of Pharmaceutical Research International, Page 24-29
DOI: 10.9734/jpri/2021/v33i60B34581

Background: Malocclusion is one of the most susceptible causes of the development of periodontal diseases and dental caries in young individuals undergoing fixed orthodontic treatment. It provides a surface area for the accumulation of food particles, which further leads to plaque formation. Various mechanical and chemical aids are used regularly to decrease the microbial load and accumulation of plaque. Chemical adjuncts such as chlorhexidine mouthwash are widely used as antimicrobial agents that have significant efficacy against oral Streptococci and Actinomyces species. Herbal agents have replaced conventional medications due to the development of antibiotic resistance. Among herbal medicaments, Triphala is the well-known drug formulation that can be used as an adjuvant for commercially available chemical aid. Chlorhexidine mouth wash requires the assistance of the caregivers. Therefore, there is a need for a newer modality to maintain oral hygiene in patients undertaking orthodontic corrections.

Objectives: 1. To evaluate the antimicrobial efficacy of Triphala oral spray on Streptococcus mutants levels in children undergoing orthodontic treatment. 2. To evaluate the efficacy of Triphala oral spray in reducing dental plaque in children undergoing orthodontic treatment. 3. To evaluate the efficacy of Triphala oral spray reducing gingivitis in children undergoing orthodontic treatment.

Methodology: A randomized control trial will be done among – participants with the age group of 10 to 15 years of age. A total of 25 children were included in the study. The participants will be told to use the spray two times a day for one week. After 7 days, plaque index and the gingival index will be re-recorded, and plaque samples will be collected for post-intervention microbial analysis.

Results: Triphala-based oral spray will effectively reduce plaque score, reduce gingival inflammation, and show inhibitory effects on microbial count.

Conclusion: Triphala oral spray can be used as an adjuvant by the orthodontic patients for reduction of the microbial load. It also provides better acceptability by the children as it does not require any assistance of the caregivers.

Open Access Study Protocol

Efficacy of New Vibration Device in Reduction of Injection Pain among Children-A Randomized Control Trial

Archana Maurya, Jayant Vagha, Tessy Sebastian

Journal of Pharmaceutical Research International, Page 238-243
DOI: 10.9734/jpri/2021/v33i60B34611

Needle-related procedures considered as the very crucial sources of pain in children. Pain management during invasive procedure is a challenge to direct health care providers. Unnecessary pain can spoil the nurse-patient relationship. Injections usually reason for some level of pain at the injection site. To develop and validation of the new vibration device for reduction of injection pain and compare the injection pain score among children between experimental and the control group. We will base this study on Analytical intervention approach. A hospital-based Randomized Controlled Trial will consider the effect of a new vibration device in intervention and routine care in the control group for reduction of injection pain. The sample will be children of the age Group 4 years to 12 years. Researcher will take before data collection selection of children as per inclusion criteria, detail explanation about nature and purpose of the study the written consent from the child’s parent. The computerized randomized sampling technique will use for the group formation. The setting of the study will be Hospital Wardha. There will be an efficacy of interventions on children's outcomes reduce injection pain and stable emotional behaviour and stable physiological parameter. Researcher will draw conclusion after the analysis of data collected from the predetermined sample size. Researcher will publish the findings of the study in an open access peer-reviewed Journal.

Open Access Study Protocol

To Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge Regarding Prevention of COVID-19 among Antenatal Mother

Shalini H. Moon, Biswas Anupriya Krishna Pada, Bombale Maheshwari Prakashrao, Bhalkar Shubhangi Shradrao, Bhokre Sai Vijayrao, K. Pahune Devendra

Journal of Pharmaceutical Research International, Page 250-256
DOI: 10.9734/jpri/2021/v33i60B34613

Introduction: Since the year 2019, COVID-19 (Corona Virus Disease 2019) has sparked numerous discussions and rumours. Undoubtedly, the core foundation of health care system has been shattered due to the absence of any specific treatments. Hence, this research study is selected and will be carried out to prevent the pandemic by providing knowledge through video assisted teachings to the antenatal mothers.

Aim: To assess the effectiveness of video assisted teaching programme on knowledge regarding prevention of COVID-19 among antenatal mothers in selected maternity hospitals.

Methodology: This study will be based on a Quantitative research approach along with the use of non-probability convenient sampling technique. The sample population will consist of 400 antenatal mothers from selected maternity hospital. Lesson plan and structured questionnaires will contribute to the context of V.A.T.P.

Expected Result: The study should be able to depict the positive effect of video-assisted teaching programme on prevention of COVID-19 among antenatal mothers from selected maternity hospitals, along with studying the association of their knowledge score to the respective demographic variables.

Conclusion: Video-assisted teaching programme should be effective method for delivering health education at all times and final conclusion will be drawn from the ultimate results of the statistical review.

Open Access Study Protocol

Cognitive Impairment within Patients of Schizophrenia and Mood Disorder: A Comparative Study

Swaroopa V. Lunge Patil, Prakash B. Behere

Journal of Pharmaceutical Research International, Page 892-899
DOI: 10.9734/jpri/2021/v33i60B34691

Background: Memory dysfunction, deficits in attention and executive functions as well impairment in cognition is found among patient suffering from Schizophrenia and Mood Disorder throughout the course of illness. All these significantly impact various domains of life in them. It also affects the patient’s insight into the illness and thus impairs therapeutic compliance.

Objectives:

  1. To evaluate Cognitive functions in patients with Schizophrenia and Mood Disorder.
  2. To compare both groups to see whether cognitive dysfunction varies between them.

Methodology:

Study Design: Cross-sectional study which is Hospital-based.

Study-Setting: The IPD and OPD of Psychiatry Department, AVBRH, Sawangi (M), Wardha.

Sample Size: 240 (120 patients with Schizophrenia and Mood Disorder each).

Patients clinically diagnosed having Schizophrenia and Mood disorder using ICD-10 criteria of age group 18-55 years, with at least 8 years of schooling will be included in the study after taking written informed consents. After collecting socio-demographic data and screening the patients with the Brief Psychiatric Rating Scale, the PGI Battery of Brain Dysfunction will be applied to the patients.

Results: This study will assess of impairment of Cognitive functions Schizophrenia as well as Mood Disorder patients would tell whether the cognitive impairment is the same or different in both groups.

Conclusion: Comparison of impairment in cognitive functions in Schizophrenia as well as Mood Disorder patients would be done. Co-relation of Cognitive impairment with Metabolic syndrome in both groups can be established.

Open Access Study Protocol

Foot Print Analysis and Prevalence of Flat Foot among Children of Rural India – A Study Protocol

Suyash Y. Ambatkar, Ratnakar Ambade

Journal of Pharmaceutical Research International, Page 906-911
DOI: 10.9734/jpri/2021/v33i60B34693

Introduction: Foot shape and its proportions changes gradually during normal growth of human beings, but the mechanical stresses during bipedal locomotion are a key factor for development of foot. To sustain static position and to arrange for stable base while performing various functional activities, Foot plays major role in it. Deformities in lower extremities of children’s are being very common. As this conditions are physiological, that’s why most of the time this conditions do not require treatment. In an average 90% of patient who are visiting to clinic for foot problem are flat foot. Primary manifestation of flat foot is decreasing in longitudinal arch, which shows that while standing or walking, there is transmission of whole body weight towards the medial side of foot sole. This is the main reason for which flat foot is considered as problem of static alignment of foot and ankle structure.

Objective: To analyze footprint of children and to determine prevalence of flat foot, their anthropometric measurement, Prevalence of structural pathologies of foot and correction of foot prints and radiological evaluation of 8 – 13 years age group of children.

Methodology: All the visiting patients of orthopedic department of AVBRH of age group 8 – 13 year, with sample size. Examination will be done along with radiological examination, radiological assessment and different anthropometric will include Plain X-ray of both feet.

Results: We expect that, anthropometric measurements of rural children may differ from other literatures.

Open Access Study Protocol

A Comparative Perspective Study between Intrathecal Midazolam & Nalbuphine as an adjuvant with Hyperbaric Bupivacaine for Post-Operative Analgesia in Total Abdominal Hysterectomy

Stuti Dubey, Sanjot Ninave, Aruna Chandak, Vijay Chandak, Neeta Verma, Nikhil Bhalerao

Journal of Pharmaceutical Research International, Page 918-925
DOI: 10.9734/jpri/2021/v33i60B34695

Background: Subarachnoid block is the preferred form of regional anesthesia for obstetric surgeries. Local anesthetic agents alone are insufficient in providing adequate postoperative analgesia, which is an essential factor for the patients & is the sole essence of anesthesia. Adding adjuvant will result in better quality, the efficacy of SAB & will prolong analgesia postoperatively. Due to minimal hemodynamic & respiratory complications, Nalbuphine, an opioid, can be favored as an adjuvant to subarachnoid block. The addition of Nalbuphine in limiting doses to Hyperbaric Bupivacaine offers improved block quality & adequate pre & post-operative analgesia. Midazolam, an imidazobenzodiazepine given intrathecally, raises the threshold of pain; it also has hypnotic, anticonvulsant, muscle relaxant & amnesic effects of other benzodiazepines.

Objectives: Primarily to compare the duration of pain relief in the postoperative period between administration of Intrathecal Nalbuphine (1mg) & Midazolam(2.5mg) ( Timing of 1st rescue analgesia). Secondarily to compare the onset of action & duration of motor & sensory block (Modified Bromage Scale), Effect on Hemodynamic Parameters, 24 hours requirement of analgesic (No. of Injection Paracetamol 15-20mg/kg ), Degree of sedation(Modified Ramsay Sedation Scale) &  After-effects(PONV, Pruritis, Shivering & Retention of urine).

Methodology: The study type will be a Comparative Prospective Study on 60 ASA 1 & 2 females in the age group 35-75 years, planned for total abdominal hysterectomy will be separated in two equivalent Group M (n=30) & Group N (n=30). Group M will receive combination Midazolam preservative-free 0.5 ml (2.5 mg) with 0.5% Hyperbaric Bupivacaine 2.5 ml(12.5 mg), & Group N will receive combination Nalbuphine 1 ml (1 mg) with Hyperbaric Bupivacaine (0.5%) 2.5 ml (12.5mg) by Intrathecal Route. Analgesia duration in the postoperative period, the onset of action & duration of motor & sensory block, effect on hemodynamic parameters, 24 hours analgesics requirement, degree of sedation, after-effects, if any, will be studied & compared.

Conclusion: Expected to prove the hypothesis that adding which of the following adjuvant 1mg Nalbuphine or 2.5mg Midazolam with 0.5% Hyperbaric Bupivacaine intrathecally given in SAB prolongs the postoperative analgesia duration more as compared to other.

Open Access Study Protocol

A Comparative Evaluation of Intra-Articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries: A Study Protocol

Amreesh Paul Francis, Anjali Modak

Journal of Pharmaceutical Research International, Page 977-982
DOI: 10.9734/jpri/2021/v33i60B34702

Background: Various degrees of pain is seen in the post-operative period following almost every arthroscopic knee surgery. The reason behind this pain is due to the irritation that occurs to the nerve endings that are found free in the synovium of the knee. Hence, to make this difficult period pain free various analgesics are given to the patient. They are given through various routes and they may be given as sole analgesics or in combination. One such routes used is the intra-articular route in which analgesics are given intra-articularly for post -operative analgesia. Dexmedetomidine is a drug which can be used the aforementioned route. The main of this study is to evaluate the effectiveness of Intra-articular Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine.

Aim: This study aims to compare Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for prolonging post-operative analgesia following knee arthroscopy surgery.

Objectives: The primary objective is to assess the duration of postoperative analgesia produced by Dexmedetomidine when used as an adjuvant to Intra-articular Bupivacaine after arthroscopic knee surgeries. The secondary objectives are to evaluate Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine, with respect to:

  1. Quality of analgesia,
  2. Number of doses of rescue analgesic required during study period,
  3. Systemic/Local side effects.

Methods: 60 patients within the age group 20-60 undergoing arthroscopic knee surgeries will be enrolled for the study. Following the completion of surgery, patients allotted to Group B will receive 19ml of Intra-articular Bupivacaine with 1ml of normal saline and patients allotted to Group D will receive 19 ml of Intra-articular Bupivacaine with 1mcg/kg Dexmedetomidine. Post-operative analgesia will be monitored using VAS and the requirement of rescue analgesics in both groups will be noted down and compared.

Expected Outcomes: The VAS and total requirement of rescue analgesics is expected to be less in Group D with minimal/no side effects.

Open Access Study Protocol

Efficacy of Modified Putikadi Ointment and Ketoconazole in the Treatment of Dadru (Tinea Corporis)

Minakshi A. Urkude, Sonali Chalakh, Akshay Pargaonkar

Journal of Pharmaceutical Research International, Page 993-1001
DOI: 10.9734/jpri/2021/v33i60B34704

Dadru is one of the most common but miserable Twak Vikar affecting all the ages of population. Increasing urbanization and industrialization have posted greater danger due to pollution and contamination with toxic, allergic and chemicals in our daily life, this fungal infection is commonly found in higher society and also in lower society due to unhygiene. According to Ayurveda, Dadru kushtha is Kapha-pitta predominance disease. It is managed by Shodhana, Shamana and Local application which may be called as Bahiparimarjan chikitsa. In today’s fast life no one has spent so much time, they want quick relief so Local application is the best line of treatment. It works fast due to its physiological effect on external skin in the form of Lepa or ointment. Putikadi Lepa which is mentioned in Sushruta Samhita and Ashtanga Hridaya includes fresh leaves of Karanja (Putik), Arka, Aragwadha, Snuhi and Jati with Gomutra reduces the symptoms of Dadru. All the drugs of Putikadi Lepa are kushtaghna, kandughna, and krimighna type. So it is more effective in Dadru kushta. But it is not possible every time to give fresh Lepa to the patients, so formulation was prepared in the form of ointment for convenience of patients in previous study. When the pilot study was carried out on Putikadi ointment, it was observed that the ointment has pungent smell after application due to Gomutra, so to remove this drawback some drugs should be added like Manjistha and Yashtimadhu to enhance the complexion of skin. This study should be taken to evaluate the efficacy of modified Putikadi ointment in the treatment of Dadru.

Open Access Study Protocol

Kidney Function Test for Screening of the Kidney Disease among Hypertensive Patients

Reshma Tighare, Ranjana Sharma

Journal of Pharmaceutical Research International, Page 1002-1007
DOI: 10.9734/jpri/2021/v33i60B34705

Background: Kidney disease results in some loss of renal function and can lead to kidney failure, which is Renal failure is defined as the full loss of kidney function. Renal failure is the last stage of kidney disease, at which point dialysis or a kidney transplant are the only treatments available. The prevalence rate of kidney disease among hypertensive patients in India is 29.8% [1].

Objective: 1. To evaluates the kidney function test by using serum creatinine, blood urea nitrogen and uric acid among hypertensive patients.

  1. To associate the demographic variables with the selected kidney function test among hypertensive patients.

Methodology: It is a cross sectional, analytical hospital based study. The patients of hypertension has selected for the study. Patients are chosen based on inclusion criteria, and the nature and aim of the study are explained in detail and the written and informed consent, from the subject will be taken before data collection by the investigator after that the blood and urine samples will be taken from the hypertensive patients for further investigation respectively. The setting of the study is selected hospitals of Vidarbha Region.

Expected Results:

  • There may be a possibility of occurrence of kidney disease among hypertensive patients

Conclusion: Following the end of data gathering, the statistical analysis will be used to develop conclusions.

Open Access Study Protocol

Correlation of Salivary Cortisol Levels with Anxiety in Type II Diabetes Mellitus Patients before and after Complete Denture Rehabilitation - An in vivo Study

Akansha Vilas Bansod, Sweta Kale Pisulkar

Journal of Pharmaceutical Research International, Page 1008-1013
DOI: 10.9734/jpri/2021/v33i60B34706

Background: Complete edentulism constitutes health care burden, resulting in alterations in physical, psychological and emotional behavior. Also, a reduction in quality of life is expressed by patients, raising their levels of stress and anxiety. Stressful situations cause increased blood pressure and heart rate resulting in the secretion of cortisol hormone, which stimulates gluconeogenesis and glycogenolysis causing hyperglycemia, which may favor the occurrence of Diabetes. As the diabetic’s population is rapidly rising, Prosthodontists are certain to see a greater number of diabetic edentulous patients. Thus, there is a need to assess the relationship of complete denture rehabilitation with the generic health of edentulous patients which can be done by checking the stress levels, and their effects on systemic health.

Objectives: To determine anxiety levels and Salivary Cortisol levels in Type II Diabetes Mellitus patients and compare and correlate them before and after rehabilitation with Complete Dentures.

Methodology: It will be a cross-sectional study, carried out on edentulous diabetic patients aged 50-70 years visiting the Department of Prosthodontics of Sharad Pawar Dental College and Hospital. With consent for participation, Glycated Hemoglobin and anxiety levels will be determined, along with fabrication of complete dentures. Patients will be assessed at two stages; before and 1 month after complete denture rehabilitation.

Results: The research has been approved by the Institutional Ethical Committee. The results expected are the significant reduction in anxiety levels after Complete Denture Rehabilitation and thus, a definitive correlation between anxiety and salivary cortisol levels.

Conclusion: Adaptation of patients to their new set of Complete dentures can be improved by their clinicians by acquisition of the knowledge of relationship of the general health of the patient and correlating it to the dental rehabilitation.

Open Access Study Protocol

Effect of Benson’s Relaxation Technique on Post-operative Stress and Pain among Women Undergone Abdominal Hysterectomy

Vaishnavi Shendre, Vaishali Taksande

Journal of Pharmaceutical Research International, Page 1055-1062
DOI: 10.9734/jpri/2021/v33i60B34713

Introduction: Relaxation programs can be effective in establishing psychological tranquility for patients after surgery [1]. Hysterectomy is the surgical removal of the uterus and its surrounding structures [2]. The vast majority of individuals who undergo surgery endure post-operative pain, which is not only excruciating and distressing, but can also lead to problems and a longer recovery time. Pain worsens stress reactions, resulting in increased tissue breakdown, coagulation, and fluid retention, all of which are detrimental to patient recovery [3].

Background: Women's reproductive health is a worldwide issue with far-reaching impacts for the health, well-being, and development of the entire population [4]. A hysterectomy is performed on about 300 women out of every 100,000 [5]. Younger women may be depressed following a hysterectomy since they have squandered their fertility [6]. Dr. Herbert Benson developed the Benson relaxation technique, which is a type of meditation that focuses on muscle relaxation followed by focused breathing to relieve stress [7].

Objective: 1.To assess the stress and pain among women undergone abdominal hysterectomy in experimental group. 2. To assess the stress and pain among women undergone abdominal hysterectomy in control group. 3. To assess the efficacy of benson’s relaxation technique in stress and pain among women undergone abdominal hysterectomy in experimental group. 4. To find out association between stress and pain score with selected demographical variables in experimental group. 5. To find out association between stress and pain score with selected demographical variables in control group.

Methodology: A pretest post-test control group and experimental group research design was adopted to assess the efficacy of benson’s relaxation technique on stress and pain among women undergone abdominal hysterectomy. In this study 100 women who fulfill the inclusion criteria were selected by purposive random sampling technique to collect data from selected hospitals of wardha. Secondary outcome involve evaluation of efficacy of benson’s relaxation technique given to the experimental group.

Expected Results: This study is mainly planned to evaluate efficacy of benson’s relaxation technique on stress and pain among women undergone abdominal hysterectomy. Hence, it is expected that the stress and pain may reduced around 60% after providing benson’s relaxation technique to women undergone abdominal hysterectomy. The conclusion will be drawn from the results and will be published in peer review journal.

Open Access Study Protocol

Correlation of Gleason Grading System and Nuclear Parameters by Nuclear Morphometry in Patients of Prostatic Adenocarcinoma: A Study Protocol

Goyal Aditi, Sonkusale Shweta, Shukla Samarth, Acharya Sourya, Vagha Sunita, Adnan Asif

Journal of Pharmaceutical Research International, Page 1255-1260
DOI: 10.9734/jpri/2021/v33i60B34740

Background: Adenocarcinoma prostate is one of the significant causes of death in men.  The Gleason Grading System is the most commonly used mortality to assess the degree, yet, identical results among blinded pathologists are challenging to obtain and hence come down to an unobjectionable result.

Aim and Objectives: To evaluate the relationship between histopathologically obtained Gleason’s Grading Score and various nuclear morphometric parameters using a computer-aided system in Prostatic Adenocarcinomas.

Methods: A series of 31 new and histopathologically diagnosed cases of adenocarcinoma prostate will be taken over one year, and the following nuclear morphometric parameters will be studied: mean nuclear area, mean nuclear length, mean nuclear perimeter, mean nuclear roundness factor, mean nuclear area factor and mean nuclear form ellipse. These individual parameters will be correlated with the Gleason Score of the individual cases.

Expected Outcome: The present study expects the nuclear atypia to be more in cases with a higher Gleason Score and avoid the inter-observer contradictions in diagnosis. It can be used as a tool to quantify the aggression of the malignancy and, thus, assess disease progression and prescribe a justifiable management protocol. Nuclear morphometrical analysis can be a more accurate, objective, and effective method in the diagnostic and prognostic significance of prostate adenocarcinoma.

Open Access Study Protocol

Effect of Radiotherapy on Microhardness and Surface Morphology of Pretreated Primary Teeth with Silver Diamine Fluoride: An In vitro Study

Simran Das, Nilima Thosar, Nilesh Rathi, Monika Khubchandani

Journal of Pharmaceutical Research International, Page 1731-1736
DOI: 10.9734/jpri/2021/v33i60B34800

Background: Radiation therapy has proven to be an effective modality in treating children suffering from cancer. High prevalence of dental caries is seen in children undergoing radiation therapy. This is primarily due to the direct effects of these harmful radiation on the enamel and not as a consequence to the reduced salivary flow. Mechanical properties of the enamel have been seen to be affected by radiation according to various studies conducted.

Objectives: The objective of this study is to evaluate whether radiotherapy causes changes in the microhardness and surface morphology of enamel in primary teeth pretreated with silver diamine fluoride.

Methodology: 22 primary teeth samples will be divided into two groups, 11 samples each-study group which will be pretreated with silver diamine fluoride (SDF) and control group. Both groups will be subjected to radiotherapy of 10 Gy radiation for a duration of 6 days. The samples will be tested for Vickers microhardness test and SEM analysis for surface morphological changes post radiotherapy. Statistical analysis will be done using “chi square test, paired and unpaired student t -test”. Surface microhardness and morphological changes of the study and control group compared.

Expected Results: It is expected that SDF application will be effective modality in prevention of caries due to frequent radiation exposure in children suffering from cancer and undergoing radiotherapy.

Conclusion: The study will conclude that SDF will cause a reduction in the microhardness of the surface and lesser morphological changes in the enamel of the primary teeth post radiation therapy in children suffering from cancer.

Open Access Study Protocol

Impact of Superior and Inferior Approach in Identification and Preservation of Spinal Accessory Nerve during Modified Radical Neck Dissection in Patients with Oral Squamous Cell Carcinoma

Naman Pandya, Anendd Jadhav, Nitin Bhola, Naman Khare

Journal of Pharmaceutical Research International, Page 1743-1751
DOI: 10.9734/jpri/2021/v33i60B34802

Background: During neck dissection, injuries to spinal accessory nerve (SAN) are most common cause of post-operative shoulder morbidity. Which is known as ‘Shoulder Syndrome’. Despite the evolution in neck dissection procedures from radical to super-selective neck dissection, post-operative shoulder dysfunction remains a point of exasperation for head and neck surgeons. It significantly impacts the standard of living for patients with head and neck cancer. According to the anatomic course and branching of SAN, there are various dissection technique for identification and preservation. Our comparison of superior dissection approach with inferior dissection approach for identification, preservation, and complete skeletonization of SAN in posterior neck dissection has not been studied based on its anatomical course.

Objective: To compare Superior Vs. Inferior approach group in regards to safety and superiority of the approach for SAN preservation with minimal or no intraoperative and or post-operative functional complications.

Methods: The patients will be randomly divided into two groups according to the approach used to identify and preserve SAN (superior Vs. inferior approach group). The intraoperative clinical and post-operative data will be collected and evaluated with appropriate statistical analysis.

Results: Collected data from 24 patients will undergo statistical analysis to obtain the results.

Conclusion: This study expects to find a superior modality amongst the Superior dissection approach and inferior dissection approach in terms of identification, preservation, and post-operative functional deficit for spinal accessory nerve.

Open Access Study Protocol

Comparative Evaluation of Efficacy of Mannitol and Hypertonic Saline (3%) for Treatment of Moderate to Severe Traumatic Brain Injury (TBI)

Sakshi Katariya, Sandeep Iratwar

Journal of Pharmaceutical Research International, Page 1823-1832
DOI: 10.9734/jpri/2021/v33i60B34812

Background: Intracranial Pressure of higher than 20 mm of Hg is considered Intracranial Hypertension. For years, Mannitol has been the go-to drug for its cure. However, it has many adverse effects. Therefore, other drugs are being considered for reducing Intracranial Pressure (ICP), and hypertonic saline (HTS) appears to be a good alternative.

Methods: The reason for this study is to report any differences in results after using of mannitol or hypertonic saline for treating Intracranial Hypertension (IH) in patients who were in the tertiary care hospital to be treated of moderate or severe Traumatic Brain Injury (TBI).

Methodology: All patients who had moderate or severe Traumatic Brain Injury (TBI) i.e, were reported at the hospital and had Glasgow Coma Score lesser than 13, were admitted in the hospital over the course of 2 months of the study will be included.  Patients will be randomized into 2 statistically comparable groups. Group A and Group B will be given the standard amount of mannitol and hypertonic saline (3%) and clinical result will be noted for both cases.

Results: The results will be calculated by rate of improvement in Glasgow Coma Score (GCS) of both groups and then compared. Primary endpoint will be clinical improvement after 7 days.

Conclusion: The rationale behind which drug of the two - mannitol or hypertonic saline solution (HS) - for treatment of people suffering Traumatic Brain Injury (TBI) to be primary varies considerably and there seems to be no protocol to determine which of these should be preferred. Most of the studies that have been done on the topic conclude that Hypertonic saline (HTS) seems to better suited for lowering Intracranial Pressure (ICP), regardless of its concentration. However, other than its apparent superiority in ICP reduction, it doesn’t seem to have any additional benefits, in relation to mortality.

Open Access Study Protocol

Association of Depression with Polypharmacy among Diabetic Patients of Geriatric Age Group in Tertiary Care Teaching Hospital

Yachika Thakkar, Sarju Zilate

Journal of Pharmaceutical Research International, Page 2099-2107
DOI: 10.9734/jpri/2021/v33i60B34851

Background: Diabetes mellitus, one of the common serious conditions among the elderly and depression is frequent finding as a Comorbidity. Polypharmacy is common in diabetes and In diabetic senior people, it has been linked to depression. Polypharmacy, especially among the elderly, is a consistent predictor of inappropriate medication. Approaching and analysing the prescription pattern in elderly diabetic patient will rationalize the drug utilization. The current research is to access the co-relation of polypharmacy in geriatric diabetic patient and accompanying depression.

Objectives: To assess depression and polypharmacy and correlate their association in diabetic patients of geriatric age group.

Methodology: This is questionnaire based cross sectional observational study. This shall be conducted in geriatric population attending Medicine department [OPD and IPD] [AVBRH], DMIMS, Sawangi [M], Wardha, Maharashtra, India. The depression will be assessed using Geriatric Depression scale. The Polypharmacy will be assessed using contingency table and odds ratio.

Expected outcome: It is hypothesized that geriatric diabetic patients with depression [GDS>= 6] are at higher risk of encountering polypharmacy.

Conclusion: To upgrades standards of life of senior diabetic patients, prescribing procedures should be reviewed.

Open Access Study Protocol

An Evaluation of the POSSUM Score's Efficacy in Predicting the Outcome of Patients Undergoing a Laparotomy - A Study Protocol

Harsh Bhalsod, H. B. Ramteke

Journal of Pharmaceutical Research International, Page 2142-2145
DOI: 10.9734/jpri/2021/v33i60B34856

Background: POSSUM Score is used to assess the outcome of complication, surgical intervention and the proportion between predicted and observed morbidity and mortality.Such scoring systems have been especially designed to compare patient’s severity of illness, predict mortality, morbidity and to plan an effective treatment protocol.

Objectives:

  1. To assess applicability of POSSUM score (morbidity and mortality) in surgical practice in a tertiary care centre in a rural area.
  2. To assess utility of POSSUM score in clinical management.

Methodology: The complications included in the study will be assessed in patients undergoing laparotomy during the hospital stay irrespective of the period of stay. The severity of these complications will be predicted using POSSUM score. The cases developing complications will be randomly selected to make a total participant size of 100.

Results: At the end of the study, we expect easy applicability of POSSUM score in assessment of morbidity and mortality in patients undergoing laparotomy.

Conclusion: We hope that POSSUM score is an easy tool which can be applied to assess the morbidity and mortality in patients undergoing laparotomy.

Open Access Study Protocol

A Study Protocol on Evidence Generation of Standard Nursing Protocol on Chemotherapy-Induced Neutropenia among Staff Nurses

Payal Bawankar, Ruchira Ankar

Journal of Pharmaceutical Research International, Page 2476-2480
DOI: 10.9734/jpri/2021/v33i60B34902

Background: Neutropenia is a condition that can occur in chemotherapy patients. Neutropenia affects roughly one out of every three chemotherapy patients. If neutropenia develops, the patient's health is affected, and the chemotherapy regimen or dose must be extended to allow the body creates new neutrophils. Even though neutropenia is common during chemotherapy, severe neutropenia is uncommon, and infections caused by it can result in significant morbidity and mortality. The protocol can help nurses make decisions about what type of care is best for their patients.

Objectives:

  1. To report practices at baseline and post-intervention of staff nurses regarding chemotherapy-induced neutropenia.
  2. To develop and implement the evidence-based standard nursing protocol on chemotherapy-induced neutropenia among staff nurses.
  3. To associate the knowledge and practice score with selected demographic variables.

Materials and Methods: A Quasi-experimental research design was utilized in the current study. Pre/post-test design was utilized so the participants’ pre-test results were considered as the control for comparing their post-test results. A non-probability purposive sampling technique will be used to collect the data. The study included 100 oncology nurses’ knowledge and practice assessed by using a structured questionnaire and checklist. The study will be conducted in a selected hospital in the Wardha district.

Expected Result: This study is on evidence generation of standard nursing protocol on chemotherapy Induced neutropenia among staff nurses hence it will be assessed by evidence generation of the standard nursing protocol. Will be accepted as the results of intervention that leads to improved Knowledge regarding chemotherapy Induced neutropenia among staff nurses.

Open Access Study Protocol

Comparison of the Effect of Triclosan Coated Polyglactin Sutures and Plain Polyglactin Sutures on Post-operative Healing in Patients Undergoing Surgical Removal of Mandibular Third Molar (MTM)

Dolly Rai, Deepankar Shukla

Journal of Pharmaceutical Research International, Page 2562-2570
DOI: 10.9734/jpri/2021/v33i60B34915

Background: Surgical site infection (SSI) has been ruled out as having the highest prevalence among infections associated with avoidable health care. The application of coatings and other treatments to medical devices to avoid bacterial colonisation has gotten a lot of press recently. Bacterial growth should be prevented rather than treated because once bacteria have formed a habitat, they form a biofilm that prevents antibiotics from penetrating the infection site. As a result, it would be necessary to incorporate an antimicrobial agent into medical devices.

Objectives: The study's main goal is to see how successful, Triclosan Coated polyglactin suture as a wound closure agent in terms of surgical site infection after surgery, bacterial colonization, trismus and pain over the plain conventional one.

Methodology: Two groups (Group-I & Group-II) with 15 individuals as subjects are considered for the study model. Systemically healthy individual with presence of mandibular third molar (MTM) with similar difficulty index, depth of, and relationship with ramus will be included in the study sample. Wound closure would be achieved by using antimicrobial triclosan-impregnated 3–0 polyglactin sutures for closing the surgical site using simple interrupted sutures (Group-I) and plain 3–0 polyglactin sutures for closing the surgical using simple interrupted sutures (Group-II), respectively. Post-operatively measurement of surgical site infection, bacterial colonization, trismus and pain will be done.

Expected Results: Polyglactin sutures coated with triclosan for closure of wound after MTM surgery, will be successful in minimising post-operative surgical site infection, bacterial colonization, trismus and pain.

Conclusion: Use of polyglactin sutures coated with triclosan, aids in the prevention of one of the most prevalent postoperative conditions, surgical site infection(SSI) and to reduces bacterial colonization, trismus and pain. The surgeon's and the patient's need for a positive cosmetic outcome postoperatively is hampered if a postoperative surgical site infection develops, which one can be overcome by their usage.

Open Access Study Protocol

Estimating the Association of Ultrasonographical Placental Grading in Utero to Gestational Age and Feto-maternal outcomes in Hypertensive Disorders of Pregnancy

Twisha Patel, Sandhya Pajai

Journal of Pharmaceutical Research International, Page 2653-2659
DOI: 10.9734/jpri/2021/v33i60B34926

Background: Worldwide, about 5-8% of all pregnant females are affected by hypertensive disorders. In rural India, the incidence is 10%. This entity has become a significant cause of maternal mortality and morbidity, resulting in 10-15% of all maternal fatalities in developing nations, particularly in developing nations. Hence, identifying this entity in pregnant females and its timely management is vital for both mother and baby. Gestational hypertension can cause placental insufficiency due to narrowing and occlusion of uteroplacental vessels leading to intrauterine growth retardation. This study aims to detect placental grading by ultrasonography in the third trimester in cases of hypertensive disorders of pregnancy and to assess its correlation with fetal-maternal outcomes.

Methodology: This will be a cross-sectional study carried out in the Department of Obstetrics and Gynecology, AVBRH, Wardha. About 130 pregnant normotensive females and 130 hypertensive pregnant females will be included in the study. Baseline data such as age, sex, parity, routine laboratory data, PIH profile, sonography scans will be collected. All the patients will be followed till delivery, and feto-maternal outcomes will be assessed. Data will be analyzed with appropriate statistical tests.

Expected Outcome: A significant correlation is expected between higher placental grading in hypertensive pregnant females compared to normotensive patients and will have a significant association with perinatal and fetal morbidity.

Open Access Study Protocol

Comparative Evaluation of the Adverse Effects of Vaccination against COVID-19 Infection among the Population in Central India

Archy Singh Bais, Fiza Naaz Ahmad, Ninad Gaikwad, Priyanka Paul Madhu, Kumar Gaurav Chhabra, Amit Reche

Journal of Pharmaceutical Research International, Page 2688-2691
DOI: 10.9734/jpri/2021/v33i60B34930

Background: India's Covaxin and Covishield has associate effectiveness rate of  81% preliminary info. Both vaccines have shown excellent safety and efficacy.

Objectives: To seek the information about vaccination side effect and Covid-19 infection after getting vaccination.

Methodology: We are examining the self-reported vaccination side effect on local and systemic side-effects within 8 to 15 days and covid 19 infections who received one or two doses of the covisheld or a covaxin.

Expected Results:  The expected results of this study will determine the vaccination adverse-effects of covaxin and covishield with its probability of  Covid-19 infection among the dental professionals after getting vaccination in state of Maharashtra.

Conclusion: An observational based study in which we have to identify vaccination side effects and infection after administration of both Coronavirus vaccines which are use in India. Both the vaccines area associate effectiveness rate of  81%. 

Open Access Study Protocol

Comparative Effect of Plaque Removal Efficacy of Toothbrush with Bristle Containing Neem and Charcoal for Maintaining Oral Hygiene: A Clinical Study

Darshana Gothane, Shwetal Somnathe, Abhilasha Chapade, Priyanka Paul Madhu, Kumar Gaurav Chhabra, Amit Reche

Journal of Pharmaceutical Research International, Page 2703-2709
DOI: 10.9734/jpri/2021/v33i60B34932

Background: The deposition of plaque and calculus is the primary etiological factor for the gingival diseases caused by poor dental hygiene. To provide healthy gums & disease-free oral cavity among the population, toothbrushes with bristle having the extract of Neem and Charcoal supplied to evaluate the effectiveness of plaque removal efficacy for maintaining oral hygiene.

Methodology: The patient was recruit to this study after obtaining informed consent from them. A Randomized clinical trial was conducted among 30 participants (male and female) in Sharad Pawar Dental College, between the ages of 33 to 44 years having at least 20 permanent teeth (excluding the third molars and crowns prosthesis). As per the Plaque Index given by Silness P. and Loe H., the first plaque range should be between <1 and >3 in 1970 is participated in the study. Following the randomization, each participant will provide a specific available toothbrush and asked to 1 minute of brushing, following which the plaque index was measured again. They were advised to brush their teeth two times a day for one minute with the allotted toothbrush in the morning and night after dinner with a commercially available toothpaste using a modified bass technique. At baseline, 7th day, and 15th day, the plaque index scores (before and after brushing) were collected, data was recorded and statistically analyzed.

Expected Results: On day baseline, 7 days, and 15 days after brushing, the mean plaque indices decreased. There was also a decrease in mean plaque indices from day one to day seven and fifteen. These decreases were all statistically significant (P < 0.001).

Conclusion: The current study demonstrated a significant changes in plaque scores with the use of toothbrushes with bristle containing Neem and Charcoal. The continues usage of the assigned toothbrush resulted in an even greater changes in plaque scores.

Open Access Study Protocol

Efficacy of Modified Betty Neuman Nursing Theory to Develop Evidence-Based Pandemic Care Pathway for Preadolescents in the School

Nirupam Nisha Sahu, Jayant Vagha, Jaya Gawai

Journal of Pharmaceutical Research International, Page 2730-2738
DOI: 10.9734/jpri/2021/v33i60B34935

Background: A study on the effect of COVID-19 on children shows that once we pay special attention to the psychological aspect of youngsters, the worst effect occurs, although less sensitive to COVID-19. There’s also evidence that nursing care supported by Betty Newman's model helps prevent 94% of patients with psychiatric cases within the medical care unit. A study that supported the appliance of the Betty Newman Systems model within the nursing care of patients with Covid-19 showed that it helps resolve the nursing problems of a patient affected by Covid-19. Supported by the above study, it's planned to develop a particular epidemic care pathway for preadolescents using the revised Betty Newman's nursing theory.

Objectives: To evaluate the efficacy of modified Betty Newman’s Nursing Theory to develop an evidence-based pandemic care pathway for preadolescents between the experimental and control groups and associate the post-test score of preadolescents with their demographic variables.

Methodology: Preadolescent students will be recruited for the Superiority trial. the standard and modified Betty Newman theory will be applied to the control and experimental group. The pre and posttest of both groups will be evaluated for their effectiveness.

Expected Outcomes: The newly developed pandemic care approach will effectively reduce the psychological impact of pandemics in Preadolescent children.

Conclusions: Generation of pandemic care pathway for preadolescents and Reduction of the psychological impact of the pandemic among preadolescents.

Open Access Study Protocol

Critical Appraisal of Curriculum Design of Academic Courses Launched Under the Faculty of Allied Health Sciences, Datta Meghe Institute of Medical Sciences (Deemed to be University) in Academic Year 2020-2021 with Reference to Typing of the Said Courses And Adherence to the Principles of Curriculum Design – A Study Protocol

Gaurav Mishra, Archana Dhok, Rajasbala Dhande, Rohan Singh, Prerna Patwa

Journal of Pharmaceutical Research International, Page 2794-2799
DOI: 10.9734/jpri/2021/v33i60B34943

Background: Talking about the present scenario of curricula, it is essential to test whether curricula are in conformity with the standard guidelines and principles of curriculum design and centricity and orientation.

This present study deals with aspect of adherence to principles of curriculum design as well as centricity and orientation of the curricular framework with reference to curricula of all academic courses under Allied Health Sciences started in the academic year 2020-2021 in Datta Meghe Institute of Medical Sciences (deemed to be university) as against principles of curriculum design and centricity of curricula.

Aim and Objectives: To critically appraise the curriculum of academic courses launched under the faculty of Allied Health Sciences, Datta Meghe Institute Of Medical Sciences (deemed to be university) in academic year 2020-2021 with reference to typing of the said courses and adherence to the principles of curriculum design.

Methods:-

Type of Study: Descriptive study.

Duration of Study: 6 months.

Place of Study: School of Health Professions Education and Research Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha.

Generation of a draft of the curriculum of academic courses included in the present study with reference to their typing and also taking into account the level and degree of commensuration of the same with principles of curriculum design along with recommendations if any.

Conclusion: All conclusions in conformity with the aim and objectives of the present study will be drawn after proper statistical analysis.

Open Access Study Protocol

Comparative Assessment of Post-Operative Sequelae Following Surgical Removal of Mandibular Third Molar with and Without Extra-Oral Application of Kinesiologic Tape

Sneha Patil, K. Rajanikanth

Journal of Pharmaceutical Research International, Page 2824-2829
DOI: 10.9734/jpri/2021/v33i60B34947

Background: The transalveolar extraction of impacted mandibular third molars creates a huge level of injury to the delicate tissues of the oral cavity, which can initiate significant inflammatory reaction. Amongst some postoperative sequelae of third molar surgeries- pain, trismus and facial oedema are the most common. Treating with taping therapy has shown acceptable outcomes in reducing pain and in managing post-operative muscle spasm.

Objectives: The motive behind this research is to compare post-operative pain, swelling and trismus following third molar surgery in both test and control groups.

Methodology: The research will be a prospective randomized control split-mouth non-blinded clinical study model to assess the impact of the Kinesiology Tape (KT) on post-operative sequalae following removal of mandibular third molar surgically. With the cumulative 15 patients to be allocated for operating bilaterally involved impacted mandibular third molar. The study will be done under two groups, Group A – Test group (KT) one side of patient’s face, subjected to beige tape application. Group B – Control group (No KT) other side of patient’s face, will be the controlled group without application of KT. Each patient will undergo 2 operative surgeries at 2 week-interval conducted by the same surgeon. Immediately after extraction extra-oral application of KT will be done for test group.

Expected Results: The use of kinesiologic tape will be effective in improvement of post-operative discomfort of the patient in the conditions of reduction of swelling, pain and trismus.

Conclusion: As kinesiologic taping originates from sports medicine, currently there are very limited evidence- based scientific studies for KT application for treatment of post-operative edema in head and neck surgeries. This study will help to evaluate the use of KT enabling patients to have a restful time after operation leading them to get a better quality of life.

Open Access Study Protocol

Evaluation of Fracture Resistance and Failure Pattern of Endodontically Treated Teeth Restored with Polyether Ether Ketone (PEEK) Post Associated with no, 1mm and 2mm Crown Ferrule Lengths

Prachi Taori, Pradnya Nikhade

Journal of Pharmaceutical Research International, Page 2834-2840
DOI: 10.9734/jpri/2021/v33i60B34949

Background: There is constant advancement in aesthetic material used in dentistry due to constant increase in demand of aesthetics.

Objectives:

  1. “To evaluate fracture resistance and pattern of failure of ETT restored with PEEK post with no ferule.”
  2. “To evaluate fracture resistance and pattern of failure of ETT restored with PEEK post with 1mm ferule length.”
  3. “To evaluate fracture resistance and pattern of failure of ETT restored with PEEK post with 2mm ferule length.”
  4. “To compare the above groups with each other.”

Methods: 30 human RC treated mandibular premolar teeth with single root will be decoronated at CEJ, 1mm and 2mm above CEJ & will be prepared to receive PEEK post which will be divided into 3 groups (n = 10) according to corresponding ferrule length.

After treatment of surface, post will be cemented using luting cement that is self-adhesive. Following thermocycling, they will be subjected to compressive static load at 45° angulation until there is fracture. Later analysis will be done with one-way ANOVA and Tukey’s HSD post hoc comparison test.

Results: Although root canal treated tooth with higher ferrule height shows higher fracture resistance in previous studies, but it would be something interesting if the use of PEEK post can improve fracture resistance of root canal treated tooth with ferrule height less than 2mm.

Conclusion: From the results of this study we will be able to conclude that if coronal dentinal structure is increased, resistance to fracture of ETT is increased remarkably.

Open Access Study Protocol

A Study Protocol on Assessment of Heart Rate Variability as a Prognostic Marker in Critically Ill Patients

Yogesh Kautikrao Kakde, Shilpa Gaidhane, Sourya Acharya, Sunil Kumar, . Amrutha

Journal of Pharmaceutical Research International, Page 2851-2857
DOI: 10.9734/jpri/2021/v33i60B34951

Background: Calculation of heart rate variability (HRV) is the most popular approach of actual evaluation of autonomic nervous system (ANS) dysregulation, representing natural physiological changes. The natural changes take place in the interim among successive heart beats when sympathetic and parasympathetic expression is balanced on the heart's electrical conduction system. Numerous adult studies have shown that reductions in HRV predate clinical decline, indicate therapy response in correlation with results. Therefore, HRV can be functional as a measure of more accurate clinical perception. This study aims to determine role of heart rate variability and other risk factors as a prognostic marker for 90-day survival among patients admitted to critical care units.

Methods: This will be an Observational Cross-sectional Study with Control Group and will include hypertension, diabetes mellitus, Myocardial Infarction, Stroke, Sepsis cases and control cases. The patients admitted in Medicine critical care unit will be included in the study and they will be evaluated for HRV and APACHE IV scoring. Patients demographic profile, anthropometric measurements and history of other comorbid conditions will be documented. Patients’ outcome indicators like duration of hospital stay, 90-day survival and mortality will be obtained .Data will be analyzed by appropriate statistical tests.

Expected Results: Mixed effects models will demonstrate that the result of three HRV will be relatively lower from the start of day and night compared to the last day and night of MICU admission. The significant relationship between the variability of time from enrollment and log heart rate values is expected over the last day and night of MICU stay. Also, average HRV is expected to persist significantly higher as compared with that of the first day and night.

Open Access Study Protocol

Study of Clinical Profile and Comparison of Various Dimensions of Chronic Otitis Media among the Adult and Paediatric Population from Rural Area

Aishwarya Vijayappan, P. T. Deshmukh

Journal of Pharmaceutical Research International, Page 2867-2872
DOI: 10.9734/jpri/2021/v33i60B34953

Background: The term Chronic Suppurative Otitis Media (CSOM) is characterized as "chronic middle ear and mastoid cavity infection, which occurs through tympanic membrane perforation with recurrent ear discharge or otorrhoea . Though there are many similarities between adult and pediatric CSOM in terms of disease progression and pathological changes, there are certain notable differences stemming from temporal bone anatomy and extent of pneumatization, the immaturity of Eustachian Tube in terms of its function and variable progression of disease. Pediatric temporal bone being more pneumatized makes the disease to spread more extensively. Childhood cholesteatoma has much greater rates of residual and recurrence disease than seen in adults. This study is aimed to compare various dimensions of CSOM among the paediatric and adult age group in rural population.

