Open Access Case Study

Effect of Sensory Integration, Neurodevelopmental Therapy and Behavioral Therapy on Overall Development in a Child with Cerebral Palsy: An Interesting Case Report

Tanushree Deshmukh, Rakesh Krishna Kovela, Mohammed Irshad Qureshi, Ragini Dadgal, Rebecca Timothy, Snehal Samal

Journal of Pharmaceutical Research International, Page 13-16
DOI: 10.9734/jpri/2022/v34i1B35348

Cerebral palsy (CP) is a collection of conditions that impact a person's ability to move, balance, and maintain posture. Cerebral palsy is a disorder that affects the motor portion of the brain's outer layer, which controls muscular movement. The cerebral motor cortex hasn't formed normally in some situations throughout fetal development. In certain cases, the impairment is caused by a brain injury that occurred before, during, or after delivery. In either situation, the damage is irreversible, and the resulting disabilities are permanent. The nature and intensity of CP symptoms vary from one person to the next, and they can even alter over time. Depending on whether areas of the brain have been affected, symptoms might vary widely from person to person. Cerebral palsy affects mobility and posture in all persons, and some people may have intellectual disabilities, seizures, odd bodily feelings or perceptions, and other medical issues. People with CP may also have vision or hearing impairments, as well as language and speaking issues. The present case report is of a child of 2.5 years old. She came with complaints of difficulty in sit to stand, standing with maximum assistance, very minimal standing balance, requires total assistance in walking. She was also having some sensory and behavioral issues reported by parents like trying to catch her own shadow, blabbering among herself. She was assessed, treatment including Sensory integration and Neurodevelopmental therapy was given to her for a period of 6 months. Baby improved profoundly well.

Open Access Study Protocol

Research Protocol of NDT- Bobath and Proprioceptive Neuromuscular Facilitation Vs Proprioceptive Neuromuscular Facilitation Alone, to Improve Trunk Control, Balance, and Gait Parameters in Post-Stroke Patients – A Randomized Clinical Trial

Sakina Saifee, Rakesh Krishna Kovela

Journal of Pharmaceutical Research International, Page 25-32
DOI: 10.9734/jpri/2022/v34i1B35350

Background: The majority of stroke survivors suffer from a lifelong disability. Spasticity on the affected side and loss of balance are the common deficits mainly responsible for the impaired postural alignment, trunk control, and gait in stroke patients. Earlier studies have proven that Proprioceptive Neuromuscular Facilitation (PNF) is not much effective than Neurodevelopmental Therapy (NDT)- Bobath and Bobath is not effective alone to provide impressive results in stroke patients. Hence, the purpose of this study is to demonstrate the combined impact of both techniques and compare them to PNF alone in trunk control, balance, and gait parameters in stroke survivors.

Methods: Total 30 stroke patients will be recruited by the study by considering the inclusion criteria and They will be split into two equal groups, A and B. Group A will receive the combined therapy of PNF and NDT-Bobath and group B will be treated with the PNF alone. The study will be carried out for 6 months. Outcome measures that are The Berg Balance scale (BBS), Trunk impairment scale (TIS), Dynamic Gait Index (DGI), Gait parameters will be utilised to evaluate stroke patients before and after the study.

Results: The expected result will show whether the combined therapy of NDT-Bobath and PNF can help you improve trunk control, balance, and gait in patients with stroke and will it be better than the PNF therapy alone.

Conclusion: If the study proves that NDT—Bobath and PNF is effective in enhancing trunk control, balance and gait parameters, it will be a valuable insight into the available literature and thus helps physiotherapists to choose the combined approach in future. If PNF alone proves to be effective then it will save the time and helps the physiotherapist to frame goals according to PNF alone.

Open Access Original Research Article

Modeling the Factors Associated with BMI among Type 2 Diabetes Mellitus Patients: A Hybrid Model Approach

Farah Muna Mohamad Ghazali, Wan Muhamad Amir W. Ahmad, Mohamad Nasarudin Adnan, Norsamsu Arni Samsudin, Nor Azlida Aleng, Nor Farid Mohd Noor, Mohamad Shafiq Mohd Ibrahim, Nurul Hidayah Binti Shamsudin, Siddharthan Selvaraj

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/jpri/2022/v34i1B35347

Background: Diabetes mellitus is a chronic illness that results in abnormally high blood sugar levels. It can result in a range of complications.

Objective: The purpose of this study is to present an ideal variable selection strategy utilizing proven Multiple Linear Regression (MLR) models and to validate the variable using Multilayer Perceptron Neural Network (MLP) models. This will validate a factor linked with body mass index (BMI) status in individuals with dyslipidemia and type 2 diabetes mellitus.

Materials and Methods: Thirty-nine patients were selected from Hospital Universiti Sains Malaysia (USM). Many variables, including BMI, gender, age, race, coronary heart disease status, waist circumference, alanine transferase, triglycerides, and dyslipidemia, were assessed in this retrospective analysis using advanced computational statistical modelling approaches. This study uses R-Studio software and syntax. Each sample's statistics were generated using a hybrid model combining bootstrap and multiple linear regression.

Results: R's statistical approach demonstrates that regression modelling is superior to R-squared performance. The hybrid model may better predict the outcome by separating the datasets into a training and testing set. The well-known bootstrap-integrated MLR technique was used to determine the validity of the variables. The eight variables examined in this case are gender ( : -2.329; p < 0.25), age ( : -0.151; p < 0.25), race ( : 2.504; p < 0.25), coronary heart disease status ( : -0.481; p < 0.25), waist circumference ( : 0.572; p < 0.25), alanine transferase ( : 0.002; p < 0.25), triglycerides ( : 0.046; p < 0.25), and dyslipidemia ( : 30.769; p < 0.25). There is a linear model that has a 9.019188 MSE.lm in this case.

Conclusion: This study will develop and extensively evaluate a novel hybrid approach combining bootstrapping and multiple linear regression. The R syntax for this procedure was chosen to ensure that the researcher comprehends the example completely. The statistical methods used to conduct this research study using R show that regression modelling is better than R-squared values for the predicted mean squared error. Thus, the study's conclusion shows that the hybrid model technique is superior. This vital conclusion helps us better understand the hybrid method's relative contribution to the result in this case.

Open Access Original Research Article

A Cross-sectional Study to Investigate the Association of Depression among COPD Patients at a Secondary Care Hospital in Nilgiris

M. B. Aishwarya Gowda, Shefali Deo, Sayoojya Rajeev Nair, Shonitha Sagadevan, Khayati Moudgil

Journal of Pharmaceutical Research International, Page 17-24
DOI: 10.9734/jpri/2022/v34i1B35349

Aim: Depression is highly affected comorbid condition with Chronic Obstructive Pulmonary Disease (COPD) patients remaining unrecognized and under-diagnosed. Co-morbid depression affects the prognosis of the disease leading to an increase in the mortality rate. 

Objective: The main objective of the study was to assess and evaluate the association of depression among COPD patients by using the Hamilton Depression Scale (HAM-D).

Study Design, Place and Duration: A cross-sectional study conducted at Government headquarters hospital, Ooty, consisting of 82 COPD patients, who were assessed for depression.

Results: Among 82 COPD patients, 17% (n=14) of the patients found without depression, 17% (n=14) of the patients suffered from mild depression, followed by 35.3% (n=29) of the patients from moderate depression, 25.6% (n=21) of the patients suffered from severe depression and 4.8% (n=4) patients diagnosed with very severe depression. Thus, the prevalence of depression in our study population was 82.9%. Depression was found to be significantly associated with age (p =0.000), alcoholism (p =0.012) and duration of disease (p= 0.000). A positive correlation was obtained between depression and age, duration of disease.

Conclusion: The study revealed that the severity of depression is strongly associated with age, consumption of alcohol, and duration of COPD.

Open Access Original Research Article

Evaluation of Sodium Valproate-Induced Hepatotoxicity and Protective Role of Vitamin C (Ascorbic Acid) and Silymarin in Adult Albino Rats

Khlood M. Mehdar

Journal of Pharmaceutical Research International, Page 33-42
DOI: 10.9734/jpri/2022/v34i1B35351

Background and Objectives: Drugs hepatotoxicity is one of the most prevalent problems seen in medical practice. Many medications are linked to hepatotoxicity, including acetaminophen, tamoxifen and sodium valproate (VPA). The objective of this study is to investigate the preventive impact of silymarin (SIL) and /or vitamin C (Vit.C) on hepatotoxic Sodium Valproate in albino Rats.  