Methods: This cross-sectional comparative study is scheduled from November 2020 to November 2023 in ENT Department of AVBRH, Wardha. Total 50 patients with chronic Otitis Media in the paediatric and adult age group will be enrolled. Baseline investigations will be performed for all patients and compared.

Expected Results: Clinical profile and behavior of chronic otitis media in adult and paediatric population in rural areas will be outlined, emphasizing middle ear changes, grade and extent of retraction pockets and cholesteatoma respectively. Pneumatization of the temporal bone and audiological status will be reported.

Conclusion: Differentiating characteristics of chronic otitis media in adult and paediatric population with specified features will be concluded.

Open Access Study Protocol

A Study Protocol for Analysis of the Optimum Utilization of Operation Theater in a Tertiary Care Hospital in Central India

Jeetendriya P. Dhakte, Ahmindra Jain, Vandana Gudhe

Journal of Pharmaceutical Research International, Page 2903-2908
DOI: 10.9734/jpri/2021/v33i60B34957

Background:  A well-structured and fully functional  operation theatre is essential for any tertiary care hospital. It’s quite challenging to meet the needs of healthcare services in constantly changing environment and administration issues. The 11th hour cancellation of planned operations is quite traumatic and depressing for the patient. Cancelation of elective surgical operations often induces considerable mental distress to patient populations, their families, and the population in general. It has a significant effect on healthcare services due to excessive hospital stays and increased health services entrainment. Elective procedure cancellations often result from inadequate use of staff and medical services. This study aims to determine the frequency, reasons, and history of cancellation of elective surgery in AVBR Hospital, Wardha.

Methodology: This will be an observational study to assess the utilization of Operation Theatre in AVBR hospital, Wardha. The secondary data will be obtained  from the Operation Theatre Records. Statistics of number of surgeries and Surgery time taken will be recorded. Data on  reasons for cancellations will be obtained and necessary information will be obtained from the OT Staff through structured questionnaires and interviews.  Data will be analyzed with appropriate statistical tests.

Expected Result: Data on reasons for the cancellation of planned surgeries.

Conclusion: Appropriate planning and availability of required material and manpower resources is essential for appropriate management of Operation Theatres and avoid wastage of man-hours.

Open Access Study Protocol

A Study Protocol on Assessment of ECG and Echocardiography Changes in Stroke Patients

Govind Mukesh Nagdev, Vasant Gawande

Journal of Pharmaceutical Research International, Page 2915-2921
DOI: 10.9734/jpri/2021/v33i60B34960

Background: Ischemic stroke is accountable for about 80% of the first episode of cerebrovascular accidents. Cerebrovascular accident due to intracerebral hemorrhage is described as an abrupt onset of clinical signs of central nervous system dysfunction resulting from focal collection of blood inside the ventricular system or brain parenchyma, which is not caused by trauma. Stroke is reported  as the most common cause of mortality in developed countries after cardiovascular problems. In cerebrovascular accidents, ECG changes like ST-T changes, QT prolongation, abnormal U waves etc have been reported. Also 2D echocardiographic changes have been reported in stroke patients. This study aims to assess different changes in electrocardiograph and 2D echo patterns cerebrovascular accident cases and their prognostic importance.

Objectives: To study variations in Electrocardiogram and 2D Echo in stroke patients in stroke patients and to rule out end organ insufficiency of vital organs.

Methodology: This will be a Prospective Cross-Sectional study. About 200 patients of Cerebrovascular accidents reporting to Dept of Emergency Medicine at AVBRH will be included in this study. All patients will undergo 12-lead electrocardiography,  at the time of arrival to the hospital. CT scan/MRI will be performed within half an hour of reporting to Emergency Department. After management of stroke,  2D ECHO will be performed. Data of all patients will be analysed with appropriate statistical packages.

Expected outcome: A Significant correlation is expected between ECG changes and stroke.

Open Access Study Protocol

A Study of Clinical Profile and Management of Allergic Conjunctivitis in Rural Tertiary Care Centre

Berelli Srilekha, Sohan Lohiya

Journal of Pharmaceutical Research International, Page 2932-2938
DOI: 10.9734/jpri/2021/v33i60B34962

Background: Among the allergic diseases witnessed over the last few decades, ocular allergy is one of the most common conditions. Many factors like pets, dust, pollen, grain exposure, air pollution play a role in allergies. Ocular allergy impairs the daily routine activities, and if left undertreated, it may progress to atopic keratoconjunctivitis, resulting in vision impairment. This study aimed to observe an association of dry eye in allergic conjunctivitis and management of allergic conjunctivitis cases reporting  in tertiary health care Centre.

Materials and Methods: This will be a cross sectional observational research conducted at AVBRH, Wardha. Baseline data of 85 enrolled patients will be collected after obtaining their informed written consent and all procedures will be explained to  patients. Patients included in study will undergo Comprehensive ophthalmic examination,  slit lamp examination, fundoscopy, tear  break up time and Schirmer’s test with topical anaesthesia.   Follow-up of all patients will be done at 1, 3, 6, and 8 weeks. Data on medical history, allergies, and lifestyle factors will be collected using a pretested standard questionnaire.

Expected Results: Estimation of correlation between dry eye in allergic conjunctivitis and efficacy of different standard drugs in the treatment of allergic conjunctivitis.

Open Access Study Protocol

Pharmaceutical and Analytical Study of Tryushanadya Lauha & Modified Form as Tryushanadya Mandura and their Comparative Evaluation for Antidiabetic Activity in Wistar Rats

Harlin Swer, Anita Wanjari, Bharat Rathi, Mujahid khan, Makarand Sonare, Shweta Kamble, Devyani Awari

Journal of Pharmaceutical Research International, Page 2947-2957
DOI: 10.9734/jpri/2021/v33i60B34964

Background: Lohais a metal that is used in many preparations after transforming it into non-metallic form by purification and incineration method uses to treat different kinds of diseases. Mandura is the rusting of iron.Tryushanadyalauha(TL) is one among the Ayurvedicherbo-mineral formulations described in BhaishajyaRatnavalliand as modified dosage form as Tryushanadyamandura(TM).The herbal contents are tryushana (i.epippali( Piper longum Linn ),maricha (Piper nigrum Linn)and shunti (Zingiber Officinale Roscoe), cavya (Piper chabaHunter), bakuchi (Psoralea CorylifoliaLinn),bhang (cannabis sativum Linn),andlavana like saindhava,aubhida,vida and sauvarchala ,andlohabhasma is the main ingredient.

Aim: Pharmaceutical and Analytical study of TryushanadyaLauha& modified form as TryushanadyaMandura and comparative evaluation for antidiabetic activity in Wistar rats.

Materials and Methods: All herbal drugs will be collected, verified, and primarily authenticated by the Department of Dravyaguna. Lohaand Mandura will be procured from the vendor and authenticated by the Department of Rasashastra and BhaishajyaKalpana, Mahatma Gandhi Ayurved College Hospital Research Centre, Salod(H), Wardha, and they will be prepared as per reference. Organoleptic, bhasmapariksha, Physico-chemical,XRD and FEG-SEM parameters will be evaluated. To assess Tryushanadya Lauha (TL) and Tryushanadya Mandura (TM)antidiabetic action will be conducted in 30 Wistar rats in 5 groups and will be compared.

Observation and Results: The study will be assessed Tryushanadya lauha (TL) and TryushanadyaMandura (TM)antidiabetic action in 30 Wistar rats by using one-way ANOVA.

Conclusion: Pharmaceutical and Analytical study of TryushanadyaLauha (TL) & modified form as TryushanadyaMandura (TM) will provide the standard parameters.

Open Access Study Protocol

Increasing False Negative RT-PCR Test in COVID-19 Patients Admitted at Tertiary Care Hospital: A Retrospective Cross-Sectional Study

Bhargavi Yadav, Alka Revankar

Journal of Pharmaceutical Research International, Page 3122-3129
DOI: 10.9734/jpri/2021/v33i60B34987

Background: COVID-19 Pandemic has caused a lot of havoc for the human race, as the urgent need to detect the virus early and fight back stronger, scientists came up with the test RT-PCR, which later on was declared as the gold standard. But lately, an exponential increase in false-negative rates was observed, which calls for an accuracy check of the test and the statistical analysis of the reasons leading false-positive results. With the advent of the COVID-19 Pandemic, RT-PCR testing has become the gold standard for laboratory diagnosis of SARS-CoV-2 infection. But the second wave of COVID-19 in India has reported a high number of false-negative RT-PCR results. This calls for the need to measure the accuracy of the test in diagnosing infection, especially considering rise in variant strains each with its own virulence and infectivity. Imaging methods like HRCT and biochemical tests such as CRP, D-Dimer are being used increasingly by doctors to support the serological diagnostic method of Covid and draft further treatment protocols

Objectives: To measure the false negative rates of RT-PCR in COVID-19 Patients. To find the epidemiology of the root cause.

Methodology: For this Retrospective Cross-sectional study, sample size of 1998 with prevalence of 7894/million population and confidence interval of  95% we would be analysing  patients of Datta Meghe Institute of Medical Sciences TCH admitted in the months of April to June 2021  with suspected COVID-19 Infection.

Results: Increasing cases of false negative RT-PCR reports would be found.

Conclusion: There is an urgent need for the reality check on efficacy of RT-PCR Test Reports.

Open Access Study Protocol

Comparative Evaluation of Virtual Reality and Behavioural Counselling on Reducing the Anxiety in Patients during the Dental Treatment

Shailendra Yadav, Muskan Fatema Khan, Shreya Makkasare, Kumar Gaurav Chabbra, Priyanka Paul Madhu

Journal of Pharmaceutical Research International, Page 3143-3149
DOI: 10.9734/jpri/2021/v33i60B34990

Background: Anxiety is an enthusiastic state of mind which goes before an experience with feared object or circumstances. The main pharmacological treatment for reducing dental anxiety is local anaesthesia but it involves an injection with a needle prick which is refused by quiet patient. Some techniques were put forward to minimize the suffering during dental treatment such as diversion techniques, TV and hypnotism rather than pharmacological means. Virtual Reality (VR) is a three-dimensional domain that provide users a perception of submission, leading them to an interactive area.

Objectives: To distract mind with virtual reality, that has quite less access to handle approaching pain and anxiety signals and to minimize patient discomfort and uneasiness during dental treatment.

Methodology: The study will be conducted among patients reporting to Out Patient Department of Sharad Pawar Dental College and Hospital eligible patients who meet the eligibility criteria will take part in the trial. The study will be conducted between two groups and the anxiety scale will be calculated pre-test and post-test for each patient. One group of patients are given VR and the other group is given behavioural counselling before beginning of dental treatment.

Results: Virtual reality, a diversion is believed to assist users to get through by other unpleasant events during dental treatment. On application of virtual reality considerable decrease in anxiety is expected.

Conclusion: Virtual reality can be used to decrease anxiety during medical and dental treatment which can affect patients desire towards the treatment. Distractions may also have enduring effect in regards to more favourable impression of therapy.

Open Access Study Protocol

Comparative Evaluation and Co-relation of Difficult Airway and Temporomandibular Joint Disorder in Skeletal Class II Vertical Growth Pattern and Class-I Malocclusion – An Observational Study

Shruti Rathi, Rizwan Gilani

Journal of Pharmaceutical Research International, Page 3192-3196
DOI: 10.9734/jpri/2021/v33i60B34996

Introduction:  In the recent years it is observed that there has been increase in the no. of cases of Temporomandibular joint disorder and TMJ pain related problem, many of patients go undiagnosed and may transform into irreversible severe cases if the predisposing factors are present. There are different clinical and radiographical methods of diagnosing TMD cases, and one of the simplest ways to diagnose and categorize a Temporomandibular disorder is Helkimo index. The present study is encouraged to measure difficult airway, in Class II malocclusion with TMD.

Materials and Method: The observational study will be conducted in Orthodontics and Dentofacial Orthopaedics department, Sharad Pawar Dental College, Sawangi (M), Wardha in collaboration with department of Radiology, Acharya Vinoba Bhave Hospital. Sawangi (M), Wardha. Total 30 patient in age group of 20 to 50 years, will be selected from the patients coming to Out Patient Department (OPD) of Orthodontics and Dentofacial Orthopaedics, Wardha. MRI of patients with skeletal class II vertical growth pattern and class I malocclusion having temporomandibular joint disorder will be taken and then airway is to be evaluated.

Expected Results: It is expected that individuals with skeletal class II vertical growth pattern and class I malocclusion with temporomandibular joint disorder may have a compromised airway.

Conclusion: No such study has been carried out to evaluate co-relation of difficult airway and temporomandibular joint disorder. Thus, this study aims to evaluate it in skeletal class II vertical growth pattern and class I malocclusion.

Open Access Study Protocol

Assessment and Comparison of Temporomandibular Joint for Occurrence and Severity of Disorders in Adult Cases with Unilateral Cleft Lip and Palate and Non-cleft Class I: An Observational Study

Nikhil Kumar, Pallavi Daigavane, Sunita S. Shrivastava, Ranjit Kamble

Journal of Pharmaceutical Research International, Page 3240-3245
DOI: 10.9734/jpri/2021/v33i60B34999

Background: Cleft Lip and Palate (CLP) are hereditary deformity of craniofacial structure. Temporomandibular disorder has number of clinical problems affecting muscles of mastication and its associated structures. There are several methods used to evaluate temporomandibular dysfunction (MRI, etc), Helkimo index is a settler in advancing indices, other indices used are CMI, MFIQ, FONSECA. The design of the following study was to evaluate the TMJ disorders in UCLP, if any, and compare with the non-cleft cases.

Methodology: Total 30 patients aged 16 to 20 years, will be selected from the patients coming to smile train Out Patient Department (OPD) of Orthodontics and Dentofacial Orthopaedics, Wardha. The total cases will be divided into two groups: a) Group I -   unliteral cleft lip and palate cases b) Group II - non cleft class I cases Digital records of the patient (lateral cephalogram, photograph, models) will be taken and stored. Helkimo, MFIQ, CMI, Fonseca will be recorded on all patients participated in study. The Helkimo index will be taken to assess the presence and severity and   MFIQ index will be taken to assess mandibular functioning in cleft cases based on the questionnaire.

Expected Results: The dental apparatus (interdental relation of maxillary and mandibular dentition) plays an important role in the temporomandibular joint's well-being. Trauma due to the occlusal instability has definite effect on the TMJ in long run. Cleft is always associated with inter jaw malocclusion and therefore TMDs in the cleft patient is thought to occur. The treatment protocol for grown cases with severe skeletal malocclusion is orthognathic surgery. The TMJ correction remains untouched. It can be expected that altered TMJ anatomy can lead to TMDs in cleft lip and palate cases.

Conclusion: To convey the occurrence of TMDs in cleft due to the inter jaw malocclusion and its early treatment approach for TMJ deprogramming along with dental and surgical correction in CLP.

Open Access Study Protocol

Effect of Neuro-Developmental Treatment versus Passive Stretching Exercises on Spastic Diplegic Cerebral palsy for Improving Posture: A Research Protocol

Rutuja Parkhi, Snehal S. Samal

Journal of Pharmaceutical Research International, Page 3267-3273
DOI: 10.9734/jpri/2021/v33i60B35003

Background: Cerebral Palsy can be defined as a cluster of disorders acting on a person’s movement, posture, and balance. Cerebral Palsy, which affects 2 to 3 out of every 1000 live births, is caused by a variety of factors, including brain injury which can affect movement, posture, and balance. It’s linked to the perinatal period in about 92% of cases. Premature birth, perinatal infections, intrauterine growth restrictions, multiple gestations, and other risk factors are all factors to consider. This disorder prevents normal motor function Development. This protocol was developed to describe the design of an interventional study for the evaluation of the effect of Neuro-developmental treatment with conventional therapy and Passive Stretching with conventional therapy on improving posture in diplegic spastic Cerebral Palsy patients.

Methods: Participants (n=70) with spastic diplegic Cerebral Palsy who meet the included criteria will be hired for the study. Patients in group A will receive Neuro-Developmental treatment and conventional therapy, while patients in group B will receive Passive Stretching with conventional therapy. The Treatment protocol will last 6 weeks. Regular evaluations will take place. The Modified Ashworth Scale and the Gross Motor Function Classification System are going to be used to assess our progress.

Discussion: The intervention’s efficacy will be assessed by analyzing gross motor functions with the help of Gross Motor Function Classification System and spasticity level using Modified Ashworth Scale. Study and analysis will significantly support the use of Neuro-Developmental treatment with conventional therapy and Passive Stretching in conjunction with conventional therapy in Cerebral Palsy patients.

Open Access Study Protocol

Comparative Evaluation of Antimicrobial Activity of Irreversible Hydrocolloid Impression Material Incorporated with Various Disinfectants – An In-vitro Study

Rakhi P. Shinde, Anjali Bhoyar Borle, Trupti M. Dahane, Seema Sathe Kambala

Journal of Pharmaceutical Research International, Page 3274-3280
DOI: 10.9734/jpri/2021/v33i60B35004

Background: Blood and saliva can easily contaminate the dental impressions. It contains variety of bacteria, fungi, and viruses which causes cross infection to health personnel & environment. Therefore, sterilizing the impression material is the best way to avoid disease transmission. Spraying and Immersion technique are conventional methods of disinfection of irreversible hydrocolloid impression material but in both of these techniques impression is disinfected only on the surface. Self-disinfecting impression are disinfected throughout the impression material. This study categorized various disinfectants into Chemical, Herbal & Physical. Nanoparticles and herbal disinfectants are mixed with irreversible hydrocolloid impression material, which will suggest its antimicrobial activity.

Aim & Objectives: To evaluate and compare antimicrobial-activity of irreversible hydrocolloid impression materials incorporated with various disinfectants.

Methodology: Commercially existing irreversible hydrocolloid impression materials will be used in the study. The disinfectants used will be chlorhexidine, silver nanoparticles and cinnamon. The selected disinfectants will be added into the irreversible hydrocolloid at the manipulation stage and their antimicrobial activity will be evaluated using the “Kirby Bauer Disk Diffusion Method” against the selected microorganisms.

Expected Outcome: Differential Antimicrobial activity of Chlorhexidine, Silver Nanoparticle and Cinnamon when added to irreversible hydrocolloid for disinfection of impressions.

Conclusion: Addition of various disinfectants in irreversible hydrocolloid may imbibe the antimicrobial activity within the impression materialand with the comparative investigations, more potent disinfectant can be applicable for clinical use as per findings of the present study.

Open Access Study Protocol

Evaluation and Correlation of Preoperative Serum C- Reactive Protein, Neutrophil-lymphocyte Ratio and Platelet-lymphocyte Ratio for Cervical Metastasis in Patients of Primary Oral Squamous Cell Carcinoma

Sanjana Wadewale, Nitin Bhola

Journal of Pharmaceutical Research International, Page 3286-3291
DOI: 10.9734/jpri/2021/v33i60B35007

Background: The influence of cervical metastasis on prognosis in a person who is suffering from oral squamous cell carcinoma (OSCC) has been notorious. C- reactive protein (CRP) is a prior biomarker for inflammation. Recent literature provide evidence of systemic inflammatory markers playing important role in determining survival rate on patient with OSCC. Hence, in current study the “utility of Neutrophil-lymphocyte ratio (NLR) ,Platelet-lymphocyte ratio (PLR), and serum CRP are evaluated and correlated for cervical metastasis”.

Objectives: This study intends to evaluate and correlate preoperative serum CRP, NLR, and PLR for cervical metastasis in patients of primary oral squamous cell carcinoma.

Methodology: The clinicopathological data, CRP and the preoperative complete blood investigation details were obtained from 40 primary OSCC patients who will undergo surgery. The optimal cut-off value of CRP, PLR and NLR was determined. The prognostic significance of markers will be determined by Univariate and multivariate analysis.

Expected Results: The elevation of CRP, NLR, and PLR levels will significantly evaluate and correlate with cervical metastasis.

Conclusion: Preoperative serum CRP, NLR, and PLR level will be a prognosticator in OSCC.

Open Access Study Protocol

A Study Protocol on Assessment of Epidermal Growth Factor Receptor (EGFR) Signalling Pathway as a Predictive Molecular Marker in Triple-Negative Invasive Ductal Carcinoma of Breast

Sahitya Vodithala, Arvind Bhake

Journal of Pharmaceutical Research International, Page 3317-3327
DOI: 10.9734/jpri/2021/v33i60B35012

Background: Breast cancer is the leading cause of cancer-related deaths worldwide. The Indian scenario is no different for the breast cancer mortality. Breast cancers have occupied the prominence not only for their incidence but the pace too. The researchers have studied numerous pathways vastly and widely in the past two decades to ascertain the prognosis and treatment outcome determinants popularly called predictive markers for breast cancer. One such cell signalling pathway that has raised the hope by assessing success for breast cancer is the Epidermal Growth Factor Receptor (EGFR) signalling pathway for a molecular subtype of Triple-Negative Breast Cancer (TNBC), which is challenging to treat therapeutically. This study aims to assess the EGFR pathway and its sub pathways in Triple-negative breast carcinoma (TNBC) and correlate the abnormalities of expressions in the EGFR pathway in TNBC for its therapeutic implications.

Materials and Methods:  This will be an observational cross-sectional study. Forty cases of TNBC will be selected.  There will be 10 cases each in 31-40 years, 41-50 years, 51-60 years, and 61 years onwards. Cases will undergo histological diagnosis of invasive ductal carcinoma, Immunohistochemistry for ER, PR, and Her2neu, IHC for EGFR, BRAF, Kras, and MAP kinase on histological sections, Polymerase chain reaction( PCR) for Kras. Data will be collected and analyzed using appropriate statistical tests.

Results: A significant correlation of EGFR, BRAF, KRAS, and MAP kinase is expected in the pathogenesis of triple-negative invasive ductal carcinoma.

Conclusion: The results can be put to the commercial advantage for clinical trials of the new drug development targeting anti-EGFR and other antibodies.

Open Access Study Protocol

Assessment of Patient Satisfaction in IPD Settings of AVBRH and Designing Strategies for Providing Patient-centric Care

Pushpanjali Seth, Vitthal Shinde, Vandana Gudhe

Journal of Pharmaceutical Research International, Page 3328-3334
DOI: 10.9734/jpri/2021/v33i60B35013

Background: Health industry is changing and growing at a very rapid phase. The patient is the most essential stakeholder in healthcare now. The Healthcare industry is a service industry where patient satisfaction are of paramount importance for the success of any organization. Healthcare is becoming more and more customer-centric. Patient satisfaction encompasses patients’ expectations, perception, and overall experience of healthcare services. Patient feedback helps a lot in improving services to patient satisfaction. This study aims to  assess the satisfaction level and causes of dissatisfaction in ABVR Hospital and provide patient-centric healthcare. 

Methodology: This will be a descriptive cross-sectional study. Patient satisfaction survey questionnaires will be administered, and personal interviews will be conducted with 50 randomly selected patients admitted to AVBRH. The qualitative and quantitative data will be analysed using appropriate statistical tools.

Results: Key reflections are expected about patient satisfaction level regarding healthcare services at AVBRH which can guide to frame patient-centric care policies.

Conclusion: Patient perception and feedback should be considered for formulating quality improvement strategic decisions. Pas the end-user of service, patients can judge the organizational and environmental dimension, empathetic work culture, and clinical aspect.

Open Access Study Protocol

Assessment of Compliance Level of Healthcare Personnel at AVBRH to Appropriate Hand Hygiene Practices: A Study Protocol

Prachi Ramteke, Rupali Naik, Vandana Gudhe

Journal of Pharmaceutical Research International, Page 3386-3393
DOI: 10.9734/jpri/2021/v33i60B35022

Background: In COVID scenario World Health Organization (WHO) recommends washing hands with water and soap or alcohol-based hand rubs for cleaning hands. Hand hygiene has been considered a central component in every program related to infection control.  It is applicable to healthcare personnel handling critical patients as well. Poor hand hygiene during intrapartum and newborn care is associated with increased death rates among newborns due to sepsis. This study aims to assess the knowledge, attitude, and practices of handwashing by healthcare staff in the hospital.

Methodology: This is an observational study which is conducted among the healthcare personnel at AVBRH hospital, Wardha. A tool consisting of a self-administered observation record form on knowledge and practices of handwashing will be used for data collection from 60 healthcare workers. Data will be analyzed using appropriate statistical tests.

Expected Results: Appropriate levels of knowledge and practices about proper hand hygiene are expected within healthcare workers of AVBRH.  Availability of alcohol-based hand rubs, sanitizers, soap and water is expected at all times.

Conclusion: Considering the pandemic situation, the availability and use of hand sanitizers can be effective to limit the spread of infections COVID -19.

Open Access Study Protocol

A Study Protocol for Evaluation of Microcytic Hypochromic Anemia by High-Performance Liquid Chromatography (HPLC)

Kaustubh Vilasrao Kharche, Arvind Bhake, Sunita Vagha

Journal of Pharmaceutical Research International, Page 3399-3406
DOI: 10.9734/jpri/2021/v33i60B35024

Background: One of the most regularassessments done in clinical practice is anemia. Different levels classify the anemiasbased onthe numerical value of hemoglobin, alteration in the morphology and chromium, underlying etiologies, red cell volumetric parameters and functionally depending on pathophysiologic processes of anemia. Microcytic hypochromic anemia (MCHC) has different underlying causes, including iron deficiency anemia, beta-thalassemia trait, and hemoglobinopathies.  Before planning the treatment, assessing the hemoglobin for its variants and the detection of abnormal hemoglobinis mandatory. High-performance liquid chromatography (HPLC) has proved to be significant for the evaluation of MCHC  because of its superior separation and quantification analytical powers.The present study has been undertakingthat anemia is the most prevailing and commonly treated clinical state managed by numerous nutritional supplements without much being done to know the underlying etiology or without evaluation of hemoglobin for its abnormalities.

Methods: This will bean observational (Prospective and Retrospective) study. Blood samples of 100 patients will be evaluated by HPLCBio-Rad variant,and various hemoglobin patterns; associate dhemoglobinopathies will be evaluated.

Results: The observations will be made according to the objectives and tabulated, which will be subjected to statistical tests for their significance and conclusions.

Conclusion: This study would contribute to understanding and knowing the etiology of MCHC in the population that our tertiary care hospitals serve.

Open Access Study Protocol

Comparative Evaluation for the Efficacy of Collecting Sample by using Vaginal Atrophy Screening Combistick (VAS Combistick) as against the Traditional Method of Collecting Sample for Screening of Vaginal Atrophy in Perimenopausal Women

Megha Tiwari, Neema Acharya, Samarth Shukla, Manjusha Mahakarkar

Journal of Pharmaceutical Research International, Page 3582-3586
DOI: 10.9734/jpri/2021/v33i60B35050

Background: Genitals and sexuality is an essential element of healthy and happily aging perimenopausal women with their partners. Vaginal atrophy (VA) of menopause is a condition associated to physiological, histological and anatomical changes noticed in the genital and urinary tracts in peri and postmenopausal women. Vaginal atrophy is the sequel of the decrease levels of estrogens in plasma, which are symptoms of menopause.

Objectives: 1. To evaluate the baseline data for vaginal maturation index (VMI) & pH in perimenopausal women. 2. To evaluate and compare the method of collecting sample by using VAS combistick & traditional method. 3. To evaluate and compare the accuracy of VMI score & pH using VAS combistick & traditional method. 4. To evaluate and compare the feasibility & acceptability using survey based analysis in VAS combistick method and traditional method.

Methodology: This will be an interventional-cross sectional comparative study. This study will include women who will come to Acharya Vinobha Bhave Rural Hospital (Obstetric and Gynaecology) OPD with at least one symptoms of vaginal atrophy. These women will take self sampling by using VAS combistick will be included in ‘sampling A’ (self sampling group) while, samples of the same group of patients taken by the traditional method will be included in ‘sampling B’ (clinician sampling group).

Results: In this study we have hypothesized that vaginal sampling by vaginal atrophy screening (VAS) combistick may be better when compared to traditional method of sampling for screening of vaginal atrophy in terms of adequacy, feasibility and acceptability.

Conclusion: VAS combistick may be considered as an alternative and better examining strategy which may give a reproducible and equivalent result to screening of vaginal atrophy in comparison to that of traditional sampling methods.

Open Access Study Protocol

Evaluation of the Effectiveness of Titanium-prepared Platelet rich Fibrin (T-PRF) and Demineralized Freeze-dried Bone Allograft (DFDBA) in Socket Preservation Followed by Implant Placement Using Two Stage Approach

Ranu Oza, Prasad V. Dhadse

Journal of Pharmaceutical Research International, Page 3763-3770
DOI: 10.9734/jpri/2021/v33i60B35074

Background: The focus of the implant therapy is now shifting to a stable restoration rather than mere osseointegration. Placement of dental implants has become an indispensable part of mainstream dentistry, offering an improved quality of life to patients. One of the physiological changes that occurs after tooth extraction is alveolar ridge resorption. A variety of bone graft materials and platelet concentrates which are abundant in growth factors have been incorporated that provides the added effect of combination for early and better healing.

Objectives: Evaluation of effectiveness of Titanium Prepared Platelet Rich Fibrin (T-PRF) and Demineralized Freeze-Dried Bone Graft (DFDBA) in socket preservation and simultaneous evaluation of implant stability three months after implant placement using two stage protocol.

Methodology: Present study will be performed over one year period. Twelve patients, each having one tooth indicated for extraction in either of the arches will be selected. Atraumatic extraction will be done followed by socket preservation using combination of T-PRF and DFDBA to promote early healing followed by placement of implant.

Expected Results: We expect early and better results of bone formation in healing sockets after preservation using T-PRF and DFDBA, which will be advantageous for implant placement. Better results in terms of bone volume, bone height, bone density and histomorphometry are expected.

Conclusion: Combined effect of DFDBA and T-PRF is expected to improve the periodontal parameters including both soft tissue and hard tissue outcomes.

Open Access Study Protocol

Comparative Evaluation of the Effects of Lighting Conditions on the Shade Selection of Ceramics using Visual Method

Rewa Kawade, Seema Sathe Kambala

Journal of Pharmaceutical Research International, Page 3771-3775
DOI: 10.9734/jpri/2021/v33i60B35075

Background: Tooth shade selection in prosthodontic restorations largely affects the patient satisfaction. Natural daylight is considered as the most recommended and standard source for shade selection. However, due to its inconsistency, shade matching lights have been introduced as an attempt to standardize the effect of light source.

Objectives: Comparative evaluation of the effects of daylight, shade matching light and dental operating light against the grey background on visual shade matching of natural teeth with VITA Classic shade guide. Daylight will be taken as the control group.

Methodology: Shade matching will be conducted in a well illuminated area with grey background. A group of 5 observers with superior color discrimination competence as determined by Pseudo Isochromatic colour test will be chosen for teeth shade matching. The matching will be carried out for 125 subjects under the three lighting conditions. The visual assessment will be done by matching the shade of maxillary central incisor of the subject with VITA Classic shade guide. Comparison will be done for two lighting conditions, each observer will perform this test three times that is for grey background in daylight, shade matching light and dental operatory light.

Expected Results: This study will determine the lighting condition that could be used as a possible alternative of daylight.

Conclusion: It will depict the lighting conditions that will best help the clinician to select the shade that will enhance the esthetics of the prosthesis and restorations.

Open Access Study Protocol

Centering Ability of Three Different Reciprocating Rotary Files Using Cone Beam Computed Tomography – In-vitro Study

Radhika A. Gupta, Aditya Patel

Journal of Pharmaceutical Research International, Page 3786-3791
DOI: 10.9734/jpri/2021/v33i60B35077

Background: Centering ability of root canal files is considered to be an imperative factor during root canal instrumentation. Hence it is decided to evaluate and compare the centering ability of Reciprocating rotary files in teeth by means of cone beam computed tomography in vitro condition.

Objectives:

  1. To evaluate the centering ability of the Reciproc file system in extracted mandibular molar.
  2. To evaluate the centering ability of the Reciproc Blue file system in extracted mandibular molar.
  3. To evaluate the centering ability of the WaveOne file system in extracted mandibular molar.
  4. To compare the above file systems with each other.

Methodology:  30 Newly extracted mandibular molars will be considered in the study. Before access opening teeth will be exposed for a pre-instrumentation CBCT scan. After this scanning standard access cavity preparation will be done followed by checking canal patency using 10#K-file. Then teeth will be divided into three groups for root canal instrumentation. Group 1: Instrumentation by using Reciproc file, Group 2: Instrumentation by using Reciproc Blue file, Group 3: Instrumentation by using WaveOne file. For evaluation of centering ability, the equation introduced by Gambill (1996) i.e., (m1 – m2) ÷ (d1 – d2) or (d1 – d2) ÷ (m1 – m2) and (b1-b2) ÷ (l1-l2) or (l1-l2) ÷ (b1-b2) will be used after post instrumentation CBCT scanning. 

Expected Results: The Reciproc Blue file system is expected to give better results in canal centering ability.

Conclusion: Centering ability is considered to be important factor in biomechanical preparation, as it can retain the instruments in centre which is crucial to offer a precise extension, without weakening of the root structure. Different files are used to evaluate and compare the centering ability of instrument by CBCT.

Open Access Study Protocol

Evaluation of Clinical Outcome of Cranioplasty Using Different Prosthetic Materials in Traumatic Brain Injury Patient: An Observational Study

Madhumaitri Patra, Sweta Kale (Pisulkar), Sandeep W. Iratwar

Journal of Pharmaceutical Research International, Page 3802-3807
DOI: 10.9734/jpri/2021/v33i60B35079

Background: Injuries of head, cerebral tumours, infections and ischemia are the most common causes of intracranial disorders and decompressive craniotomy may require to treat those patient followed by reconstruction later on. After loss of skull bone, cranial reconstruction or Cranioplasty is a choice of treatment worldwide for the restoration of the skull integrity. There are different types of materials which can be used for Cranioplasty but all have their own advantages and pitfalls.

Objective: Evaluation of clinical outcome of Cranioplasty using different prosthetic materials i.e Polymethyl methacrylate (PMMA), Titanium (Ti), Polymethyl methacrylate Bone Cement(PMMA Bone cement) in traumatic brain injury patient.

Methods: The patients will be divided into 4 groups according to the material used for Cranioplasty. (PMMA, Ti, Autologous bone graft, PMMA Bone cement). The intra operative clinical data and post-operative data will be collected from the previously collected records. (operative time, blood loss, including any complication or graft rejection). Statistical analysis will be done.

Results: Collected data form 40 patients will be statistically analysed to obtain the result. Expected outcome is PMMA Bone cement, is an equally effective prosthetic material as compared to PMMA and Ti in terms of intra operative and post-operative clinical outcome for Cranioplasty in traumatic brain injury patients.

Conclusion: This study would help in knowing the feasibility of using PMMA bone cement as a Cranioplasty material and will evaluate the clinical outcome of PMMA, Ti and PMMA bone cement in Cranioplasty.

Open Access Study Protocol

Comparative Evaluation of Preventive and Interceptive Orthodontic Treatment Need in Children of 6-9 Years and 9.1- 12 Years

Sumukh Nerurkar, Ranjit Kamble, Sunita Shrivastav, Jeni Ann Mathew

Journal of Pharmaceutical Research International, Page 3815-3820
DOI: 10.9734/jpri/2021/v33i60B35081

Introduction: Preventive and interceptive orthodontics, emphasizes on reduction of later need for complex orthodontic treatment. This thus increases the comprehensiveness of healthcare and help in strengthening the primary care. In literature, there is no comparison between the preventive and interceptive treatment needs in patients belonging to growing age (6-9 years) and those belonging to non-growing age (9.1-12 years). There is a need to compare these finding according to the age group.

The present study aims to utilize the IPION to quantify the proportion of central Indian children who would gain from the preventive and interceptive orthodontics.

Materials and Methods: The study will be conducted in the Department of Orthodontics, SPDC, Wardha in collaboration with Department of Public Health Dentistry, SPDC, Wardha. Total 383 patient in age group of 6 to 12 years, will be selected. All the features of the IPION-6 and IPION-9 will be recorded, and the variables will be multiplied by weighting factors according to the instructions of the original study by Coetzee. All the features of IPION-12 will be recorded, and the variables will be multiplied by weighting factors.

Expected Results: There will be a decrease in the need of orthodontic treatment in patients who have completed the age of 9 years.

Open Access Study Protocol

Determining the Risk Factor of Oral Cancer on Chewing Smokeless Tobacco Kharra: A Case–control Study

Jonathan Lalnunsanga, . Lalruatzela, James Lalduhawma, Kumar Gaurav Chhabra, Priyanka Paul Madhu

Journal of Pharmaceutical Research International, Page 3821-3826
DOI: 10.9734/jpri/2021/v33i60B35082

Background: Oral cancer is the sixth most common cancer globally; however, the incidence is much higher in the developing countries, including Pakistan, India, Sri Lanka. The etiology of oral cancer is multifactorial with majority of the cases attributable to separate and combined use of tobacco (smoked and smokeless), excessive alcohol consumption, betel quid, and betel quid substitutes. Among this, Kharra chewing (areca nut and tobacco) is the most prevalent addiction and the most common risk factors of oral cancer in central India.

Objectives: To evaluate the risk of oral cancer associated with kharra users and non-tobacco user. To evaluate the association for the risk factors of oral cancer with kharra and non-tobacco user.

Methodology: A hospital based case control study will be carry out in the study, the study will be conducted among the patient who had confirmed diagnosis of oral cancer and visited the hospital in AVBRH and SPDC Sawangi (Meghe) Wardha. Non- probability convenient sampling technique will be used for selecting the sample. The structured questionnaire will be used for collection of the data.

Expected Results: This study is mainly planned to evaluate the effects of Kharra chewing on oral cancer risk with the help of structured questionnaire. Hence, it is expected to identify the effects of Kharra chewing on the risk of oral cancer.

Open Access Study Protocol

Comparative Evaluation of Apical Debris Extrusion during Root Canal Preparation using Three Different Rotary File Systems: A Study Protocol

Rutuja Rajnekar, Nikhil Mankar

Journal of Pharmaceutical Research International, Page 3863-3868
DOI: 10.9734/jpri/2021/v33i60B35088

Background: Apical extrusion of debris leads to postoperative inflammation and endodontic failure.

Objectives: To comparatively evaluate debris extrusion by using Trunatomy rotary files, 2 shape, ProTaper next rotary files.

Methodology: Sixty Extracted single rooted human premolar teeth will be included in the study. After access opening, canal patency will be established by 15 K-file till the apical foramen followed by determination of working length by visual method. Now the samples will be divided into 3 groups: Group1: Trunatomy, Group 2: 2 shape file, Group 3: ProTaper Next files. Following this the manufacturer's instructions will be followed for the instrumentation. During instrumentation, extruded debris and irrigants will be collected into the preweighed test tubes. Following this, these tubes will be stored in an incubator at the temperature of 70°C for next 5 days. To evaluate the resultant weight of extruded debris, these test tubes will be weighed.

Expected Results: Trunatomy rotary file system is expected to produce less debris than 2 shape, ProTaper Next file system.

Conclusion: This study would be helpful for clinicians to choose better and efficient file system for instrumentation which produce comparatively less debris extrusion further reducing the chances of endodontic flareup.

Open Access Study Protocol

A Study on Reducing the Discharge Turnaround Time of IPD Patients at AVBRH

Pratiksha Suresh Chaudhari, Vitthal Shinde, Vandana Gudhe

Journal of Pharmaceutical Research International, Page 3894-3900
DOI: 10.9734/jpri/2021/v33i60B35092

Background: Smooth and patient-friendly admission and discharge processes attract a good number of patients and improve hospital turnover, ultimately bringing good profits to hospitals within optimum use of resources. Delay in the discharge process causes stagnation of patients, ultimately affecting new admissions. Discharge procedures for some critical patients are complicated and challenging.  A lot of time is spent on discharge intimation, billing, Pharmacy Clearance, handover, etc.  This study aims to assess the discharge process causes of delay in discharge and reflect on ways to improve the efficiency of the discharge process so that the discharge turnaround period can be reduced.

Methodology: This will be a Retrospective Observational study conducted in AVBRH, Wardha. Data will be collected from 60 discharged patients admitted to IPD wards. Data will be collected using a structured questionnaire during personal interviews. Data will be analyzed using appropriate statistical tools.

Expected Results: Some administrative and management gaps and handover gaps are expected to be found, which can be corrected to increase the efficiency of the discharge process.

Conclusion: This Will be drawn as per the findings of study.

Open Access Study Protocol

Evaluation of a Triple Antibiotic Paste as a Root Canal Obturating Material for Deciduous Teeth: A Study Protocol

T. Dahake Prasanna, R. Thosar Nilima

Journal of Pharmaceutical Research International, Page 3909-3920
DOI: 10.9734/jpri/2021/v33i60B35094

Background: Teeth with infected root canals, secondary to endodontic infections are a common problem in primary as well as permanent dentition. The key to successful endodontic treatment is seen only after the complete removal of infection from root canals. Systemic antibiotics have limited reach to endodontic spaces. In pediatric dentistry, difficulties in antimicrobial control require the development of a new root canal obturating paste with broad antimicrobial activity, minimal tissue toxicity, and high safety index. In this experimental study, a new Triple Antibiotic Obturating Paste (TAOP) will be developed and its efficacy will be evaluated.

Methods and Design: This is a pre-clinical in-vitro microbiological and in-vivo animal study, utilizing laboratory-grown white Wistar rats aged 2-3 months and weighing 200-300 grams. The antibiotic sensitivity test (AST) will be conducted using 21 standard aerobic and anaerobic microbial strains for determining potency through serial dilution and agar diffusion assay. The systemic and local tissue toxicity will be assessed by inserting the test and control materials into the dorsal connective tissues of the experimental rats. The antimicrobial efficacy of triple antibiotic obturating paste [thermo-modulated in-situ polymeric hydrogel matrix of TAOP, containing chitosan-carbopol and poloxamer blended with clindamycin (5%), metronidazole (5%), and doxycycline (1%)] will be evaluated against Metapex [Ca(OH)2-Iodoform paste] on endodontic microflora. The microbiological study data will be evaluated through One-way ANOVA trailed by ‘Tuckey’s post hoc test’ for intergroup as well as, t-test for intragroup comparison. The animal study data will be evaluated through One-way ANOVA for intergroup and ‘paired t-test’ for intragroup comparison.

Results: The newly developed bio-degradable obturating material will be more suitable than the conventionally used one, to eliminate resistant endodontic pathogens from root canal systems, along with good pharmacokinetic and pharmacodynamic responses as well as minimal local and systematic tissue toxicity when used in primary teeth.

Conclusion: The application of such novel multi-antibiotic formulation as an obturating material not only will achieve efficient disinfection of the endodontic spaces but also increase chances of therapeutic success due to the elimination of side effects associated with cytotoxicity and material properties as it contains most of the bioresorbable organic ingredients.

Open Access Study Protocol

Comparative Evaluation of Remineralization Potential of Acidulated Phosphate Fluoride and Hydroxyapatite Nanoparticles with and without Iontophoresis on the Incipient Carious Lesion in Permanent Teeth

Rutuja Ragit, Nilesh Rathi, Nilima Thosar, Monika Khubchandani

Journal of Pharmaceutical Research International, Page 3938-3943
DOI: 10.9734/jpri/2021/v33i60B35097

Background: A non- invasive method used to improve the drug delivery with the help of electric arena is termed as Iontophoresis. The iontophoresis process may cause deeper penetration of ions using electric current. Remineralizing nanomaterial may be infused at higher concentrations in the deeper layer of incipient caries under the influence of iontophoresis. Hydroxyapatite crystals are the most stable form of calcium phosphate which is responsible for the mechanical strength of the dental tissues. Improvedre-mineralization occurs more with the apatite particle size of less than 4 µm. Due to the size of the nanocomplexes ofhydroxyapatite, there can be possibilities that they would enter the porosities and diffuse into the body of the subsurface lesion to enhance remineralization using iontophoresis technique.

Objectives: 1) To evaluate the remineralization potential of APF gel with or without iontophoresis on the incipient carious lesion in permanent teeth. 2) To evaluate the remineralization potential of hydroxyapatite nanoparticles with or without iontophoresis on the incipient carious lesion of permanent teeth. 3) To compare the remineralization potential of APF gel and hydroxyapatite nanoparticles with or without iontophoresis on the incipient carious lesion in permanent teeth.

Methodology: Forty extracted intact teeth will be taken and artificial caries will be induced.  These specimens will be randomly divided into five groups as per the treatment - 1) APF gel application 2) APF gel with iontophoresis 3) Hydroxyapatite nanoparticles solution application 4) Hydroxyapatite nanoparticles solution with iontophoresis 5) Distilled water (control group). Remineralization will be analysis by using Vickers hardness test.  The alterations in the carious lesion will be assessed by confocal laser scanning microscopy.

Expected Results: APF gel and hydroxyapatite nanoparticles with iontophoresis will give superior remineralization effect as compared to the conventional method.

Conclusion: The utilization of the iontophoresis with hydroxyapatite nanoparticle will provide improved mineralization of incipient caries and prove to be a better method for treatment.

Open Access Study Protocol

Comparison of the Efficacy of Transconjunctival Incision with Lateral Canthotomy and Intraoral Vestibular Incision for Management of Infra-orbital Rim Fracture

Shreya Pawar, Nitin Bhola

Journal of Pharmaceutical Research International, Page 3980-3985
DOI: 10.9734/jpri/2021/v33i60B35102

Background: The treatment of an infraorbital rim fracture necessitates careful consideration. There several different techniques which are implicated with exposure of the infraorbital rim having its own sets of merits and demerits. Here, we intend to compare two incisions used for the management of fracture of the infraorbital rim.

Objectives: The focus of this study is to compare and analyze the efficacy of transconjunctival and intraoral incisions in terms of time taken for fracture exposure, adequacy of exposure and fixation, and post-operative complications such as soft tissue injury, chemosis, infraorbital nerve paresthesia, ectropion, scleral show, lagophthalmos, and wound dehiscence.

Methodology: Two groups with 10 patients requiring open reduction and internal fixation of infraorbital rim fracture in each group will be included in the study. The patients will be divided  randomly into Group A consisting of patients undergoing open reduction and internal fixation using transconjunctival incision or Group B consisting of patients undergoing open reduction and internal fixation using intraoral incision. The two approaches will be compared on the basis of time taken for exposure of fracture site, adequacy of exposure and fixation and post operative complications like soft tissue injury, chemosis, infraorbital nerve paresthesia, ectropion, sclera show, lagophthalmos and wound dehiscence.

Expected Results: The efficacy of intraoral incision would be better than transconjunctival incision as it would lead to lesser post operative ocular complications like chemosis, ectropion etc.

Open Access Study Protocol

To Evaluate the Practices and Attitude Regarding the Material of Choice and Method amongst Dentist for Repair of Defective Restoration of Tooth in Vidarbha: A Cross Sectional Study

Priyanka Paul Madhu, Kumar Gaurav Chhabra, Vaishnavi Dhotkar, Sumedha Chandiwale, Alfiya Sheikha

Journal of Pharmaceutical Research International, Page 3994-3997
DOI: 10.9734/jpri/2021/v33i60B35104

Background: The findings of this study will help dental care professionals reach out to the material of choice in more meaningful ways by catering to a list of potential reasons that will determine the selection of material for repair restorations based on its longevity, strength and knowledge of dental professionals of Vidarbha.

Objective: 1. To evaluate the practices regarding material of choice and method amongst dentist for repair of defective restoration of tooth.

  1. To evaluate the attitude regarding material of choice and method amongst dentist for repair of defective restoration of tooth.
  2. To correlate the practices and attitude regarding material of choice and method amongst dentist for repair of defective restoration of tooth.

Methodology: An online based cross sectional questionnaire study will be conducted by assessing the responses to 15 selected questions regarding carried assessment of the practice and attitude about reparative restorations among dental professionals of Vidarbha Region. The aspect on which results will be analyzed is the preferred material by dentists for reparative restoration. The questionnaire will be distributed amongst dental health professionals and their responses will be recorded along with validation of questionnaire. A convenient sampling method has been applied in the cross-sectional study depending upon the responses received after the survey. The results will be determined based on response on material selection and its longevity.

Survey Procedure: questions will be asked by online platform to dental health professionals with explanation of purpose of the study. The questions will be both open and close end type.

Expected Results: The expected result of the study will determine preferred material of choice and method for repair of defective restoration amongst dental health professionals of Vidarbha.

Conclusion: There are many key factors that affect the regarding material of choice and method amongst dentist for repair of defective restoration of tooth. Hence this study will evaluate material of choice and method amongst dentist for repair of defective restoration of tooth.

Open Access Study Protocol

“Prognostic significance of PD-L1 Immunoexpression in Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma”: A Study Protocol

Shelley Durge, Alka Hande

Journal of Pharmaceutical Research International, Page 4008-4013
DOI: 10.9734/jpri/2021/v33i60B35106

Background: “Oral squamous cell carcinoma” (OSCC) is a most common type of invasive disease. It involvs damage to the oral epithelium. It gives a bad prognosis. There are alterations in cells of the oral mucosa called “oral epithelial dysplasia” (OED) and are categarised as “Oral Potentially Malignant Disorders” (OPMD). As a result, prior alteration in premalignant lesions would encourage prior cancer treatment and could essentially diminish morbidity and mortality.  “Programmed death ligand 1” (PD-L1) is functionally imputed ligand of the “co-inhibitory programmed death receptor 1 (PD-1)”. (PD-L1)” is over-expressed on different cells including lymphocytes, tumor cells and different tissues in numerous malignancies. In this study, we will make effort to evaluate a new role of PD-L1 by correlating the immunoexpression of PD-L1 and clinicopathological characteristics and its prognostic significance in OSCC. We will evaluate and compare immunoexpression of PD-L1 in normal mucosa, OPMD and OSCC.

Methodology: Total 93 samples will be included in this study and they are divided into three groups, 31 in each group of the following: OPMD, OSCC and normal oral mucosa (control).Immunohistochemical staining will be performed and the integration of PD-L1 expression with various clinical features of OPMD and OSCC will be performed.

Expected Result: The present study will find immunohistochemical expression of “PD-L1” in OPMD and OSCC and its correlation with clinicopathological characteristics of OPMD and OSCC and 3 years disease-specific survivalof OSCC patients.

Conclusion: There is natable positive correlation of “PD-L1” appearance with OSCC. In case of OPMD, the progression of disease in terms of prognosis could be monitored. The unpredictable “PD-L1” appearance may be the main focus of integration therapy in OSCC. To provide personal immunotherapy to a variety of patients, the condition of PD-L1 should be considered.

Open Access Short Research Article

Study on the Plasmid and Genomic DNA Stability of DH5α Host System

Laxmisai Dixitha Vengili, Phavethra Sago, Yaswanth Kumar Reddy Kuncha, Venkata Suneela Kolli, Lasya Sri Varugu, Sree Lakshmi Mandadapu, Suryanarayana Veeravilli, Praveen Kumar Vemuri

Journal of Pharmaceutical Research International, Page 1325-1328
DOI: 10.9734/jpri/2021/v33i60B34751

Plasmids are extremely valuable as a source of DNA and for use in biotechnology. Our research goal was to develop plasmids with extremely high copy numbers for lab-scale plasmid preparations. Using the beverage method simplifies the process of obtaining a large quantity of plasmid DNA for various applications. Diet Coke as a beverage demonstrated that DNA recovery is highly adequate. Diet Sting with EcoRI and BamHI enzymes was used to detect restriction digestion with high sensitivity. However, for lab-scale preparative work, our findings show that plasmid yield can be significantly increased by using standard growth procedures and commonly used growth media.

Open Access Short Research Article

Relationship between Shukra Sara Purusha with Quality of Semen: A Pilot Study

Nikhate Sunil P., Raole Vaidehi P., Karemore Shruti

Journal of Pharmaceutical Research International, Page 1816-1822
DOI: 10.9734/jpri/2021/v33i60B34811

Dhatu sarata is an excellent state for any particular dhatu (tissue). Shukra dhatu (Reproductive tissue) is one of the seven dhatu reflects reproductive health. Garbhotpadan (reproduction) is main function of Shukra dhatu (Reproductive tissue). Characteristics future of shukra (Semen) is given by ayurvedacharya and this quality of shukra (Semen) said to be best for fertility. Shukta dhatu (Semen) can be correlated with semen. Its quality and quantity affects reproduction and any deformity is lead to infertility in male. Pilot study was conducted to find out relationship between Shukta dhatu sarata and quality of semen. An observational pilot study conducted on apparently healthy volunteers. 30 male volunteers of age group 25-35 yearr were selected and their Shukra dhatu sarata (Supreme quality of Reproductive tissue) were assessed with standard proforma. Then categorized into Uttam (supreme), Madhayama (Moderate) & Hina (Average) sara on the basis of presence number of characteristics. Semen analysis i.e. semen volume, total sperm count, sperm motility is done in laboratory of same individuals.  Higher Sperm count, good Sperm motility and high semen volume are found in Uttam Shukradhatusara (Supreme quality of Reproductive tissue) individuals as compare to hina shukradhatusara (Average quality of Reproductive tissue) individuals. It is not possible to come to any conclusion as this was pilot study. Further study should be conducted on large sample size.

Open Access Short Research Article

A Survey about the Awareness, Knowledge and Attitude towards Intellectual Property Rights (IPR) among the Dental Researchers of SGT University, Gurugram

Monika Dhayal, Vidushi Sheokand, Amit Bhardwaj, Chinnu Mary Varghese, . Harender, Madhur Goyal

Journal of Pharmaceutical Research International, Page 1995-1999
DOI: 10.9734/jpri/2021/v33i60B34836

With the advancements in modern science and technology, Intellectual Property Rights came in to existence to benefit and encourage innovative people for their work. The term intellectual property rights gained his strength from a long time and much expanded since then. These rights are applied to all innovation irrespective of educational qualifications and implies to all subjects. Dentistry in recent years has also developed interest in the field of intellectual property rights (IPR) and Patents due to extensive research in the fraternity. Therefore, it is need of the hour to check out the awareness about intellectual property rights. If people would aware about IPR, then only can proceed for IPRs in future for their research findings. As the universities are the main hub of intellectuals therefore, aim of the present study was to determine the intellectual property rights (IPR) awareness level among the dental scholars of SGT University, Gurugram.  Hence, this would be an advantage for dental researchers to explore and expand their scope of activities.

Open Access Short Communication

Problems Regarding Polypharmacy in Elderly in Indian Population

Anurag Kumar, Sunil Kumar

Journal of Pharmaceutical Research International, Page 1113-1118
DOI: 10.9734/jpri/2021/v33i60B34722

Among the general population, various international studies have shown that poly pharmacy is common in the older adults but those adults who were residing in nursing homes took the maximum number of drugs. It has also be shown that nearly half of the older adult population take one or more medications that are not medically necessary as per their conditions. According to various research, it has been clearly established that there is a strong association between multiple drug use and negative clinical consequences. In addition to that, conducting well-designed inter-professional intervention studies, which often include clinical pharmacists, that focus on enrolling high-risk older patients taking multiple medications with mixed results on distal health outcomes can improve the effectiveness of enhancing the overall quality of prescribing medications. It is critical to do research on poly pharmacy in a nation like India or other low to medium income countries. Poly pharmacy is induced by a multitude of variables at the levels of health-seeking, prescription, distribution, and usage. Society-based issues such as a lack of education and access to adequate healthcare in both rural and urban regions, as well as a general lack of health knowledge and passion, further aggravate the situation. Poly pharmacy is a key challenge in senior care. The senior population frequently has several medical diseases and may possibly suffer from cancer, which necessitates the use of multiple drugs for therapy. Multiple drugs used by an aged person can increase the likelihood of drug-drug interactions, noncompliance with the prescription, adverse drug responses, and reduced patient compliance.

Open Access Short Communication

Sexual Transmitted Disease among Youth

Akash Pathak, Anupma Sawal

Journal of Pharmaceutical Research International, Page 2025-2029
DOI: 10.9734/jpri/2021/v33i60B34841

Infections transmitted through sexual contact are known as sexually transmitted infections (STIs). There are ones that can be cured such as syphilis, gonorrhea, and chlamydia infection as well as some that can’t be cured, but are modifiable ones like HIV, herpes simplex, HPV (human papilloma virus), and hepatitis B infections. It is estimated that 20% of individuals living with HIV/AIDS are in their twenties and that almost one out of twenty young adults contract an STI every year. Adolescents are more likely to practice unprotected sex, have more than one sexual partner, and have intergenerational and transactional sex. That’s why, the importance of sexual education should be taught. The cervical lining makes female adolescents and young women more susceptible to STIs. Moreover, they may have difficulties getting the information and services they need to avoid STIs, as well as difficulties locating STI prevention services. In addition, they may have difficulty locating STI prevention services, or they may not have transportation to go to the clinics or they may not be able to afford the treatments. In places that are not youth-friendly, they may feel uncomfortable, even if they can get STI prevention services.

Open Access Short Communication

Introduction to System Risk in Medical Device Design

Akash Sharma, Gaurav Luthra

Journal of Pharmaceutical Research International, Page 2909-2914
DOI: 10.9734/jpri/2021/v33i60B34958

Medical devices designed for human use can be used to help patients overcome illness or disease and improve their quality of life. Researchers are working with more difficult tasks involved in making a medical device fit for human use. This means that the device should be safe, accurate, and cost-effective in terms of risk management, which entails identifying, understanding, controlling, and preventing failures that result in hazardous exposures while humans use medical devices. Risk and hazard analysis is a structured approach for assessing the potential difficulties that could arise from the usage of a medicine or a medical device. The purpose of this paper is to examine the necessity of risk analysis, risk management tools, and the risk management process's benefits. The ultimate goal is to reduce use-related risks, ensure that intended users can safely and effectively utilize medical devices throughout the product life cycle, and simplify the assessment of new device submissions and design control documents.

Open Access Short Communication

A Short Note on Netarsudil

S. Padmaja, R. Srivignesh

Journal of Pharmaceutical Research International, Page 3090-3092
DOI: 10.9734/jpri/2021/v33i60B34982

Glaucoma currently affects over 60 million people worldwide and also one of the leading cause of irreversible blindness. Early Medical intervention is the preliminary therapy to prevent the progression of optic nerve damage and vision loss by reducing the Intra Ocular Pressure (IOP). IOP is the regulated balance between production of aqueous humour and the rate of aqueous flow via uveoscleral outflow pathway and trabecular meshwork pathway (TM).  There are many groups of drugs like beta blockers, carbonic anhydrous inhibitors, prostaglandin analogues etc., are available. Netasurdil which is the Rho – associated protein kinase (ROCK) inhibitor is the novel group of drugs which has been in research for the Glaucoma.

Open Access Minireview Article

Lights and Shadows of Rituximab in Dermatology

Ashok Kumar, Geo Danny, Sane Roja Renuka, Arisha Salam

Journal of Pharmaceutical Research International, Page 179-187
DOI: 10.9734/jpri/2021/v33i60B34602

Rituximab is a CD 20 monoclonal antibody drug used in various spectrum of diseases today. It has proven to be a boon, especially in the field of dermatology. Although Rituximab was initially introduced as a novel method to treat B-cell Non Hodgkin Lymphoma, its use has rapidly expanded to include a number of other Lymphomas and Autoimmune diseases.This review is to give a bird’s eye view of updates on rituximab.

Conclusion: With its horizons expanding in dermatology, and with better information regarding its efficacy and safety profile, Rituximab has now become an approved first‑line therapy for pemphigus. In conclusion, Rituximab has proven to be a substantial boon for dermatologists in difficult to treat cases.

Open Access Minireview Article

COVID-19: Etiology, Transmission, Epidemiology, Treatment and Clinical trials

Vinod Kumar, Dolly Rani, Anuradha Saha, Jenifer Robinson, Chandra Mohan

Journal of Pharmaceutical Research International, Page 705-714
DOI: 10.9734/jpri/2021/v33i60B34669

In 2019, human race again came across a highly transmittable and pathogenic viral infection viz. COVID-19 and along with its pandemic nature, caused severe acute respiratory syndrome (SARS), and owes its emergence from the local seafood market of Wuhan city, China. Corona virus is currently prevalent all over the world wherein it caused infection in more than 29,599,29 individuals worldwide with mortality rate nearby 6.84% in approximately 213 countries within a short span of time and the infection due to this virus is still on a higher verge. The data showed that the transmission rate of COVID-19 is higher than the previous viral infections, particularly because of changes in genetic recombination at S protein in the RBD region. Till now there is no approved treatment available against COVID-19 infection and has been observed for human to human transfer widely. The present review summarizes the etiology, transmission, epidemiology, possible approaches for the treatment of COVID-19 and Clinical trials.

Open Access Minireview Article

Phytoconstituents and Medicinal Importance of Cannabis sativa

Anjali Thakur, . Sushma, Reena Sharma

Journal of Pharmaceutical Research International, Page 2146-2150
DOI: 10.9734/jpri/2021/v33i60B34857

Cannabis sativa has been reported that it is a widely spread species all over the world. It has been receiving more attention due to its therapeutic potential. Popularly, it is also known as marijuana. The phytoconstituents and characteristics of Cannabis sativa, stem, leaves and seeds were provided with more information in feed materials for its utilization and nourishment. Positive biological activities and pharmacological aspects provided from Cannabis sativa. Cannabis played a key role as a medicinal plant in the lives of tribal people mostly living in the Himalaya, providing products for both food as well as their medicinal purposes. The role of cannabis for treating several medicinal conditions increased day by day. The present paper is reviewed on phytoconstituents and medicinal importance of Cannabis sativa which is mainly aimed at researching the state of the art, and enhancing the knowledge of this versatile plant. Cannabis sativa is from the Cannabaceae family, which is mostly able to live in temperate as well as tropical regions. It is the most commonly used psycho-active drug all over the world and the only one most popular illegal drug. This review mainly analyzes the botanical, descriptional and diversity along with the medicinal importance of marijuana among the human being which is found throughout the worldwide.

Open Access Minireview Article

Spironolactone in Dermatology: A Mini Review

Jayakar Thomas, S. Soundarya, S. Vaishnavi

Journal of Pharmaceutical Research International, Page 2180-2183
DOI: 10.9734/jpri/2021/v33i60B34861

Spironolactone is a drug, similar in structure to aldosterone and acts as an aldosterone receptor antagonist with an anti-androgenic effect.

This drug has proven to be useful in several dermatological entities, however its use has not been well explored. Its use in diseases such as acne has opened the door to the possibility of new therapies depending on the clinical manifestations of the patients, as well as its possible to use it as a first line treatment. Other diseases associated with the use of spironolactone where its effects have been shown to be useful are hidradenitis suppurativa, hirsutism and female pattern androgenetic alopecia. In this review we discuss the use of spironolactone in different skin diseases that are common in our environment, dosage according to different studies, treatment recommendations and adverse effects; all of the above mentioned in order to use this drug in a daily clinical practice.

Open Access Minireview Article

The Prevalence of Depression among Medical Students: A Worldwide Literature Review

Abdulaziz H. M. M. M. Alajmi, Bandar B. J. M. M. Almutairi, Mohammad R. M. R. H. Alajmi, Salman S. S. S. S. A. Alazemi, Abboud Mohammad Alhussain, Fawaz Majed Ata'Allah Sh Salman, Abdullah J. A. Alomran

Journal of Pharmaceutical Research International, Page 2520-2526
DOI: 10.9734/jpri/2021/v33i60B34908

Stress is one of the main factors that might lead to depression in the long term; medical students are susceptible to stress and depression more than other students.

Aim: to look at the prevalence of depression among medical students.

Methodology: The authors looked at published studies on the internet about the depression rates among medical students in different areas around the world.

Results: Most of the literature showed that there is a significant prevalence of depression among students during medical school.

Conclusion: Due to high rates of depression among medical students, coping strategies for stress and depression should be offered to medical students to prevent future complications.

Open Access Minireview Article

A Brief Review on Postpartum Depression

Vaishnavi Dange, Dalia Biswas

Journal of Pharmaceutical Research International, Page 2639-2644
DOI: 10.9734/jpri/2021/v33i60B34924

Postpartum depression is a medical condition in which a woman faces mental issues after delivery. Postpartum depression is associated with anxiety, mood swings, tiredness, feeling scared all the time, trouble sleeping or sleeping, weight loss, stress eating, losing interest, sudden weight gain, and difficulty concentrating or making decisions, fatigue and several other issues. It can happen during pregnancy as well as after giving birth. Some women experience baby blues while some experience postpartum depression. Women feel depressed and sadly most of the time. Depression can make it difficult for mother to take care of herself and the child. Various lifestyle choices also need to be mentioned while talking about factors causing PPD. Some factors affecting PPD are lack of physical activity and exercise, bad eating habits, disturbed sleep cycle etc. it may include hormonal changes, sleep deprivation, risk factors, psychological stress. One of the chief factors affecting postpartum depression is the sleep cycle. It is seen that less sleep is brought near to postnatal depression. Exercise, psychosocial support, physical stretching or working activity can decrease symptoms of depression. Exercise causes the release of mood-boosting hormones such as dopamine and serotonin, which elevates the mood. Low esteem caused by depression can be decreased by an elevated mood. Exercise can also increase endogenous endorphins and opioids which gives a positive mood. It also increases problem solving capacity and confidence. The most common management methods used for managing depression are psychological support, professional help, interpersonal psychotherapy and cognitive therapy.

Open Access Minireview Article

Significance of Microalgae Biotechnology: Production of Omega-3 Microbial Oils from Marine Thraustochytrids

Sonal Setya, Avneet Kaur

Journal of Pharmaceutical Research International, Page 2800-2806
DOI: 10.9734/jpri/2021/v33i60B34944

Thraustochytrids are multicellular fungal-like aquatic protists that originate all over the ocean. They're renowned for producing higher-value omega-3 polyunsaturated dietary fats (-3-PUFAs), such as docosahexaenoic acids (DHA), along with hydrolytic enzymes. Omega-3 dietary fats with a long chain Human, and also marine fish species, require Eicosapentaenoic Acid (EPA) and DHA to survive. Fish oil is direct current. For the production of microbial oils from marine habitats, a new and sustainable usage of EPA and DHA is required. Thraustochytrids are single-celled eukaryotic microbes that may accumulate larger quantities of lipids. Omega-3-rich oils have industrial and commercial importance, owing to their advantages to human health and the environment. Fish is the major source of omega-3 dietary fats. The renaissance of attention in omega-3 as practical foods in this developing industry has increased the need for alternate sources of omega-3. These lipids are necessary for brain and retinal functional development as well as the prevention of cardiovascular and Alzheimer's illnesses. The worldwide demand for omega-3 productions, chiefly DHA, has increased significantly in the recent decade as a result of the rising usage of these lipids as a significant component of infants nourishing methods and supplementation. The polyunsaturated dietary fats produced from oleaginous microalgae have aids over the others PUFA supplies including such fish’s oils, which are odourless and not reliant on fish’s supplies. The generation of omega-3 oils from marine habitats is discussed in this study, which has several advantages.

Open Access Minireview Article

Effects of Genetically Modified Animals on Human Activities and Ecosystem

Neelkant Prasad, Manvi Singh

Journal of Pharmaceutical Research International, Page 2873-2879
DOI: 10.9734/jpri/2021/v33i60B34954

The first transgenic animals was mice which are now still the transgenic organisms most commonly used. There are various strategies in place for transferring foreign genes to the specific organisms. Transgenic organisms were used to study the gene and biological functions primarily for basic research. Transgenic animals may also be important models for researching human and animal diseases, and for developing new medicines. Transgenics can also be the source of both human and medicinal organs and cells. Transgenesis’ effect on developing animals for both the production of food and feed is still non-existent but is anticipated to become a fact in the coming months. A few transgenic animals were obtained and marketed. The use of the transgenic animals poses some welfare issues, and the EU has established specific regulations. Transgenesis in animals already impacts human activities and people’s perception of the living organisms. The techniques accessible make it possible for transgenic human generation. Until now, this was not done or suggested. The human effects of transgenesis may be enormous. There are theoretical and ethical discussions under way on this subject.

Open Access Original Research Article

Evaluation of Lung Function Test in Zumba Dancers

Prateeksha Moharana, Preetha S, G. Sridevi, Lavanya Prathap

Journal of Pharmaceutical Research International, Page 6-11
DOI: 10.9734/jpri/2021/v33i60B34578

Introduction: Exercise is very important in each and every individual’s life. Zumba exercise is a form of physical exercise that combines all the exercise which is beneficial for the body. The aim of the study is to evaluate the effect of zumba exercise training on pulmonary function tests in individuals.

Materials and Methods: This study was carried out among 60 individuals where 30 people belonged to a normal group and 30 people were zumba dancers. The values were recorded through a computerised spirometer. This study was done among zumba dancers in the Chennai region. The results were analysed using SPSS software. unpaired T test was used to analyse the statistical significance. p<0.05 was considered significant.

Results: The mean values of the lung function test for FVC, FEV1 and FEV1/FVC ratios were 3.73, 2.88 and 82.33% respectively and all the values were statistically not significant.

Conclusion: The study showed that pulmonary function tests in zumba dancers were good when compared to the control group.

Open Access Original Research Article

The Use of Ophthalmic and Nasal Naphazoline in the Outpatient Setting

Nehad Jaser Ahmed, Hasan Soliman Yusufoglu

Journal of Pharmaceutical Research International, Page 19-23
DOI: 10.9734/jpri/2021/v33i60B34580

Aim: The present study aimed to describe the use of ophthalmic and nasal naphazoline in the outpatient setting.

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

Results: During the study period of 6 months, 393 patients received naphazoline. Most of them were male patients (77.35%) and the age of 34.35% of them was between 20 and 29 years. The majority of the prsecriptions that contained naphazoline were prescribed by residents (99.75%). Most of the patients received naphazoline as nasal drops either alone (47.84%) or combined with chlorpheniramine (36.13%). The majority of the prescriptions were written by the emergency department (99.24%).

Conclusion: The present study showed that naphazoline was commonly prescribed in Alkharj. Further studies are needed to explore the frequency and pattern of naphazoline use as well as to explore the frequency of prescribing other sympathomimetic vasoconstrictors in different settings.

Open Access Original Research Article

Estimation of Knowledge, Attitude and Practices of Tuberculosis Patients in Penang: A Prospective Study

Zohra Bhatti, Amer Hayat Khan, Syed Azhar Syed Sulaiman, Madeeha Laghari, Irfhan Ali Bin Hyder Ali

Journal of Pharmaceutical Research International, Page 39-50
DOI: 10.9734/jpri/2021/v33i60B34584

Background: A clear understanding of knowledge, attitudes, and practices (KAP) of tuberculosis (TB) patients is important to encourage patients' contribution to TB prevention and control. Appropriate knowledge, positive attitude, preventing transmission and early diagnosis of TB are key factors in improving patient outcomes.

Objective: This study aimed to investigate the knowledge, attitude, and practices about TB and determine related influencing factors among TB patients.

Methodology:  A cross-sectional prospective study by using a validated structured tool was conducted among TB patients more than 18 years of age. Descriptive statistics were used to summarize socio-demographic characteristics and TB knowledge, attitude, and practices level. To compare scores of each domain with various demographic factors, the Kruskal Wallis H test was applied.

Results: Total participants in the study were 337. Of these, 231(68.5%) were male and 106(31.5%) were females with a mean age of 46.5±17.1 years. A significant difference was observed between males and females TB knowledge and practices concerning age. Patients with ³ 12 years of educational background profoundly have better knowledge.

Conclusion: Overall, TB patients have shown encouraging results of the study, but poor attitudes and practicing behaviors are observed among TB patients. More extensive strategies should be developed to enhance the campaign of awareness programs among TB patients to improve preventing behavior towards disease. 

Open Access Original Research Article

Evaluation of the Knowledge of Saudi Women in Childbearing Period towards Toxoplasmosis Induced Teratogenicity – Evidence from A Cross-Sectional Study

Wael Mansy, Abdulrahman Alwhaibi, Ali Mohammad Alqahtani, Nasser M. Al-Arifi, Abdulaziz N Alotaibi, Salmeen D Babelghaith, Norah Aljabli, Sara Alsubei, Raghad Al Fayez, Nouf Al Ameel, Mohamed N Al-Arifi

Journal of Pharmaceutical Research International, Page 71-79
DOI: 10.9734/jpri/2021/v33i60B34588

Background: Toxoplasmosis is an environmental teratogen that may disrupt fetal development if transferred to the mother during pregnancy, resulting in maldevelopment and newborn mortality.

Objective: To assess knowledge of Saudi women in their childbearing period as regards risk factors of Toxoplasmosis infestation, testing, awareness of disease manifestation and prevention. 

Methods: Anonymous online survey was used to examine the knowledge of Saudi women in their childbearing period about Toxoplasmosis induced teratogenicity. The non-probability sampling yields a calculated size of 600 women. The cross-sectional design of the research required categorizing the questions into two significant portions, one for sociodemographic data and the other for assessing Toxoplasmosis awareness. First, a descriptive statistic summarized the demographic characteristics. In categorical data, chi-square tests were employed to compare groups.

Results: A total of 613 women in their childbearing years completed the questionnaire. Most respondents interviewed were 36-40 (46.7%), and Para 1-5 (80%), and 86% were graduates. In addition, 42.2 % had the basic knowledge of Toxoplasmosis, 25.3 % were aware of the manifestations of the disease, and 76.3% correctly identified premature labor or miscarriage as sequelae of the infection. Aside from the frequency of abnormalities and parities and knowledge of toxoplasmosis, no other demographics in our research sample showed a significant association.

Conclusion: The basic knowledge of Toxoplasmosis among Saudi women of childbearing age is unsatisfactory (42.6 %). Age, family income, educational level and the number of abortions were significantly associated with knowledge of Toxoplasmosis among Saudi women in their childbearing age.

Open Access Original Research Article

A Survey of Physicians’ Opinion and Treatment Preferences Regarding Febrile Seizures in Children

C. Tulasi Priya, Chaudhary Devand Gulab

Journal of Pharmaceutical Research International, Page 80-85
DOI: 10.9734/jpri/2021/v33i60B34589

Background: Fever of either low or high-grade is a big concern when present in the pediatric age group; it is much more worrisome if children are younger than 5 years of age. Fever can subside on its own or with the help of simple remedies and or medications. However, some children will develop seizures when they have a fever. Febrile seizures are one of the most common presenting complaints seen in pediatric patients in emergency room visits and physician consult. Two different types of seizures are seen in children, simple and complex seizures. Simple febrile seizures are non harming and self-limiting, while, complex seizures are prone to have long-term side effects on children. Febrile seizures can occur with or without a source of an underlying cause. In this study, we aimed to identify physicians’ opinions, knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age.

Objectives: To determine physicians’ opinion knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age.

 Methods: A cross-sectional study plan was designed and conducted in June - July 2021 involving general physicians and pediatricians (n = 600). The questionnaire form including 15 closed-end questions was distributed to physicians. Descriptive statistics were used to analyse the data.

 Results: 100% of physicians prescribed antipyretics to control fever and or to prevent complications, especially febrile seizures. All participants were aware that axillary temperature of > 37.2 ° C is defined as fever. All most all, general physicians and most pediatricians used antipyretics to treat other associated symptoms and signs, even when the fever was absent. 76.3% believed that high fever might be an indicator of underlying serious occult bacterial infection. Almost all physicians (91.3%) advised parents to switch to the use of alternate medication when the fevers did not subside after initial treatment with paracetamol; everyone recommended that non-medical supportive treatments like tepid sponging along with antipyretics and ibuprofen to reduce the fever soonest possible. 68% of pediatricians and 90% of general practitioners believe that febrile seizures will cause brain damage. 74% of general practitioners preferred to refer children immediately to specialty centers, for further management of seizures. However, Pediatricians at tertiary care centers, as well as those in private practice used diazepam or lorazepam.   

Conclusion: Differences are negligible between general physicians and pediatricians while managing fever and fever complications including febrile seizures. Irrespective of the knowledge, awareness and the availability of fever guidelines by many national and international organizations, physicians are leaning towards child and parents comfort in treatment fever. The gap is wider in general physicians’ preparedness than pediatricians. A considerable gap exists to improve physicians' approach, diagnosis, and management of fever in the pediatric population.

Open Access Original Research Article

A Descriptive Study of Under-five Mortality

Mohammad Haroon Rahemi, Masihullah Masih

Journal of Pharmaceutical Research International, Page 86-97
DOI: 10.9734/jpri/2021/v33i60B34590

Introduction: The under-five mortality is a global problem, which is an important indicator to, demonstrate the quality of health services in a region or a country. The under-5 mortality rate is the probability of dying before five years of age (per 1,000 live births). In the 1990s under-five mortality rate was 12,7 million, but it decreased to 6,2 million in 2015. In Afghanistan due, to more than forty years of war and internal conflict, low socio-economic status, and high level of illiteracy, the under-five mortality rate is very high. 

Objective: This study aimed to determine the mortality rate and it’s causes in children under the age of five in Nangarhar Province.

Methods: This is a descriptive study conducted from 2018-2019 in Nangarhar University Teaching Hospital (NUTH). According to Health Management Information System (HMIS) data reports in the mentioned period, 9164 under five patients were admitted in the different wards of Nangarhar University Teaching Hospital.

Results: The mortality of 824 patients were recorded (824/9164) due to different causes, which contribute 9% of total mortality. Of the 824 deaths, 371 consisted of neonatal deaths, which make 45% of total mortality, the 55% (453/824) deaths have occurred between the age of 28 days and five years. The principal causes of neonatal deaths were 35 percent prematurity, 27 percent birth asphyxia, 24 percent sepsis, 8 percent malformation, and 6 percent was consisting of other diseases such as neonatal jaundice, neonatal tetanus, neonatal diarrhea, birth trauma, etc. In this, study the causes of death occurred in the age of 28 days to five years were 30 percent due to malnutrition, 22 percent pneumonia, 20 percent Diarrhea, 10 percent Measles, 6 percent Malaria, 8 percent Meningo-encephalitis and 4 percent due to other diseases like pertussis, poisoning, trauma, burns, pediatric cardiac disease, neoplastic disease, and others.

Conclusion: The data of our study has taken from the Health Management Information System (HMIS) department of the 2018-2019 years which was collected from different wards of Nangarhar University Teaching Hospital. The rate of under-five mortality was about 8.99 ~ 9%. The result of our study was different from other countries and the mortality rate may be changed from time to time. These changes belong to several factors such as variable definition, promotion of socio-economic status, risk factors, geographical situation, peoples’ education level, availability of health services, and preventive measures.

Open Access Original Research Article

Controlling Oral Pathogens using Ficus Benghalensis Mediated Silver Nanoparticles

K. Thirumagal, M. Jeevitha, S. Rajeshkumar, Selvaraj Jayaraman

Journal of Pharmaceutical Research International, Page 98-105
DOI: 10.9734/jpri/2021/v33i60B34591

Aim: To find antimicrobial property of Ficus benghalensis mediated silver nanoparticles (AgNPs)

Introduction: Nanoparticles have been studied in recent years because of certain properties like physical, chemical, electronic, thermal, magnetic, optical, dielectric and biological. This study was conducted in order to evaluate antimicrobial properties of F. benghalensis mediated                      AgNPs.

Materials and Methods: In this study, extract of F. benghalensis was used to synthesize silver nanoparticles characterized using UV- visible spectrophotometer, Fresh F. benghalensis mediated AgNPs show excellent antimicrobial activity against oral pathogens, Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis. and Candida albicans.

Results: F. benghalensis mediated AgNPs showed antimicrobial activity against gram positive S. aureus with a zone of inhibition of 16.22 ± 0.31 mm at the concentration of 100 μl. The zone of inhibition against S. mutans was 12.14 ± 0.21 mm followed by zone of inhibition against E. faecalis was 12.12 ± 0.2 mm and antimicrobial activity against C. albicans showed a zone of inhibition of 14.02 ± 0.24 mm at the concentration of 100 μl. The zone of inhibition of the nanoparticles was shown to be increased with increase in concentration against all the pathogens and the maximum inhibition was shown against S. aureus.

Conclusion: Overall, antimicrobial activity was seen to be increased with increase in concentration. Thus there was potent antimicrobial activity in F. benghalensis mediated AgNPs which could be beneficial when applied in treatment of infectious oral diseases in future.

Open Access Original Research Article

Dynamics of Changes in Quality of Life and Local Levels of TNF-α and IL-1β in Patients with Acute Viral Rhinitis

Dmytro Grebeniuk, Yaroslav Hrytsun, Halyna Nazarchuk, Oksana Mashevska, Lidiia Levytska, Liliia Chepel, Mykola Melnychenko, Iryna Pallii, Vitalii Bobyr

Journal of Pharmaceutical Research International, Page 106-114
DOI: 10.9734/jpri/2021/v33i60B34592

Introduction: Acute viral rhinitis is one of the most common pathologies among the population of the globe. Although, at first glance, this pathology seems simple and well-studied, but due to the high incidence, the load it creates on the health care system encourages in-depth study.

Aims: To examine the dynamics of changes in quality of life and local levels of TNF-α and IL-1β in patients with acute viral rhinitis in different treatment regimens.

Methodology: The prospective study included 84 patients with a confirmed diagnosis of acute viral rhinitis. In accordance with the purpose and objectives of the study, all patients on days 1, 5 and 10, in addition to routine studies, were determined by local levels of TNF-α and IL-1β, as well as to determine the quality of life.

Results: In patients of the study group, only partial recovery of local levels of TNF-α and IL-1β and indicators of the physical component of quality of life was observed during 10 days of treatment. The emotional and functional components of quality of life in patients of this study were more correlated than with the physical component and local levels of proinflammatory cytokines, which are objective indicators of the activity of the inflammatory process. Complementing the traditional treatment regimen with 0.25% oxolin in the form of an ointment has reduced the duration of the disease, reduced the incidence of bacterial complications and improved the quality of life of patients with acute viral rhinitis in the short term.

Conclusions: The dynamics of local levels of TNF-α and IL-1β reflects the nature of the inflammatory process in the nasal mucosa and clearly correlates with the physical component of quality of life.

Open Access Original Research Article

Analytical Method Development and Validation for Estimation of Mifepristone in Pure and Pharmaceutical Dosage Form

Sheetal Bastia, Vaibhav Gawade, Vitthal Chopade, Rahul Jagtap, Vishal Modi

Journal of Pharmaceutical Research International, Page 120-130
DOI: 10.9734/jpri/2021/v33i60B34594

Mifepristone structurally belongs to the class of anti-progesterone steroids, which are used as an oral contraceptive. The reverse phase HPLC method was designed in a simplified and rapid way for the estimation of Mifepristone in bulk as well as tablets. The method was established using a Kromasil C18 column of dimensions of 250mm×4.6mm and a particle size of 5m.The used mobile phase was Acetonitrile: Water (70:30, v/v). The pump was pumped at 1 ml/min at a temperature of about 30 ± 2 °C and the eluted analyte was identified at 305 nm. Mifepristone eluted with a mean retention time of 6.27 minutes. The intended method was validated as per ICH (International Council for Harmonisation) guidelines, indicating a high degree of specificity, system suitability, accuracy, precision, and robustness. The LOD (Limit of detection) was found to be 0.7238 ppm and the limit of measurement was 0.9562 ppm. The method linearity was found to be between 1-6µg/ml, with an R2 of 0.9923. In accuracy studies, the percent recovery was found to be between 99.39% - 100.50%. The method was discovered to be precise as the values of the percent RSD were found to be less than 2.0% for both intraday and interday. The method was discovered to be reliable and robust. Mifepristone in marketed pharmaceutical tablet dosage form was effectively quantified using the established Reverse Phase HPLC method.

Open Access Original Research Article

Evaluation of Oral Health Condition among the Pregnant Females at Tertiary Care Hospital of Hyderabad, Sindh

. Palwasha, Yaswant Rai, Maria Javaid, Nisar Ahmed Khokhar, Roohi Nigar

Journal of Pharmaceutical Research International, Page 142-145
DOI: 10.9734/jpri/2021/v33i60B34596

Background: Gestational is special and interesting period for every woman that covers the physiological hormonal changes and leads to the development of new healthy life. Changes in hormones during pregnancy may alter the physiological conditions that impose the bad impact of different body parts including gastric and oral health of the mother. Oral health plays an important role for maintaining normal and healthy life of human being and if any disease or disorder appeared within the oral cavity, it may leads to severity of disease and disturbed normal routine life.

Aims and Objectives: This study aims to evaluate the condition of oral health during gestational period.

Materials and Methods: Descriptive cross sectional study was carried out for the period of six months at Department of Gynecology & Obstetrics ward, Liaquat University of Medical & Health Sciences, Jamshoro and females with positive pregnancy were included in the study and total 146 females were selected, after the signature on informed consent form. Medical history was taken in order to ensure any major disease or medication affecting oral health.

Results: After collection of proper data from all participants, the results were finalized, 19 females were belonging to age group of 18-21years, and 51 females belong to 26-29 years. 47 females had good OHI-S score, 59 had fair OHI-S score. 31 female had 1st trimester, 81 females had 2nd trimester and 34 had 3rd trimester. 19 females had normal PI index, 94 had simple gingivitis and 33 females had periodontitis.

Conclusion: It was important to maintain good oral hygiene before and during pregnancy, so as to prevent the occurrence of periodontal disease and to avert the irreparable damage that may arise during the period of pregnancy.

Open Access Original Research Article

Emergency Medical Services Challenges Regarding Resource Capacity and Competency during COVID-19 Pandemic

Ghaydaa Filimban, Khaled Aljasser, Loui Alsulimani, Asma Altalhi, Abdulaziz Alshebili, Taha Masri, Hattan Bojan, Fahad Alhajjaj, Mohammad Altuwaijri

Journal of Pharmaceutical Research International, Page 146-157
DOI: 10.9734/jpri/2021/v33i60B34597

Objectives: This study aimed to investigate the availability of resources, personal protective equipment PPE) and beliefs amongst Emergency Medical Services (EMS) professionals in Makkah city. Also, we aimed to assess various aspects of how Emergency Medical Services are handling the COVID-19 pandemic via online self-administrated questionnaire.

Methods: A cross-sectional analysis was conducted on a convenience sample of 276 EMS providers from the city of Makkah in Saudi Arabia during the period from July 2020 to June 2021. SPSS (version 21.0) was used for data entry and data analysis. We approximate a 95% confidence interval (±0.05).

Results: Emergency Medical Technicians (EMTs) and paramedics are representing most of the participants, 44% and 43%, respectively. EMS doctor, EMS registered nurse and others represent the remaining 13%. When the participants assessed their level of satisfaction on how their institutions have handled the pandemic, 34% expressed that they were satisfied, 14% were very satisfied, while 21% and 13% expressed that they were dissatisfied and very dissatisfied. On the availability of resources, 42% had access to N95 masks whenever they needed access to them while 33% did not have access.

Conclusion: As the study demonstrates a relationship between the capability of emergency medical services personnel to handle a pandemic like COVID-19 and institutional preparedness, there are still significant gaps in EMS personnel's PPE training. EMS agencies should be supported in their efforts to effectively prepare their workers while the pandemic continues in our communities. Therefore, institutions should adopt guidelines that stipulate care for patients with COVID-19, provide training to emergency personnel, and properly distribute resources and PPE.

Open Access Original Research Article

Ocular and Extraocular Symptoms among Medical Undergraduates with Cellphone Addiction, A Cross-sectional Study

Kiran Khan, Ata ur Rehman, Ghazala Nasim Pasha, Syeda Laraib Fayyaz, Nasima Iqbal, Ruqaya Nangrejo

Journal of Pharmaceutical Research International, Page 166-171
DOI: 10.9734/jpri/2021/v33i60B34600

Aim: To find out the frequency of ocular and extraocular symptoms due to cellphone use among the medical students.

Study Design: Cross-sectional study

Place and Duration of Study: Study was conducted in private and public sector medical and dental colleges of Karachi from January 2019 to September 2019. 

Methodology:  Self-designed, self-explanatory questionnaire was used to collect data. The setting for the collection of the data has been classrooms, common rooms, cafeteria and open sports areas of the medical and dental colleges which has been surveyed by the different team members of the group. The data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 22.

Results: The mean age of the study participants was 21.2 ±1.82 years, among them majority was female i.e. 60.25%. Participants were having different degrees of blurred vision, eyestrain, dry eyes, eye redness and irritation, difficulty in refocusing the eyes and double vision with frequency of 17.25%, 24.25%, 9.5%, 10.75%, 9% and 5% respectively. Respondents during the survey stated that they were having different physical problems apart from disturbance in eyesight. About 39.75% respondents complained of varying degree of headache and or migraine. 36% were having pain in neck, shoulder or back while 25.25% were having variable degree of fatigue. About 21.5% complained pain in fingers and wrist, 9.5% complained of hand stiffness and their inability to grip or hold any other thing properly.

Conclusion: It has been concluded that cellphone usage has serious ocular and extraocular hazards so there is a need to limit its usage as it is affecting the physical and mental health of the students.

Open Access Original Research Article

The Potential Effect of Henna (Stone Dye) Extract Paraphenylenediamine on Human Blood Cells, Liver and Renal Function

Umsalma B. Eissa, Fathia Khogali, Elamin E. Mohamed, Elbadri E. Osman, Osman Mohammed Elmahi, Hisham Ali Waggiallah

Journal of Pharmaceutical Research International, Page 192-200
DOI: 10.9734/jpri/2021/v33i60B34604

Some of the dyes that are used for coloring hair and skin contain a chemical compound called paraphenylenediamine (PPD), which is potentially toxic. The study comprised 50 adult Sudanese women who were selected by stratified random sampling and working as henna artist. Urine samples were taken for detection of PPD while blood samples were taken for investigating kidney and liver functions by measuring its relevant hematological indices. In other hand Thin Layer Chromatography (TLC) and High Performance Liquid Chromatography (HPLC) were used to detection of PPD in black henna (stone dye) samples and urine. The PPD was detected in the urine of all women who used the black henna its concentration varied according to duration of exposure being significantly higher in those with >10 years of exposure (p≤0.01). Similarly significant changes in liver function, kidney function and hematological indices were found in the group of women who used natural henna. This study concluded that natural henna is safe to use, while Black dye is potentially hazardous. It contains the high concentration of PPD, is the one most commonly associated with adverse effects.

Open Access Original Research Article

Streptozotocin-induced Antidiabetic Activity of Vitex negundo, Vitex trifolia and Vitex parviflora Combined Phytosomal Formulation

Dharmendra Kumar Ojha, Alok Pal Jain

Journal of Pharmaceutical Research International, Page 207-213
DOI: 10.9734/jpri/2021/v33i60B34606

Multifactorial metabolic diseases, for instance diabetes develop several complications like hyperlipidemia, hepatic toxicity, immunodeficiency etc., Hence, instead of mono-drug therapy the management of the disease requires the combination of herbs. Marketed herbal drugs comprise of irrational combinations, which makes their quality control more difficult. Phytoconstituents, despite having excellent bioactivity in vitro demonstrate less or no in vivo actions due to their poor lipid solubility, resulting in high therapeutic dose regimen; phospholipids encapsulation can overcome this problem. Hence, present study was designed to develop a phospholipids encapsulated polyherbal antidiabetic formulation. The prepared Vitex negundo, Vitex trifolia and Vitex parviflora leaves extract and phytosomal formulation were studied for the acute oral toxicity and anti-diabetic activity against streptozotocin-induced rat’s model. The antidiabetic activity was compared with control group, the standard drug Glibenclamide (500 mcg/kg /po), leaves extracts and its phytosome formulation (100 and 200 mg/kg/po). Acute toxicity studies show no mortality and morbidity up to the dose 2000mg/kg of body weight. In this study, body weight, serum glucose levels, total cholesterol, triglyceride, HDL, LDL, and total protein were measured. The results showed that there was a significant decrease (P<0.05) in the serum glucose levels, cholesterol, total protein, LDL and triglyceride levels in diabetic rats when compared to the normal (control) rats and increase the level of HDL and body wt. Further the research proves that phytosome formulation is superior in controlling blood sugar than Vitex negundo, Vitex trifolia and Vitex parviflora leaves extract.

Open Access Original Research Article

Varicose Vien (Risk Factors and Prevalence) in KSA – Questionnaier Study

Masoud Ahmad Al-Ghamdi, Rakan Abdullah Alghamdi, Baiader Saleh Alsheikh, Mohammed Abdulaziz Alharthi, Abdullah Saad Alqurashi, Emad Yousef Alqurashi, Ruwaydah Abdulaziz Althunayyan, Mishal Mohammed Awaji, Abdulaziz Munahi Alanazi, Ahmed Mosa Alzahrany, Abdulrahman Muwaffaq Khoj, Abdullah Ata Abdulqader, Alya Faisal Alsharif, Amjad Khalid Abumilha, Abeer Mousa Alshuqayfi

Journal of Pharmaceutical Research International, Page 244-249
DOI: 10.9734/jpri/2021/v33i60B34612

The purpose of this study is to determine the relationship between different variables (namely: age group, gender, risk factors like smoking history, alcohol consumption, long duration of sitting and standing hours, family history of varicosities, history of leg trauma or surgery, frequent constipation, pregnancy more than once, and hormonal therapies including OCPs) and the presence of varicose veins. Also, the purpose is to determine the prevalence of varicose veins among the sample taken in the study, and the prevalence of the different symptoms and complication among this population.

A significant relationship was found between the presence of varicose veins and age group, gender, alcohol consumption, long duration of sitting and standing hours, family history of varicosities, history of leg surgery, frequent constipation, pregnancy more than once, and hormonal therapies including OCPs. The results are concordant, in most parts of this study, with the previous studies in different times and regions, done for the nearly similar purposes.

Open Access Original Research Article

Prevalence of Helicobacter Pylori Infection in Patients with Chronic Dyspeptic Symptoms at Rawal General and Dental Hospital, Islamabad

Anwar Hussain Abbasi, Hina Andaleeb, Beenish Batool Alam, Khawaja Ashfaq Ahmed, Nadeem Yousuf, Subaika Noreen Sajjad

Journal of Pharmaceutical Research International, Page 257-262
DOI: 10.9734/jpri/2021/v33i60B34614

Background: Helicobacter Pylori infection is the most common cause of chronic dyspeptic symptoms all over the world and covers more than 60% of the out-patient department’s (OPD) registry. That is why we aimed to conduct this study to determine the prevalence of helicobacter pylori infection in patients with chronic dyspeptic symptoms visiting at our out-patient department (OPD) of Rawal General and Dental Hospital.

Methods: This was a descriptive cross-sectional hospital based study conducted in the Department of Gastroenterology, Rawal General and Dental Hospital, Islamabad between the periods of two years June 2018 – June 2020 with in patients who presented with a chief complain of dyspepsia through a consecutive sampling technique. Baseline and clinical variables were collected and correlated with the presence and absence of H. pylori infection among 355 finally recruited participants.

Results: The overall prevalence of H. pylori infection was 59.71% (n = 212). Among them, married males were more common. Positive H. pylori patients were younger than negative H. pylori patients, 40.24±6.62 vs. 44.9±8.05 (p 0.04). Participants who had a history of NSAIDS intake for past 7 days were significantly associated with positive H. pylori infection, 54.24% (n = 115), p 0.02. While on the other hands, patients who were receiving proton pump inhibitor for the past 4 weeks were significantly associated with absence of H. pylori infection when they presented with chronic dyspeptic symptoms, 65.03% (n = 93), p 0.01.

Conclusions: Our study has found that almost two third of the population suffering from chronic dyspeptic symptoms had positive H. pylori infection and these patients are younger than H. pylori negatives. Chronic NSAID users have direct relation in increased prevalence of H. pylori detection while use of PPI plays safety role in prevention and reducing of H. pylori infection.

Open Access Original Research Article

A Study of the Attitudes towards Mentally Ill People among a Sample of Primary Health Care Physicians in Saudi Arabia

Mohamed Ghowinam, Mohamed Lamlom, Ahmed Al harthi, Ahmed S. Hassan, Sarah Ahmed Rayyani, Nada Abdulhakim Alghamdi, Afnan Samih Felemban, Abdulla Abid Jan, Salman Anwar Thabet, Ragad Abdulaziz Abdulbari, Wareef Adnan Rafeea

Journal of Pharmaceutical Research International, Page 267-277
DOI: 10.9734/jpri/2021/v33i60B34616

Background: Psychiatric illnesses are a public health problem worldwide, affecting people of all age. Mental health is an important sector of primary health care services. An increasing number of Saudi citizens and residents utilize primary healthcare services for mental health concerns; hence, there is a need to objectively assess these doctors' attitudes towards people with mental illness.

Objectives: Assessment of the attitudes toward mentally ill people among a sample of primary health care physicians in Saudi Arabia & determination of risk factors associated with bad attitudes.

Methods: A cross-sectional study was conducted over a period of 30 days (1st September 2021 to 30 September 2021). The study has been conducted on Convenient Sample of Arabic speaking physicians working in primary health care centers in Saudi Arabia who accepted to share in research. Demographic Data was gathered using an electronic self‑administered questionnaire and physicians’ attitudes towards mentally ill people have been evaluated by an Arabic previously validated Questionnaire.

Results: This study included 214 physicians, 114 male physicians and 100 females. 72% of participants have a highly positive attitude toward mentally ill patients with a mean score (50±4) and only 28% of participants have a negative attitude with a mean score (38±4). Better attitudes were significantly associated with being female, having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person. There were no statistically significant differences regarding participants age, nationality, marital status, place and mode of residency, specialty, and having current or past history of mental illness.

Conclusions: Primary health care physicians in Saudi Arabia have positive attitudes toward mentally ill patients, female physicians , having (Board, PhD or Fellowship), working for less than a year and having a history of involvement in the care of a mentally ill person were significantly associated with better attitudes.

Recommendations: Further larger studies are needed on large number of primary health care centers physicians in Saudi Arabia and other Arab countries. Additional research and programmatic work are needed to understand the reasons for negative attitudes. Effective teaching and training programs is necessary to bring in positive attitude change towards mentally ill people among primary health care physicians.

Open Access Original Research Article

A Study on Assess the Perceived Image of Nursing and Factors Influencing Them among the Nursing Students

Anuj Gavankar, Aniket Gavankar, Aniket Ghumde, Krushna Ghume, Seema Singh

Journal of Pharmaceutical Research International, Page 278-286
DOI: 10.9734/jpri/2021/v33i60B34617

Introduction: In a developing country like India, nursing education is difficult to come by. As a result, this research examines nursing experts' beliefs besides expectations, in addition to desired future activities. It is vital to build and sustain a constructive picture of nursing, especially in today's culture, where nurses' achievements are rarely in light of credit, they have earned.

Aim: To assess the perceived image of nursing and factors influencing them among the nursing students.

Methodology: This study was based on a Descriptive evaluative research approach. Non-probability convenient sampling technique was used. The populace were undergraduate students from selected college, consisted of 400 samples. Structured questionnaires were used based on a 5-points Likert scale.

Results: The study shows that 1% of nursing students were strongly disagree, 4.75% were disagree, 7.75% were not sure, 68.75% were agreed and 17.75% were strongly agreed with level of perceived image of nursing whereas level of factors that influenced the perceived image of nursing were poor i.e.,62% had poor, 24.5% had average, 11.25% had good and 2.25% of nursing students had very good level.

Conclusion: The study shows corelation between the perceived image of nursing and factors influencing them among nursing students. Later on, more investigations are expected to investigate students view of the nursing occupation.

Open Access Original Research Article

Perception of Osteoporosis among General Population in Eastern Province, Saudi Arabia

Abdullah Al-Mula, Abdul Sattar Khan

Journal of Pharmaceutical Research International, Page 287-292
DOI: 10.9734/jpri/2021/v33i60B34618

Background: Osteoporosis is a progressive bone disease that if not detected and treated early, it can lead to serious complications. It is a silent disease because the patient is usually asymptomatic; therefore, perception of this disease is very important.

Objectives: The aim of the study was to evaluate osteoporosis perception among general population in eastern province, Saudi Arabia.

Methods: A cross-sectional study was conducted through an online self-administered questionnaire. A modified questionnaire was used for data collection. The questionnaire assessed the understanding of symptoms, risk factors, preventive factors, and treatment availability of osteoporosis. The study included all people in eastern province, Saudi Arabia. The sample size was 391. It was conducted from September 2018 to May 2021.

Results: 61.6% of 391 participants questioned did not have a good perception of osteoporosis. There was a variability in the correct response rate, which indicates the presence of gaps in some aspects of osteoporosis perception more than the others do. The cut-off score was 50%.

Conclusion: According to the findings of the study, people in eastern province, Saudi Arabia have poor perception of osteoporosis. Therefore, efforts should be made to establish educational campaigns and use the new technologies in order to raise osteoporosis perception.

Open Access Original Research Article

Morphological Characteristic and Incidence of Elongate Styloid Process in South Indian Population: A Case Series

M. Afrin Nisha, Lavanya Prathap, Ganesh Lakshmanan

Journal of Pharmaceutical Research International, Page 293-300
DOI: 10.9734/jpri/2021/v33i60B34619

Introduction: Styloid process is a slender osseous projection, cylindrical and sharp projection of the temporal bone, located in front of stylomastoid foramen. Styloid process is from Reichert’s cartilage of the second branchial arch, this is a part of the splanchnocranium. This is Connected to the hyoid bone through the Stylohyoid ligament. The morphology of the Styloid process is due to hormonal and genetic changes. Orthopantomography is a radiographic method used to visualise mandibles. It also provides a rotational view of the jaw. The aim of the study is to analyse the elongation of the Styloid process in the South Indian population.

Materials and Methods: The study was conducted in dental institutions with convenience sampling. The random orthopantomogram sample was collected from a dental institution. Total number of orthopantomogram involved in the study was 80 (40-males and 40-females) that is used to examine elongation of the Styloid process in the South Indian population. The minimised sampling bias is done by stratification according to age and gender.

Statistical Analysis: The data were analysed by using SPSS software. The probability value p< 0.05 is considered as significant and the value p>0.05 was considered as not significant.

Results: This study showed various types of Styloid processes in males and females. However we concluded that there is a difference in shape of Styloid processes. The most common type of the Styloid process found in males is pseudo articulated (32.5%) whereas in females the most common type of Styloid process found is uninterrupted (37.5%)

Conclusion: From the current study we have concluded that the pseudo articulated Styloid process is more in males whereas uninterrupted is more in females. Only retrospective studies were done so far. Therefore in future studies with live models and larger sample size should be conducted.

Open Access Original Research Article

Factors Associated with Glycaemic Control among Diabetic Subjects in Essaouira Province, Morocco: A Cross-Sectional Study

Khaoula Houguig, Samia Rkha, Mahassine Rayadi, Nadia Ouzennou

Journal of Pharmaceutical Research International, Page 301-313
DOI: 10.9734/jpri/2021/v33i60B34620

Aims: The objectives of this study are to determine the frequency of poor glycaemic control, defined by a glycated hemoglobin (HbA1c) rate ≥ 7% in diabetic subjects in the province of Essaouira (Morocco), and to identify the associations between poor glycaemic control and socio-demographic, psychosocial, and pathology-related factors in the diabetic subject.

Study Design: This is a a quantitative analytical cross-sectional study.

Methodology : A face-to-face interview was conducted with 522 diabetic subjects followed at 12 health centers ,4 urban and 8 rural, in the province of Essaouira, between January and December 2020

Results: The mean age of the subjects was 57 years,78% female and 22% male. HbA1c was≥7% in 60% of cases. Rural residence (OR=2.75, 95% CI: 1.86-4.05), poor observance of medication (OR=5.57, 95% CI: 3.07-10.11), poor observance of hygiene and dietary rules (OR=4.1, 95% CI: 2.76-6.11), duration of diabetes more than 8,4 years (OR=1.96, 95% CI: 1.35-2.85), low monthly income (OR=1.96, 95% CI: 1.35-2.85) , were statistically associated with poor glycaemic control. On the other hand, being a member of a diabetes association (OR=2, 95% CI: 1.31-3.06) and having good support from family and friends (OR=1.96, 95% CI: 1.35-2.85) have positively influence glycaemic control.

Conclusion: More than half of the diabetic subjects had a poor glycaemic control, the diabetic subjects living in rural areas, having a poor observance of medication, having a poor observance of hygiene and dietary rules and having a duration of evolution of the disease more than 8,4 years are more susceptible to have glycaemic imbalance.

Open Access Original Research Article

Comparison of Effect of Phyllanthus emblica (Indian Gooseberry) with and without Honey on Hemoglobin, RBC and PCV among Adolescents

M. Kamalli, R. Priyadharshini, Palati Sinduja

Journal of Pharmaceutical Research International, Page 325-333
DOI: 10.9734/jpri/2021/v33i60B34623

Introduction: Phyllanthus emblica commonly known by names such as Indian gooseberry, amla belongs to the Phyllanthaceae. The plant is used as a medicine and tonic which is highly nutritious and forms an important dietary source of vitamin C and amino acids. Honey is rich in iron which helps in boosting the hemoglobin content in blood by increasing their synthesis. Complete blood count (CBC) is an array of tests to evaluate the cells in the blood which are the red blood cells, white blood cells, platelets. 

Aim: The aim of the study is to compare the effect of Phyllanthus emblica (Indian Gooseberry) with and without honey on hemoglobin, RBC (Red Blood Cell) and PCV (Packed cell volume) among adolescents. 

Materials and Methods: Ten adolescents including both male and female were selected as subjects for the study. The first group of subjects were categorised to consume gooseberry alone and the second group of subjects were categorised to consume gooseberry along with honey. After 15 days, CBC was taken for the subjects of both groups to analyse the results. Independent ‘t’ test was applied to evaluate the significance of clinical trials performed in two groups. 

Results and Discussion: The participant history included fatigueness, pallor, menstrual history, blood pressure, pulse. There is an increase in the mean value of Hb (Hemoglobin), RBC (Red Blood Cell), HCT (Hematocrit), MCV (Mean corpuscular volume), MCH (Mean corpuscular hemoglobin) and RDW (Red cell distribution width). Independent statistical analysis showed that p value is not significant as all the values are not <0.05.

Conclusion: The present study concludes that gooseberry with honey supplementation has shown better results than gooseberry supplementation but it is not statistically significant. It is evident that gooseberry has nutritive and restorative properties. Daily use of gooseberries is safe and can show more significant increase in counts of RBC, Hb in longer duration.

Open Access Original Research Article

Comparative Clinicopathological Study on pH and Haemoglobin of Blood

K. S. Vikraman, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 339-344
DOI: 10.9734/jpri/2021/v33i60B34625

Aim: Aim of this study to compare the pH and hemoglobin of blood on different genders and different age groups.

Introduction: The full form of pH is the potential of hydrogen, pH is known as the negative logarithm of H+ ion concentration. The pH of any components of body, including blood, is indicated on the pH scale. The value of pH ranges from 0 to 14. A pH value of 7.0 is considered as neutral. Blood is slightly basic; the normal pH level of blood is 7.35 to 7.45. Usually, the body maintains the pH of blood close to 7.40. Hemoglobin is a protein molecule that helps the RBC to transport oxygen. The term heme reforms to the iron-containing porphyrin. This iron-containing hemoglobin is responsible for the red color of the red blood cells.

Materials and Methods: 15 blood samples were collected from the lab in Saveetha Dental College and Hospitals. The low sample size is one of the limitations. The pH value is measured by using a multi reagent strip, hemoglobin level was measured by using an automated counter machine, and these values were plotted. The pH value was tabulated and the data were analyzed with SPSS version (23.0).

Results: Mean hemoglobin value was observed different in different age group. In age groups of 21-30 years, the value was 12.95g/dl, in age groups 31-40 years the value was 12.08g/dl, in age groups of 41 to 50 years the value is 13.20g/dl and for age group more than 50 years the value is 14.05g/dl.  Mean pH value on comparing with age, the value of pH was 7 for the age group of 21-30 years, 31-40 years was 7, 41 to 50 years was 7.04 and for more than 50 years was 7. Correlation analysis reveals no significant relationship between hemoglobin and pH with increasing age in both males and females. 

Conclusion: The value of hemoglobin is increased among different age groups and the pH level remains the same and on comparing with gender the hemoglobin level increases with age group and pH remains the same.

Open Access Original Research Article

Ex vivo Antimicrobial Evaluation of Different Drugs Using RT-PCR Test

Gupta Hitesh, Arora Manpreet, Puri Abhiney, Singla Mamta

Journal of Pharmaceutical Research International, Page 352-359
DOI: 10.9734/jpri/2021/v33i60B34627

Introduction: Various medicaments are used in conjugation with mechanical cleaning and shaping to render root canals free of microbes. The different medicaments used tend to react among themselves sometimes resulting in deleterious products. For this reason use of alternative medicine, therapy is advocated.

Aim: To evaluate the antimicrobial extent of different homeopathic drugs in comparison to the Ayurvedic and Allopathic medicines.

Materials and Methods: A biofilm model of 8 mm dentine discs was prepared from single-rooted teeth, which were inoculated with E. faecalis for 21 days. 100 samples were divided into six groups Group I: Saline (negative Control), Group II: 2% Chlorhexidine Gluconate, Group III: Propolis, Group IV: RHUS Glabra, Group V: Zincum Oxydatum. The infected biofilm was then treated with the medicaments for seven days followed by testing to obtain threshold cycle (Ct) values using the Real-time polymerase chain reaction technique. DNA isolation was carried out and amplification was done using 16S rRNA gene sequence-based nested species-specific primers. DNA denaturation was done using DNA Thermocycler and a threshold cycle was obtained using Real-time Polymerize chain reaction technique. 

Results: The threshold cycle (Ct) values obtained were subjected to statistical analysis that revealed a significant difference between the groups and among all 2% Chlorhexidine Gluconate, being the highest (30.3460±0.02505) followed by Propolis (30.1365±0.02621) then RHUS Glabra (30.0865±0.02581) better than Zincum Oxydatum (29.8070±0.02319) and least being Saline (29.6380±0.02505).

Conclusion: All the homeopathic medicines showed antimicrobial properties comparable to the allopathic and ayurvedic drugs. Among RHUS Glabra and Zincum Oxydatum, RHUS Glabra performed significantly better.

Open Access Original Research Article

Comparison of Haemoglobin, RDW, RBC Values among Diabetes Mellitus and Normal Individuals

Sharwini Baskar, R. Priyadharshini, Palati Sinduja

Journal of Pharmaceutical Research International, Page 364-371
DOI: 10.9734/jpri/2021/v33i60B34629

Introduction: Diabetes mellitus is a disorder characterized by hyperglycemia. It has been reported that 75% of the primary cause for mortality in diabetes mellitus patients is cardiovascular disease which is caused by hyperglycemia. Erythrocytes of diabetes mellitus patients have a shorter life span than normal. Red cell distribution width (RDW) is a measure of the heterogeneity of the volume of red blood cells (Red Blood Cells). High RDW has various adverse outcomes. The study aims to compare Haemoglobin, RDW and RBC values among diabetes mellitus and normal individuals.

Materials and Methods: Blood samples of 20 patients with and without diabetes were collected from outpatients visiting Saveetha dental college and hospitals. The results of the following parameters Haemoglobin, RDW, RBC were analyzed using Independent t Test in SPSS software. The statistical significance (P value) was set at 0.05.

Results: It is evident that there is a higher incidence of diabetes among the male population compared to females which result in higher RBC and Haemoglobin values. The RDW value is also reported to be higher in diabetic patients than non-diabetic patients. For Haemoglobin  p value was 0.984 (>0.05), RDW p value was 0.180 (>0.05), RBC p value was 0.680 (>0.05). The p values  were >0.05 which is statistically not significant.

Conclusion: The Hemoglobin, RBC and RDW values are higher for diabetic patients than non-diabetic. Higher RDW has various adverse effects such as cardiovascular disease which may cause mortality in diabetes mellitus patients.

Open Access Original Research Article

Insilco Study on the Structural Characterization and Inhibitor Detection for Super Small Secreted Glycoprotein of Reston ebolavirus

Muddapur M. Uday, Priya I. Melmalagi, Prajwal J. Kamble, Nikita M. Ummannanavar, Ramya Munavalli, Amal Bahafi, Aejaz A. Khan, S. M. Shakeel Iqubal, Tasneem Mohammed, Abdul Rahman Ikbal, Kayamkani Abedulla Khan, Muazzam Sheriff Maqbul, Ibrahim Ahmed Shaikh, V. G. Shanmuga Priya

Journal of Pharmaceutical Research International, Page 384-392
DOI: 10.9734/jpri/2021/v33i60B34632

Super small secreted glycoprotein (ssGP) is a virulent protein that plays a vital role during the Ebola viral infection. This study entails in silico structural and finding inhibitor compound for the secreted glycoprotein of Reston ebola virus (strain Philippines-96). The physical and stereochemical properties and the protein's secondary and tertiary structure were predicted initially. Later, as the predicted model was evaluated to be a reliable structure, binding pockets were predicted, and known binding ligands to similar proteins were identified. Analogue compounds to known ligands were collected and docked against ssGP. The compound with the least binding energy was identified and recommended as a potent inhibitor towards ssGP. From this study, in-vitro and in-vivo analysis was computed for the selected ligand for designing effective drugs against Reston ebolavirus.

Open Access Original Research Article

Comprehensive Analysis and Assessment on Codon Usage Pattern of Hemolytic Genes from Different Strains of Leptospira interrogans

Chandan Dharmashekara, Sabhyata M. Gopal, Gayatri Vaidya, Bhargav Shreevatsa, H. H. Bhavana, Chandrashekar Srinivasa, S. M. Gopinath, Shiva Prasad Kollur, Sharanagouda S. Patil, Kuralayanapalya Puttahonnappa Suresh, Raghu Ram Achar, Ashwini Prasad, Chandan Shivamallu

Journal of Pharmaceutical Research International, Page 400-410
DOI: 10.9734/jpri/2021/v33i60B34635

Background: Leptospirosis is a disease that is zoonotic in nature. It is easily able to survive in the environment and gets transmitted from the reservoir hosts such as rat to humans. Though the cause of Leptospira interrogans virulency is not determined, these studies expresses that the product of a Leptospira interrogans gene sphH is hemolytic in nature and is capable of lysing the erythrocyte cells and also few epithelial cell membranes.

Aim: In this study, we have analyzed the codon usage bias of the gene sphH, taken from 49 strains of Leptospira interrogans.

Materials and Methods: Data Collection: The full CDSs nucleotide of the gene sphH from 49 Leptospira interrogans was downloaded separately in FASTA format from the NCBI nucleotide database. Molecular Evolutionary Genetics Analysis (MEGA) program was used to edit and align the coding sequences. With the help of statistical techniques such as RSCU and ENC we have determined the codons mostly used to express the gene sphH and source of the bias with methods such as parity rule 2, neutrality plots.

Result: The nucleotide content of the , gene across 49 variants of leptospira divulged that the usage of A (36.03% ± 0.74) and T (31.81% ± 0.65) occurred more frequently than the usage of G (17.88% ± 0.57) and C (14.28% ± 0.66) making the gene composition AT more than GC. The composition of bases in the 3rd position saw base T most frequent than base A.

Conclusion: The codon and amino acid use patterns reflect this bias in genetic composition. Leptospiral strains have a similar general codon usage pattern and are slightly biassed. The majority of the frequently occurring codons are A- and U-ending, showing that mutational bias is the primary driver determining codon usage in this bacterium. There were significant changes in synonymous codon usage frequencies between Leptospira interrogans and with other virulent strains. Codon use preferences to account for these differences.

Open Access Original Research Article

Formulation and Evaluation of Microemulsion of Curcumin in Thymol-Menthol Carrier System

Meera C. Singh, Priyanka Nangre, Nikita N. Bagade, Rukhsana A. Rub

Journal of Pharmaceutical Research International, Page 420-434
DOI: 10.9734/jpri/2021/v33i60B34637

Aim: To formulate and evaluate the Micro emulsion of curcumin in thymol-menthol carrier system.

Study Design: Curcumin dissolves in mixture of thymol & menthol to reasonable extent.100 mg of curcumin in 1 g of thymol and 0.6 g of menthol mixture was finalized as product mixture. The solution of curcumin in eutectic mixture being oily liquid, it gave the idea for development for the micro emulsion

Place and Duration of Study: Department of Pharmaceutics and Department of Pharmacognosy, STES’s Smt. Kashibai Navale College of Pharmacy, Kondhwa (BK), National Chemical Laboratory, Pune between June 2016 and May 2017.

Methodology: Micro emulsion system with eutectic mixture of thymol and menthol was chosen as oil phase and carrier for curcumin, tween 80 as surfactant and ethanol as co-surfactant. Ternary phase diagrams were constructed to obtain the optimum concentration range of oil phase, surfactant and co-surfactant. The micro emulsion of 100 mg curcumin containing 4.95 % oil phase, 33.39 % surfactant, 11.13% co-surfactant, 50:50% of water was optimum. Micro emulsion of curcumin was prepared by water titration method and evaluated for globule size, drug content, pH, viscosity, conductivity and In vitro drug release study. The ex-vivo permeation study for micro emulsion of curcumin was carried out on excised mice skin using Franz Diffusion apparatus. The cytotoxicity study for thymol, menthol was performed on healthy L929 murine fibroblast cell line. Anticancer activity of thymol-menthol eutectic mixture alone and with curcumin was performed on HeLa cell lines.

Results: The preformulation studies did clearly indicate good compatibility of drug with thymol menthol carrier system. The cytotoxicity study was done on thymol – menthol(TM) as a preformulation aspect to ascertain the toxicity of these two excipients to be tried. It was found that TM was not cytotoxic in 120ug/mL concentration and thus was safe to be used in concentration below 120ug/mL. Batch B1 was optimised. The average globule size of micro emulsion was found to be 131.54 nm, zeta potential was found to be -0.57 mV. The drug content in micro emulsion batch B1 was determined and found to be 74.6%.Permeability study across mice  skin ex-vivo model showed 52.38% permeability compared with curcumin alone which was 22.41%. So permeability of curcumin is enhanced substantially with micro emulsion made in thymol and menthol, owing to fact that thymol and menthol act as good permeation enhancers. The In vitro drug release study of micro emulsion was compared with curcumin alone. About 48.75% of curcumin was released from micro emulsion showed increase in release rate.

Conclusion: Eutectic mixture of thymol and menthol showed promising results as penetration and solubility enhancer for curcumin. Solubility of curcumin was improved so as its rate of permeation which was used to develop formulation of micro emulsion with proven anticancer activity. The solubility of curcumin formulated with combination of eutectic mixture was increased up to 50 %.

Open Access Original Research Article

The use of Ophthalmic Dorzolamide in Al-Kharj

Nehad J. Ahmad, Mohamad Ayman Salkini

Journal of Pharmaceutical Research International, Page 465-470
DOI: 10.9734/jpri/2021/v33i60B34641

Aim: The present study was to explore the use of ophthalmic dorzolamide in Al-Kharj.

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

Results: Only 24 patients received ophthalmic dorzolamide during the study. The age of more than 54% of the patients was more than 59 years and more than 54% of them were males. More than 54% of the patients received ophthalmic dorzolamide for 2 months and 37.50% of them received ophthalmic dorzolamide for 3 months. All of the prescriptions were prescribed by ophthalmology department and more than 95% of the prescriptions were written by residents.

Conclusion: The present study showed that ophthalmic dorzolamide was uncommonly prescribed in Al-Kharj. Further studies are needed to explore the frequency of using dorzolamide in other settings and to explore the frequency of using other eye drops that are used to decrease intraocular pressure.

Open Access Original Research Article

Disintegration, Hardness and Dissolution Profiles of Paracetamol Tablets Formulated using Sucrose and Formaldehyde Cross-Linked Starches

Ifeanyi Justin Okeke, Angus Nnamdi Oli, Zwanden Sule Yahaya, Thaddeus Harrison Gugu, Emmanuel Chinedum Ibezim

Journal of Pharmaceutical Research International, Page 478-485
DOI: 10.9734/jpri/2021/v33i60B34643

Background: Native starches have some limitations such as the inability to withstand some processing conditions, poor flow, packing and compressibility. Cross-linking of starch is one of the methods used to overcome these drawbacks to obtain derivatives with better and desirable properties. This study is aimed at assessing the utilisabilty of sucrose and formaldehyde cross-linked starches obtained from Zea mays, Triticum aestivum, and Oriza sativa as an excipient for paracetamol tablet formulation. The formulated tablets were evaluated for hardness, disintegration and drug release rate.

Results: The formulated tablets had hardness in the range of 4.35 – 6.37 Kgf. Tablets produced from the native starches had significantly (P < 0.05) lower disintegration time compared to their respective cross-linked starches. The disintegration time of the tablets from the cross-linked starches was in the following order, modified rice starch tablets > modified maize starch tablets > modified wheat starch tablets. The optimal batches containing the modified starches released over 90% of the drug within 40 min.

Conclusion: Sucrose and formaldehyde cross-linked starches obtained from Zea mays, Triticum aestivum, and Oriza sativa could serve as possible excipients for paracetamol tablets formulation. 

Open Access Original Research Article

Knowledge of Cleft Lip and Cleft Palate among Medical Students of a Tertiary Care Hospital in South India

Sajitha Mohan, Surya Rao Rao Venkata Mahipathy, Praveen Ganesh, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran, Suresh Rajendran

Journal of Pharmaceutical Research International, Page 513-517
DOI: 10.9734/jpri/2021/v33i60B34648

Background: Sufficient knowledge and awareness of cleft lip and palate deformity is required to identify and manage at the condition at the earliest.

Objectives: This study was conducted to assess the awareness and knowledge of medical students on cleft lip and palate. To assess the understanding of the possible causative factors of cleft lip and palate among the same population.

Materials and Methods: A cross sectional study was carried out among 128 medical students attending a tertiary care hospital in south India. This was performed through a researcher administered questionnaire which contained queries regarding risk factors and management.

Results: A total of 89.1% of the subjects were aware of the term cleft lip and palate with the majority being females. Though they were not well informed regarding the treatment procedures, and timings. The results were then interpreted in table formats for better understanding of the level of education on the topic.

Conclusion: There is a general lacking of experience in the diagnosis and management of cleft lip and palate among medical students which should be addressed to ensure timely cure and quality of life of the patients.

Open Access Original Research Article

Adherence to Pharmacological Treatment and Factors Affecting the Adherence among Hypertensive Patients Attending Primary Health Care Centers in Jazan, Saudi Arabia

Husameldin Elsawi Khalafalla, Ahmad A. Shugairi, Faisal A. Othathi, Abdulrahman M. Alhuraysi, Abdulaziz Y. Albrraq, Ahmad Y. Rayani, Mohammed O. Shami, Mohammad Jareebi, Abrar A. Doweri

Journal of Pharmaceutical Research International, Page 525-535
DOI: 10.9734/jpri/2021/v33i60B34650

Background: Hypertension (HTN) is a major health problem globally because it can result in significant morbidity and a reduction in life expectancy, HTN is responsible for 9.4 million deaths annually, either due to heart attack or stroke with a contribution of 45% and 51%, respectively

Objective: Evaluate the level of adherence to anti-HTN medications and which factors affect this adherence in the Jazan area

Methodology: The researcher investigated the adherence to anti-hypertension (anti-HTN) medication of participants aged more than 18 in the Jazan region of Saudi Arabia, they conducted interviews with patients who attend primary health care centers and focused on their socio-demographics, such as age, education, and topographical location of their home. The data from the interviews were analyzed using the Hill-Bone scale to determine perfect and imperfect adherence to anti-HTN medication 

Results: 82.7% of the participants show imperfect adherence to medication which is a significantly higher percentage than that found in other areas of Saudi Arabia and the Middle East. The researchers further analyzed the data for correlations between sociodemographic characteristics and adherence to anti-HTN medication. This showed that patients living in the mountainous areas of Jazan have a stronger adherence to their medication than those living in the plains or on the coast (OR = 10.77, value = 0.011). Also, those patients with an income of 5,000 RS or less are more likely to adhere to their medication than those with higher income (OR = 0.18, value = 0.035). Other socio-demographic characteristics showed no strong correlation with medication adherence. 

Conclusion: Overall, anti-HTN medication adherence in the Jazan region is poor and researchers recommend the implementation of an educational program to highlight the importance of adhering to anti-HTN medication.

Open Access Original Research Article

Autologous Intrauterine Platelet Rich Plasma Versus G-CSF instillation for Improvement of Endometrial Growth and Vascularity in Recurrent in Vitro Fertilization Failure

Asawari Deo, Deepti Shrivastava, Arzoo Chadha

Journal of Pharmaceutical Research International, Page 536-542
DOI: 10.9734/jpri/2021/v33i60B34651

Background: in vitro fertilization [IVF] is an expensive, cumbersome yet most successful treatment for infertility. Inspite of its success, at the most 40% of the procedure only result in good outcome. Often at times which can be very frustrating and disappointing journey for the couple as well as the clinicians who despite of strict adherence to treatment protocols fail to produce result, it is mostly attributed to implantation failure, which is mostly due to poor receptivity of the endometrium. Several treatments ranging from chinese acupuncture to hormones to endometrial injury all have been treat with not definitive treatment. Autologous platelet rich plasma (PRP) and G-CSF have come up to be exciting new therapy in that aspect. In neutrophilic granulocytes, platelet-rich plasma (PRP) has been shown to increase endometrial development and receptivity, whilst G-CSF has been shown to promote the growth of stem cells and progenitor cells. This study offers an intriguing perspective on the two medications in comparison.

Materials and Methods: It is a prospective ,cross-sectional, single blind study, conducted over a period of 6 months in 25 women who had failed to conceive after one or more embryo transfers with high-quality embryoswomen having a poor endometrial pattern, as defined by an endometrial thickness of less than 7mm despite conventional treatment with estradiol valerate (up to 12 mg/day), or suboptimal endometrial vascularity, defined as < zone 2 as determined by applebaum's criteria, success of which was measured in number of clinical pregnancies resulted.

Results: The mean PRP endometrial thickness was 5 mm which significantly increased to 7.34 mm post platelet rich plasma, against post-G-CSF endometrial thickness was 8.02 mm from 6.03mm pre infusion. Out of 10 cases who were infused with PRP,7 of them showed good vascularity (more than or equal to zone 3)out of 10 of those were given G-CSF,5 of them showed good vascularity. Number of clinical pregnancies resulted after instillation of PRP were 4 while 3 in case of G-CSF group.

Conclusion: It can be concluded that although both PRP and G-CSF are equally effective in increasing endometrial thickness but endometrial vascularity is better inproved with platelet rich plasma, clinical pregnancy rates were also better with PRP but being a small sample study it was not significant statistically.

Open Access Original Research Article

The Prevalence of Antenatal Depression among Women in Medina, Saudi Arabia

Samah Alfahl, Alhanouf Dhaifallah Hamad Alharbi, Najim Z. Alshahrani

Journal of Pharmaceutical Research International, Page 543-549
DOI: 10.9734/jpri/2021/v33i60B34652

Background: Antenatal depression is a recognized global burden. However, it has remained an ignored part of public health. Most of the maternal depression interventions have been directed towards post-natal depression.

Purpose of the Study: The purpose of this study was to understand the third-trimester antenatal depression risk factors and prevalence among Saudi Arabian women.

Method: This study employed cross-sectional study design from April 2020 to June 2020 and 201 participants were recruited for this study. The study was conducted at Medina in the Maternity and Children's Hospital (MCH) from April 2020 to June 2020. The inclusion criteria were pregnant women who visited the outpatient clinic of antenatal care in MCH. Pregnant women who had a known familial history or already been diagnosed with depression before pregnancy were excluded from this study. The collection of the data was through researcher administered questionnaire to the pregnant women meeting eligibility criteria who were visiting the clinic of antenatal care at the Maternity and Children's Hospital. Data were collected using a structured and validated Patient Health Questionnaire-9 (PHQ-9). All the collected data were analyzed using descriptive statistics, Anova and t-test statistics. 

Results: Antenatal depression among participants stands at 35.8% for normal/ minimal depression, 31.3% for mild depression, 3.9% for moderate depression, 5.5% for moderately severe, and 3.5% for severe depression. Antenatal depression was mostly prevalent in the third trimester.

Conclusion: The antenatal depression prevalence among pregnant women in Medina is high. Screening for mental health problems and provision of supportive mental health services as a component of antenatal care services is recommended.

Open Access Original Research Article

Development and Validation of RP-HPLC Stability Indicating Method for Simultaneous Estimation of Dolutegravir and Lamivudine in Bulk and Pharmaceutical Dosage Form

Khushboo Patel, Ujashkumar Shah, Darshak Patel, Jayvadan K. Patel, Tejas B. Patel

Journal of Pharmaceutical Research International, Page 570-584
DOI: 10.9734/jpri/2021/v33i60B34656

Aims: Dolutegravir (DVR) and Lamivudine (LMN) is anti-viral drug combination used in treatment of HIV-I infection. FDA approved dosage regime for DVR and LMN is 50mg and 300mg respectively. The aim of present research work is to develop and validate a reverse phase high performance liquid chromatography (RP-HPLC) method for simultaneous estimation of DVR and LMN in bulk and pharmaceutical dosage forms. Further the stability indicating nature of method has been evaluated.

Methodology: A chromatographic separation was achieved on Hypersil BDS C18, 250 × 4.6 mm 3.5 μm particle size, column as stationary phase and mobile phase composed of Phosphate Buffer pH 3.0: Acetonitrile (60:40%V/V) with flow rate of 1.5mL/min with 20µL injection volume. The analytes were estimated at 232nm using PDA detector. The DVR and LMN solutions were exposed to various forced degradation stress conditions to evaluate the stability behavior of the product. The method was also validated as per ICH Guideline (Q2R).

Results: The retention time for DVR and LMN was found 3.94 and 2.62 min, respectively. The developed method was found linear within concentration range of 27.5 to 82.5 μg/ml (50-150%) for DVR and 167.5 to 502.5 μg/ml (50-150%) for LMN. The% recovery (Accuracy) was found between 99.50%-101.23% and 100.09%-101.51% for DVR and LMN respectively in range of 50-150% for both drugs. The%RSD for the accuracy at all levels was less than 2.0%. LOD and LOQ, for DVR were found to 0.669 and 2.028 μg/mL, respectively, and for LMN 0.102 and 0.308 μg/mL, respectively.

Conclusion: The developed RP-HPLC method indicates no interference from the excipients and degradants peaks. All the degradant peaks were having been efficiently resolved through the use of the evolved analytical method with changed retention times. The results obtained were statistically analyzed and meet the acceptance criteria as specified in ICH Q2R1 guideline. Hence, developed method can be successfully applied for the analysis of estimation of DVR and LMN in bulk as well as pharmaceutical dosage form.

Open Access Original Research Article

Non-reporting of Medication Administration Errors among Nurses in Qatar

Nesiya Hassan, Rajvir Singh, Rinu J. George

Journal of Pharmaceutical Research International, Page 591-604
DOI: 10.9734/jpri/2021/v33i60B34658

Background: Prompt recognition and reporting of Medication Administration Errors (MAE) are paramount in ensuring patient safety in hospitals. The data on under-reporting MAE in Middle East Area is limited.

Aim: The study intended to estimate the percentage of fear factor and explore the perception of nursing professionals regarding the reason for the occurrence and underreporting of MAE.

Design: A cross-sectional design was utilized to conduct the current study.

Place and Duration of Study: The study was conducted in eight hospitals working under Public health sector of Qatar between August and September 2016 

Methodology: The data were collected with a purposive sample of 487 clinical nurses employed by the public health sector of Qatar who responded to a pre-designed online questionnaire.

Results: The perceived prevalence of fear factor in non-reporting MAE was 23.45%, 95% confidence interval (C.I).: 16% to 33%. The single factor confirmatory factor analysis (CFA) model explained 65% of the variance in the fear factor of nonreporting of medication administration errors. The highest mean score in the subscale of reasons for non-reporting of MAEs includes fear (mean 0.652±1.671) and administrative responses (mean 0.304±1.466), and reporting processes (mean -0.505±1.669), whereas disagreement over hospital definition (mean -1.158±1.528) of error was the least significant reason for nonreporting of MAE by the clinical nurses.

Conclusion: The study focuses on quantifying the fear factor and underscores the Nurses' fear about the professional consequences of reporting MAE. The findings in this study not only provide evidence concerning the fear of reporting MAE but also shed light on the contributing factors and reasons for the nonreporting of MAE. Nursing leadership needs to concentrate on modifying existing strategies and policies to more comprehensible approaches to reporting errors.

Open Access Original Research Article

Assessment and Management Pattern of Chemotherapeutic Drug Induced Adverse Effects among Cancer Patients at Tertiary Care Centre

Syed Meraj Fatmi, Kavita Dhar, Jyotsna Sharma, Shaktibala Dutta

Journal of Pharmaceutical Research International, Page 605-614
DOI: 10.9734/jpri/2021/v33i60B34659

Aim and Objective: Cancer chemotherapy drugs causes substantial toxicity and produces number of adverse effects which can significantly reduce patient's health related quality of life. The aim of this study was to perform the assessment and explore the management practice of chemotherapy induced side effects among cancer patients.

Material and Methods: Demographic characteristics of patient undergone cancer chemotherapy and adverse drug reactions (ADRs) of chemotherapeutic drugs were noted in patient's case report form. Assessments of ADRs were performed for Severity, Causality and Preventability of each ADR. Association between occurrence of severe ADRs and patient' characteristics were studied using chi square statistics. Frequencies of ameliorative therapy were studied in each patient.

Results: 120 patients were selected and included in the study and a total of 412 ADRs were detected after cancer chemotherapy. Majority (60%) of the participant were female. Most common cancer was found as breast cancer (23%). Commonly used chemotherapy regimens were combination of carboplatin and paclitaxel (14%). Upon severity assessment of ADR, more than one third categorized as "Severe" ADR (36.4%). Majority of the Severe ADR were alopecia and nausea & vomiting. Most of the ADRs (73%) on preventability assessment were found as Not-Preventable. There is a significant association between occurrence of severe ADRs and age, sex & chemotherapy regimen. Combination of palonosetron, dexamethasone and pantoprazole were used as ameliorative therapy (43.3%).

Conclusion: Cancer chemotherapy drugs produce numerous adverse effects. Assessment of severity of ADRs and associated triggering factor may support in management practice of side effects.

Open Access Original Research Article

Efficacy of Mindfulness Meditation on Emotional Maturity of Mothers of Cerebral Palsy Children

Madhuri Wane, Priyanka Telang, Chaitanya A. Kulkarni

Journal of Pharmaceutical Research International, Page 615-622
DOI: 10.9734/jpri/2021/v33i60B34660

Background: Cerebral palsy (CP) is a disorder of movement that is seen in early childhood. Children with CP sometimes are not able to walk, sit, crawl, or rollover, as early as other kids of their age. This study aims to find the impact of mindfulness meditation on the emotional maturity of mothers of cerebral palsy children.

Methods: We did this research at Acharya Vinoba BhaveRural Hospital, Sawangi (Meghe), Wardha, we included 50 mothers of children of cerebral palsy visiting at Paediatric therapy unit at Ravi Nair physiotherapy college, Sawangi (Meghe), Wardha. The Purposive Sampling Method was used and the study duration was 6 months. We used variables such as age, educational status, occupational status, income, marital status, region, and emotional maturity scale questionnaire.

Results: The research analysis revealed a high degree of emotional immaturity in the mothers of children with CP from the rural population. 4% of the women were emotionally immature and 96% of them had an extremely immature type of EMS. After giving intervention there was an improvement and the EMS score at 12 weeks was 2% were emotionally immature and 48% were extremely emotionally immature at 24 weeks 0 % were emotionally immature and 24% were extremely emotionally immature.

Conclusion: Education has a marked effect on people. Mental health training is among the most efficient way of controlling emotional debility and making mothers emotionally strong and preventing social harm. This research looked at the impact of mindfulness meditation on the mental health of mothers of cerebral palsy children.

Open Access Original Research Article

Relationship between Desirable Fetus Gender and Type of Consumed Diet: A Cross-sectional Study

Afaf Abdulrahman Yaslam, Hoda Jehad Abousada, Rubuah Mohammed Ayyashi, Rawan Abdulkarim Agala, Halah Abdulrahman Hafiz, Hanan Misfer Alzahrani, Najwan Hassan Abduljabar, Lujain Khaled Alhazmi, Mohammed Saaduddin Sahibzada, Alaa Omar Abusarir, Atheer Nasser Alhrany, Raibal Adnan Sabbahi, Wejdan Ali Alshehri, Ghada Meshall Almahyawi, Nour Ahmed Naaman

Journal of Pharmaceutical Research International, Page 667-676
DOI: 10.9734/jpri/2021/v33i60B34664

Background: The fetus's development can be influenced by the mother's nutrition in a variety of ways, including the gender of the fetus. However, several research have been published that suggest a link between maternal nutrition and the baby's gender. In other words, the baby's gender can be determined by the mother's nutrition. This study aimed to evaluate the relationship between maternal diet and baby gender.

Methods: This was an analytical cross-sectional study to spot light on the relationship between maternal diet and baby gender. Since the aim of the study was to determine the relationship between maternal diet and baby gender 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 during the period from April to October 2021.

Results: The study included the participation of 755 women from different age groups in the Kingdom of Saudi Arabia. The most prevalent age group was 36-40 years (n= 193, 25.6%) followed by the age group more than 40 years (n= 189, 25%) while the least frequent age group was below 22 years (n= 83, 11%). The number of participants who reported having one children were 116 participants. On asking the participants who had male babies whether they craved for special food or not, their answers varied. Salty food, pickles and potato chips were preferred among 298 participants while sweets and chocolate were the favorite food among 155 participants. The special diet is statistically significant with the baby gender at p value of 0.001.

Conclusion: The current study showed that diet preference among mothers affects the gender of the baby as the results showed. Some mothers intentionally reported following special diet in order to have specific gender.

Open Access Original Research Article

Efficacy of Mobilization with Movement in Patients with Colles’ Fracture: A Randomized Clinical Trial

Vishista Biswas, Saumya Srivastava, Harramb Mittal

Journal of Pharmaceutical Research International, Page 677-685
DOI: 10.9734/jpri/2021/v33i60B34665

Background: Fracture of the distal radius or Colles’ Fracture mainly occurs due to fall on an outstretched hand and Physiotherapy plays an indispensable role in preventing postoperative complication namely hand stiffness. Mulligan concept of mobilization is a specific form of manual therapy technique that embraces skilled movements which is used to mobilize or manipulate soft tissues and joints with the target to improve tissue extensibility, increase in range of motion of joints, foster relaxation and reduce tissue swelling/ inflammation.

Objective: To compare the effectiveness of Mulligan concept of mobilization with movement technique and conventional physiotherapy treatment following postsurgical Colles’ Fracture in terms of range of motion and functional activities.

Methods: A total number of 36 patients were recruited for the study. They were divided into two groups: group I and group II. Group I (n= 18) was given mobilization with movement (MWM) along with wax bath and group II (n=18) was given conventional physiotherapy along with wax bath. The interventions were given for 7 days. The value of goniometer and Michigan hand outcome questionnaire (MHOQ) were taken both at baseline and after 7 days of interventions.

Results: After intervention, there were no significant differences between the groups as the collected information was summarized by using frequency percentage, for qualitative data; and mean, the standard deviation, Median and Inter Quartile Range (IQR) for quantitative data. To compare the difference in proportion Chi square test was used. To compare the ROM and Michigan Hand Outcome Questionnaire between two groups Independent sample t-test was used. Within the group comparison was analysed by using paired t-test. The p-value less than 0.05 was considered significant for the study.

Discussion: This study showed consistent with the previous studies as there was a significant improvement in the range of motion and hand functions between and within the groups.

Conclusion: It can be concluded that both the treatments are equally effective.

Open Access Original Research Article

Root Canal Morphology of Mandibular First Premolars using Radiography: An in vitro study

Irshad Hussain Jakhrani, Mahwish Memon, Sana Javed, Azizullah Muhammad Nawaz Qureshi, Aosaf Anwar Memon, Munir Ahmed Banglani, Salman Shams

Journal of Pharmaceutical Research International, Page 692-697
DOI: 10.9734/jpri/2021/v33i60B34667

Objective: The goal of this study was to document the Root Canal morphology of the first mandibular premolars using radiography.

Materials and Methods: The trial took place at the LUMHS Operative Dentistry Department. Two hundred removed permanent mandibular first premolars that met all of the study's inclusion criteria were gathered from LUMHS Jamshoro/Hyderabad and nearby private dental clinics in Hyderabad. All debris, soft tissues, and calculus were removed from the teeth, which were then preserved in a 10% formalin solution. Each tooth's length was measured from the crown's tip to the root's apex. An removed tooth, on the other hand, was examined from all angles, including buccal, lingual, and proximal. Root concavities and grooves, as well as bifurcation and apical curvature, were found.

Results: Comparison between both views showed 189 teeth have 1 root in and 186 have 1 canal in buccolingual view, while 182 teeth have 1 root and 179 have 1 canal in mesiodistal view. 11 teeth on buccolingual and 18 teeth on mesiodistal view showed 2 roots and 14 teeth on buccolingual and 21 teeth on mesiodistal view showed 2 canals. 110 teetj showed type I canal pattern.

Conclusion: It is concluded that mandibular first premolar teeth have a wide range of radicular traits, with the majority of them having one root and one canal.

Open Access Original Research Article

Gender Determination using Gonial Angle - A Panoramic Study among South Indian Population

Prateeksha Moharana, Lavanya Prathap, Ganesh Lakshmanan

Journal of Pharmaceutical Research International, Page 715-721
DOI: 10.9734/jpri/2021/v33i60B34670

Introduction: Sex determination is a valuable and important factor in the forensic dentistry. Mandible has several useful traits for sex determination. Forensic practitioners study this by two methods: morphological and metrical analyses. Among various methods, the gonial angle may be used to differentiate male and female strongly to express sexual dimorphism.

Aim: To analyse the gender determination using gonial angle as panoramic study among south indian population.

Materials and Methods: This is a retrospective study conducted among 200 individuals. Gonial angle is a measurement taken by measuring the angle between the 2 tangents from the gonion.As a standard procedure, measurement of right gonial angle and left gonial angle were carried out by Adobe Photoshop and the results were recorded and analysed statistically using SPSS tool.

Results: The mean right gonial angle  for males is 95.25 and for females is 95.22 The mean left gonial angle for males is 95.39 and for females is 95.15. The significance of the right gonial angle  is P=0.874 and significance of the left gonial angle is P= 0.147. The total mean value for right gonial angle was found to be 95.23 and for left gonial angle is 95.27. Therefore, there was no significant difference found between the right  and left gonial angle.  

Conclusion: Within the limitations of the study, there is no statistically significant difference observed between males and females in the gonial angle measurements. The Gonial angle measurements can be used to determine the gender and the growth pattern of the mandible. Measurement of gonial angle has its own surgical importance too in the field of orthodontics and therefore future studies should be carried out using larger samples to get reliable results.

Open Access Original Research Article

Prevalence of Single Umbilical Artery (Isolated and non-isolated) and Its Correlation with Birth Defects and Premature Death

Aditi Sandeep Lothe, Varsha Pandey

Journal of Pharmaceutical Research International, Page 722-734
DOI: 10.9734/jpri/2021/v33i60B34671

Background: The single umbilical artery (SUA) is linked to congenital abnormalities in almost every organ system, however published findings have been inconsistent. Although It has been proposed that inherited and long-term environmental factors do play a role, there is a need for further investigations on the same. The goal is to look into the possibility of a link between a single umbilical artery (SUA) in the incidence of chromosomal anomalies in the second trimester of pregnancy and their collective occurrence.

Methods: The exclusion of any one of the two umbilical artery and a present umbilical vein was considered as a single umbilical artery for the purpose of this research. A single umbilical artery was established by gross or histologic investigation of the placenta, neonatal evaluation, or autopsy. As a direct consequence, a newborn who did not have a single umbilical artery documented in these records was presumed to have an umbilical cord consisting of three vessels.

Results: SUA was identified in 0.46 percent of our population (4241/918 933). SUA risk factors included pregestational diabetes in the mother, consistently high blood pressure, prior Cesarean delivery.  Some other factors include smoking, epilepsy, and conception via assisted reproductive technology. SUA was associated with gastrointestinal atresia or stenosis in the neonate, esophageal and anorectal atresia or stenosis followed renal agenesis. SUA was linked to an elevated risk of congenital cardiac abnormalities by up to 7–8 times. There was a link between microcephaly, congenital hydrocephalus. There was a link established between other congenital brain and spinal cord anomalies as well. SUA displayed a lesser relationship with hernia associated with the diaphragm, limb reduction defect. It also showed a smaller relation to cleft lip or cleft palate. The risks of trisomy 13 and 21 were both increased, while the risk of trisomy 18 was maximum. Fetuses diagnosed with SUA, whether or not accompanied with a deformity, had two times the higher potential possibility of SUA in a future pregnancy.

Conclusion: Single Umbilical Artery is closely linked to gastrointestinal atresia or stenosis, implying the same developmental processes. The higher likelihood of reappearance of Single Umbilical Artery implies that inheritable and/or long-term environmental variables play a role. SUA was shown to have high correlations with trisomies 13 and 18.

Open Access Original Research Article

Knowledge, Attitude and Practise about Beneficial and Harmful effects of Diet Soda

Faaizah Fathima, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 735-742
DOI: 10.9734/jpri/2021/v33i60B34672

Background and Aim: Soda or light drinks are sugar free and don't contain calories. Artificial sweeteners such as aspartame drastically affect our health by causing various diseases like stroke etc. The main aim of this study is to determine the level of knowledge possessed about diet soda and their attitude towards it.

Materials and Methods: A Cross sectional survey was conducted among dental populations with a sample size of 102. A self administered, structured questionnaire was prepared based on knowledge, attitude and practice about diet soda and consisted of 10 questions. It was circulated to the participants through Google forms. The statistics were done using SPSS software, a chi-square test was used to check the association and the ‘p’ value of 0.05 was said to be statistically significant.

Results: From this survey it was inferred that 81.37% people find diet soda unhealthy whereas 18.63% felt it isn't healthy. 56.86% felt it contained calories but 43.14% felt it didn't. Around 61.76% think that artificial sweeteners will lead to more headaches whereas 38.24% felt it won't cause headaches.

Conclusion: This study revealed that many people have little knowledge and are unaware of the consequences of diet soda. Therefore this study may help to gain wide knowledge about diet soda and also help them to change their attitude towards it.

Open Access Original Research Article

Incidence of Granulomatous Mastitis at Saveetha Medical College and Hospital for the Past Two Years

Shruthi Kamal, R. Kapila

Journal of Pharmaceutical Research International, Page 750-756
DOI: 10.9734/jpri/2021/v33i60B34674

Background: To find the incidence of Granulomatous mastitis at Saveetha Medical College and Hospital for a period of past two years.

Methods: Retrospective study Incidence of Granulomatous Mastitis at Saveetha Medical College and Hospital for the past two years. The specimens were received from the histopathology section of the pathology department. Detailed gross examination of the specimen was done. This was followed by fixation and staining, done using hematoxylin and eosin stains.

Results: In the period of two years from 2019 to 2020, 10 cases have been reported . Out of which five cases belonged to the reproductive age group, two cases in the post menopausal age group and three cases belonged to peri menopausal age group.

All the patients presented with a lump on the breast and abscess. The treatment consists of corticosteroid therapy and minimal surgical intervention.

Conclusion: Granulomatous mastitis is an inflammatory condition that mimics carcinoma of breast. Hence diagnosis is mainly made through exclusion and examination of histopathology slides. Core needle biopsy is the gold standard technique used in the diagnosis of the condition. It’s a self limiting disease, and requires surveillance,corticosteroid therapy and surgical intervention.

Open Access Original Research Article

Antibacterial and Antifungal Activity of Selected Indian Traditional Medicinal Plants

Honnesh N. H., Santanu Saha

Journal of Pharmaceutical Research International, Page 623-634
DOI: 10.9734/jpri/2021/v33i60B34675

Antibacterial and antifungal activities are the universal supporting activities for other therapeutic activities like anti-inflammatory, wound healing etc. The traditional medicinal plants Pongamia pinnata and Macaranga peltata selected. The selected plants different extracts (Ethanol, Chloroform, Petroleum ether, Ethyl acetate and Methanol) were prepared and preliminary phytochemical screening was performed. The antibacterial and antifungal activity was performed by Agar well method by using Ciprofloxacin and Erythromycin standards. In this study we come to conclusion that the selected medicinal plants alcohol extract is having significant antibacterial and antifungal activity.

Open Access Original Research Article

The Use of Simethicone in a Public Healthcare Organization in Riyadh Region

Mohd Faiyaz Khan, Nehad J. Ahmed

Journal of Pharmaceutical Research International, Page 772-776
DOI: 10.9734/jpri/2021/v33i60B34678

Aim: Simethicone is anti-flatulence medicine that is used to relieves abdominal pain due to excessive gas in the digestive tract. The present study aimed to describe the use of simethicone in a public healthcare organization in Riyadh Region.

Methodology: This is a retrospective study that includes reviewing the outpatient electronic prescriptions of simethicone in a public healthcare organization in Riyadh Region.

Results: During the study period, 113 patients received simethicone. More than 56 % of them were females and the age of 22.12% of them was between 50 and 59 years. More than 26% of the patients received simethicone for 1 week and 23.90% of them received simethicone for 1 month. Most of the prescriptions were written by residents (90.27%) and more than 57% of the prescriptions were prescribed by emergency department.

Conclusion: The present study showed that simethicone was prescribed frequently in a public healthcare organization in Riyadh Region.  More studies are needed to explore the frequency of use and the appropriateness of prescribing simethicone and other anti-flatulence medicines.

Open Access Original Research Article

Childhood Asthma and Risk Factors in KSA (Cross Sectional Study)

Najya Abdullah Attia, Hoda Jehad Abousada, Samirah Saeed Almasoudi, Abdulaziz Abduallah AlHarbi, Omniah Dakiel Alghanmi, Abdullah Jamaan Alghamdi, Fahad Ahmed Almarshud, Reema Khaled Alhazmi, Abdulaziz Hisham Haddad, Abdullah Saeed Alzahrani, Ammar Yasir Aljahdali, Shuaa Adel Mahmoud, Refal Ghassan Ajjaj, Sara Mohammed Mannan, Aeshah Ali ALnashri

Journal of Pharmaceutical Research International, Page 782-788
DOI: 10.9734/jpri/2021/v33i60B34680

The goal of this study is to see if there's a link between age, gender, and risk factors including having a smoking parent, allergic rhinitis, skin allergies, food allergies, and a family history of atopy with the diagnosis of childhood asthma. The goal is also to evaluate the prevalence of asthma in the study's pediatric sample, as well as the prevalence of other symptoms and complications in this group.

A link was discovered between childhood asthma and age, allergic rhinitis, skin allergies, food allergies, and atopy in the family. In most areas of this investigation, the findings are consistent with earlier studies conducted at various periods and in other places for almost identical aims.

Open Access Original Research Article

Assessment of Complete Blood Count and D-dimer among Patients with Plasmodium falciparum Malaria

Mohammed Abdulhafeez Hassan, Albara Ahmad, Hisham Ali Waggiallah

Journal of Pharmaceutical Research International, Page 800-806
DOI: 10.9734/jpri/2021/v33i60B34682

Background: The most virulent of the human malaria parasites is P. falciparum which is responsible for the bulk of the malaria-related morbidity and mortality. Changes in blood cell parameters are already a well-known feature of malarial infections

Aim: The purpose of this research was to assess the total blood count and D-dimer levels in patients with P. falciparum malaria in Khartoum State, Sudan.

Study Design: It is case- control study was conducted on blood cells prameters and plasma D-dimer for patients infected with Plasmdium falciparum malaria

Place and Duration of Study: study was carried out in Yastabshiroon hospital, Khartoum state, from October 2020 to January 2021.

Methodology: The study comprised fifty people who tested positive for P. falciparum using the National Public Health Laboratory's malaria diagnostic standard. The control group consisted of fifty healthy Khartoum locals with about equal gender and age distribution. To collect data from the study group's personal and medical information, such as name, gender, age, and medical condition, a structured questionnaire was developed.

Result: D-dimer levels were considerably greater in P. falciparum malaria cases compared to non-falciparum malaria cases, neutrophil and lymphocyte counts were significantly lower, although white blood cells (WBCs) count was significantly lower in P. falciparum infection patients compared to non-falciparum (p≤0.05). Hemoglobin concentration and platelet count were similarly significantly lower (p≤0.05). Platelet counts and mean cell hemoglobin concentration (MCHC), on the other hand, were significantly lower in individuals with severe parasitemia compared to those with low and moderate parasitemia.

Conclusion: The study concluded that P. falciparum infection causes considerable hematological alterations. The results of the current investigation revealed a significant increase in the D-dimer mean level, as well as a significant decrease in the count of hemoglobin, total white blood cells (TWBCs), lymphocytes, neutrophils, and platelets. It was also discovered that patients with high parasitemia had considerably lower platelet counts and mean cell hemoglobin concentration (MCHC) levels than those with low and moderate parasitemia.

Open Access Original Research Article

Determination of Serum Electrolyte and Calcium Abnormalities in Neonates with Birth Asphyxia

Gnanavelu Injeti, Anjali Kher, Amar Taksande, Abhilasha Singh Panwar

Journal of Pharmaceutical Research International, Page 807-815
DOI: 10.9734/jpri/2021/v33i60B34683

Introduction: Birth asphyxia and Hypoxic–ischemic encephalopathy (HIE) are significant causes of neonatal mortality and morbidity. Serum sodium, potassium, and calcium level abnormalities may occur in neonates with birth asphyxia, and their early detection and prompt treatment will improve the outcome of these neonates.

Aim: To study serum electrolyte and calcium levels and their correlation with birth asphyxia and HIE severity.

Methods: A prospective cross-sectional study was conducted in full-term neonates diagnosed with birth asphyxia, and their serum sodium, potassium, and calcium estimation were done at birth to 12 hours of birth and repeated at 24 to 48 hours of birth. Serum electrolyte and calcium level abnormalities and short-term outcomes of these neonates were studied.

Results: It was observed that at Apgar score 1 and 5 minutes, with an increase in severity of birth asphyxia serum sodium and calcium levels decreased while potassium levels increased. A significant positive correlation was observed between serum sodium levels and Apgar score at 1 and 5 minutes. Serum calcium levels showed a significant positive correlation with 5 minutes Apgar score. Serum potassium levels at < 12 hours showed a significant negative correlation with 5 minutes Apgar score.

Conclusion: With increased severity of HIE and Birth asphyxia, serum sodium levels decreased, and serum potassium levels increased. Serum calcium levels decreased with the severity of birth asphyxia but did not decrease their HIE severity.

Open Access Original Research Article

Gestational Diabetes as a Risk Factor for Cardiovascular Disorders

Riffat Sultana, Lalit Maheshwari, Imran Ellahi Soomro, Iram Jehan Balouch, Shazia Tabassum, Fazal ur Rehman

Journal of Pharmaceutical Research International, Page 816-821
DOI: 10.9734/jpri/2021/v33i60B34684

Background: Gestational diabetes (GD) is identified as a risk factor for increasing the onset of cardiovascular disorders (CVD). However, it is not clear whether this risk is linked with the intercurrent pathogenesis of type 2 diabetes mellitus. Thus, it is essential to identify markers and risk factors responsible for the pathogenesis of CVD and develop therapeutic strategies to decrease the cardiovascular health burden in affected women. 

Objective: The present study aims to evaluate the effect of GD on the future onset of CVD and assess the impact of type 2 diabetes mellitus in this context.

Study Design: A cohort study was conducted in Karachi Institute of Heart Diseases Karachi Pakistan from June 2017 to June 2018. A total of 227 females who give birth to at least one kid were included in this study. Females with previous history of cardiovascular disorders and any other chronic disorders were excluded from this study. Using a biennial questionnaire behavioral, life style characters and health outcomes were evaluated. Multivariable Cox model was used to measure hazardous risk and ratio for cardiovascular disorders with 95 % confidence interval.  

Results: In this study, 11.8% of participants were diagnosed with gestational diabetes with a mean age of 31.6 ± 2.6 years. 28% of women with GD were developed hypertension later on compared to the non-GD participants (8%), indicating a positive association between GD and hypertension. A multivariate Cox analysis revealed that women with GD had a 28% increased risk of incidence of hypertension as compared to the non-GD group (HR. 1.24 [95% CI 1.13 – 1.65); P<0.01).

Conclusion: Females with GD are at higher risk for developing CVD later in their life. This association might be due to obesity and sedentary lifestyle.

Open Access Original Research Article

Ameliorative Effect of Cannabidiol against Gastric Ulcer Induced by Diclofenac in Rats

Sara A. Aldossary

Journal of Pharmaceutical Research International, Page 836-844
DOI: 10.9734/jpri/2021/v33i60B34686

Purpose: The aim of his study is to examine the effect of using cannabidiol upon gastric ulcer induced by diclofenac in rats. Method: The experiment was conducted on four groups, with normal rats serving as a control in group one. A single oral dose of diclofenac was administered to Group 2 rats in order to induce a stomach ulcer. The rats in the third group were given a single oral dosage of diclofenac sodium, followed by a 5-day therapy with cannabidiol, which began three days before the diclofenac administration. Drug control on cannabidiol-treated rats in the final group (Group 4). Results: The investigation showed that when cannabidiol was administered, the levels of acidity from diclofenac use decreased, significantly. Conclusion: The investigation resulted in a decrease in overall acidity levels among the rats treated with diclofenac, indicating that cannabidiol was effective in treating the condition.

Open Access Original Research Article

Effectiveness of Video Assisted Teaching [VAT] in Terms of Knowledge and Self-expressed Stigma Regarding COVID-19 and its Preventive Measures among Housekeeping Staff at Selected Hospital, Gurugram, Haryana: A Pre-experimental Study

Khiumajuliu Abonmai, Sunil Kumar Dular, Rekha Chhillar

Journal of Pharmaceutical Research International, Page 854-864
DOI: 10.9734/jpri/2021/v33i60B34688

Background: The coronavirus disease 2019 (COVID-19) is a contagious disease caused by newly discovered virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The current study is here about Covid-19 and its preventive measures as housekeeping staffs are on the front lines of fighting this global pandemic, as they are responsible for deep cleaning, disinfecting and scrubbing the surfaces and areas that are hosts of potentially dangerous germs and viruses which can widely spread and affect so many lives.

Objectives: The objectives of the study have drawn to fulfill the research reflecting on the effectiveness of Video Assisted Teaching [VAT] regarding COVID-19 and its preventive measures in terms of knowledge and self-expressed stigma among housekeeping staff at selected hospital, Gurugram, Haryana.

Materials and methods: A pre-experimental study with one-group pre-test post-test design was conducted among 100 housekeeping staff by convenient sampling technique in selected hospital, Gurugram, Haryana.

Results: Among 100 housekeeping staff, 91.66% were having previous knowledge regarding COVID-19, 76% were male and mean age was 54 years of age. Overall, 93 (93%), 7 (7%) and 0 (0%) participants had adequate, moderate and inadequate knowledge regarding COVID-19 and its preventive measures and 42 (42%), 58 (58%) and 0 (0%) participants had favorable, moderate and unfavorable stigma related to COVID-19. There was no significant association between the pre-test knowledge and self-expressed stigma regarding COVID-19 and its preventive measures with the demographic variables.

Conclusion: The study found a significant difference in knowledge and self-expressed stigma on COVID-19 and its preventive measures among housekeeping workers in a chosen hospital in Gurugram, Haryana, before and after VAT programme. It was proved that Video Assisted Teaching was effective in teaching COVID-19 and its preventive measures to housekeeping staff in a selected hospital in Gurugram, Haryana. With continuing education, housekeeping staff may become more aware about COVID-19 and reduces the spreading of the diseases.

Open Access Original Research Article

Comparative Study of Drug Likeness and Pharmacokinetic Properties of Synthetic Antiviral Drugs to that of Remdesivir: In-silico Approach

Akshatha C, Gayatri Vaidya, Chandan Dharmashekara, Bhargav Shreevatsa, H. S. Vikas, H. H. Bhavana, Kollur Shiva Prasad, Chandrashekar Srinivasa, Sharanagouda S. Patil, S. Bindya, P. Ashwini, Pallavi M, Chandan Shivamallu, Raghu Ram Achar

Journal of Pharmaceutical Research International, Page 879-891
DOI: 10.9734/jpri/2021/v33i60B34690

COVID-19's recent appearance in Wuhan, China, has affected more than three million twenty-five million individuals worldwide. It is considered a pandemic disease by WHO. Till now, there is no approved therapeutic for treating COVID-19 infection. The involvement of RNA-dependent RNA polymerase in coronavirus replication is crucial, and it could be a potential therapeutic target. To identify potent inhibitors against coronavirus, we have applied a molecular docking tool targeting RdRp by antiviral synthetic ligands and phytochemical ligands. Auto Dock 4.2.6 was used to do molecular docking in order to predict the most effective drug. In the present study, molecular docking studies of fifty ligands against the protein RNA dependent RNA polymerase. A comparative study was done using standard antiviral ligands Remdesivir. Out of fifty ligands, the top ten compounds were selected, which shows maximum binding affinity.Furthermore, ADME analysis and Lipinski's five rules were investigated to check the drug-likeness and pharmacokinetic properties of the top ten ligands. We observed from the following results that except few, all the ligands showed the best binding energy compared to standard ligands against coronavirus. Depending on the higher docking score, ADMET and drug-likeness prediction top five ligands were selected. This study will provide a lead molecule against RNA-dependent RNA polymerase for further in-vivo and in-vitro of coronavirus.

Open Access Original Research Article

Morphometric Study of the Mastoid Process and Notch in Dry Human Skulls

Sheron Blessy, Karthik Ganesh Mohanraj

Journal of Pharmaceutical Research International, Page 912-917
DOI: 10.9734/jpri/2021/v33i60B34694

Introduction: Mastoid process is a pyramidal bony projection . It is located in the posterior inferior region of the temporal bone. Mastoid notch is on the medial side of the mastoid process. Clinical significance causing infection of the middle ear could spread to the mastoid area causing mastoiditis.  The aim of the study is to determine the morphometric and morphological analysis of mastoid process and mastoid notch in dry human skull and their clinical implication.

Materials and Methods: The present study was taken from the department of Anatomy in Saveetha Dental College and Hospital by taking 72 dry human skulls. Digital vernier caliper was used to measure the mastoid process and mastoid notch of different parameters. The data was measured and analyzed statistically, using paired sample ‘t’ tests.

Results: The present study shows 0.641 significance in the right and left length of the mastoid process which is not significant. Right breadth and left breadth of the mastoid process of 0.007 and mastoid notch of right and left length 0.00 are significant.

Conclusion: It concludes that the mastoid process and mastoid notch have varied significant differences in the dry human skulls. This study will be helpful in mastoid surgeries.

Open Access Original Research Article

Computational Quantum Chemical with Biological Studies on Uracil-5-Tertiary Sulfonamides

G. V. Gaurav, K. Rama Krishna

Journal of Pharmaceutical Research International, Page 926-937
DOI: 10.9734/jpri/2021/v33i60B34696

Aims: To study Computational Quantum Chemical (CQC), Pharmacokinetic and other biological components are listed in pairs of Uracil-5-Tertiary Sulfonamides “5-(4-(2,3-dihydrobenzo [b] [1,4]dioxine-2-carbonyl)piperazin-1-yl)sulfonyl)pyrimidine-2,4(1H, 3H)-dione ” (I) and “N-butyl-N-methyl-2,4-dioxo-1,2,3,4 -tetrahydropyrimidine-5-sulfonamide ” (II).

Methodology: NMR (1H, 13C), FT-Raman, FT-IR, and UV-Vis spectral chemical data were calculated and reported. DFT values ​​for both combinations (I and II) were calculated using B3LYP / 6-31 + G (d, p) and B3LYP / 6-311 + G (2d, p). NMR chemical modification was calculated using the independent atomic orbital measurement method (GIAO). UV-Vis display is also calculated using the same basic sets.

Conclusion: The limits of Hyperpolarizability, HOMO and LUMO are listed. Pharmacokinetic properties (ADMET), drug similarity, bioactivity school, logP, pKa calculated using Molinspiration, pkCSM, Swiss ADME, Chem Axon.

Open Access Original Research Article

An Assessment of Knowledge, Attitude and Practices (KAP) towards Diabetes and Diabetic Retinopathy

M. Varaprasanna Rao, T. Yugaprasanth

Journal of Pharmaceutical Research International, Page 764-771
DOI: 10.9734/jpri/2021/v33i60B34698

Introduction: Diabetes mellitus is an endocrine metabolic disorder whereas Diabetic retinopathy is a major complication of diabetes. Diabetes occurs due to defect in insulin secretion, action, or both which in turn leads to chronic hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism and is associated with long-term damage, dysfunction, and failure of different organs (eyes, kidneys, nerves, heart, and blood vessels). DR is a progressive alteration in the microvasculature that lead to retinal ischemia, altered retinal permeability, neovascularisation, macular edema.

Methods and Materials: It was a prospective cross-sectional study, which was carried out over a period of 6 months (December-2020 to May-2021). The knowledge, attitude and practice were assessed in diabetic patients on diabetes and diabetic retinopathy by using questionnaires. A total of 362 diabetic patients are included in this study. The completed questionnaires were collected and analysed using SPSS software (version 19) and results were expressed in percentages.

Results and Discussion: In the study, majority of the patient were male and in the age group of 46-55 years. Patients had good knowledge on diabetes when compared to diabetic retinopathy, positive attitude was seen towards diabetes than diabetic retinopathy and good practice patterns were observed in diabetes retinopathy than diabetes.

Conclusion: Our study concluded that the patients had good knowledge on about diabetes and a very poor knowledge on diabetic retinopathy. Positive attitude was seen in diabetes than diabetic retinopathy where as good practice patterns was seen in diabetic retinopathy than diabetes patients.

Open Access Original Research Article

Isolation and Charecterization of Phytoconstituents from Annona reticulata L. Leaf Extracts

Sonal D’Souza, Nishmitha Gretta D’Souza, Jennifer Fernandes, Jane Mathew

Journal of Pharmaceutical Research International, Page 953-961
DOI: 10.9734/jpri/2021/v33i60B34699

Aims: The present work was designed to isolate the chemical constituents from the leaf extracts of the plant Annona reticulata L. most commonly known as Ramphal or Bullock’s heart or Custard apple belongs to the family Annonaceae.

Methods: The extraction of leaf powder was done using various solvents. The preliminary phytochemical tests were carried out using standard chemical tests. Phytochemical constituents were isolated using column chromatography and characterization of the compounds were carried out using IR, 1H NMR, and mass spectroscopy data.

Results: The results from the preliminary phytochemical studies showed the presence of alkaloids, triterpenoids, carbohydrates,saponins and flavonoids. Isolation of leaf extracts revealed the presence of a steroid, alkaloid and flavonoid which were confirmed by spectral analysis to be α – amyrin caprylate, xylopine and fisetin.

Conclusion: The study confirmed the presence of α – Amyrin caprylate, Fisetin and Xylopine as its main chemical constituents.

Open Access Original Research Article

Time Series Models for COVID-19 New Cases in Top Seven Infected African Countries

Alemayehu Siffir Argawu

Journal of Pharmaceutical Research International, Page 983-992
DOI: 10.9734/jpri/2021/v33i60B34703

Introduction: In Africa region on the date of December 09, 2021 at 14:46 GMT, the total cumulative cases of COVID-19 was 8,889,437 with total deaths and total recoveries of 224,731 (2.5% of death rate) and 8,185,382 (92% of recovery rate) respectively. Thus, this study aimed modelling and forecasting of COVID-19 new cases in top seven infected African countries using time series models.

Methods: The top seven infected African countries COVID-19 new cases dataset was taken from our World COVID-19 dataset. The study period was from February 14 to September 06, 2020. Different time series models were used for modelling and forecasting of COVID-19 new cases data. Models comparisons were done by normalized BIC, root mean square error (RMSE), mean absolute percentage error (MAPE), and R-squared values.

Results: The COVID-19 new cases data of Algeria, Egypt, Ethiopia, Morocco, and South Africa were fitted by ARIMA (0,1,0), ARIMA (0,1,0), Damped trend, Brown, and ARIMA (0,1,14) models in the study period, respectively. Whereas Ghana, and Nigeria COVID-19 new cases data were followed by simple exponential smoothing models. The 95% confidence levels for lowest to highest forecasted COVID-19 new cases were 258 to 197 with decreasing trend in Algeria, 63 to 933 with increasing trend in Egypt, 636 to 2,141 with increasing trend in Ethiopia, 0 to 1,022 with constant trend in Ghana, 1,900 to 2,807 with increasing trend in Morocco, 0 to 543 with constant trend in Nigeria, and 2,056 to 2,444 with increasing trend in South Africa for the next one month (from September 7 to October 6, 2020).

Conclusion: The findings of the study used for preparedness planning against further spread of the COVID-19 epidemic in African countries. The author recommends that as many countries continue to relax restrictions on movement and mass gatherings, and more are opening their air spaces, and the countries’ other public and private sectors are reopening and then strong appropriate public health and social measures must be instituted on the ground again and again before the virus is distributed and attacked more and more peoples in the region. And, the researcher recommended that risk factors of COVID-19 new cases should be conducted for next time in Africa countries.

Open Access Original Research Article

Physiological Effects of Cryptic Ancient Religious Chants

Abhijit. V. Bodne, Varsha Patond

Journal of Pharmaceutical Research International, Page 1042-1048
DOI: 10.9734/jpri/2021/v33i60B34711

Aim: One of the variables that contributes to higher academic achievement is awareness. In Indian schools, traditional practises are applied to improve mental skills with the purpose of adding value. Prayers and other mantras, for example, can help to regulate and enhance the cardiovascular heart's rhythm while also modifying baroreflex sensitivity.

Method: 50 healthy individuals were selected for the study. Comparisons of the effects of reciting Mary's petitions or mantra during voluntary breathing and metronome device control on rate of respiration, spontaneous pulse, blood pressure, and brain circulation in the RR region. The purpose of this study is to compare the impact of singing the Gayatri mantra (GM) on awareness to the function of letter substitution (DLST). Respiratory frequency, normal breathing, baroreflex sensitivity, heart oscillation frequency were recorded. The Bonferroni adjustment was utilised in the frequent measurement analysis of difference.

Conclusion: With the DLST net, both of these times showed complete upgrades in total points. In comparison to PL (3.85 percent), the extent of the development of net points was large after GM (22.67 percent). When repeated seven times per minute, both prayers and mantras generate a noticeable, forceful, and simultaneous rise in present-time cardiovascular system pulsations. The sensitivity of the baroreflex also increases significantly, from 9.2 (SD 4.4) to 11.7 (4.5) ms/mm Hg, P0.06.

Open Access Original Research Article

Frequency of Hypocalcaemia among Children (Age 2-60 Months) Presenting with First Episode of Afebrile Seizures: A Cross Sectional Study

. Asadullah, Salma Shaikh, Ayesha Farhat, . Amanullah, Sehrish Memon, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 1063-1068
DOI: 10.9734/jpri/2021/v33i60B34714

Aim: To determine the frequency of hypocalcaemia among children aged 2 to 60 months presenting with afebrile seizures.

Study Design: A cross sectional study.

Place and Duration: Department of Pediatrics, Liaquat University of medical and Health Sciences Jamshoro, from February to August-2020.

Methodology: A total of 130 children aged 2 to 60 months, having afebrile fits with birth weight more than 2.5 kg were enrolled. After taking full history, detailed examination was done. Two ml blood sample was taken from each patient and was sent to diagnostic laboratory of the institution to find out calcium levels. In case of proven hypocalcaemia, injection calcium gluconate 100 mg/kg was administered. Mean and standard deviation were calculated for quantitative variables while frequency and percentages were noted for qualitative variables. Frequency of hypocalcaemia was recorded and study variables were compared between children with and without hypocalcaemia.

Results: Majority of the patients, 69 (53.1%) were male, 64 (49.2%) less than or equal to 12 months of age, 28 (21.5%) had maternal educational status as illiterate, 78 (60.0%) belonged to rural areas, 59 (45.4%) belonged to middle socioeconomic status, 69 (53.1%) had poor exposure to sunlight, 80 (61.5%) had malnutrition, 82 (63.1%) had child spacing of less than 2 years, 79 (60.8%) with less than 5 episodes of fits per day and 88 (67.7%) had duration of fits per day as less than 5 minutes. Frequency of hypocalcaemia was noted in 81 (62.3%) cases.

Conclusion: We concluded that hypocalcaemia is the frequent cause of afebrile seizures in children aged 2 to 60 months.

Open Access Original Research Article

Comparison between Study of Bone Mineral Density in Males and Females of Various Age Groups

Anupama Sawal, Preeti Thute, Deepali Withale, Geetanjali Yadgire

Journal of Pharmaceutical Research International, Page 1069-1077
DOI: 10.9734/jpri/2021/v33i60B34715

Background: Osteoporosis is one of the complex diseases which have multiple etiology. The cause of it is maybe genetic and environmental or nutritional. There are various techniques for the measurement of bone mineral density. The DXA (DUEL ENERGY X-RAY ABSORBTIOMETRY AND BONE DENSITOMETER) is frequently used to measure bone mineral density. The other measures to measure bone mineral density are Quantitative computed

Results: With the increase in negative T tomography and ultrasound tonometry. The WHO standard for distinguishing patients as normal with 1 standard deviation of peak bone mass. Osteopinic 1 to 2.5 below peak bone mass .osteoporotic ;>2.5  standard deviation below peak bone mass.

Materials and Methods: The study included 200 Subjects of various age groups of both sexes. The study was carried out in the department of anatomy with the collaboration of the Department Of Orthopedics. The proforma was structured to include the details of the subjects with height, weight, etc.  With a score of one, the risk of fracture increased 1.5 to 3 fold.

Conclusion: The study of Bone Mineral Density (BMD) can help in increasing awareness about bone health in growing countries. There is a significant association between various age groups and a non-significant association between genders for BMD evaluation.

The current study puts up to our understanding of BMD disparities among people that would suggest the use of local testimonial scales for an authentic explanation of BMD reports.

Open Access Original Research Article

To Estimate the Level of Awareness of Contraception amongst the Teenage Girls

V. K. Chimurkar, Anupama Sawal, Darshana Fulmali, Vaishnavi V. Chauhan

Journal of Pharmaceutical Research International, Page 1086-1092
DOI: 10.9734/jpri/2021/v33i60B34717

“What is contraception?”

Contraception is the method for birth control which helps to prevent unwanted pregnancies. There are so many methods of contraception including long acting reversible methods, barrier methods, hormonal methods, lactational amenorrhea method, fertility awareness based methods, emergency contraceptives, etc.

In present decade, the knowledge of contraception in teenage girls is mandatory as the involvement of teenagers in sexual activities is increasing day by day. The reasons can be many such as social media, electronic gadgets, peer pressure, etc. There are so many studies that have shown that knowledge of contraceptives, especially among the teenage girls in universities remains limited and the rate of sexual activity before marriage,  and  unwanted pregnancies, illegal abortions remains higher among college going  students.    It leads to various health conditions in girls as well as mental and social disturbances in both girls and boys.   There is a need to make them aware about the consequences they have to face after engaging in sexual activities and ending up with teenage pregnancies, unwanted pregnancies and unsafe abortions.

Current study aimed to assess the awareness of contraceptives, sexual behavior, and factors associated with contraceptives use among female undergraduate students as well as girls who are illiterate in Wardha region, Maharashtra.

Aim: ‘The study was conducted to estimate the level of awareness of contraception amongst the teenage girls’.

Objectives:

  • To provide proper sex education to the teenagers.
  • To aware teenagers about complications of teenage pregnancies.
  • To acknowledge them about sexual activities and their consequences.
  • To acknowledge them about contraceptives and their proper uses.           

Materials and Methods: Sawangi, Wardha.  Total   study participants were 140 girls. One group  of 70 girls,    age  between 13 years to 16 years, half of them from school located in Wardha and half of them from rural area around the Wardha.  Another group of 70 girls belongs to 17 years to 19 years, half of them from school and half from rural area.  The participants were on voluntary basis. The girls belong rural area that had never been to the school.  None of them were given questionnaire to fill. Answers were recorded on the questionnaire by the social worker who was assigned the job.  Adequate time was given to each adolescent to answer the questions asked. The data thus collected was analyzed. Prior permission and consent were taken from the school Principal and the parents.

Conclusion: The present study concludes that there should be sensitization of teenage girls about contraception and various contraceptive methods. It will help them to prevent the unwanted pregnancies and it adverse outcomes of abortions which is beneficial to maintain their further reproductive life.

Open Access Original Research Article

Knowledge, Awareness and Practice of Usage of Interdental Aids among Dental Professionals

Lasya Genji, M. Jeevitha, S. Preetha, Selvaraj Jayaraman

Journal of Pharmaceutical Research International, Page 1104-1112
DOI: 10.9734/jpri/2021/v33i60B34721

Aim: To evaluate knowledge, awareness and practice of usage of interdental aids among dental professionals.

Introduction: Dental caries and periodontal diseases, the two most common oral diseases, are mainly avoidable by professional and self-care activities. Dentists’ knowledge and people's attitude on oral hygiene maintenance have a key role in the prevention of oral diseases.

Study Design: This was a survey conducted in an online forum. It was a questionnaire based survey.

Methodology: A set of 10 questions to assess knowledge, awareness and practice of usage of interdental aids was distributed among dental professionals. The data was collected and statistically evaluated using SPSS software.

Results: Majority of the dental professionals are aware of the purpose of interdental cleaning among which 74.5% being MDS and 3.92% being BDS.

Conclusion: Because of the minimal positive reaction to interdental aids among general dentists, educational campaigns offering information on various interdental aids should be conducted.

Open Access Original Research Article

Awareness of Dry Eyes Disease among Dental Students - A Survey

S. Abinaya, Palati Sinduja, R. Priyadarshini

Journal of Pharmaceutical Research International, Page 1119-1130
DOI: 10.9734/jpri/2021/v33i60B34723

Introduction: Dry eye is a common condition that affects 85 percent of adult students worldwide, has no effective treatment, and results in significant loss of productivity at work.

Aim: This study aims to assess the knowledge and awareness of dental students about dry eye disease.

Materials and Methods: An online google form was used to distribute a questionnaire based study with 12 questions to 100 people. The study began with the participants being briefed on the trial's details. The study used a 100-person sample size. The information was gathered and statistically examined.

Results: In this study, 96% of the students were aware that lack of sleep causes Dry Eyes Disease and 4% of the students were unaware of it. Around 83% of the students were aware that dry eye is reversible and 17% of the students were not aware of it. The overall result was positive, most of them were aware of the dry eye disease. This proves an outright positive result.

Conclusion: The present study shows that the students under 75% were aware of Dry Eyes Disease but 25% were unaware of dry eye disease. There is no sufficient awareness among dental students. So, by this survey, we create more awareness among dental students.

Open Access Original Research Article

Knowledge and Awareness on Tendency of Disease in Different Blood Groups among General Population- A Survey

M. Vignesh, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 1138-1148
DOI: 10.9734/jpri/2021/v33i60B34725

Background: Blood groups are classified into two types ABO system and Rh system and ABO system have the antigen on the RBC and the antibody of the blood and whereas Rh blood system only contain the only antigen called D antigen that is present on the surface of RBC and the criteria to find the Rh+ or Rh- is by presence or absence of D antigen and this is the prime understanding of the blood groups where the antigen, antibody and cellular units together comprise the host response to the antigen or disease and enhance it. Our study is to create the awareness among the people for different blood groups disease-causing tendency

Materials And Methods: The questionnaire was made comprising of 15 questions using google forms and it is circulated among 100 peoples and the data was collected and evaluated by Chi-square test using SPSS VERSION 26. (p<0.005)

Results: The results showed that more than 75% of the study population are unaware of the blood groups associated with systemic illness and further survey is needed to analyze more population.

Conclusion: From the results, we concluded that certain programs and initiatives are needed to overcome the disease caused by the blood groups and our study focuses mainly on improving the knowledge of the individual about the knowledge and awareness of disease in blood groups.

Open Access Original Research Article

Comparative Anti Inflammatory Activity of Hexane and Aqueous Extract of Mucuna pruriens

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

Journal of Pharmaceutical Research International, Page 1156-1166
DOI: 10.9734/jpri/2021/v33i60B34727

Introduction: Mucuna pruriens is a tropical legume native to Africa and tropical Asia. The plant is an annual climbing shrub with long vines that can reach a height of 15 meters in length. Mucuna pruriens belong to the family legume. It is a herbal drug that is used as a medicine for the treatment of male infertility, nervous disorder, and also as an aphrodisiac. It has been shown that it potentially has more medical importance. It causes orange hair that causes a severe itch when in contact with the skin. It releases a protein called mucanain.

Aim: To determine the anti-inflammatory activity of aqueous and hexane extract of Mucuna pruriens.

Materials and Methodology: The extract was prepared and the anti-inflammatory effect was done using a UV-Beckmann spectrometer. The anti-inflammatory activity of nanoparticles prepared using plant extract was investigated by albumin denaturation assay. The results of the test were described as the standard deviation and analyzed using UV-Vis spectroscopy. Correlation and analysis were done in SPSS.

Results: The hexane solution and aqueous solution of Mucuna pruriens have a high percentage of inhibition at the 30 μl, 40 μl and 50 μl concentration when compared with a standard solution. And hexane has a high percentage of inhibition at 50μl when compared with a standard solution. The obtained data were analyzed using spearman correlation analysis and the non-parametric correlation was statistically significant at p value< 0.05.

Conclusion: The aqueous and hexane extract of Mucuna pruriens show good anti- inflammatory activity. In that hexane extract has good anti-inflammatory activity when compared with aqueous extract. And it is used for disease. And further research should be done with the action and mechanism of Mucuna pruriens.

Open Access Original Research Article

Determination of Bone Age and its Correlation to the Chronological Age Based on the Greulich and Pyle Method in Saudi Arabia

Abdulmalik B. Albaker, Asim S. Aldhilan, Hamza M. Alrabai, Salah AlHumaid, Ismail H. AlMogbil, Nawaf Fahad A. Alzaidy, Saleh Asaad Hamad Alsaadoon, Ohud Abdulrahman Alobaid, Faisal Hassan Alshammary

Journal of Pharmaceutical Research International, Page 1186-1195
DOI: 10.9734/jpri/2021/v33i60B34731

Introduction: Many clinical indications need the measurement of bone age, including growth and development abnormalities, the timing of corrective procedures in pediatric patients, and the assessment and treatment of specific endocrine conditions. These evaluations are also useful in forensic science.

Aim: This study aims to compare the bone age of children aged 4 to 18 years old with their chronological age in order to determine whether the Greulich-Pyle (GP) method is trustworthy for Saudi youngsters.

Materials & Methods: Multiple approaches for determining bone age have been published, but Greulich and Pyle's methodology is the most extensively utilized. This method is based on an inspectional evaluation that compares the radiograph to the pattern described in a 1950 atlas using a sample of North American children aged birth to 18 years for the female sex and up to 19 years for the male sex. It is one of the most commonly utilized procedures for assessing the skeletal age of children and adolescents since it is rapid and quick to perform. It is based on the fact that ossification centers in the hand and wrist bones emerge in a predetermined order. For male and female youngsters, the degree of ossification in various hand and wrist bones is compared to the nearest matching plate on the Greulich & Pyle Atlas. This cross-sectional study was performed during April 2021 to September 2021.

Results: Total 216 patients were included or selected in this study among age group 4-18 years, the sex distribution among them were 148 (68.5%) and 68 (31.5%) were male and female respectively. Chronological age and bone age assessment by GP methodamong doctors when chronological age was 135.2 ± 45.0 (range, 45-216 months). Chronological age in male and female were 143.5 ± 44.0 and 116.9 ± 41.8 respectively with p value <0.001 which was statistically significant. The bone age were observed in two reading, first reading and second reading after 15 days by two doctors separately and all the finding were recorded almost similar and significant with p value <0.001. Correlation between Chronological age and Bone age by GP method in both sex observed significant p value <0.001. Linear regression analysis showed that the bone ageand its correlation to the chronological age assessment in first reading in male(r=0.761 and p<0.001) and female(r=0.889 and p<0.001), in reading after 15 days in male(r=0.760 and p<0.001) and female(r=0.868 and p<0.001).

Conclusion: In order to evaluate whether the Greulich-Pyle (GP) technique is accurate for Saudi children, the bone age of children aged 4 to 18 years old should be evaluated to their chronological age, according to this research.

Open Access Original Research Article

Depression and Its Associated Factors in Hospitalized Patients

Iram Shehzadi, Naqash Siddique Gorsi, Waqas Ahmad Khalid

Journal of Pharmaceutical Research International, Page 1203-1207
DOI: 10.9734/jpri/2021/v33i60B34732

Background and Objectives: The basic aim of this study was to analyze the prevalence of depression and its associated factors among hospitalized patients in local hospital of Pakistan.

Methods: This Cross sectional study was conducted in Jinnah Hospital Lahore during June 2019 to June 2020.

Results: This study includes 200 patients who were admitted in Jinnah hospital, Lahore. We collect and analyze the data and find the mean values of age, BMI, patient’s income status, economic status and some other socio-demographical values of patients. The data represents that the most frequent reason of admitted in hospital is some kind of gastrointestinal issues. It was also noted that the median length of hospital stay was 7-8 days in 75% of the patients.

Conclusion: It is concluded that depression is a great factor which contribute towards the hospitalized patients suffering. Hospitalized patients were at higher risk for anxiety if they were physically inactive and stayed 8 days or longer in hospital. The risk for depression was higher in patients with a low income and older patients.

Open Access Original Research Article

Morphometric Analysis and Variation of Pterion, Asterion and Lambda in Dry Human Skulls and Its Sexual Dimorphism

Sadhana Karunakaran, Karthik Ganesh Mohanraj

Journal of Pharmaceutical Research International, Page 1218-1226
DOI: 10.9734/jpri/2021/v33i60B34735

Introduction: Pterion is a H- shaped sutural junction of the frontal, parietal, squamous part of the temporal and greater wing of sphenoid bone. Asterion is a sutural junction of lambdoid, parietomastoid and occipitomastoid sutures. Lambda is the junction where lambdoid sutures and sagittal sutures meet. These sutures play an important role in infants' brain development. Flexibility of these allows the bones to overlap and hence it can pass through the brain canal easily without any damage to the brain.

Aim: To analyse pterion asterion and lambda of dry human skulls morphologically and morphometrically and determine its sexual dimorphism.

Materials and Methods: 40 dry human skulls were collected from the department of Anatomy of Saveetha dental college and hospitals. By excluding abnormal and damaged skulls, 20 skulls were studied. Out of 20 skulls, 11 were male skulls and 9 were female skulls. On investigation, Pterion was classified into four types: Sphenoparietal, stellate, Epipteric and Frontotemporal. Asterion was classified into types: Type-1 and Type-2 based on the presence and absence of wormian bones respectively. Lamda was classified into two types: Normal and Abnormal. Statistical analysis was done by SPSS software. Paired Sample T test was used to analyse the data.

Results: Percentage of occurrence of different types of pterion in males and females: Sphenoparietal (59.09 % of males and 59.09 % of females), Stellate (27.7% of males and 22.2% of females), Epipteric (99% of males and 16.6% of females) and Frontotemporal (45.5% of males and 5.5% of females). Different types of Asterion: Type-1 (13.63% of males and 16.66 % of females and Type -2 (86.63% of males and 83.33% of females). Different types of Lambda: Normal (90.9% of males and 94.4% of females), Abnormal (9% of males and 5.55% of females).

Conclusion: In the present study, there was no correlation between the male and female skulls in the presence of Pterion, Asterion and Lambda. Therefore these cannot be used as reliable parameters for determining sexual dimorphism.

Open Access Original Research Article

Frequency of Pituitary Adenoma among the Patients with Chronic Headache

Asadullah Jatoi, Asma Jatoi, Noman Ahmed Shaikh, Ashok Kumar Narsani, Mona Liza Mahesar

Journal of Pharmaceutical Research International, Page 1235-1241
DOI: 10.9734/jpri/2021/v33i60B34737

Background: Antero-superior, Pituitary Gland lies in vicinity of optic chiasm and antero-inferiorly, it is related with posterior wall of sphenoid bone. Pituitary Gland is consisting of three lobes: Anterior, intermediate and posterior and their secretion are regulated by hypothalamus.

Aims and Objectives: To identify pituitary adenoma in the patients coming with complain of chronic headache.

Materials and Methods: Seven hundred sixty-four patients were included in our study. All the patients with chronic headache with/without decreased vision and visual field defects were included our study. Those patients already diagnosed with any other cause of headache such as uncontrolled blood pressure, tumor or diagnosed case of pituitary adenoma and patient with glaucoma were excluded. Detailed history was taken and ocular examination was done. MRI orbit and brain with contrast was done in all patients.

Results: Out of 764 patients, 32 patients were diagnosed as having pituitary adenoma. Macro-adenoma was present in 30 patients and micro-adenoma in 2 patients. On MRI majority of patients had optic chiasm compression with bi-temporal hemianopia.

Conclusion: All the patients with chronic headache with/without visual disturbances and visual field defect must be properly examined and investigated as that will help other researchers to diagnose the Pituitary Adenomas.

Open Access Original Research Article

Effectiveness of Online Practical Exercises among Third-year Dental Undergraduate Students - A Questionnaire-based Survey

S. Amrithaashri, Palati Sinduja, R. Priyadharshini

Journal of Pharmaceutical Research International, Page 1261-1273
DOI: 10.9734/jpri/2021/v33i60B34741

Introduction: When teachers and students synthesize knowledge from multiple subjects and experiences, objectively weigh dramatically different viewpoints, and integrate various inquiries, education may become transformative. Online applications have been marketed as effective and well-accepted methods for improving student learning in health professional education, including physiotherapy. This study aimed to evaluate the efficacy of online technology for physiotherapy teaching and learning, as well as user expectations. Educators may create such opportunities by encouraging students to develop their capacities for study, creativity, critical synthesis, creative expression, self-awareness, and intentionality in critical learning spaces.

Materials and Methods: Survey was distributed to third-year undergraduate students. It suggests that most of the students are aware of online practical classes and also they have knowledge about online classes.

Results and Discussion: It is concluded that types of classes students prefer, 69% prefer online classes, 31% prefer offline classes, gaining of knowledge in online classes 91% can gain knowledge, 9% are not able to gain knowledge, Preference in online classes 49% preferred theories, 49% prefer practical classes, 2% prefer none Association between gender and preferences of online practical classes was done using chi-square test p=2, p>0.05 which is found to be statistically not significant.

Conclusion: It is concluded that most of the students are aware, and students also have knowledge about online practical exercises and classes, the results and this study was compared with other studies.

Open Access Original Research Article

Restless Leg Syndrome in Dormitory and Its Relationship with Sleep Quality

Mohammed Abdullah Aljaffer, Abdulrahman Mohammed Alrajhi, Salem Wadie Basamad, Saud Khalaf Alhothaly

Journal of Pharmaceutical Research International, Page 1281-1290
DOI: 10.9734/jpri/2021/v33i60B34744

Introduction: Restless legs syndrome, is a widespread, chronic, multifactorial movement condition of the limbs in which patients have an insatiable need to move their legs.

It was linked to poor quality sleep among students.

Objective: This study aim to explore The Relationship between them among health sciences students who live in dormitory.

Methods: We conducted a Quantitative cross-sectional observation study by using a validated questionnaire targeting Health sciences students and compare to those who live in dormitory Summary statistics for the data are presented in the form of numbers and percentages for categorical variables. A mean score for restless leg symptoms and quality of sleep was calculated. A higher score reflects severe symptoms or poor sleep quality.

IBM SPSS 26 for windows software was used for the analysis, and a P-value < 0.05 is considered statistically significant.

Results: A total of 148 students participated in this study. The highest percentage of participants are from the faculty of medicine (58.1%), while participants from other health sciences faculties ranged from 5.4% to 14.2%. 58.1% of the participants are living in the dorms.

The relationships between dormitory and restless leg syndrome average score and with sleep quality average score were studied using independent sample t test. The results showed no statistically significant difference between those living in the dorms and those outside the dorms in any of the scores. Even though the results showed no statistically significant difference between students of different faculties in the sleep quality score.

Conclusion: There was no statistically significant difference regarding living in dorms, but there was a statistically significant difference regarding the faculties.

Open Access Original Research Article

Calculation of the Zone of Inhibition and Sensitivity Pattern of Fenugreek Seeds Extract and Negila sativa Seeds Extract on ESBL E. coli Growth Plates

Ata Ur Rehman, Kiran Khan, Ghazala Nasim Pasha, Ulfat Sultana, Tajwar Sultana, Ruqaya Nangreja

Journal of Pharmaceutical Research International, Page 1298-1303
DOI: 10.9734/jpri/2021/v33i60B34746

Background: The reason behind the poor outcomes in treating bacterial infections is mainly the limited treatment options. The strains of ESBL are generally resistant to broad-spectrum penicillin, monobactams, and third-generation cephalosporins. Literature is currently highlighting the efficacy of herbs against many resistant organisms. Hence, the study aims to identify the sensitivity pattern and zone of inhibition of Fenugreek seed extract and Nigella sativa Extract against ESBL E. Coli.

Methodology: The calculated sample size was n = 40. The ESBL E. coli growth plate samples were recruited from an associated lab which were identified by performing biochemical tests on appropriate media i.e. Mueller-Hinton agar was used.  Agar dilution methods were performed to examine the antibacterial effects of fenugreek seed extract (FGSE) and Nigella sativa seed extract (NGSE) against ESBL E. coli. wells of 8mm diameter were punched in the inoculated plates by using sterile cork borer, 100μl of different concentrations of Fenugreek seed extract (30, 40, 50, 60, and 80mg/ml) and Nigella sativa extract (30, 40, 50, 60, and 80mg/ml) were added to wells and the plates and the plates were incubated for 24 to 48 hours at 37°C. After 48 hours presence or absence of zones of inhibition were investigated.

Results: Total 40 samples were calculated for each concentration of the solution of extracts i.e. FGSE group and NGSE group. The effective concentration of FGSE was found to be 40mg/ml and for NGSE was found to be 60mg/ml that showed maximum. Both the extracts showed inhibition of growth of organism at different concentrations table 2 shows the zone of inhibition.

Conclusion: The Fenugreek seed extract at 40mg/ml and Nigella sativa seed extract at 60mg/ml have highest sensitivity and are effective in inhibiting the growth of ESBL E. coli on growth plates.

Open Access Original Research Article

Trends of Seasonal Influenza Incidence among the Population of Abha, Saudi Arabia During 2019

Amal M. Alshahrani, Ali Yahya Ali AlHalbub, Omar Obaidallah Althobaiti, Saud Ghazi Alshumrani, Zainah Ghazi Alshumrani, Najim Z. Alshahrani, Kholoud Ghazi Alshumrani, Bayan AlGhamdi, Shaima Mohammed Mashhour Al Modeer, Omar Alsudairy, Alhanouf Dhaifallah Hamad Alharbi, Mohammed Alshehri, Abdulrahman Ali Alqahtani, Abdulbari Ahmed Hanash, Nawaf Safaq Alshammari

Journal of Pharmaceutical Research International, Page 1311-1317
DOI: 10.9734/jpri/2021/v33i60B34749

Background: Influenza is one of the infections in which a specific pattern is observed according to seasons which result in severe forms of disease. By providing regular and extensive quality in epidemiological studies, the surveillance system can help in reducing the threat to public health posed by influenza that eventually minimizes the effect of illness. They also help in reporting the health ministry about the relevant information as an aid to reduce the impact of disease on public health.

Objective: To assess the incidence of seasonal influenza in Abha City, Saudi Arabia.

Methods: This surveillance report conducted among citizens of Abha, Saudi Arabia, 2019. It is based on sentinel surveillance and case-based data collection of laboratory-confirmed cases through electronic health records. All data were obtained from the department of infectious diseases of public health department in Aseer health directorate.

Results: The total reported positive cases for influenza viruses were 808 (22.30%) patients in the city of Abha for the year 2019, among them 435 males and 373 females (F= 9.5149; P=0.002038) which 665 (82.3%) were typed as influenza A and 143 (17.7%) as influenza B. (F= 674.46; P=0.001). The prevalence of the disease is commonly seen in the age group of 5-15 (42.35 %) with a mean age of 15.45±4.50 followed by 16 to 50 years age (37.45%) and 51-65 age group (10%). There was no death registered among these cases. In February maximum cases were found, whereas in June and July minimum cases were recorded. The influenza positivity rate showed one primary peak and three secondary peaks that were recorded in February and January, March and December.

Conclusion: Importance of conducting effective epidemiological surveillance for influenza virus in various regions in Abha specially in winter season with a peak in the month of February.

Open Access Original Research Article

A Secure Block Chain Based Contract Manufacturing System for Pharma Industries Using Imperative Ant Loop Optimization Algorithm

Neha Saini, Arvind P. Bhanu

Journal of Pharmaceutical Research International, Page 1408-1422
DOI: 10.9734/jpri/2021/v33i60B34761

Manufacturers that work under contract for another firm may make their goods under their own brand or label. Using their own or their clients' designs, formulas, and needs as a guide, contract manufacturers perform this service. The pharmaceutical industry relies heavily on contract manufacturing. Due to a lack of capital, some companies are unable to obtain the required equipment for large-scale mass production of certain chemicals. In order to create the final product, they can work with a third-party chemical manufacturer to obtain the necessary chemicals and combine them with their own resources. An organization should carefully assess the benefits and drawbacks of contract manufacturing before committing to this strategy. There may be advantages to contract manufacturing, if the company works with the right service provider capable of delivering high-quality products. The contract manufacturing system proposed in this study is a blockchain-based solution for the pharmaceutical business. Initially, the customer uploads the order details that are preprocessed using normalization method.  The preprocessed data is authenticated using the crypto smart contracts before being stored in the blockchain ledger. Then the stored data can be encrypted for security purpose by using the triple MD5 algorithm. Finally, the trust of the order data is evaluated using the proposed Imperative Ant loop optimization algorithm. In order to demonstrate the effectiveness of our system, we use the MATLAB simulation programme to compare it to other approaches.

Open Access Original Research Article

The Comparison of Trichoscopic Findings in Female Pattern Hair Loss (FPHL) and Chronic Telogen Effluvium (CTE) in Female Patients

Sugat Jawade, Bhushan Madke, Adarsh Lata Singh, Swapna Jawade

Journal of Pharmaceutical Research International, Page 1423-1428
DOI: 10.9734/jpri/2021/v33i60B34762

Background: Chronic hair loss is a major complaint in middle-aged females. It is sometime difficult to differentiate between female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients. Trichoscopy is a non-invasive technique that can help to distinguish between FPHL and CTE.

Aims: To compare the trichoscopic findings in female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients.

Materials and Methods: It is a cross sectional prospective comparative study carried out in the department of dermatology, Acharya Vinoba Bhave Rural Hospital affiliated to Jawaharlal Nehru Medical College, Wardha, Maharashtra. Adult female patients with ages ranging from 30 to 60 years old complaining of diffuse hair loss were included in the study. Patients with scarring alopecia were excluded from the study.  Patients were divided into two groups consisting of 20 patients in each group. Group A and B included patients with FPHL and CTE respectively. Trichoscan (SIF hair analysis system) was performed on frontal region of the scalp.

Results: Hair diameter variability was significantly seen in FPHL.  Hair diameter was reduced in FPHL (0.045) as compared to chronic telogen effluvium (0.063) with statistical difference between them. Hair density was significantly reduced in FPHL (32 ± 12.24) as compared to CTE (60.66 ± 18.12). Vellus hair density was significantly more in FPHL (22.4 ± 14.3) as compared to chronic telogen effluvium (7.73 ± 6.71). Single hair unit was more in FPHL (65 ± 17.08) as compared to chronic telogen effluvium. Density of yellow dots is more significantly observed in female pattern hair loss as compared to chronic telogen effluvium.

Conclusion: Trichoscopic features based on hair shaft diameter, hair follicular density, vellus hairs, yellow dots and variability in hair shaft diameter can easily help to distinguish female pattern hair loss from chronic telogen effluvium. This differentiation can help dermatologists to plan better and specific management of hair loss in female patients.

Open Access Original Research Article

Awareness of the General Population about the Causes, Management and Prevention of Peptic Ulcer Disease in Arar City, Northern Saudi Arabia

Abdelrahman Mohamed Ahmed Abukanna, Basil Falah Ayed Alanazi, Talal Atallah Rahil ALRuwaili, Essa Abdulrhman Mater AL Harbi, Thamer Mohammed Matrud Alanazi

Journal of Pharmaceutical Research International, Page 1429-1436
DOI: 10.9734/jpri/2021/v33i60B34763

Background: Gastro-dudenal ulcere is a global problem with a lifetime risk of development ranging from 5% to 10%.

Objective: This study aims to determine the public awareness in Arar, Saudi Arabia, regarding the causes, management and prevention of gastro duodenal ulcer.

Methods: A cross-sectional study was conducted in Arar city, Saudi Arabia in the period of 1 September to 30 October 2021 among the general population of Arar, Saudi Arabia.

Conclusion: Almost half of the participants had knowledge about gastric or duodenal ulcers and most of them know the risk factors and possible complications. There is non-significant relationship between gastro-duodenal ulcers awareness and age, gender and educational level while a significant relationship was found between level of awareness and social status, functional status and the average monthly income of the participants.

Open Access Original Research Article

Relationship between Osteoarthritis and Endocrine Disease in KSA: A Cross-Sectional Study

Eman AbdulAziz Balbaid, Abdullah Talal Salem, Sameer Mari Alqahtani, Ziyad Abdulrhman AlOraini, Ahmed Saeed Alsaedi, Mohammed Abdullah Alghamdi, Tameem Abdullah Sabrah, Abdalaziz Awad Almarwani, Ahmed jaza alreshidi, Mohammed Saleh Almarshoud, Abdulaziz Yahya Sahhari, Abdulhamid Abdulrhman Alfawzan, Hanoof Mohammed Alqahtani, Athba Mohammad Alkinani, Fahad Abdulkarim Alrumayan

Journal of Pharmaceutical Research International, Page 1447-1456
DOI: 10.9734/jpri/2021/v33i60B34765

Background: Osteoarthritis (OA), the most common kind of arthritis, affects millions of people throughout the world. This problem occurs when the protective cartilage that cushions the ends of the bones wears away over time. The goal of this study was to draw attention to the link between osteoarthritis and a number of endocrine illnesses in the Saudi population.

Methods: This was a cross-sectional research with the goal of shedding light on the link between osteoarthritis and endocrine problems. The research was conducted in Saudi Arabia at colleges, hospitals, and shopping centers. During the months of June to November 2021, data was collected from patients and the general public.

Results: The study included 743 participants. Among them, there were, 519 females (69.9%) and 224 males (30.1%). The most prevalent age group was 20-30 years (n= 354, 47.6%). Majority of study participants were Saudi (n= 713, 96%) and the rest were non-Saudi. The mean body mass index (BMI) among study participants was 29.47 + 7.53 with median BMI of 30 kg/m2. It was found that 85 participants took anti-inflammatory drugs for more than twice per week during the last three months (11.4%). It is noticed that the prevalence of autoimmune disease among study participants is low. However, female participants were higher in hypothyroid (P= 0.001).

Conclusion: Finally, it appears that weight, rather than IR, explains the relationship between endocrine disease and knee OA. Individuals with arthritic knee pain may benefit from endocrine disease therapy since the accumulation of endocrine disease components is connected to a higher degree of knee discomfort, independent of age, sex, or weight.

Open Access Original Research Article

Risk Perception and Hesitancy of Dental Health Professionals towards COVID-19 Vaccine in Riyadh Region, Saudi Arabia-A Web-based Survey

Rabiya Basari Uppin, Abdullah Maseer Alkhaldi, Tareq Matar Al-Shammri, Fahad Ebrahim Alnafisah, Nasser Nasser Almutairi

Journal of Pharmaceutical Research International, Page 1480-1489
DOI: 10.9734/jpri/2021/v33i60B34766

Background: Vaccine hesitancy is a common phenomenon due to its unknown long term side effects. Data regarding the sam is scanty in the Saudi Arabia region hence the purpose of this study was to assess the safety concerns and reasons for vaccine hesitancy and acceptance among dental health professionals in Saudi Arabia. 

Materials and Methods: A total of 138 dental health professionals serving in a Riyadh region of Saudi Arabia were studied using an online-based structured, close-ended, and self-administered questionnaire developed by Paudel et al consisting of three sections: demographics, experiences, and willingness to get the vaccination, and perception of COVID-19, and COVID-19 vaccine safety. It was a cross sectional study where convienence sampling technique was employed. The total perception score was calculated by adding respondents' agreement with a set of eleven items using a Likert-type scale. Non-parametric tests (Mann– Whitney U and Kruskal–Wallis) were used for analysis (p<0.05).

Results: A total of18.1% of respondents were diagnosed COVID-19 positive beforethe study. Many (71.7%) considered themselves at increased risk of contracting COVID-19. More than half (55.6%) of the participants believed the increased risk is due to their job type. Nevertheless, a considerable proportion of dental health professionals (89.9%) were willing to be vaccinated. The most common reason for hesitancy was the government approval of the safe and effective vaccine. The nationality, marital status, and type of dental professionals showed a statistically significant difference in vaccine safety perception and effectiveness concerns (p<0.05).

Conclusion: The COVID-19 vaccination is well accepted by dental professionals in the Riyadh region of Saudi Arabia. However, vaccine hesitancy is mainly related to the safety and effectiveness of the vaccine and government approval of the vaccine.

Open Access Original Research Article

Analysis of Pesticide Residues in Water, Rice, Fruits and Vegetables

J. Divyashree, Sapna Tomar

Journal of Pharmaceutical Research International, Page 1462-1473
DOI: 10.9734/jpri/2021/v33i60B34768

Pesticides have played a major role in increasing agricultural output by pest control and eliminating insect driven illnesses. Kerala’s tragedy on endosulfan exposure made us to study pesticides in water, rice, fruits and vegetables from Thiruvananthapuram location. Rice (the main cereal consumed in Kerala), fruits, and vegetables, as well as water samples from wells and streams in the Thiruvananthapuram districts, were collected for analysis of residue levels in major food items consumed by people in Kerala. The research was carried out to measure the concentration of organochlorine, organophosphorus, and synthetic pyrethroid pesticides using gas chromatography. The water and food samples collected were analysed for pesticide residues and the quantities were estimated using GC-ECD/NPD. A standard mixture containing Pesticides (OCs, OPs, Pyrethroids, and carbamates) was run before the actual samples. The detection was used to estimate the residues of fifteen commonly used pesticides, namely organochlorine pesticides (endosulfan, dieldrin, aldrin, lindane, DDT), organophosphorus pesticides (chlorpyrifos, profenophos, quinalphos, dimethoate, phorate) and synthetic pyrethroid pesticides (cypermethrin, fenvalerate, deltamethrin, carbofuran).  The study concluded that food exposure to pesticides would result in unacceptable health hazards and awareness of pesticide residues in foodstuffs, as well as to quantify the possible health. Hence, necessary to maintain the survey of pesticide residues in all food commodities in order to safeguard the consumers.

Open Access Original Research Article

Sub-foveal Choroidal Thickness in Primary Macular Hole- case Study of Lumhs, Jamshoro

Asadullah Jatoi, Mona Liza Mahesar, Noman Ahmed Shaikh

Journal of Pharmaceutical Research International, Page 1514-1518
DOI: 10.9734/jpri/2021/v33i60B34773

Background: Primary macular hole is a defect in fovea and is a frequent cause of decrease vision and metamorphopsia. Primary macular Hole (PMH) was first time introduced by Johnson and Gass in 1988.

Aims and Objectives: This study aims to evaluate the sub-foveal choroidal thickness in primary macular hole.

Materials and Methods: This prospective and controlled study was done at Institute of Ophthalmology, Liaquat University of Medical & Health Sciences, Jamshoro for the period one year. Visual acuity was checked with Snellen Chart and ophthalmic examination was done with bio-microscopic slit lamp using 90 diopter (D) lens pre-operatively and post-operatively. Swept Source optical coherence tomography (SS-OCT) was used to confirm the diagnosis, outcome of PMH surgery, to measure choroidal thickness of both eyes preoperatively and postoperatively at the end 2nd month.

Results: From the selected patients, the average ages was 63 year, ranging between 46 to 80 years and from them 45 were females and 26 were males. 41 were right eye and 30 were left eye. PMH characteristics was used for the determination of duration of symptoms and minimum hole diameter, In 63 patients hole was closed and in 8 patients the hole was opened. The average duration of symptom was 5 months and Average minimum diameter was 320 μm and range was 139-650 μm among the patients with closed hole.

Conclusion: Sub-foveal CT was thinner in eyes with PMH as compared to fellow normal eye. But it was not related with anatomical results of PMH surgery. The sub-foveal CT reduced thickness is due to longer duration and larger minimum diameter of PMH.

Open Access Original Research Article

Melissa officinalis L. Essential Oil: Chemical Composition, Antioxidant, Antibacterial and Antifungal Activities- in vitro Study

Hafedh Hajlaoui, Soumaya Arraouadi, Emira Noumi, Mejdi Snoussi, Adel Kadri

Journal of Pharmaceutical Research International, Page 1529-1537
DOI: 10.9734/jpri/2021/v33i60B34775

The present investigated chemical composition of Melissa officinalis L. essential oil (MOEO) extracted by hydrodistillation. The MOEO was analyzed by gas chromatography-mass spectrometry (GC-MS), revealing the presence of thirty compounds, representing 98.46% of the oil constituents. The predominant components were 1,8-cineole (39.80%) followed by citronellol (16.66%), geraniol (12.25%), myrcene (5.85%) and geranial (5.45%). The antioxidant potential of MOEO has been summarized using DPPH test (IC50), superoxide anion (O2·) scavenging activity (IC50), β-carotene (IC50) and reducing power (FRAP) (EC50). Results demonstrate strong scavenging superoxide anion capacity and moderate to weaker activity against the other assays. Potent inhibitory effect has been observed towards Micrococcus luteus and Bacillus cereus as well as the Candida albicans ATCC 90028, C. tropicalis (Strain 1) and C. albicans (Strain 8). Our work provides a view for the further studies on the antioxidant and antimicrobial of the MOEO and its main components.

Open Access Original Research Article

Thymus vulgaris L. Essential Oil: Effect on Fatty Acids and Proteins Oxidation of Little Tuna (Euthynnus alletteratus) Minced during Refrigerated Storage

Hafedh Hajlaoui, Soumaya Arraouadi, Emira Noumi, Kaïss Aouadi, Mejdi Snoussi, Adel Kadri

Journal of Pharmaceutical Research International, Page 1544-1551
DOI: 10.9734/jpri/2021/v33i60B34777

People are uncomfortable having their food chemically treated to boost its shelf life. Thus, Tunisian Thymus vulgaris Essential Oil (TVEO) were investigated in parallel with its capacity to limit fatty acids and proteins oxidation in tuna (Euthynnus alletteratus) minced during refrigeration storage (4°C). Our results revealed that for tuna preservation, the measured concentrations of PV, TBARS and TVB-N during different storage periods showed a good efficiency of this Essential Oil (EO) (3%) in limiting lipids and proteins oxidation of tuna flesh. Moreover, we observed increase in all batches which was significantly different (P< 0.05) with lots treated with TVEO were the most conserved comparing to the BHT. Overall outcomes suggest that TVEO use for tuna conservation could represent a promising strategy to improve the qualitative characteristics as well as the safety of seafood.

Open Access Original Research Article

Antioxidant and Antimicrobial Activities of Thymus vulgaris L. Essential Oil Growing Wild in Tunisia

Hafedh Hajlaoui, Soumaya Arraouadi, Hedi Mighri, Kaïss Aouadi, Mejdi Snoussi, Emira Noumi, Adel Kadri

Journal of Pharmaceutical Research International, Page 1560-1571
DOI: 10.9734/jpri/2021/v33i60B34779

The aim of this work is to investigate the chemical composition, antioxidant, and antimicrobial activities of Tunisian Thymus vulgaris essential oil (TVEO). DPPH, superoxide anion, reducing power, chelating effect on ferrous ions and β-Carotene assays have been employed to determine the antioxidant potential of TVEO. In contrast, 24 reference bacterial strains and 16 fungal strains have been used for the assessment of the antimicrobial activity. Results revealed that TVEO has as carvacrol (67.33%) chemotype, it was equipped with an important antioxidant capacity that is better (P<0.05) than synthetic antioxidants (BHT, BHA, Vitamin C and EDTA) except for superoxide anion test. A higher antimicrobial activity was also observed with IZ, MIC and MBC values of bacterial strains were ranged from 10.33±0.57 to 37.33±0.57mm; 0.019 to 0.078 mg/mL and 0.039 to 0.31 mg/mL respectively. But those of fungal strains were varied between 24.66±1-47.33±1.53 mm; 0.004-0.078 mg/mL and 0.019-0.15 mg/mL respectively. In summary, the obtained data makes TVEO as a good and suitable candidate for its use in food and pharmaceutical purposes.

Open Access Original Research Article

GC-MS Profile, α-glucosidase Inhibition Potential, Antibacterial and Antioxidant Evaluation of Peels Citrus aurantium (L), Essential Oil

Hafedh Hajlaoui, Soumaya Arraouadi, Kaïss Aouadi, Mejdi Snoussi, Emira Noumi, Adel Kadri

Journal of Pharmaceutical Research International, Page 1580-1591
DOI: 10.9734/jpri/2021/v33i60B34781

This study was designed to analyze the chemical composition of Citrus aurantium Essential Oil (CAEO) peels and to evaluate α-glucosidase inhibition potential, antioxidant and antibacterial activities. According to GC-MS analyses, 37 compounds were identified with limonene was the most abundant (62.2%). Majority of the identified compounds belong to hydrocarbon monoterpenes fraction (75.7%), followed by oxygenated monoterpenes (19.16%). CAEO α-glucosidase inhibition outlined an important activity with IC50 = 10±1 mg/mL. Moreover, antioxidant activity revealed that CAEO exhibited a potent scavenging effect through 2,2-diphenyl-1 picrylhydrazyl radical (DPPH.) (IC50=33.66 µg/mL) and an important ferric ion reducing antioxidant power (FRAP) activity (EC50=98.67 µg/mL). Antimicrobial data demonstrate that CAEO was active against a panel of pathogenic bacteria and that CAEO was able to destroy bacterial cells (bactericidal) according to the MBC/MIC ratios towards Gram+ and Gram- tested strains.

Open Access Original Research Article

The Association of Anemia with Vitamin D Deficiency among Patients Visiting King Khalid General Hospital in Majmaah, Saudi Arabia

Muath Alanazi, Raed Alharbi, Saleh Aloyuni, Ranjay Choudhary, Wael Alturaiki, Saeed Banawas, Bader Alshehri, Mohammed A. Alaidarous

Journal of Pharmaceutical Research International, Page 1616-1623
DOI: 10.9734/jpri/2021/v33i60B34785

Aims: To assess the association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.

Methodology: We reviewed the medical records of 120 patients (median age, male 37.44 [±17.86] and female 43.22 [±16.23] years; range 1–96 years) who attended the King Khalid General Hospital laboratory in Majmaah city, Saudi Arabia, between January 2019 and January 2020. The laboratory data included the following parameters: complete blood count (Hb, MCV, MCHC, MCH, Hct, WBC, RBC, and Plt) and vitamin D (25(OH)D) levels.

Results: The chi-squared analysis showed that moderate anemia was highest among the participants who had vitamin D levels >30 ng/ml and less than 20 ng/ml, with a prevalence rate of 5% (n=6) for each category. Mild anemia was prevalent among 4.12% (n=5) of the participants with vitamin D levels <20 ng/ml. Finally, there were significant associations between parameters including age, RBC count, WBC count, platelet count, MCV, MCH, MCHC, hematocrit, vitamin D, and anemia. In addition, the odds ratio results indicated that mild vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.63 to 1.92). Moderate vitamin D deficiency was associated with the degree of anemia, ranging from mild to moderate (OR=1.76 to 1.97). The results confirmed a negative association between normal vitamin D values and the degree of anemia.

Conclusion: There is a significant association between vitamin D deficiency and anemia among patients visiting King Khalid General Hospital in Majmaah City, Saudi Arabia.

Open Access Original Research Article

Role of Glucose 6 Phosphate Dehydrogenase (G6PD) in Diabetic Cataract

Muhammad Ishaque Bhatti, Ali Raza Memon, Muhammad Jamil Laghari, Rizwan Ahmed Memon, Sindhu Laghari, Fazeela Rizwan Memon, Salman Shams

Journal of Pharmaceutical Research International, Page 1646-1651
DOI: 10.9734/jpri/2021/v33i60B34789

Introduction: Diabetes mellitus and its complications are spreading with increased rate in Asian population especially in Pakistan. Uncontrolled diabetes can lead to different micro vascular complications. Cataract is one of the complications of diabetes which may lead to lens degenerative changes and visual impairment. G6PD plays a vital role in preventive measurements from cataract development in normal population.

Objectives: This Study was designed to estimate G6PD levels in diabetic without ocular manifestations & diabetic cataract population.

Methodology: This cross sectional comparative study was done at the Department of Biochemistry LUMHS Jamshoro in collaboration with the Diabetic clinic, Institute of Ophthalmology & Diagnostic Research Laboratory LUMHS Jamshoro. 100 diagnosed subjects of diabetes were selected by Non-Probability type of sample technique with consent of subjects and they were divided in to two groups Group A as control 50 diabetic subjects with out ocular manifestation while Group B as case study group contain 50 subjects of diabetes with cataract. The fasting blood glucose level was estimated by Hexokinase Method while G6PD level was measured by kit method on SD Biosensor while HbA1c(% ) was estimated by TTAB methodology. The data was statistically analyzed by SPSS 21.

Results: The mean level of G6PD in Group A was 15.63±2.45 u/Hb while in group B it was 9.01±3.11 u/G HB. This result finally concluded that there was significantly (<0.05) decline of G6PD diabetic cataract as compared with diabetic without cataract.

Conclusion: This study concluded that there was significant decline in G6PD level in diabetic cataract. It is also concluded that the estimation of G6PD level in diabetic population will be beneficial to take early preventive measurements against diabetic vascular complications.

Open Access Original Research Article

Morphological and Morphometric Analysis of Stylomastoid Foramen in Dry Human Skulls and its Clinical Implications

B. Vaishali, Karthik Ganesh Mohanraj

Journal of Pharmaceutical Research International, Page 1659-1664
DOI: 10.9734/jpri/2021/v33i60B34791

Introduction: Stylomastoid foramen present between two processes which are styloid process and mastoid process. Facial nerve and stylomastoid arteries are transmitted through the stylomastoid foramen. Facial canal gets terminated in the stylomastoid foramen. Stylomastoid foramen has a site for facial nerve block. Complications reduced by localization of foramen.

Aim: The aim of this study was to analyse the morphology and morphometry of stylomastoid foramen.

Materials and Methods: Damaged skulls were excluded and 60 dry human skulls without any damage were taken for this study. By using digital vernier caliper length and breath of the stylomastoid foramen was measured. Then the statistical analysis was done using SPSS software and paired t-tests were done for comparison.

Results: The length and breadth of the right stylomastoid foramen was 2.39 ± 0.18 mm and 0.85 ± 0.12 mm and the left stylomastoid foramen was 2.18 ±0.33 mm and 1.13 ± 0.38 mm. From the paired t-tests it was very clear that the difference between the breath of right and left stylomastoid foramen was significant (p<0.05) and difference between the length of right and left stylomastoid foramen was not significant (p> 0.05).

Conclusion: The narrow size of stylomastoid foramen varied from individual skull to other. The accurate value for length and breadth, was measured to determine the variations of facial nerve emerging through it. The change in length and breadth of stylomastoid foramen can be correlated with its clinical aspects with reference to facial nerve.

Open Access Original Research Article

Consumers’ Level of Awareness and Safety Perceptions of Food Additives

Badrah Al-Ghamdi, Ghidah Al-Tabsh, Alaa Al-Deibani, Rahaf Al-Muhanna, Shahlaa Gari, Nusaiba Khayyat

Journal of Pharmaceutical Research International, Page 1665-1674
DOI: 10.9734/jpri/2021/v33i60B34792

Aims: We aimed to measure the prevalence of Jeddah residents’ knowledge and their awareness of these ingredients.

Study Design:  A cross-sectional study.

Place and Duration of Study: The study conducted in Jeddah, Saudi Arabia, during 2019.

Methodology: This study was cross-sectional via an electronic survey that was handed out, and 676 of 868 respondents fit the inclusion criteria: all individuals were eighteen and above in addition to residing in Jeddah in 2019. Statistical analysis was performed using SPSS version 21. Pearson's chi-square was used to test association.

Results: The results showed that 63.5% of consumers needed more information about food additives. About 80.5% were familiar with preservatives which, in their opinion, were the most disconcerting food additives. Moreover, 37.2% desired easier and accurate labels to gain a better understanding of this topic, while 43.6% said that the most acceptable idea for disseminating information about food additives to the public was by animation in independent display areas.

Conclusion: The study’s findings are examined in terms of the implications for future research and for the development of concrete communication materials to improve food additive awareness in Jeddah, Saudi Arabia. The level of knowledge was low. Further studies are needed to be done in Saudi Arabia about this topic.

Open Access Original Research Article

Outcome of Deliberate Paraphenyline Di-Amine Ingestion among Young Women

Odho Lutuf Ali, Imtiaz Begum, Ali Raza, Aatir Hanif, Farhat Minhas, Khalil Ahmed

Journal of Pharmaceutical Research International, Page 1682-1686
DOI: 10.9734/jpri/2021/v33i60B34794

Background: Para phenylene diamine (PPD) or black stone, a common hair-dye ingredient in South Asia, has recently emerged as a new means of suicidal attempts in developing countries especially in Asia.

Objective: To determine the outcome of deliberate Para phenylene di-amine ingestion among young women.

Methodology: This descriptive analysis was conducted upon a sample of 400, young women (aged 18 to 35 years) presenting to the emergency department from June 2019 to December 2021, with deliberate Para phenylene di-amine ingestion. After taking written informed consent, the data was recorded onto a structured questionnaire containing inquiries pertaining to basic biodata, socioeconomic details, time elapsed since ingestion, clinical signs and symptoms and the outcome (within 24 hours).

Results: The mean age of the sample stood at 23 (SD ± 2) years. Out of the total 400 cases of deliberate ingestion reporting to the study setting, 19 were asymptomatic and were discharged after initial care. Among the symptomatic patients, 212 (53%) recovered within 12 hours without need for intensive care, while 139 (34.75%) needed admission to intensive care unit, following which a full recovery was achieved within 24 hours (98 patients) or more (31 patients), while the remaining 10 patients succumbed to the poisoning. 30 patients reached the hospital in critical state and died in the emergency department.

Conclusions: The cumulative mortality rate recorded in the research was 10%. Factors such as time between ingestion and presentation to the hospital, the quantity of ingestion and the general health status, affected the outcome of the patient.

Open Access Original Research Article

Satisfaction Levels of Remote Healthcare Simulation amongst EMS Professionals in Pune, India

Parag Rishipathak, Monesh Bhandari, Anand Hinduja

Journal of Pharmaceutical Research International, Page 1710-1716
DOI: 10.9734/jpri/2021/v33i60B34797

Aim: Healthcare education comprises of various components including theory, practicals, clinical and cognitive skills. The teaching andragogy has evolved from classroom sessions and laboratory experiments to clinical rotation duties. Simulation has played a significant role as a new revolutionary tool in andragogy as it involves self-reflective and immersive learning. The COVID-19 pandemic and social distancing rules necessitated the suspension of all in-person learning activities at workplaces, public places and all educational institutes. Consequently, distance learning became essential. As a result, the classroom sessions were replaced by online mode sessions and the teaching faculties had no option but to adapt to the new technology in a short period of time. It is crucial to gauge the satisfaction levels amongst Emergency Medical Professionals (EMP’s) attending remote simulation sessions to devise more user friendly programs for the future. The aim of the study is to assess the satisfaction level of the Emergency Medical Professionals exposed to remote simulation

Study Design: Quantitative Study.

Place and Duration of Study: Symbiosis Centre for Health Skills, Pune in October 2021.

Materials and Methods: A quantitative study on satisfaction level was conducted in October 2021, amongst 200 Emergency Medical Professionals (EMP’s) in the city of Pune, India. Simulated Clinical Experiences (SCE’s) on various cardiac emergencies were designed by Simulation Educators. The participants attended the session via virtual platform Microsoft Teams for a period of 2 hours. A 19-item student satisfaction survey, was used to determine the participant’s satisfaction with the remote simulation session.

Results and Discussion: The study was conducted with the aim to adjudge the level of satisfaction amongst EMS professionals with the remote simulation mode of teaching. In the post Covid era, remote learning has become a norm and cannot be ignored. The session successfully recreated a real patient care setting and the participants enjoyed the immersive learning experience. Although limited number of participants could actively engage in the patient care during the session, the debriefing ensured that all participants were involved in the session.

Conclusion: The unanimity in the satisfaction scores is very encouraging for facilitators to devise interesting SCE’s and teach in the remote simulation mode. This shall ensure that the continued medical education does not suffer as a result of the pandemic.

Open Access Original Research Article

Evaluation of Antioxidant and Xanthine Oxidase Inhibitory Potential of Methanolic Root Extract of Acorus calamus- an In vitro Study

Ashfaaq Ahmed, R. Gayathri, V. Vishnu Priya, J. Selvaraj, S. Kavitha

Journal of Pharmaceutical Research International, Page 1724-1730
DOI: 10.9734/jpri/2021/v33i60B34799

Background: Gout is an inflammatory joint disease that elevates the uric acid levels in blood that triggers the formation of urate crystals in the joint,especially since the past 50 years. Xanthine oxidase catalyses oxidative hydroxylation of hypoxanthine to Xanthine to uric acid. show it's higher in men aged above 50 years. Acorus calamus is a mid term, perennial, fragrant herb. Therefore, the main approach for the treatment of gout is reducing uric acid.

Aim: To analyze the antioxidant and Xanthine Oxidase inhibitory potential of methanolic root extract of Acorus calamus.

Materials and Methods: Preparation of methanolic root extract of Acorus calamus was done by hot percolation method. Phytochemical screening test was done. The antioxidant activity was carried out by DPPH radical scavenging assay. Anti gout potential of the herbal extract was analysed by the evaluation of Xanthine oxidase inhibitory potential. The data were analyzed statistically by a one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test to see the statistical significance among the groups. The results with p<0.05 level were considered to be statistically significant.

Results: Methanolic root extract of Acorus calamus shows a strong presence of phytochemicals such as alkaloids ,terpenoids, steroids, saponins, flavonoids.IC50 of antioxidant potential of Methanolic root extract of Acorus calamus was found to be 210 µg/ml.Ic 50 of xanthine oxidase inhibitory potential of methanolic root extract of Acorus calamus was found to be 310 µg/ml.

Conclusion: Methanolic root extract of Acorus calamus exhibited significant antioxidant and anti gout potential. Further research on the natural Xanthine oxidase inhibitors especially in vivo studies and investigation of active compounds and its pharmacokinetics to be elucidated.

Open Access Original Research Article

Synthesis, Anti Cancer and Anti Fungal Studies of New Phenyl Ethylene Derivatives

V. S. R. N. Phanikumar, M. Kiranmai Reddy, G. Veera Raghava Sharma

Journal of Pharmaceutical Research International, Page 1737-1742
DOI: 10.9734/jpri/2021/v33i60B34801

Synthesis of Phenyl ethylene derivatives (4a-4f ) are reported in this communication. Products were characterized by1HNMR, Carbon (13C) NMR  and Mass spectral data. Synthesized compounds of 4a-4f were screened for anti cancer and anti fungal activities and their results are presented. The main intermediate (3) was prepared from 4-methoxy phenyl acetone (1) reacted with aqueous ethylamine and NaBH4  to get the compound (2).Further dehydrohalogenation of (2) with 4-bromobutanol and potassium carbonate at 80°C  resultedin compound (3)which on  further dehydration with p-toluene sulfonic acid under reflux conditionsgave 4a to 4f.

Open Access Original Research Article

Patient’s Satisfaction about Dental Services during Pandemic COVID-19 at Riyadh Elm University: A Questionnaire Study

Sarah Abu-Raisi, Atheer Al-Baqami, Razan Al-Ruwaili, Sarah Al-Qahtani, Lama Al-Julayfi, Bushra Al-Ghanoom

Journal of Pharmaceutical Research International, Page 1752-1759
DOI: 10.9734/jpri/2021/v33i60B34803

Background: Health-care organizations all throughout the world are concerned about quality. Patients' satisfaction has been studied at a number of dental clinics throughout the globe. Patient satisfaction is an important factor in assessing the relationship between the quality of health-care services delivered and the patients' confidence. During the COVID-19 epidemic, the study's goal was to find out how satisfied patients were with the quality of dental treatment, as well as the preventative measures and precautions offered at Riyadh Elm University's dentistry clinics.

Materials and Methods: During the COVID-19 epidemic, a pre-validated questionnaire was issued to patients visiting Riyadh Elm University clinics. The research took place from March to September 2020. The questionnaire included questions about consultation provision, gratification with the receptionist's performance, satisfaction with your treating healthcare professional, treatment expenses, satisfaction with the level of housekeeping prevention strategies and preemptive provided, and eventually an overall assessment of the clinic's services.

Results: During the COVID-19 pandemic, 1313 questions were gathered from the Riyadh Elm University dentistry clinic's electronic system. During the pandemic COVID-19, (92%) of the participants agreed that getting an appointment at the dental clinics was straightforward, (88.9%) were satisfied with treatments received at Riyadh Elm University's Dental Clinic during the COVID-19 epidemic, and (66 percent) with treatment costs. During the pandemic COVID-19, the vast majority of participants (91 percent) were satisfied with their treatment provider, and the vast majority of participants were satisfied with the services offered by Riyadh Elm University's dentistry clinic.

Conclusions: Riyadh Elm University's dentistry clinics were successful in achieving participant satisfaction with services, staff, treatment, and fees during the COVID-19 outbreak.

Open Access Original Research Article

A Study Design for Awareness Regarding Appropriate Antimicrobial use and Antimicrobial Resistance among Health Care Professionals and Lay Persons

Tileshkumar Turankar, Shilpa Gaidhane, Sonali G. Choudhari, Abhay Gaidhane, Shantanu Raju Sawale

Journal of Pharmaceutical Research International, Page 1760-1765
DOI: 10.9734/jpri/2021/v33i60B34804

Aim: This study is designed to determine the awareness of anti-microbial resistance and appropriate antimicrobials use among health care professionals (intern, junior residents and nurses) and lay persons.

Methods: The study will be held at rural tertiary care hospital in central India including junior resident, Interns and nurses, patient and their relatives. Survey tool and data questionnaire will be provided to participants in English and Marathi.

Results: Comparison of knowledge of antimicrobial resistance among hospital staff, patient and their relatives will be done.

Conclusion: There is a need to frame policies to prevent excessive use of Antimicrobials and to increase awareness about the knowledge of proper usage antimicrobial and antimicrobial resistance among lay person.

Open Access Original Research Article

Assessment of Cytotoxic, Antioxidant, Thrombolytic, Anti Inflammatory and Antimicrobial Activity of Curcuma longa Linn, Cissus quadrangularis and Boerhaavia diffusa Herbal Mixture - An In vitro Study

Y. Dinesh, R. Abilasha, Pratibha Ramani, S. Rajeshkumar

Journal of Pharmaceutical Research International, Page 1766-1777
DOI: 10.9734/jpri/2021/v33i60B34805

Background and Aim: Plants play an important role in drug research, and the pharmaceutical industry is heavily reliant on natural products for new drug development. Curcumin, a natural compound contained in the rhizomes of the plant Curcuma longa Linn., has been shown to have anti-inflammatory properties in scientific studies. Cissus quadrangularis L. is a fleshy plant that can be found all over the world, especially in Asia, Africa, and a few other warm tropical areas. Boerhaavia diffusa L. (Nyctaginaceae) is present in the tropical regions of India, South America, and Africa. B. diffusa roots are commonly used in Ayurveda to treat various ailments. The aim of the study is to assess the cytotoxic, antioxidant and thrombolytic, antiinflammatory and antimicrobial properties of the aqua-alcoholic extract of the herbal mixture (Curcuma longa Linn +Cissus quadrangularis +Boerhaavia diffusa )

Methods: Aqua-alcoholic extract of mixture of Curcuma longa Linn, Cissus quadrangularis and Boerhaavia diffusa was prepared. Phytochemical in-vitro studies were done using the CCB mixture cytotoxicity by brine shrimp lethality assay, antioxidant activity by DPPH assay, anti inflammatory activity by albumin denaturation assay, antimicrobial activity against Staphylococcus aureus, Streptococcus mutans, Escherichia coli and Candida albicans by agar well diffusion method, thrombolytic activity by clot lysis assay.

Results: The CCB mixture showed good cytotoxic activity at varying concentration in brine shrimp lethality assay, increasing antioxidant activity with DPPH assay, increasing thrombolytic activity, increasing anti inflammatory activity with increasing concentration, the anti microbial activity was not efficient as positive controls.

Conclusion: In this in-vitro study the CCB mixture shows improved cytotoxic, antioxidant, thrombolytic, anti-inflammatory and antimicrobial activity. Further studies on invivo animal and human clinical trials needs to be done.

Open Access Original Research Article

Morphological and Morphometrical Analysis of Dry Human Scaphoid Bone in South Indian Population and Its Clinical Implications

K. Uma Maheswari, Karthik Ganesh Mohanraj

Journal of Pharmaceutical Research International, Page 1803-1809
DOI: 10.9734/jpri/2021/v33i60B34809

Introduction: Scaphoid is the second largest among all the carpal bones, which is present on the radial side of the proximal row of carpal bones. Scaphoid Fractures are the most common of the carpal bone injuries. Scaphoid Fractures heal slowly due to thelimited blood circulation of the bone

Materials and Methods: The study was performed on 20 Scaphoid Bones,which were collected from the Department of Anatomy,Saveetha dental college. By using digital vernier callipers,morphological and morphometrical parameters (length and breadth)of scaphoid bones were measured,tabulated and statistically analysed.

Results: All the 20 scaphoids showed the presence of tubercle. Double foramina in the main dorsal sulcus were seen in 7 right and 6 left specimens. No significant differences were found in lengths and breadths of the bone.In the present study, at least one foramen is found in all the main dorsal sulcus and the number of specimens showing presence of double foramen in the main dorsal sulcus are 7 right and 6 left specimens.

Conclusion: This study showed that no significant morphological and morphometric differences were found between right and left sides. The data obtained in the present study will be helpful for the hand surgeons, radiologists and clinical anatomists for surgical reduction to follow up the reunion of fractured scaphoid bones.

Open Access Original Research Article

Accuracy in the Dimension of Extracted Tooth with Intraoral Periapical Radiograph: A Comparative Study

Akshay Nambiar, Joyce P. Sequeira

Journal of Pharmaceutical Research International, Page 1833-1839
DOI: 10.9734/jpri/2021/v33i60B34814

Introduction: Because of its simplicity, cheaper cost, lower radiation exposure, and easy availability in a dental clinical setting, intraoral periapical radiographs (IOPAR) are frequently utilised for preoperative planning and evaluation for most minor oral surgical procedures.

Aim: The Aim of this study is to Assess the Accuracy and Reliability of Intraoral Periapical Radiograph with the extracted teeth.

Methodology: The study is comprised of 54 patients. For each extracted tooth, the actual measurements for tooth length will be measured with a Vernier caliper with a least count of 0.01mm. After obtaining the actual length of the tooth with the Vernier Caliper, the Length of the tooth will be measured from the Intraoral Periapical Radiograph using a Vernier caliper.

Results: By comparing the length of the actual tooth with that of an IOPAR, it was found out that the difference that was obtained is statistically significant.

Conclusion: There is significant overestimation in the dimension of the tooth.

Open Access Original Research Article

Dextromethorphan Use in the Outpatient Department

Menshawy A. Menshawy, Nehad J. Ahmed, Abdullah A. Alrizqi, Bander A. Alhuthali, Ibrahim A. Alghamdi, Saleh Alghamdi

Journal of Pharmaceutical Research International, Page 1846-1851
DOI: 10.9734/jpri/2021/v33i60B34816

Aim: The present study was conducted to describe the use of dextromethorphan in the outpatient department. 

Methodology: This is a retrospective study that involves evaluating electronic prescriptions for dextromethorphan among outpatients in a public hospital in Alkharj.

Results: During the study period, 348 patients received dextromethorphan. Most of them were females and the age of more than half of them was between 20 and 39 years. Most of the patients used dextromethorphan for 5 days (63.51%) and about 30% of patients used it for 7 days. Most of the prescriptions were written by emergency department (93.97%).

Conclusion: The present study showed that dextromethorphan was commonly prescribed in the outpatient setting in Al-Kharj. Furthermore, more studies are needed to explore the appropriateness of its use.

Open Access Original Research Article

Role of Neoadjuvant Chemotherapy in Locoregionally Advanced Oral Cancers

Vinay Nandlal Baretha, M. B. Bagawan, Ashok Kshirsagar

Journal of Pharmaceutical Research International, Page 1858-1865
DOI: 10.9734/jpri/2021/v33i60B34818

Background and Aim: Oral-carcinoma is one of the most common cancer world-wide. Its treatment in advanced conditions to increase the survival rate is a major concern. This study was aimed at assessing the use of neoadjuvant cancer therapy (NACT) for improving the operability in non-operable patients with advanced oral carcinoma (T4b and N3 disease) and to observe easier resection in T4a disease.

Methodology: This prospective study included total 40 patients with advanced oral carcinoma (T4a, T4b, and N3 stages), who were administered with NACT- Cisplatin (80 mg/m2) over 2 days and 5-fluorouracil (750 mg/m2) for 4 days along with hydration and antiemetics (3 cycles for every 4 weeks) and later, if resectable, will be taken for the surgery . Follow up of patients (6 months) was advised to assess recurrence if any. Chi-square test was performed to analyze the association of NACT with resectability and operability in patients. Histopathological examination was done to see for extent and margns status post surgery. Non operable cases were given palliative radiotherapy and symptomatic treatment.

Results: Patients displayed T4a (70%), T4b (30%), and N3 (15%)stages of oral cancer. Stable disease was observed in 57.5% of patients, indicating its importance in cancer treatment. Easier resection was observed in 67.85% i.e. 19 patients. Significant association of locoregionally advanced oral cancer (T4a, T4b and N3 disease) with respectability (P=0.012) and operability (P=0.001) after NACT was observed. The most common adverse events observed during NACT were nausea/vomiting (28.3%), neutropenia (11.66%), diarrhea (8.33%), and anemia (3.33%).

Conclusion: Easier resection in 67.85% cases among operable group seen and 50% of cases among non operable group became operable. Further studies on its profound use in oral squamous cell carcinoma can help reduce morbidity and increase the survival rate.

Open Access Original Research Article

Evaluation of Anti Cholesterol and Antioxidant Potentiality of Aqueous Extracts of Citrus aurantifolia, Zingiber officinale and its Formulation - a Comparative In vitro Study

Priyanka Sivasubramanian, R. Gayathri, V. Vishnu Priya, J. Selvaraj, S. Kavitha

Journal of Pharmaceutical Research International, Page 1873-1882
DOI: 10.9734/jpri/2021/v33i60B34820

Background: Several plant extracts and herbs have been used for treating and prevention of cardiovascular diseases hypertension, angina pectoris, congestive heart failure, atherosclerosis, cerebral and venous insufficiency and arrhythmia. Similarly, aqueous extracts of Citrus aurantifolia and Zingiber officinale which is commonly called as lemon and ginger respectively and its formulation were analysed for its antioxidant and anti cholesterol activity.

Objective: This research has been performed in order to evaluate the anti cholesterol and antioxidant potentiality of aqueous extracts of Citrus aurantifolia, Zingiber officinale and its formulation respectively.

Methods: The study setting carried out for this research was in vitro, hence the work was performed outside the living organism. Citrus aurantifolia and Zingiber officinale were purchased from a farm in chennai. The experiment began starting from the preparation of aqueous extract of lemon and ginger. A formulation was made combining equal amounts of the two extracts followed by this, a phytochemical screening test was conducted. Antioxidant and anti cholesterol potential of the extracts and its formulation were also analysed. The data was statistically examined by one-way analysis of variance (ANOVA) continued by Duncan’s multiple range test, it was compiled to see the statistical significance among the groups present. The results carrying p<0.05 level were contemplated to be statistically significant.

Result: From the study, though both the extracts possessed a good antioxidant and anti cholesterol potential, comparatively the formulation exhibited an increased antioxidant and anti cholesterol potential respectively (IC₅₀ = 250 µg/ml) and (IC₅₀= 375µg per ml). Here, the formulation exhibited significantly more activity than the individual extracts.

Conclusion: Even though there is sufficient knowledge among citizens about the nutritional value present in herbal formulations, there isn’t enough in-depth study conducted on the formulation of these two extracts based on their cholesterol inhibitory activity. From this particular study it was proven that the formulation showed synergism. Hence the formulation of these extracts could be preferred over other synthetic drugs since it is natural, cost effective and easily accessible.

Open Access Original Research Article

The Prescribing of Glucosamine Supplements in the Outpatient Setting in Alkharj

Nehad J. Ahmad, Mohamad Ayman Salkini

Journal of Pharmaceutical Research International, Page 1908-1912
DOI: 10.9734/jpri/2021/v33i60B34824

Aim: This study aimed to describe the prescribing and use of glucosamine supplements in Alkharj.

Methodology: This is a retrospective study that includes reviewing the electronic prescriptions of glucosamine supplements among outpatients in Alkharj.

Results: During the study period of 6 months, only 36 patients received glucosamine supplements from the outpatient department in a public hospital Alkharj. The age of more than 63% of the patients was more than 49 years. Most of the patients who received glucosamine supplements were females (75%). All of the glucosamine supplements prescriptions contained capsules for 30 days. More than 52% of the prescriptions were prescribed by specialists. More than 80% of the prescriptions were prescribed by orthopedic department and 8.3% were prescribed by rheumatology.

Conclusion: The present study showed that the use of glucosamine was uncommon in Al-Kharj. Further studies are needed to explore the frequency of using glucosamine in different settings in Alkharj.

Open Access Original Research Article

Awareness of Blood Pressure Changes during Menstrual Cycle

. Joshitha, A. Jothi Priya, R. Gayatri Devi

Journal of Pharmaceutical Research International, Page 1920-1927
DOI: 10.9734/jpri/2021/v33i60B34826

Introduction: Blood pressure is not constant at different days of the month and even throughout the day. Variation in BP during different phases in the menstrual cycle can also be attributed to the effect of the female hormones on cardiovascular systems. The purpose of the study was to evaluate the awareness of blood pressure changes during the menstrual cycle.

Aim: To Assess the Awareness of Blood Pressure Changes during Menstrual Cycle.

Materials and Methods: The sample size used for the study is 100. A self structured questionnaire was prepared and uploaded on google forms. This standard questionnaire in google forms was circulated. After which all the data was collected and the data was analysed using Chi square analysis. The Chi square analysis was done using SPSS software.

Result: We were able to establish a fair awareness about blood pressure changes during the menstrual cycle among our study population. It was statistically significant with p value of 0.037 (P<0.05).

Discussion: Variation in BP during different phases of the menstrual cycle can also be attributed to the effect of ovarian hormones on cardiovascular function. Since hormonal changes follow a non-linear trend throughout the menstrual cycle, it may have an unpredictable effect on BP regulation

Conclusion: There is a fair amount of awareness about blood pressure changes during menstruation among both women and men but women have more awareness.

Open Access Original Research Article

Prevalence of Anxiety Disorder among MBBS under Graduate Students during COVID-19 Pandemic, Tamilnadu

Ardhanaari Manickavasagam, . Premasubathira, M. Pavanasaravanan, S. Sumitra, Vijay Chathoth, Ramarao Mannam

Journal of Pharmaceutical Research International, Page 1935-1943
DOI: 10.9734/jpri/2021/v33i60B34828

Anxiety disorder is one of the most common psychiatric co-morbidity found to be prevalent in many pandemic situations or while experiencing a delimiting illness to self or community. This study aimed at screening undergraduate students pursuing MBBS for anxiety disorder. It was focused on early diagnosis, intervention and creating awareness among themselves and their community. The  study was done among 272 undergarduate medical students from Tamil nadu during the period when COVID- 19 infection was prevalent in the community. They were requested to fill a proforma and questionnaire and were screened with Hamilton Anxiety scale. Study reported 80.9% mild, 11.8% moderate and 5.1 % severe levels of anxiety in study population.

Aim: To study the prevalence of anxiety among MBBS under graduates during COVID pandemic in Tamilnadu.

Study Design: Cross sectional online screening and assessment study.

Place and Duration of Study: The study was done online from Meenakshi Medical college and Research Institute, Enathur, Kanchipuram, Tamilnadu, from December 2020 to January 2021.

Methodology: The study included 272 MBBS undergraduate students of Tamilnadu (180 female and 92 male participants; age range 18-24 years All the participants were asked to fill an online proforma questionnaire following an online consent form and were screened and assessed for anxiety disorder using Hamilton Anxiety scale. Students who had severe COVID-19 infection or non consenting individuals were excluded from the study.

Results: 80% of the study population belong to age group between 19-21 years of age.  This study had more female (66.2%) participants when compared to male (33.8%). Majority of the study population belong to Hindu religion (89%) followed by Christians (5.9%) and Muslims (5.1%). Majority of the study population belong to upper socio-economic status (76.5%). Most of the study population were not infected by COVID-19 disease 76.8%) followed by 14.7% with past history of COVID -19 infection and 8.5% were actively infected during the study period. Most of the study population reported on anxious mood (85.3%) with various severities ranging from mild (32.7%), moderate (34.9%), severe (13.6%), very severe (4%) while only 14.7% had no anxious mood. 67.6% of the study population reported of anxious mood from mild to moderate in severity. 84.2% of study population reported on tension with various severities ranging from mild (30.5%), moderate (31.3%), severe (16.2%), very severe (6.3%), whereas 15.8% reported on absence of tension. 62.1% of the study population reported of having fearfulness with varying severities mild (27.2%), moderate (25%), severe (6.6%) and very severe (3.3%) while 37.9% did not report of fear. Majority of the study population reported of insomnia (63.6%) with varying severities of mild (26.5%), moderate (16.9%), severe (13.2%) and very severe (7%) while 36.4% did not report of insomnia.71% of the study population reported of impaired attention and concentration. 71% of the study population reported of depressed mood, mild (29.8%) , moderate (19.1%), severe (16.2%)and very severe (5.9%) while 29% had no mood symptoms. Hamilton – Anxiety scale revealed that 80.9% had mild, 11.8% moderate, 2.2% severe and 5.1% had very severe anxiety levels.

Conclusion: Majority of the study population had anxiety symptom severity ranging from mild to very severe. Pandemic situation had led to an increase in the incidence of anxiety disorder even among medical students. Early screening and management of symptoms might lead to better prognosis.

Open Access Original Research Article

Complimentary Food Practices in Rural Areas (6 Months to 1 Year)

Samidha Borkar, Jayant Vagha

Journal of Pharmaceutical Research International, Page 1944-1950
DOI: 10.9734/jpri/2021/v33i60B34829

Background: Diet is defined as nutritionally adequate & appropriate intake of food items that also provide the required energy & protein intake by ensuring proper growth and development. Adequate nutrition of the infants & child is essential. Complementary needed practices are included apart from breast milk to meet one's needs. A balanced diet is defined as nutritionally adequate & appropriate intake of food items that also provide energy and protein.

Methods: A cross-sectional/observational study is to be conducted by taking approval to meet one’s need; complimentary food practices are included apart from breast milk, from the ethical committee which includes multigravida women as study participants PNC, PEDS ward, AVBRH. The data of sample size is recorded, tabulated analyzed.

Results: As many as 43.33% of the mother from the study group has started weaning practices before six months of age. Whereas the standard complementary feeding practices is Dal pain (66.66%) followed by mashed roti/bread (60%) furthermore Dalia (53.33%). The no meals per day were three meals by 36.66% of participants. The typical food being Dal pani, a thin gruel, with most of the participants starting weaning

Conclusion: Poor complementary feeding practices are observed in a rural typica e comisfood is Dal pani, a thin gruel, with most participants starting weaning before 6 months of age.

Open Access Original Research Article

The Perception of Attitude as a Factor that Affect Professionalism among General Physicians of Primary Health Care Centers in Saudi Arabia

Fatimah Ibrahim Tahtouh, Abdulbari Ahmed Hanash, Mohammed Ibrahim Tahtouh, Esmahan Ibrahim Tahtouh, Razia Aftab Ahmad

Journal of Pharmaceutical Research International, Page 1951-1961
DOI: 10.9734/jpri/2021/v33i60B34830

Background: Medical professionalism is considered, in modern clinical practice as the basis of the social contract between physicians and their society. It encompasses a wide range of values such as altruism, accountability, excellence, duty, service, honor, integrity, and respect for others. It has been researched extensively in the Western world, but only a dearth of studies exist in Saudi Arabia and the Middle East.

Methods: A cross-sectional study was conducted on 157 physicians working in primary health care centers in Abha and Khamis-Mushayt cities of Saudi Arabia. The study tool was a self-addressed validated questionnaire.

Results: Participants in the study were 157 general physicians, of whom 63.7% were males. The Saudis were 84.1%. The mean of experience of work in years was 3.5 years. Only, 50.3% had training in medical professionalism training, whereas 49.7% did not receive any training in professionalism (the mean number of training sessions was 3.1). The mean score of professionalism was 109.1 (out of a potential total of 130 points). Participants with High professionalism were 49%, while 49.7% were found to have moderate professionalism, and only 1.3%, was with poor professionalism. Factors related to a significantly positive association with professional behavior were; higher age, being married, being non-Saudi, higher qualifications (like Diploma/MSc), increased practice experience, and professional training one is involved in.

Conclusion: The participant physicians reported high levels of professional behavior. However, there is a need to focus on addressing job satisfaction factors to improve participants’ practice attitude and subsequently increase professionalism.

Open Access Original Research Article

The Use of Topical Chloramphenicol for Eye Diseases in the Outpatient Setting

Nehad J. Ahmad, Abdullah I. Hamdi, Nawaf Binduhaim, Hesham A. Alkhulifi, Menshawy A. Menshawy

Journal of Pharmaceutical Research International, Page 1970-1974
DOI: 10.9734/jpri/2021/v33i60B34832

Aim: The present study was conducted to evaluate the outpatient prescribing pattern of ophthalmic chloramphenicol in a public hospital in Alkharj.

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

Results: During the study period from 1st of January 2018 to the end of June 2018, 168 patients received ophthalmic chloramphenicol. More than 50 % of them were males and the age of 55.95% of them was less than 20 years. More than 46% of the ophthalmic chloramphenicol prescriptions were prescribed for 7 Days and 39.29% were prescribed for 5 days. More than 83% of the prescriptions were prescribed by emergency department.

Conclusion: The present study showed that ophthalmic chloramphenicol was uncommonly prescribed in Al-Kharj. Further studies are needed to explore the appropriateness of its prescribing and its use in order to decrease the bacterial resistance and to increase its efficacy.

Open Access Original Research Article

Role of Yogurt in Children having Diarrhea and Severe Acute Malnutrition at Nutrition Stabilization Center Hyderabad

Aqsa Abbasi, Farzana Shaikh, Muhammad Nadeem Chohan, Khuda Bux Khoso, Zamir Ahmed, Abdul Hameed Radhan

Journal of Pharmaceutical Research International, Page 2007-2012
DOI: 10.9734/jpri/2021/v33i60B34838

Aim: The aim of conducting this study is to evaluate the role of yogurt in the dietary management of diarrhea in the severe malnutriated children.

Study Design: Observational prospective study.

Place and Duration: Nutrition Stabilization Center, Department of Pediatrics Civil Hospital Hyderabad from 1st July 2018 to 31st December 2018.

Methodology: A total of 100 children with severe acute malnutrition and Diarrhea, age 6 months to 5 years were enrolled. After admitting children were treated with yogurt instead of fluids, f-75 and ORS. Within 7 days of admission we observed and recorded that children tolerated the breast milk and yogurt, clinically improvement, General condition, Edema, Sunken eyes, Thirst, Skin pinch, Weight gain and Social response of baby. Chi-square test was also applied to observe the difference efficacy of yogurt in diarrhea in children suffering from malnutrition. P-value ≤0.05 was considered as significant.

Results: Most of the children were 13 to 48 months of age. The average age and weight of the children was 32.04±13.53 months and 5.23±1.39kg respectively. Average number of stool was significantly reduced at day 1 and day 5. Overall it was observed that efficacy of yogurt in diarrhea in children suffering from malnutrition was 69%.

Conclusion: This study suggest that yogurt-based diet is effective in treating diarrhea in severely acute malnourished children. It should be granted priority in the nutritional management of severe malnutriated children affected by diarrhea.

Open Access Original Research Article

Topical Hydrocortisone Use in the Outpatient Department

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

Journal of Pharmaceutical Research International, Page 2020-2024
DOI: 10.9734/jpri/2021/v33i60B34840

Aim: This study aimed to describe the use of topical hydrocortisone in the outpatient department in Alkharj.

Methodology: This was a retrospective study that included reviewing the electronic prescriptions of topical hydrocortisone among outpatients in Alkharj. The inclusion criteria included all of the outpatient prescriptions that contained topical hydrocortisone in the study period.

Results: During the study period between January 2018 to June 2018, 196 patients received topical hydrocortisone. More than 52% of the patients were males and the age of 31.63% of them was less than 10 years. Most of the patients received topical hydrocortisone as a cream (87.76%). Most of the prescriptions that contained topical hydrocortisone were written by residents (98.98%) and most of the prescriptions that contained topical hydrocortisone were written by emergency department (70.41%).

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

Open Access Original Research Article

Psychological Status of Healthcare Workers during COVID-19 Pandemic in Saudi Arabia

Feras Abdullah Al-Awad, Hawraa Mohammed Aldhamen, Abdullah Ali Alghamdi, Abdulaziz Abdulkhaliq Alwakeel, Kawthar Mohammed Aldhamen, Lina Adel Alafghani, Khames T. Alzahrani, Abdulmajeed Alwabel, Samaher Barabie, Ahames Alharthi, Baraa Omar

Journal of Pharmaceutical Research International, Page 2030-2042
DOI: 10.9734/jpri/2021/v33i60B34842

Background: The 2019 Corona Virus Disease (COVID-19) is a global pandemic affecting the lower respiratory tract that is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2). It has caused psychological stress on people around the world, particularly those in the medical field. The purpose of this study is to determine the levels of anxiety, depression, burnout, and the sources of anxiety among healthcare workers (HCW) in Saudi Arabia during the COVID-19 pandemic. To determine the coping strategies of HCWs in dealing with mental health issues that may affect them during the pandemic.

Methodology: An observational cross-sectional study was carried out between May 2020 to November 2021 in Saudi Arabia. A Total of 260 HCW of both genders who are working in private and governmental hospitals were selected. However, non-healthcare workers such as technicians, administrators, clerical staff and maintenance workers were excluded.

Results: A total of 260 HCWs 98 (37.7%) doctors, 27 (10.4%) nurses, 6 (2.3%) pharmacists, 5(1.9%) physiotherapists, 113(43.5%) interns and 11 (4.2%) others, of whom 127 (48.8%) were male and 133 (51.2%) were female. The majority of participants aged from 20-29 years old 205 (78.5%), followed by 30-39 years old 26 (10%), 40-49 years old 18(6.9%), and 50-59 years old 10(3.8%), and 70-79 years old 1(0.4%). Around 42(16.2%) HCWs were working in ER, 82(31.5%) in wards, 83(31.9%) in outpatient clinics, 15(5.8%) were working in both wards and outpatient clinics, 6 (2.3%) in ICU and around 32(12.3%) in all demographics.

Conclusion: The results of this study illustrated the burden of psychological problems among different healthcare workers during the COVID-19 pandemic. The findings suggest that all health care workers (HCWs) were affected by varying degrees severity of anxiety and depression, insomnia and complaining from cardiovascular symptoms.

Open Access Original Research Article

Frequency of Complementary Feeding, Top Feeding and Exclusive Breast Feeding among Infants at Tertiary Care Unit: A Retrospective Cross Sectional Study

Sehrish Memon, Ayesha Farhat, Asadullah Memon, Iqra Khokhar, Hina Naqvi, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 2050-2055
DOI: 10.9734/jpri/2021/v33i60B34844

Aim: To determine the frequency of complementary feeding, top feeding and exclusive breast feeding among infants at tertiary care unit

Study Design: Retrospective cross sectional study

Place and Duration: Pediatric Out Patient Department (OPD) of Sheikh Zayed Hospital, Lahore from November 2017 to May 2018

Methodology: Three hundred children were enrolled. The mothers of the children were asked about the feeding practices (i.e. exclusive breast feeding, top feeding, complementary feeding) which were described as frequency distribution table

Results: Exclusive breast feeding was found in 54 (18%) children, complementary feeding started at 6 months of age in 102 (34%) children, while the top feeding was given in 144 (48%) children.

Conclusion: At the age of 6 months, complimentary feeding was practiced most frequently. Exclusive breast feeding was not very common. So, mothers should be encouraged to promote breast feeding among their children.

Open Access Original Research Article

Gingival Recession among the Patients Wearing Fixed Braces Visiting Dental College of Larkana

Mor Khan Shar, Amna Nisar, Aalishan Ali Raza, Sarang Sohoo, Zahra Batool, Abdul Bari Memon, Mehran Mazhar Abro

Journal of Pharmaceutical Research International, Page 2077-2082
DOI: 10.9734/jpri/2021/v33i60B34848

Aim: To evaluate gingival recession among the patients wearing fixed braces visiting dental college of Larkana.

Study Design: Descriptive Cross-Sectional

Place and Duration of Study: Department of Orthodontics, Bibi Aseefa Dental College (BADC) Larkana December 2018 to February 2020.

Methodology: This study was carried out at Bibi Aseefa Dental College Larkana. The patients were recruited with consecutive sampling technique. The gingival recession was evaluated clinically using Miller`s classification. A structured questionnaire was used for the information relevant to oral hygiene status. Data was analyzed using SPSS version-23.0.Chi-square test was applied between the gender and gingival recession at 95% confidence interval.

Results: Males were 23% and females were 77%. The mean age was 21.03±4.684.The class-I recession was observed in 6% patients and Class-II was in 2% patients. The gingival recession was observed in 8.5% patients. There was significant relationship between gingival recession and gender (p-value-0.018).

Conclusion: It is concluded that there were many patients facing the problem of gingival recession during treatment. There was significant association of gender and gingival recession.

Open Access Original Research Article

A Study of Carotid Doppler and Highly Specific C Reactive Protein in Type II Diabetes Mellitus and Its Correlation with Macrovascular Complications

Vijayashree S. Gokhale, Rupesh S. Parati, Ponvijaya Yadav, Keyuri Mehta

Journal of Pharmaceutical Research International, Page 2092-2098
DOI: 10.9734/jpri/2021/v33i60B34850

Background: Diabetes has a multitude of macrovascular complications, one of them being Carotid artery Atherosclerosis leading to stenosis and predisposing patient to Stroke. A hypothesis put forward is the presence of low-grade inflammation in Diabetic patients, which may enhance atherosclerosis. A study was planned to assess Carotid artery stenosis and HsCRP levels in Diabetic patients, so as to identify at risk group and take measures to prevent complications such as stroke and ischemic heart disease.

Aim: To study the patients by clinical parameters, ultrasound carotid doppler study, and estimation of HsCRP with patients of type II DM.

Study Design: Cross sectional observational study.

Place and Duration of Study: Study was conducted at Department of General Medicine, Dr D Y Patil Medical College, Pune from July 2019 – September 2021.

Methodology: The study included 50 subjects with type 2 DM (as per inclusion and exclusion criterion). All participants were explained the nature of the study and after informed consent all subjects were clinically examined and were subjected to carotid artery doppler and HsCRP levels.

Results: In our study 16% had carotid stenosis of <50% while 8% had >50%. However, 42% had increased intima-media thickness. On the other hand, 52% subjects had raised HsCRP levels.

Conclusion: In our study, Carotid Stenosis and impending stenosis was seen in significant number of Diabetic patients of more than 5 years duration, who also had higher HsCRP levels.

Open Access Original Research Article

Comparative Evaluation of the Influence of Single Preoperative Antibiotic Dose of Amoxicillin (1gm) and Postoperative Antibiotic Dose of Amoxicillin Drug (500mg) Regimen on Postoperative Outcome and Implant Stability in Single Tooth Dental Implant Surgery: Randomized Controlled Trial

Soumya Dudhani, Shwetha Shetty, Amit Jagtap

Journal of Pharmaceutical Research International, Page 2108-2119
DOI: 10.9734/jpri/2021/v33i60B34852

Aims: A single blinded randomized controlled trial was conducted to test the efficiency of two antibiotic regimens on post operative outcome and implant stability in single tooth dental implant to overcome the increasing drug resistance due to over prescription of medicines and side effects of the same.

Methodology: 20 participants needing single tooth dental implant were enrolled based on inclusion and exclusion criteria. The participants were randomly assigned into groups. 10 participants in group 1 received only a single preoperative dosage of amoxicillin 1gm which was followed by paracetamol. In group 2, 500mg amoxicillin was given postoperatively followed by a three times a day for 3 days regimen. The postoperative outcome was evaluated based on swelling, post-operative bruising, suppuration and wound dehiscence noticed on 2nd and 7th day postoperatively. ISQ (implant stability quotient) was checked 3 months post implant placement as osseointergration is the main goal of implant placement.

Results: Post-operative bruising, suppuration and wound dehiscence were not noticed in the entire study due to sterile environment during implant placement. When swelling was compared between group 1 and 2 it was statistically insignificant on day 2 (Mann Whitney u=40.00, p=0.383) and day 7 (Mann Whitney u=50.00, p=01.00). ISQ (IMPLANT STABILITY QUOTIENT) score in group 1&2 also showed statistically insignificant results (t=0.00, p=1.00) Which states that there was no significant difference in the stability of implants when single preoperative antibiotic dose of amoxicillin(1gm) and postoperative antibiotic dose of amoxicillin drug(500mg) regimen 3 times a day for 3 days was given.

Conclusion: this study shows that in healthy individual, when single implant is placed in proper sterile environment with routine dental hygiene such as brushing and chlorhexidine mouthwash use by patient, single preoperative dose of amoxicillin 1gm is sufficient for the success of implant. However, considering the limitations of the study, further work is necessary to validate reliability.

No adverse effects were observed in the study

Funding: NIL

Reg no:DYPDCH/EC/648/12/2021

Open Access Original Research Article

Factors Associated with Delayed Presentation among Women with Breast Cancer

Munawar Hussain Mangi, Rubina Bashir, Seema Rahim, . Paras

Journal of Pharmaceutical Research International, Page 2120-2124
DOI: 10.9734/jpri/2021/v33i60B34853

Purpose: Breast cancer in women is one of the most common tumors in women worldwide. Throughout Pakistan, there have been multiple reasons that cause a delay in the presentation of breast cancer and many reasons are neither reported nor studied. The objective of our study is to provide detailed estimates on the prevalence and causes of delays in order to plan targets for intervention.

Materials Methods: This is a Quasi-Experimental study done at Department of General surgery, Shaheed Benazir Bhutto Medical College, Lyari Karachi from September 2018 to August 2020. We recorded the histories of 200 women by conducting structured interviews after their written consent and noted their mean age, standard deviation, early symptoms, and reasons for delayed presentation. Only patients who discovered their symptoms are included in the study.We then conducted the analysis on early and advanced stage patients using SPSS Version 20.

Results: The mean patient's age was 44.2 ± 4.13years, where 200 females were observed with a maximum age of 70 years and minimum age of 20 years in our data. Approximately 49% of breast cancers were advanced stage and about 69% had a rural residence, while painless bump was observed in 91% of women,hospital distance was less and more than 60 minutes and that’s has hindered presentation too. Similarly, about 71.2% of breast cancer patients presented with advanced-stage disease. We observed the most common factor to be a painless lump and misdiagnosed first visit.

Conclusion: Our study concludes that distance, rural residence, painless breast lump, and misdiagnosis are the most common reason of delay presentation by the patients and should be intervened.

Open Access Original Research Article

Knowledge, Attitude and Awareness about the Benefits of Indoor Plants: Reduction in Stress Level and Mental Health Satisfaction

M. K. Arun Ganesh, R. Gayatri Devi, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 2132-2141
DOI: 10.9734/jpri/2021/v33i60B34855

Background: Environmental pollution is a serious threat to living beings and global warming. Indoor pollution also comes under environmental pollution. One of the sustainable but underexploited solutions is the indoor plants which are of much significance and importance. The indoor air quality is improved by indoor plants, which benefits humans by improving their physical and mental health.

Aim: The aim of this study is to analyze and gain knowledge on the awareness people of age 25-35 have on the benefits of indoor plants.

Materials and Methods: The self-administered questionnaire was designed based on awareness. The questionnaire was distributed through Google forms linked to 110 numbers of the study population of age between 25 and 35. Methods of representation of each output variable were represented in the pie chart form. The measure that was taken to minimize the sampling bias was that the validity was checked both internally and externally. The statistics were done using SPSS software, chi square test was used to check the association and P value of 0.05 was said to be statistically significant.

Results: From this study, 83.6% of the participants’ have indoor plants at their homes or workplaces. 82% people felt that indoor plants help to reduce stress levels which was not statistically significant (p: 0.07) and 89% of them felt indoor plants helping to promote healing of injuries faster which was statistically significant (p: 0.02).

Conclusion: Indoor plants were beneficial to the majority of the population in different ways. Populations between the age 25 and 35 were aware about indoor plants and awareness camps, social media, seminars and workshops can be conducted among the people to promote knowledge on indoor plants.

Open Access Original Research Article

Effects of Light-Curing Techniques on Dental Resins - A Cross-Sectional Study

Saeed Awod Bin Hassan, Ayman Mousa A. Alfaifi, Abdulrahman Mohammed Nasser Otudi

Journal of Pharmaceutical Research International, Page 2213-2218
DOI: 10.9734/jpri/2021/v33i60B34866

Background: Commonly used dental resin composites are used as dental filling materials with the help of light induced polymerization reaction. The purpose of this cross-sectional research was to compare the results of different light intensities on the hardness of different dental composites. Following light treatment units were used.

  • QTH also called Quartz Tungsten Halogen
  • LED also called Light Emitting Diodes

Methods:  This one-month cross-sectional, in-vitro study was carried out in the Dental Materials Laboratory in Saudi Arabia. Using non-probability, convenient sampling, a single trained operator prepared 60 dental restorative composites (DRC) samples in steel molds with a diameter of 10mm and each mold was 2mm thick. During the polymerization of DRCs, the effects of light intensities, sorption and solubility, and microhardness were all measured. SPSS was used for statistical analysis and a p-value of <0.05 was declared striking.

Results:  When QTH and LED lamps were used, the average micro hardness of DRC was estimated to be 15.480.46 and 18.260.53, respectively. The mean light intensity of QTH was 434 mW/cm2 and for LED lights it was 925mW/cm2. There was no notable difference in DRC sorption and solubility capability (p=0.001) during the polymerization reaction (p=0.128).

Conclusion:  When it came to increasing the surface micro hardness of DRC, LED light was found to be more effective than QTH light.

Open Access Original Research Article

Effect of Methotrexate and Linoleic Acid on BAX/BCL2 Ratio in Human Hepatocyte Cell

Ayse Gül Kabakci, Halil Mahir Kaplan, Ergin Şingirik, Memduha Gülhal Bozkır

Journal of Pharmaceutical Research International, Page 2227-2236
DOI: 10.9734/jpri/2021/v33i60B34868

Aims: To investigate the effect of methotrexate and linoleic acid on BAX/BCL 2 ratio in human hepatocyte cell.

Study Design: Original Research Article.

Place and Duration of Study: The study was carried out in partnership with the Department of Anatomy and Department of Medical Pharmacology of Çukurova University Faculty of Medicine, using the laboratory facilities of the Department of Medical Pharmacology.

Methodology: Human hepatocyte cell line (CRL-11233) cells obtained from the American Type Culture Collection Organization (ATCC) were used. Expressions of apoptotic pathway markers, apoptosis inducing factor  BAX, BCL2 and BAX/BCL2 were evaluated. All analyzes were examined in four groups (Group 1; control, Group 2; linoleic acid given, Group 3; methotrexate given and Group 4; linoleic acid and methotrexate given).

Results: The mean ± standard error values of the obtained results as nanogram / milliliter (ng / ml) are in Group I, Group II, Group III and Group IV, respectively; BAX values, 0.900 ± 0.1864, 1.002 ± 0.2098, 8.352 ± 1.467 and 4.295 ± 1.522, BCL 2 values, 13.93 ± 1.198, 13.92 ± 1.739, 2.938 ± 1.059 and 9.250 ± 1.492 and BAX/BCL2 values 0.065, 0.072, 2.843 and 0.464.

Conclusion: While BAX/BCL2 level increased in the group given methotrexate, it decreased in the group given linoleic acid and methotrexate.

Open Access Original Research Article

Preliminarily Phytochemical Screening, Anti Inflammatory and Antimicrobial Activity of Macrotyloma Uniflorum (Horse Gram) Leaf Ethanolic Extract on Selected Oral Pathogens

P. A. Vasishta, R. Gayathri, V. Vishnu Priya

Journal of Pharmaceutical Research International, Page 2244-2250
DOI: 10.9734/jpri/2021/v33i60B34870

Aim: To know the Preliminary phytochemical screening, Anti Inflammatory activity and antimicrobial activity Macrotyloma uniflorum (Horse gram) leaf ethanolic extract on selected oral pathogens.

Introduction: Macrotyloma uniflorum also known as horse gram is a plant grown for feeding horses, rarely by humans and also in Ayurvedic cuisine. This plant is a legume from tropical southern Asia which belongs to the family of Fabaceae and the kingdom of Plantae.

Materials and Methods: Macrotyloma uniflorum ethanolic plant extract was made and statistical analysis was done using various methods in order to know the anti inflammatory and antioxidant properties by preliminary phytochemical screening.

Results and Discussion: The polyphenolic compounds flavonoids and tannins appear to be the most promising in Macrotyloma uniflorum ethanolic plant extract.

Conclusion: The study demonstrated in vitro antioxidants and anti- inflammatory activities of Macrotyloma uniflorum leaf extract through scavenging, chelating and reducing   activity.

Open Access Original Research Article

Prevalence and Factors Related to Metabolic Syndrome in Xo Dang Patients at Kon Tum General Hospital, Vietnam

Le Huu Loi, Dinh Thi Van Anh, Nguyen Quang Thieu, Cao Ba Loi, Nguyen Trong Hung, Phan Huong

Journal of Pharmaceutical Research International, Page 2258-2266
DOI: 10.9734/jpri/2021/v33i60B34872

Introduction: Metabolic syndrome (MetS) is a common disorder and different ethnicities may have different prevalence and related fators. MetS is associated with many chronic diseases and there is a great need for research on MetS in different ethnic groups, especially the communities of ethnic minorities.

Aim: The aim of this study is to determine the prevalence and some factors related to MetS among Xo Dang, an ethnic minority group at Kon Tum province.

Methods: diagnosis of Mets according to IDF/AHA consensus, comparing the characteristics of 261 patients of Xo Dang with 561 patients of Kinh ethnicity.

Results: The rates of habits related to MetS among Xo Dang ethnicity were all higher than 50% and not different from those of Kinh ethnicity. The mean values ​​of waist circumference, maximum and minimum blood pressure, levels of glucose, triglyceride, and HDL-C levels in the blood of the Xo Dang were not significantly different from those of the Kinh ethnicity. The levels of disorders among Xo Dang ethnicity in descending order were increased triglycerides (71.26%), hyperglycemia (42.53%), hypertension (38.31%), increased waist circumference (36.02%), and low HDL-C (26.82%). The rate of increasing waist circumference and the prevalence of MetS in the Xo Dang people was higher than that of the Kinh ethnicity. Xo Dang persons who were female had a higher risk of developing MetS. Smoking was associated with MetS among Kinh ethnicity, however, was not with Xo Dang ethnicity.

Conclusion: It seems that the prevalence of metabolic syndrome of Xo Dang people was higher than that Kinh people and the rate of habits related to metabolic syndrome in the Xo Dang people was high.

Open Access Original Research Article

A Comparative Study of the Effect of Propofol and Etomidate as an Induction Agent on Haemodynamic Changes during Induction and Endotracheal Intubation

Bhavini Shah, Shweta Birajdar

Journal of Pharmaceutical Research International, Page 2304-2318
DOI: 10.9734/jpri/2021/v33i60B34878

Aims: Presently Propofol and Etomidate are popular as rapid acting inducing agents. Due to reflex sympathetic stimulation, direct laryngoscopy and endotracheal intubation typically cause a cardiovascular stress response characterized by hypertension and tachycardia. This study is conducted to compare the effects of these two drugs on hemodynamic responses during induction and endotracheal intubation, to compare time of induction to choose the better induction agent and to study adverse effects of the two drugs, if any.

Study Design: Prospective double blind study

Place and Duration of Study: Department of anaesthesiology Dr D.Y Patil medical college hospital and research centre Pimpri Pune Duration -Sept.2018 -sept 2021.

Methodology: This is prospective randomized double-blind study. 60 ASA I and II patients randomly divided into two groups group P and group E of 30 each of either sex in age group of 18-65 years posted for elective surgery under general anesthesia. Group P: (n-30) received 2.5mg/kg Propofol and Group E:(n-30) received 0.3mg/kg Etomidate for induction. vital parameters such as HR,  SBP,  DBP,  MAP, and SPO2 recorded at baseline (T0), before induction (T1), after induction (T2), during laryngoscopy (T3 ) ,after intubation at 1min, 2min, 3min, 5min and at 10 min. Time of induction was taken as period between time of start of study drug till loss of eyelash reflex

Conclusion: Induction time between the two study groups was statistically insignificant. (p>0.05) The fall in heart rate at post induction (T2), at 1 min, 2 min after intubation in Group P as compared to Group E was statistically significant, fall in SBP, DBP and MAP at post induction (T2), at 1 min, 2 min, 3 min and 5 min after intubation in Group P as compared to Group E was statistically significant. Pain on injection was more with propofol. However, myoclonus was more with etomidate.

Open Access Original Research Article

In-vitro Antibacterial Activity of Hydroethanolic Leaf, Stem, Root Extract of Acalypha indica - A Comparative Study

. Prithiksha, R. Gayatri Devi, J. Selvaraj, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 2340-2347
DOI: 10.9734/jpri/2021/v33i60B34882

Background and Aim: Acalypha indica is a weedy, short lived and monoecious plant. It has an antioxidant effect and it must be implemented to control the disease where free radicals are involved. Acalypha plant is useful for the bronchitis, pneumonia, pulmonary tuberculosis patients. A. indica plant is used in the rejuvenation in the worst conditions which may undergo infections in the microorganisms and it is the chemotherapeutic agent and distributed in the large contributions in human health and well being. The main aim of this study is to assess which part of A. indica has an antibacterial activity.

Materials and Methods: Agar well diffusion method was used for assessing the antimicrobial activity of the plant extract. The nutrient broth is inoculated with bacterial strains E. faecalis. The broth was then incubated at 37°C overnight. Antibacterial activity was determined by measurement of the diameter of zones of inhibition (mm).

Results: When compared to root, stem and leaves of hydroethanolic extract of A. indica, leaf maximum inhibition against E. faecalis. As the concentration of extract increases from 25 µg/ml to 100 µg/ml, the zone of inhibition also increases. This shows the antimicrobial activity is better at higher concentration.

Conclusion: A. indica has effective antimicrobial activity. It reduces the growth of various human pathogenic bacteria. The root, stem and leaf of A. indica possess Antibacterial activity against E. faecalis. leaf extract has significant antibacterial activity.

Open Access Original Research Article

Anticancer Potential of A. marmelos Fruit Extract in Human Colon Cancer Cell Lines is Mediated through the Regulation of EMT Signalling Molecules

Sheron Blessy, R. Gayatri Devi, J. Selvaraj, A. Jothi Priya

Journal of Pharmaceutical Research International, Page 2355-2362
DOI: 10.9734/jpri/2021/v33i60B34884

Background and Aim: A.marmelos is commonly called as Bael and is used as a medicinal plant mostly in the Ayurveda. Bael has the property of gastrointestinal effect. Bael phytochemicals are radioprotective, chemoprotective and it has efficacious properties in the treatment of cancer and its preventions. The main aim of this study is to estimate an anticancer activity of Bael in colon cancer cells of human.

Materials and Methods: Dimethyl sulfoxide (DMSO), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), Phosphate-buffered saline(PBS) are used as materials. The cell line used is HT 29. MTT test was used to check cell viability by calorimetric technique. The HT 29 cell was exposed to different mediums. Then the cell viability is calculated. Real time PCR was used to analysis gene expression in which cDNA synthesis was performed in varied sample volume. Melting curves were acquired for all samples. Data is analyzed by comparative CT method. It was analyzed by graph pad prism.

Results: The findings showed that the effect of Bael fruit extraction of HT 29 cells shows a significance of P<0.05. One of the parameters is treated with untreated control cells. The other two parameters are 100μg, 200μg. In Vimentin mRNA and E cadherin mRNA expression one is treated with untreated control cells and 100μg.

Conclusion: This concludes that the properties of the bael can act as an anticancer potential in human colon cancer cell HT 29 through EMT signalling molecules.

Open Access Original Research Article

Nutritional Composition, Mineral analysis and Sensory Evaluation of Cake and Chocolate with Moringa oleifera Leaf Powder

Santhadani Lenin, Ramasamy Sujatha, Shanmuga Sundaram

Journal of Pharmaceutical Research International, Page 2367-2373
DOI: 10.9734/jpri/2021/v33i60B34886

Moringa oleifera is a plant native to India that thrives in tropical and subtropical climates around the world. Moringa is commonly farmed around the world because it can resist both severe drought and moderate winter. The nutritional composition of dry M. oleifera leaf powder was investigated in this study. The leaf extract was examined for its proximate, mineral, vitamin, and sensory properties. The analysis were carried out in supplemented M. oleifera in cake and chocolate prepared with varying proportions such as C, 10%, 15% and 20% respectively. The results in Chocolate sample were carried out for nutritional analysis represented in moisture (1.36, 1.56, 1.73 and 1.96 g/100g), ash (3.44, 3.75, 3.96 and 4.03 g/100g), Protein (8.25, 9.25, 9.87 and 10.01 g/100g) and Fat (36.38, 30.47, 28.29 and 27.22 g/100g). Mineral analysis for Calcium (43.13, 47.73, 48.75 and 49.22 mg), Potassium (558.55, 587.90, 589.20 and 599.73 mg), Phosphorus (76.64, 89.44, 90.24 and 91.74 mg) and Iron (8.43, 9.44, 9.78 and 9.94 mg). Vitamin analysis for β – Carotene (0.02, 0.06, 0.06 and 0.08 mg) and Vitamin – C (0.23, 0.47, 0.53 and 0.61 mg). The sensory analysis was carried out for Concentration of Leaf Powder, Colour and Appearance, Smell, Taste, Mouth Feel and over all Acceptability. Whereas in Cake sample the nutritional analysis represented in moisture (04.32, 05.23, 5.44 and 5.93 g/100g), in ash (05.73, 06.43, 6.76 and 7.06 g/100g), Protein (08.16, 08.75, 8.95 and 8.54 g/100g) and Fat (04.74, 04.23, 04.15 and 04.08 g/100g). Mineral analysis for Calcium (26.71, 27.21, 27.43 and 26.43 mg), Potassium (32.44, 35.26, 35.64 and 35.21 mg), Phosphorus (53.76, 53.99, 57.25 and 55.16 mg) and Iron (01.25, 1.86, 2.05 and 2.16 mg). Vitamin analysis for β – Carotene (00.04, 0.05, 0.05 and 0.06 mg) and Vitamin – C (00.08, 0.12, 0.13 and 0.08 mg). With the addition of Moringa leaf powder, the sensory qualities were found to be within acceptable limits. Moringa leaves are a good source of proteins, minerals, and vitamins, and they can be used as a supplement to improve the nutritional profile of chocolate and cake in the baking industry.

Open Access Original Research Article

A Study to Assess the Knowledge, Awareness and Preventive Practices Regarding Dengue Fever among Patients Visiting Medical OPD at Civil Hospital, Nadiad City

Dhara Vyas, Pooja Kavaiya, Reeva Parmar, Roshni Patel

Journal of Pharmaceutical Research International, Page 2421-2426
DOI: 10.9734/jpri/2021/v33i60B34895

Background: Dengue, the mosquito borne disease has become global public health problem. The present study was conducted to assess the knowledge, awareness and preventive practices regarding dengue fever among patients visiting medical OPD at civil hospital, Nadiad City.

Methods: A cross-sectional study was conducted with 100 randomly selected patients from Civil Hospital, Nadiad during September to November 2021. A structured questionnaire was used covering socio-demographic characteristics of the participants, knowledge, awareness, treatment and preventive practices regarding dengue fever. Data were analyzed using descriptive, inferential.

Results:  Of the 100 participants recruited in the study, 47% were females and 53% were males. A majority 63% belong to 15 - 45 years of age, were Hindus 80%, studied up to primary level (68%), resided in the urban area (64%) and 22% had past dengue exposure. Although patients had heard of dengue, the overall mean score of knowledge, awareness and preventive practices regarding dengue fever was 16.5 ± 1.4, with 23%, 68%, and 9% participants having good, average and poor knowledge respectively regarding dengue.

Conclusion: It was evident that the patients have the sufficient knowledge regarding dengue fever and its prevention, but execution of this knowledge in putting the dengue preventive measures to practice was poor. There is a need to create awareness for hygiene and cleanliness to prevent mosquito bites.

Open Access Original Research Article

Unintended Pregnancy and Associated Factors among Pregnant Women in Rural Ethiopia

Temesgen Senbeto Wolde, Gizachew Gobebo Mekebo

Journal of Pharmaceutical Research International, Page 2432-2440
DOI: 10.9734/jpri/2021/v33i60B34897

Background: Unintended pregnancy is a worldwide problem that affects the health of women, families and relatives. This study was aimed to identify the major factors associated with unintended pregnancy among women in rural Ethiopia.

Methods: We used 2016 Ethiopian Demographic and Health Survey (EDHS) data on 853 rural pregnant women aged 15–49. Analyses of the data were done using SPSS 25 version 25. Chi-square test was used to filter candidate independent variables to be included in a multivariable logistic regression. And the multivariable logistic regression model was employed to estimate the relative association of factors associated with unintended pregnancy. The significance of the factors was considered based on p-value of less than 0.05.

Results: The prevalence of unintended pregnancy in study area was 20.9% (95% CI: 18.2, 23.8). The unintended pregnancy was associated with region Afar (AOR: 0.308, 95% CI: 0.101, 0.943) and Somalia (AOR: 0.064, 95% CI: 0.012, 0.331), women aged 35 or older (AOR: 2.016, 95% CI: 1.014, 4.009), women who had primary education (AOR: 0.284, 95% CI: 0.190, 0.425) and secondary/higher education (AOR: 0.201, 95% CI: 0.123, 0.329), Women who knew about contraceptives (AOR: 0.481, 95% CI: 0.379, 0.610), and parity 1 or 2 (AOR: 0.782, 95% CI: 0.750, 0.815). 

Conclusion: About one-fifth of the pregnancies were unintended. Region, age, educational level, knowledge about contraceptive and parity were significantly associated factors of unintended pregnancy. Providing health education to women needs to be encouraged to minimize the magnitude of unintended pregnancy. 

Open Access Original Research Article

Vitamin D Deficiency and Risk of Hair Loss: Knowledge and Practice of Adult Female Population in Saudi Arabia, 2020

Abdullah Ayidh Alotaibi, Ali Alfarhan, Ahmad Nueva AlMutairy, Saleh Ibrahim Alomary

Journal of Pharmaceutical Research International, Page 2464-2475
DOI: 10.9734/jpri/2021/v33i60B34901

Background: Vitamin D deficiency is a global problem related to public health causing multiple disorders, for example rickets, osteoporosis (weak bones) and osteomalacia. Lack of information, education and perception about the normal requirements of vitamin D is leading to emergence of many diseases in Saudi population. We aimed to assess Knowledge and practice of vitamin D deficiency and risk of hair loss among adult female population in Saudi Arabia.

Methods: We performed a cross sectional study in adult females older than 16 years who are residing in Saudi Arabia. We excluded female healthcare workers. Knowledge and practice of vitamin D deficiency and risk of hair loss were measured among included female. Data were analyzed using SPSS.

Results: A total of 810 female were included. Most of participants were between 18-25 (41.6%) and 26-35 (39.5%) years old. 42.6% of total participant were single. 96% of them heard about vitamin D. The main source of information were Relatives & friends (55.8%) followed by health care professional (50.75%).  503 (62.1%) of the participating females correctly knew that there is a relationship between vitamin D deficiency and hair loss, 188 (23.2%) thought that there is no relationship while 119 (14.7%) did not know or did not have any opinion. Regarding practice, about 216 (26.7%) participants exposed themselves to sunlight, and 40% were taking Vitamin D supplement. The overall knowledge score was 9.4±2.80 out of 18. A significant difference in knowledge score was found according to age, nationality, residence and marital status.

Conclusions: The overall knowledge score was average among participants, and majority of them heard about vitamin D. About two third of the participants knew that there is a relationship between vitamin D deficiency and hair loss. There is a need to increase the taking of vitamin D supplement among female for prevention from diseases.

Open Access Original Research Article

Stability Testing of Amoxicillin Nano-suspension as Promising Tool for Drug Delivery System

Lina Eltaib, Md Ali Mujtaba

Journal of Pharmaceutical Research International, Page 2481-2488
DOI: 10.9734/jpri/2021/v33i60B34903

While nano-suspension amoxicillin is one of the approaches for improving dissolution rate of amoxicillinan antibiotic used widely. Stabilizing these nanodosage forms is always a challenge. The present study utilizes nanoprecipitation solvent evaporation technique for preparation of amoxicillin nanoparticles andproposed stability study approach of the same. The methodology was based on investigating stability of amoxicillin nano suspension in vitro, the optimized drug(polymer ratio re-formulated into nano-suspensions) and we compared our results with marketed suspensions. Samples were initially characterized and then subjected to stability testing at ambient temperature and relative humidity up to 6 months assayed using a validated HPLC method. During initial characterization, increase in saturation solubility and dissolution rate observed in all samples. During stability testing, there was gradual decrease in saturation solubility and dissolution rate of the samples, over the period of 3 months. This study considers long-term isothermal measurements, consistent with short-term non-isothermal (accelerating) measurements, providing predictive model to calculate the isothermal degradation periods. As per our results, we agree with the possibility to calculate the value of kinetic constants based on a fixed degradation limit, regardless of the shape of the curve. The accuracy of the prediction would be assessed by comparison of estimated shelf life versus data coming from traditional stability studies.

Open Access Original Research Article

Development and In-vitro, In-vivo Evaluation of Gastro Retentive Floating Tablets of Felodipine

Jadav Subhash, P. Dwarakanadha Reddy, Suggala Venkata Satyanarayana

Journal of Pharmaceutical Research International, Page 2500-2509
DOI: 10.9734/jpri/2021/v33i60B34906

Direct compression was utilized to develop the floating tablets, because of moisture sensitivity of Felodipine(FD), formulation included polymers such as CARBOPOL 934 & HPMC K 15 M. FD Floating tablets were designed to enhance drug availability by prolonging gastric retention time (GRT). Physical properties of tablets, such as hardness, thickness, friability, and weight variation as well as drug content and floating behaviors, were evaluated. Further, tablets were studied for In vitro drug release tests for 12 hours, while floating in the dissolution medium, In- vivo imaging studies were conducted. According to FTIR studies, there is no interaction between the drug and polymer, In-vitro buoyancy of tablets was 12 hours, the in-vitro dissolution release studies exhibited sustained and prolonged drug release profiles. The release mechanism from these tablets has been confirmed to be non-Fickian diffusion, which also fits the zero order and higuchi models, GRT of floating tablets was observed to be 4 hours. Based on in –vitro characteristics, F14 is the most efficient formulation. It was exploited in- vivo imaging studies by incorporating BaSo4, and the floating concept was used to boost gastric retention time, which was initially assumed.

Open Access Original Research Article

Role of Cytokines and Vaccines in Break through COVID 19 Infections

Richard Owusu Nyarko, Purabi Saha, Roshan Kumar, Ivan Kahwa, Edward Amoah Boateng, Paul Owusu Boateng, Asum Christian, Asare Bertram

Journal of Pharmaceutical Research International, Page 2544-2549
DOI: 10.9734/jpri/2021/v33i60B34912

Background: Despite efforts to develop a COVID-19 vaccine, it has failed to provide long-term immunity and protection against COVID-19 and the newly worrying SARS-CoV-2 coronavirus strains. Understanding cytokines, which are key in generating unique immune responses from pathogenic organisms, is important for creating vaccines.

Objective: In order to better understand cytokines and how the current COVID-19 vaccinations can assist reactivate latent cytokines, the scientific community and the general public must be educated.

Materials and Methods: Medical and scientific indexing sources like PubMed and Google Scholar were used to search for relevant medical and scientific publications.

Results: After vaccination, cytokines in the immune system can be activated, which can help signal chemicals that can increase the immune system's ability to fight against new and break-through COVID 19 infections.

Conclusion:  It has been discovered that both the Pfizer-BioNTech and the Moderna vaccines are safe and effective in preventing break through COVID-19 infections, regardless of whether the patient experiences symptoms or not. It is an adenovirus, not an mRNA, that Johnson & Johnson's vaccine is made of.

Open Access Original Research Article

Sequences of S-surface of Human COVID-19

Fadyia Mahdi Muslim Alameedy

Journal of Pharmaceutical Research International, Page 2571-2576
DOI: 10.9734/jpri/2021/v33i60B34916

Aims: Diagnosing the Coronavirus and viruses that share infection for different age groups through real time PCR, as well as using the Sanger sequencing method to homology sequence identity between local human Coronavirus isolate and NCBI-BLAST submitted Coronavirus isolate.

Study Design: Cross section.

Place and Duration of Study: From the central health laboratory and quarantine centers, work was carried out in different places for the purpose of diagnosis in Al-Hakim and Al-Sadr Teaching Hospital and the Central Health Center in addition to the private laboratories, between April 2020 and July 2021.

Methodology: Diagnosing the virus through qRT- PCR, PCR and sanger sequencing. Sample: We included 300 patients (174 men, 128 women; age range 18- 83years) with from people who were infected for the first time with the Coronavirus and repeated infections with the virus with other viruses that affect the respiratory system.

Results: The current study showed that the number of cases of Coronavirus infection (110) case, Influenza virus (90) case, Parainfluenzavirus (65) case, Metapneumovirus (108)case and Rhinovirus (95)case for the period from 4-4-2020 up to 26-26 7-2021 all viruses were diagnosed through qReal time PCR technique by designing primers according to the location NCBI Regarding the sequences test, the results showed the percentage of similarity with the studied strains at a rate ranging between (99.92 - 78 %).

Conclusion: Most of the infections with the Coronavirus are common with respiratory viruses in different proportions, in addition to the fact that the age group (51-61) year is more infected, and (110) case of Influenza shares with the Coronavirus more infection and the results of Sanger sequences between(99.92 - 78 %).

Open Access Original Research Article

Nomophobic Prevalence and Social Intelligence of Higher Secondary Students during COVID-19

Jijish Elias, M. Mirunalini, Issac Paul

Journal of Pharmaceutical Research International, Page 2618-2624
DOI: 10.9734/jpri/2021/v33i60B34515

Aim: To identify the nomophobic prevalence and extent of social intelligence among adolescent students and identify the correlation between these variables.

Study Design: Descriptive survey method.

Place and Duration of Study: Various Higher Secondary schools in Kerala between June 2021 and December 2021.

Methodology: 1068 higher secondary students were drawn for the study and the social intelligence and nomophobic prevalence of those students were identified using two standardised tools. The data collected wereanalysed to identify the level of their social intelligence and nomophobic prevalence, The correlation between these two factors was also studied.

Results: The scores achieved by the sample were analysed appropriately and the quartile values on comparison show that the higher secondary students are having a moderate social intelligence and nomophobic prevalence. The correlation studies show that these factors are negatively correlated.

Conclusion: Higher secondary students show moderate nomophobic prevalence, It should not be allowed to become an addiction. The negative correlation implicates that nomophobic prevalence decreases the social intelligence of adolescents.

Open Access Original Research Article

Preliminary Phytochemical Analysis and Assessment of Antioxidant and Anti Cholesterol Activity of Ethanolic Leaf Extract of Acalypha indica linn

E. Ilammaran Varshan, S. Kavitha, R. Gayathri, V. Vishnupriya, J. Selvaraj

Journal of Pharmaceutical Research International, Page 2581-2588
DOI: 10.9734/jpri/2021/v33i60B34918

Background: Acalypha indica Linn. is a weed plant found in shady wetlands. It is commonly called as kuppai meni in Tamil, belonging to the family Euphorbiaceae. It is found to be one of the greatest Indian plants with anti-venom, antibacterial, antiviral and antimicrobial properties.

Aim:Preliminary phytochemical analysis and assessment of antioxidant and anti cholesterol activity of ethanolic leaf extract of acalypha indica linn

Materials and Methods: Phytochemical screening and in vitro antioxidant and hypolipidemic potential of Acalypha indica Linn.was analysed as per the standard methods. The data were analyzed statistically by one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test and it was used to see the statistical significance among the groups. The results with the p<0.05 level were considered to be statistically significant.

Results: Ethanolic leaf extract of Acalypha indica Linn exhibited a significant antioxidant and hypolipidemic activity and increased in a dose dependent manner as compared to the standard drug.

Conclusion: Many researchers are working towards replacing synthetic drugs with herbal alternatives. Herbal extracts are natural and will aid in longevity.

Open Access Original Research Article

Study of Women's Reproductive Health Knowledge, Awareness, and Attitudes in Borgaon Village, Wardha, India

Bhishmani Tarare, Jagruti Chaple

Journal of Pharmaceutical Research International, Page 2589-2601
DOI: 10.9734/jpri/2021/v33i60B34919

Background: Reproductive health is defined as a state of complete physical, psychological, and social contentment, free of sickness, as well as the functions and activities of the reproductive system..As many women in India are unaware of the sexual health and its comorbidities they end up falling in serious illness leading to various life threatening diseases.

Aim: The aim was to study about knowledge, awareness and attitude towards reproductive health of women in Borgaon Village of Wardha,India.

Methodology: This is a descriptive cross-sectional study conducted at Borgaon village of Wardha district Maharashtra India. Total 100 women aged 20 to 45 were selected by simple random sampling method was enrolled in study after verbal consent . Women were contacted and interviewed with a semi structured questionnaire.The study was conducted in 6 months duration with the help of questionnaire.

Results: As per the statistics, 78percent women use sanitary pads though 55percent women were still using napkins & cottons due to lack of awareness, shyness & low economic condition. 82percent women were aware about contraception but still 59percent women preferred to use it, because they were worried about its side effects. It was found that, when women came across any gynecological problem only 67percent of them had quick approach to doctor. 76percent women thought about the need of learning reproductive knowledge.

Conclusion: It was concluded that we still need to aware the society about reproductive health of women because whole society should be well known about the measures to be taken and how to act wisely to deal with a woman suffering from any illness regarding reproductive health.

Open Access Original Research Article

Assessment and Comparative Study of Biofilm Formation with Frequency of Multi Drug Resistance in Strains of Staphylococcus aureus

Kiran Fatima, Kashif Ali

Journal of Pharmaceutical Research International, Page 2602-2612
DOI: 10.9734/jpri/2021/v33i60B34920

Background: The study was conducted to identify the role of biofilms in the antibiotic susceptibility in the strains of Staphylococcus aureus. A total of 19 non-repeated pus/wound swab samples from different anatomic locations and 17 samples that were previously identified as Staphylococcus aureus and preserved in the labs were included in the study. The Staphylococcus aureus was identified based on colony morphology, Gram’s stain, biochemical tests (catalase and coagulase tests) and molecular identification through PCR amplification. Methodology: A total of 26 samples were recovered out of the 31 samples. Kirby-Bauer disk diffusion susceptibility test was used to determine the sensitivity or resistance of Staphylococcus aureus to methicillin. Out of the 26 strains, 4 were highly resistant, 10 were moderately resistant and 12 strains were sensitive. Three different protocols (Tube Method, Congo Red Agar Method and Tissue Culture plate method) were used for the detection of biofilm formation for both resistant and sensitive strains. Result: Comparative analysis of the antibiotic susceptibility and biofilm formation by different protocols showed that 70% strains that are resistant to antibiotic methicillin produced moderate-strong biofilms. 50% have produced the moderate-strong biofilms in all 3 protocols. In case of sensitive, 50% strains had produced none-weak biofilms in all 3 protocols. Decisions: The strains that had zone of inhibition of close to resistance produced weak-strong biofilms but they all produced weak biofilms in CRA method. It can be concluded that the strains of Staphylococcus aureus that have the ability to produce biofilms become methicillin resistant.

Open Access Original Research Article

Highlights on the Efficacy of "Ayurveda "and it Importance to Human Health

Krishna Rathod, Manisha Dunghav

Journal of Pharmaceutical Research International, Page 2630-2638
DOI: 10.9734/jpri/2021/v33i60B34923

Background: Ayurveda is an ancient medicine system of the Indian subcontinent. The word Ayurveda is a conjugation of two Sanskrit words 'ayus', meaning 'life' and 'veda', meaning 'science', thus ayurveda literally means the 'science of life'. Moreover, Moreover, Ahara vidhi literally means method of taking diet. It includes diet and dietary guidelines. The concept of diet in Ayurveda has a broader view beyond ingestion of food, unlike modern dietetics which is restricted to concept of calorie consumption, Ayurveda recommends methods of taking food, its quality and quantity based upon individual’s capacity to digest (Agni).

Materials: Questionnaire on the basis of Literature available in Ahara vidhi -Dietary Guidelines in Ayurveda Classics was developed.

Methods: Proper guideline of development of questionnaire has been followed.

Results: After the Development of Dietary Questionnaire the questioner sent to the expert to check the face validity and content validity of the Questionnaire with proper concept of statistical Analysis.

Discussion: In this article, various aspects of concept of diet in Ayurveda are discussed.

Conclusion: Ayurveda diet practices and principles are helpful to improve the human health.

Open Access Original Research Article

Development of GC Method for Analyzing Potential Genotoxic Impurities at Low-level Determination in Atorvastatin Calcium

Sudharsanacharyulu Sowmith, Krishnamohan Tummalagunta, Govindh Boddeti, J. V. Shanmukha Kumar

Journal of Pharmaceutical Research International, Page 2645-2652
DOI: 10.9734/jpri/2021/v33i60B34925

Atorvastatin Calcium (ATC) is a specific HMG-CoA reductase inhibitor utilized in the avoidance and treatment of cardiovascular infection in those at high danger and treat strange lipid levels. For the quantitative analysis of four PGIs in the medicine ingredient ATC, an ICH-approved Gas chromatography (GC) approach has been developed. Within the examined fixation range, the novel approach was explicit, exact, precise, and direct. Pollutant D, with 0.6 ng/mL, had the lowest recognition level among the four PGIs, which were all below 10 ng/mL. Every contaminant from ATC has been effectively chromatographically separated into its component parts. At a low level, ATC's technique was found to be highly effective in terms of pollution reduction. Proposed techniques are relied upon to measure the strength of ATC creation and to examine PGIs as a reference for ATC assessments. This method can be used to check for pollution levels in the manufacturing process of pharmaceuticals. The API's PGI levels will be kept low thanks to the GC's oversight. As a result, this study's findings will help ensure the safe use of APIs during clinical therapy.

Open Access Original Research Article

Role of Antioxidants by Comparative Evaluation of Oxidative Stress in Heterozygous v/s Homozygous Sickle Cell Disease Patients: Research Protocol

Rina Raibhan Wasnik, Nilkanth Ramji Akarte, Archana Dhok, Ashish P. Anjankar

Journal of Pharmaceutical Research International, Page 2671-2679
DOI: 10.9734/jpri/2021/v33i60B34928

Background: Red blood cells are sources for oxidants in Sickle cell anaemia, a genetic disorder of itself. Heme iron and oxygen in oxygenated hemoglobin have bonding interaction and association with electron transfer. In response, antioxidant has modus operandi   to reduce oxidative stress and damage to RBC and tissue.

The studies on biochemical indicators for oxidative stress in sickle cell would further enhance the understanding and present knowledge of effects of antioxidants on the status of iron metabolism and consequent relief to the sickle cell anaemia patients.

Objectives: To   evaluate   oxidative   stress and Antioxidant levels and iron indices factors in heterozygous and homozygous sickle cell disease patients and compare between them along with normal healthy control and Iron Deficiency anaemia

Methodology: Comparative Cross-Sectional Study is designed to explore specific antioxidant levels and oxidative stress along with Iron Indices among sickle cell anaemia   diagnosed cases attending/admitted in the department of Medicine, Paediatrics and   Community Medicine at Jawaharlal Nehru Medical College and its Hospital, Sawangi, Meghe, along with age and sex matched healthy individuals from general population.

Results: Oxidative stress as evaluated by stress markers may be higher among the Homozygous sickle cell disease than among the Heterozygous.

Conclusion: Oxidative stress may be compounded in sickle cell diseases patients in conjugation with iron deficiency.

Open Access Original Research Article

Comparative Evaluation of Surface Roughness of Cention N after Brushing Simulation with Herbal and Fluoridated Toothpaste - An In-vitro Study

N. Mohamed Arsath, S. Balaji Ganesh, S. Jayalakshmi

Journal of Pharmaceutical Research International, Page 2680-2687
DOI: 10.9734/jpri/2021/v33i60B34929

Introduction: Cention N, a new alternative tooth coloured resin based filling material. Toothbrushing abrasion is a key issue in restorative dentistry. A smooth surface is a crucial factor to be considered for establishing a successful restoration because the surface roughness of a restorative material results in plaque deposition, discoloration of the restoration, microleakage and secondary caries. The present study aims in evaluating the surface roughness of Cention N before and after brushing with herbal toothpaste and fluoridated toothpaste.

Materials and Methods: A total of 8 Cention N samples were prepared and randomly divided into two groups into 2 groups as Group A- herbal toothpaste(n=4), Group B- fluoridated toothpaste(n=4). The samples were placed in a brushing simulator for 30000 cycles and their surface roughness was evaluated by using stylus profilometer-Mitutoyo SJ 310 and with the results collected a statistical analysis was performed using the statistical software “SPSS VERSION 23” and its results are demonstrated in the form of bar graph.

Results: The Ra values of both the samples before and after brushing simulation was constant and only the Rq and Rz values showed difference between the groups. There was no notable changes in surface roughness parameters between the groups. The statistical “paired t test” analysis depicts that the p value for Rz parameter was 0.359 which is (p<0.05), hence statistically insignificant.

Conclusion: Brushing simulation did not influence the surface roughness of Cention N restorative material. There was no significant increase or decrease in surface roughness values after brushing simulation which indicates cention N material can withstand abrasive forces, but the results can vary in oral cavity environment.

Open Access Original Research Article

Awareness on Importance of Immune Boosting Diet among Dental Students- A Survey

Bondada Venkata Mani Anirudh, R. Gayathri, V. Vishnu Priya

Journal of Pharmaceutical Research International, Page 2692-2702
DOI: 10.9734/jpri/2021/v33i60B34931

Introduction: An immune system is essential for survival. The immune system must be looking for any signs of invasion mostly caused by microorganisms. It plays a vital role in protecting the body against diseases, fighting against foreign bodies and does a remarkable job in defending against microorganisms. A Natural immune booster is an additional immunising agent which helps to increase and sustain the immune response of the body. The aim of this study is to show the awareness level on importance of immune boosting diet among dental students

Materials and methods: A questionnaire was prepared consisting of a total 14 questions and was uploaded through an online survey link. The responses were collected and analysed which were later interpreted as pie charts. A total of 100 undergraduate dental students have taken the survey with consent. The data was analysed by IBM SPSS software where descriptive statistics and chi square test was done, where the results are plotted as graphs.

Results: A total of 100 participants have taken the survey in which 50% were males and 50% were females. A question was asked whether food directly affects our health in which 96% have answered yes. In another question pertaining to how many meals you eat per day. 48% have answered three times and 48% have answered two times. 98% believe that skipping meals affects our immunity/health. 94% believe that Indian spices can boost our immunity. 92% believe green tea is a great antioxidant. 57% have answered that taking natural food along with supplements can boost immunity instead of just taking either one. 48% answered that fat has more calories followed by carbohydrates. 88% believe that Consumption of carbohydrates can lead to increase in triglycerides. 97% believe that consumption of citrus fruits can increase immunity

Conclusion: According to the study, students are aware about the nutrition which is required for maintaining and improving their immunity. As a budding doctor, the students should be aware about the nutrition which is required for maintaining immunity especially during this COVID 19 pandemic.

Open Access Original Research Article

In-Vitro Antioxidant and Pharmacognostic Studies of Phaseolus vulgaris (Linn) Seed Coat

Sagarika Majhi, Sarika Chaudhary, Madhu Verma, . Rajkumari, Meenakshi Sharma, Iti Chauhan, Lubhan Singh, Hitesh Talan, Shivani Sharma

Journal of Pharmaceutical Research International, Page 2710-2721
DOI: 10.9734/jpri/2021/v33i60B34933

Objectives: Pulses have grown increasingly popular as a result of their high nutritional content and phytochemical content. However, before to eating, the seed coats of some legume food items were removed, resulting in the food losing its nutritious content. The study deals with the study of pharmacognostic & physico-chemical profile along with in-vitro estimation of bioactive compounds of Phaseolus vulgaris (Linn) seed coat.

Methodology: The morphology of kidney beans was evaluated. Seed length, width, thickness, and surface area were also determined. In physico-chemical parameters extractive value ash value, moisture content, swelling index were recorded. Phytochemical screening displayed the presence of alkaloids, flavonoids, phenol, amino acid, tannins, carbohydrates and saponins. HPTLC & in-vitro estimations were done.

Results: Morphology revealed dark brownish red seed, kidney to oval shaped, medium size and bland taste. Microscopically, the transverse section showed the presence of proteinaceous aleurone cells, macro-sclereids and starch granules with irregular oval shape in the cotyledon specify the energy reservoir of seeds. HPTLC showed the presence of flavonoids in Phaseolus vulgaris seed coats. The antioxidant profile revealed TFC (total flavonoid content) as 13.62 mg/g QE (quercetin equivalent) and TPC (total phenolic content) as 32.03 ± 1.50 mg/g GAE. IC50 value for vitamin C was found to be 369.03 µg/ml as compared to Phaseolus vulgaris seed coat 423.00µg/ml.

Conclusion: The study can serve as a valuable source of information and due to presence of phytoconstituents like flavonoid (quercetin) it could be considered for its neuroprotective activity.

Open Access Original Research Article

Evaluation of Hypolipidemic Potential of Aqueous Seed Extract of Moringa oleifera –An In vitro Study

Sariga Jayachandran, S. Kavitha, R. Gayathri, V. Vishnupriya, J. Selvaraj

Journal of Pharmaceutical Research International, Page 2722-2729
DOI: 10.9734/jpri/2021/v33i60B34934

Introduction: Various parts of the tree Moringa oleifera Lam belonging to the Moringceae family  are used extensively  by the Indians as a major food constituent and also as  herbal medicine. The dried seeds are used as a hypolipidemic agent for patients who suffer from obesity.

Aim: The study was aimed at evaluation of hypolipidemic potential of aqueous seed extract of Moringa oleifera - an In vitro study. 

Materials and Methods: Hypolipidemic potential and antioxidant potential of aqueous seed extract of Moringa oleifera was analysed and compared with the standard drug. The data were statistically analyzed by one-way analysis of variance (ANOVA) followed by Duncan’s multiple range test and it was used to see the statistical significance among the groups. The results with the p<0.05 level were considered to be statistically significant.

Results: The DPPH radical scavenging activity showed that the plant extract possessed a significant In vitro antioxidant( Ic50=220µg/ml)  and hypolipidemic activity.(( Ic50=380µg/ml).

Conclusion: The aqueous seed extract of Moringa oleifera exhibited a significant antioxidant and hypolipidemic potential.

Open Access Original Research Article

Assessment of the Dental Students and Dental Practitioners Awareness about Bleeding Disorders across Saudi Arabia

Tariq Abdullatif Alnaim, Omar Sami Almajed, Saud Salman Alqahtani, Ibrahim Abdulwahab Alhulibi, Syed Akhtar Hussain Bokhari

Journal of Pharmaceutical Research International, Page 2739-2744
DOI: 10.9734/jpri/2021/v33i60B34936

Introduction: Bleeding disorders are a group of disorders which results from defective platlets functions or coagulation or both and it can be classified into platlets disorders, blood vessel disorders and coagulation factors disorders. Bleeding disorder patients undergoing dental procedures may need special management before dental procedure.

Aim: To assess the awareness level of the dental students and practitioners in Saudi Arabia about the bleeding disorders.

Materials and Methods: This cross-sectional study was conducted among 502 dental students and dentists in Saudi Arabia. This was a questionnaire based internet survey consisted of 331 clinical year dental students and 171 dentists. The questionnaire contained 15 questions.

Results: The highest percentage of participants were from the Eastern Province (31.1%). Almost half of the participants were males (51.2%). The dentists represented (34.1%). Around (47.8%) of participants reported that they had encountered bleeding disorder patients before. Almost (50.8%) participants who encountered those patients said that they referred them to a physician for a consent. Six questions were used to assess the knowledge of the participants about the bleeding disorders based on the number of the correct answers. Only (1%) were able to answer all the questions correctly. Most of the participants (93.8%) said that they need to learn more about bleeding disorders.

Conclusion: Majority of the dental students and general practitioners had poor knowledge of the management of bleeding disorder patients.We strongly recommend intensifying dental educational programs and more training is required in management of patients with medical complications.

Open Access Original Research Article

An Evaluation of Physical and Psychological Changes in School Children during Online Education - A Cross Sectional Study

S. Sujitha, G. Sridevi

Journal of Pharmaceutical Research International, Page 2785-2793
DOI: 10.9734/jpri/2021/v33i60B34942

Background: Covid -19 is a great pandemic that keeps people indoors. This has increased the levels of perceived stress among not only adults but also young children. Children are much exposed to online education that keeps them in front of a computer or mobile phone exposing them to virtual education. This causes them to get stressed very easily.

Objective: To evaluate the physical and psychological changes in school children during online education.

Methods: A cross-sectional survey of a sample consisting of 100 school children undergoing online education through their schools was conducted. The participants were administered with a self developed questionnaire consisting of 17 questions. The responses were collected using google forms. Descriptive statistics, frequency analysis and chi square test was used to analyse the data.

Results: The study reported that school children were stressed during online education. Crosstab evaluation was done for the questionnaire. It reported that the majority of the female children said that they feel good about online education and are able to manage the stress.

Conclusions: This study concluded an innovative finding that there is a gradual increase in the level of stress from moderate high among school students after the start of the COVID-19  outbreak.

Open Access Original Research Article

Knowledge, Attitude and Practice Analysis of Antibiotics Use and Misuse in Tertiary Care Rural Hospital Patients

N. T. Katole, J. S. Kale, Nandkishor Bankar

Journal of Pharmaceutical Research International, Page 2807-2814
DOI: 10.9734/jpri/2021/v33i60B34945

Introduction: In recent decades, the increase in bacterial resistance against all major antibiotics is a growing worldwide problem and is a significant threat to global public health in the 21century.

Objective: Assess the knowledge, attitude, and practice of antibiotics use and misuse among the tertiary care rural hospital patients.

Methods: This is a cross-sectional analytical study  conducted at tertiary care teaching rural hospital in India between December2020 to April 2021. A self-administered questionnaire was distributed to the patients of outpatient departments in hospital. The questionnaire consisted of 3 parts, first part consist of  demographic variables, second and third part regarding knowledge, attitude and practice of patients towards use of antibiotics. SPSS 21 was used for data analysis.

Results: Out of the 110 participants, 56(50.91%) were males and 54(49.09%) were females. 55(50%) patients received antibiotics from friends, relative and pharmacist  without medical doctor checkup. 38(34.55%) patients had started antibiotics as preventive medication for any infection, 73 (66.36%) patients got better earlier and have stopped. 52(47%) patient expect antibiotics from doctor for common cold. 42% patient obtained antibiotics without valid prescription from relatives, pharmacist or self-prescription without producing valid prescription obtained from the doctor. In the knowledge domain while majority of respondent  were well aware that antibiotics are hazardous during pregnancy and lactation and can lead to severe allergic reactions. But very few respondent knew about resistance can transfer from animal to human and human to human, also very few respondent knew about antibiotics can alter human body bacterial flora.

Conclusion: There is lack of knowledge regarding antibiotics use and resistance among general population.  Strict strategies need to employ like antibiotics prescription audit, antibiotics dispensing monitoring, effective public health education, and promoting health worker and patient communication.

Open Access Original Research Article

Patient Satisfaction Scoring After Pre Anesthesia Evaluation

P. Jeffrin Reneus Paul, Henry Prabhu Alfred

Journal of Pharmaceutical Research International, Page 2830-2833
DOI: 10.9734/jpri/2021/v33i60B34948

Background: Evaluation of patient satisfaction after pre anesthesia has become an important part in the improvement of anesthesia services. This can also be used for the improvement of staff-patient relationship. This study is done to know about the satisfactory condition of the patient after pre anesthesia. The satisfactory tool we use are the same for both adult and paediatric age group since only few paediatric patients were included in the study.

Methods: This study is a research, conducted on one hundred and twenty patients who undergone several surgeries at Saveetha Hospitals in Chennai, Tamil Nadu, India between January and March of 2021. Patients were asked several questions 24 h in the post-op section using a pre anesthesia Patient Satisfaction questionnaire. Based on their responses the data was collected to analyse the level of satisfaction of the patient.

Results: The overall satisfaction score was found to be 68.8%. Percentage of satisfactory patients who were found to be less feared and concerned is 87.5%. Percentage of patients with whom the doctor maintained a good relationship with is 75%. 82% Patients were found to be happy with the amount information provided to them about the procedure. In elective situations the patient satisfaction was at a higher level.

Conclusion: The satisfaction level among the patients were moderate. Patients described the staff-patient relationship was very satisfactory. They also described low fear and concern regarding anesthesia. The study also emphasised that the information regarding the anesthesia to the patients were satisfactory overall.The study was approved by the authors institution.

Open Access Original Research Article

Fibroblast Growth Factor 23 (FGF23) is an Early Specific Marker in the Diagnosis and Staging of Chronic Kidney Disease (CKD) in Human

Radwa M. Mohamed, Eman S. El-Hadidi, Osama M. Ahmed, Wael M. El-Sayed

Journal of Pharmaceutical Research International, Page 2841-2850
DOI: 10.9734/jpri/2021/v33i60B34950

Objective: To evaluate the clinical utility of serum FGF23 as an early specific biomarker in the diagnosis and progression of chronic kidney disease (CKD) patients.

Methods: A number of 120 male patients with CKD who were classified according to the eGFR into four stages (n=30 for each stage), in addition to 30 healthy control men were included.

Results: Patients in stage 2 of CKD did not show any significant difference in serum levels of urea and creatinine, and lactate dehydrogenase (LDH) activity. With the progression of CKD from stage 3 to stage 5, there were linear increases in the serum urea and creatinine levels, and LDH activity. There was a significant decrease in serum albumin and a significant elevation in creatine kinase in all CKD stages. There was a significant decrease in serum Ca2+ level in stages 2-4. Only patients in CKD stage 5 showed a significant elevation in serum phosphorus level. There were significant elevations in serum aminotransferases, C-reactive protein, and parathyroid hormone levels in stages 4 and 5. Serum testosterone level was significantly reduced in stages 3 and 4 as compared to control. With the progression of CKD stages from stage 2 to 5, there were linear significant elevations in serum TNF-a and FGF23 levels.

Conclusions: FGF23 was the most sensitive indicator in the early diagnosis and staging of CKD. Other biomarkers were elevated in the late stages in addition to their low specificity. Therefore, FGF23 could be used in the diagnosis and prognosis of CKD patients.

Open Access Original Research Article

Formulation and Evaluation of Floating Sustain Release Pellets of Anti Gout Drug

Upasana J. Patel, Hiteshkumar A. Patel

Journal of Pharmaceutical Research International, Page 2858-2866
DOI: 10.9734/jpri/2021/v33i60B34952

Objective: The objective of this investigation was to formulate and evaluate effervescent pellets of febuxostat to achieve sustain release effect.

Place and Duration of Study: APMC College of Pharmaceutical education and research, Department of Pharmaceutics, Himatnagar-383001, between June 2019 and July 2021.

Materials and Methods: The gastro retentive effervescent pellets of febuxostat were formulated using Sodium CMC and HPMC K4M and HPMCK15M as a sustain release polymer. Pellets were prepared by extrusion- spheronization technique using microcrystalline cellulose as spheronizing agent and sodium bicarbonate and citric acid as a gas forming agent for effervescent pellets. The pellets were characterized with respect to their floating lag time, total buoyancy time and % cumulative drug release.

Results and Discussion: DSC study showed that there was no change in the melting endotherm of the drug and drug-polymers mixture which means drug and polymers were compatible with each other. The optimized formulation B14 exhibits a floating lag time 4.00±0.004 sec. and cumulative % drug release at 12th hour 99.58±0.02. Scanning electron microscopy photomicrograph revealed that the surface was rough and pellets were spherical shaped in nature.

Conclusion: Febuxostat sustain release pellets was successfully formulated and evaluated as effervescent pellets with gas former agents and sustain release polymer HPMC K15.

Open Access Original Research Article

Postpartum Vitamin-D Deficiency and its Relations with Sociodemographic Factors

Amruta Choudhary, Snehal Deshmukh, Ranjit Ambad, Saunetra Inamdar, Roshan Kumar Jha

Journal of Pharmaceutical Research International, Page 2880-2885
DOI: 10.9734/jpri/2021/v33i60B34955

Background: Deficiency of Vitamin D or 25(OH) cholecalciferol is a severe health problem worldwide. Vitamin D is essential for calcium and bone metabolism and protects against various autoimmune disorders, cardiovascular diseases, chronic infections, cancers, and infertility. It also plays a vital role in pregnancy. During pregnancy, the fetus acquires their vitamin D from their mother and r the first few months of life after delivery, particularly in breastfed infants. Deficiency of Vitamin D in infants can lead to rickets, respiratory infections, allergic diseases, heart failure.

Aims and Objective: To investigate the prevalence of vitamin D deficiency in the postpartum period and to study its relation with the sociodemographic characteristics of the patients.

Materials and Methods: This was cross-sectional observational study was conducted over one year. Sociodemographic characters and serum concentrations of vitamin D in the 25(OH)D were compared.

Results: To a total of 550 patients were enrolled. The mean age of patients was 26.5 years, around 58% of patients were from the peri-urban area, maximum number of patients were primiparous. Around 90% of patients did not have any sun exposure on a regular basis. Around 59% of enrolled patients were either unbooked or had only one antenatal visit. The mean plasma concentration of 25(OH)D in postpartum patients was 27.6ng/mL. No association was found between sociodemographic factors studied and vitamin D concentration.

Conclusion: This study showed the higher prevalence of vitamin D deficiency in India's postpartum patients despite having abundant sunlight and identifies the need for supplementation of vitamin D in pregnancy and postpartum. This supplementation has to be followed routinely in hospitals in obstetric management protocol.

Open Access Original Research Article

Structure Activity Relationship, Topological Analysis and Molecular Docking Analysis of Pharmaceutical Molecule 2356 -Tetrafluoro-4-Pyridine Carbonitrile

M. Sony Michael Mary, R. Racil Jeya Geetha, M. Amalanathan, R. Benisha

Journal of Pharmaceutical Research International, Page 2886-2902
DOI: 10.9734/jpri/2021/v33i60B34956

The theoretical vibrational spectral features of 2,3,5,6 Tetrafluoro-4-pyridinecarbonitrile were explored and compared with experimental results. The geometrical parameters, vibrational wavenumbers, bonding features and Energies were calculated at the B3LYP level with the basis set 6-311++G(d,p) levels. The calculated wavenumbers, vibrational energy distribution Analysis (VEDA), potential energy distributions (PEDs), and vibrational spectra were used to suggest reliable vibrational assignments. Molecular Electrostatic Potential investigations revealed the reactive zones around the molecule. The computed HOMO-LUMO energies were -8.369 and -3.380 eV, respectively, indicating charge transfer inside the molecule. The charge transfer of charge due to intra molecule interactions has been explained using naturalbond orbital analysis. The ELF and LOL calculations were provide a visual aid for interpreting the results of electronic structure. The molecular docking approach was used to find the optimal ligand–protein orientation using the ligand 2,3,5,6 Tetrafluoro-4 pyridinecarbonitrile, which was docked with five distinct proteins. The main aim of the present study is to evaluate the biological activity of the selected compound using theoretical calculations.

Open Access Original Research Article

In vivo and In vitro Anti Oxidant Activity of Ethanolic Extraction of Justicia gendarussa Burm Leaves

Ulhas Shrimant Surwase, Shivanand Malkappa Patil

Journal of Pharmaceutical Research International, Page 2922-2931
DOI: 10.9734/jpri/2021/v33i60B34961

Oxidation is very essential to many living organisms for the production of energy to fuel biological processes. The free radicals and other reactive oxygen species (ROS), which are continuously, produced in vivo, responsible for oxidation. The aim of the present study was to investigate in vitro and in vivo antioxidant potential of ethanolic extraction of justicia gendarussa burm leaves [EEJG]. The study was done by using various in vitro and In vivo methods such as Hydroxyl Radical scavenging activity, Determination of Reducing Power, Metal chelating activity, Carbon tetrachloride (CCl4) induced lipid peroxidation and Inhibitory Test on Protein Oxidative Modification and in vivo Lipid peroxidation, reduced glutathione and Catalase was studied. The ethyl acetate extract showed the highest total phenolic content and total flavonoid content among other extracts of justicia gendarussa burm leaves. The percentage inhibition and IC50 value of all the extracts were followed dose-dependency and found significant (P < 0.01) as compared to standard (ascorbic acid). The oxidative stress markers as Lipid peroxidation (LPO) (CAT) and reduced glutathione (GSH) were increased significantly (P < 0.01) at 250 and 500 mg/kg of EEJG treated animals and decreased significantly the thiobarbituric acid reactive substances [TBARS] level at 500 mg/kg of EEJG as compared to control group. These results revealed that the ethanol extract of Justicia gendarussa burm leaves exhibits both In vitro antioxidant activity against DPPH and In vivo antioxidant activity by modulating brain enzymes in the rat. This could be further correlated with its potential to neuroprotective activity due to the presence of flavonoids and phenolic contents in the extract.

Open Access Original Research Article