Methods: Thirty adult male albino rats were divided equally into six groups; group (I): normal control, group (II): VPA 700 mg/kg,  group (III): VPA + SIL 50 mg/kg, group (IV): VPA+ Vit.C 50 mg/kg and group (VI): VPA + SIL +Vit.C, VPA. The animals were killed after 14 days, and livers were taken for histological and biochemical analysis.

Results: After 14 days, animals were sacrificed, and livers were collected for histopathologic examination and biochemical assessment. VPA group exhibited a significant increase in serum alanine aminotransferase and aspartate aminotransferase. Liver sections showed loss of normal pattern of hepatocytes, inflammatory infiltration, congested central vein and fatty infiltration. Each of ascorbic acid and silymarin partially improved the histological pattern of the liver. When they were combined together, they depict marked improvement in the measured parameters and showed normal liver sections.

Conclusion: silymarin (SIL) and /or vitamin C (Vit.C) has hepatoprotective effects against VPA induced toxicity on liver.

Open Access Original Research Article

Frequency of Bile Duct Injury during Laparascopic Cholecystectomy Procedures

Munawar Hussain Mangi, . Paras, Seema Rahim, Rubina Bashir, Ameer Ali Khaskheli

Journal of Pharmaceutical Research International, Page 58-62
DOI: 10.9734/jpri/2022/v34i1B35416

Objective: To determine the frequency of bile duct injury during laparascopic cholecystectomy procedures.

Study Design: This is an observational study.

Setting: Study carried out at General Surgery department, Shaheed Benazir Bhutto Medical College, Lyari Karachi, from July 2019 to August 2021.

Materials and Methods: All diagnosed patients of gallstones on the clinically and findings of ultrasound of abdomen with age (20-60 years), gender were included in study. Patient not willing for surgery, pregnant ladies, bleeding disorders, obstructive jaundice and carcinoma of gall bladder were excluded from this study.

Results: Out of 162 patients, there were 15 males (9.25%) and 147 females (90.74%), with a male to female ratio of 1:11.6. The mean age was 36.01±8.11years (20 to 60 years). According to our observation, there were 6 cases (3.70%) of common bile duct injury during the operation. Treatments offered range from ERCP and conservative treatment to reconstructive surgery. Four patients (2.46%) were converted to open cholecystectomy, 1 patient underwent open cholecystectomy subsequent ERCP, and 1 patient underwent open Cholecystectomy with Subsequent Reconstructive surgery.

Conclusion: In our study bile duct injury commonly occur during laparoscopic cholecystectomy. Over time, improving surgical technique and experience reduced the overall incidence of CBD injuries.

Open Access Original Research Article

Analysis of Determinants of Neonatal Mortality in Afar and Somalia Regions, Ethiopia

Belema Hailu Regesa, Temesgen Senbeto, Gizachew Gobebo, Reta Lemesa, Ravi Kanth Makarla, Getachew Tadesse, Kebede Lulu, Terefa Bechera, Sagni Daraje, Agassa Galdassa, Ketema Bedane, Alemayehu Siffir, Jiregna Olani, Girma Teferi, Maru Mossisa, Emebet Chimdi, Gosa Tesfaye Degaga, Birhanu Woldeyohannes, Bizunesh Kefale, Geribe Hemba

Journal of Pharmaceutical Research International, Page 63-71
DOI: 10.9734/jpri/2022/v34i1B35784

Background: Children face the highest risk of dying in their first month of life. Ethiopia is one of the sub-Saharan countries with highest newborn deaths. Afar and Somalia regions in Ethiopia are among the regions with high death rates of newborn children. This study aimed to analyse and identify determinants of neonatal mortality in Afar and Somalia regions, Ethiopia. 

Methods: This study used 2016 Ethiopian Demographic and Health Survey data for the analysis. The multivariable logistic regression model was used to identify the significant determinants of neonatal mortality. Adjusted odds ratio with a 95% confidence interval and p-value < 0.05 in the multivariable logistic regression model was reported to declare the statistical significance and strength of association between neonatal mortality and determinants.

Results: A total of 2567 newborn children were included in this study. Mortality rate among newborns in the first month was 41 per 1000 live births in Afar and Somalia regions. Health facility delivery (AOR: 0.634; 95% CI: 0.409–0.982), being female (AOR: 0.206; 95% CI: 0.073–0.528), multiple births (AOR: 3.958; 95% CI: 2.293–11.208), small size at birth (AOR: 1.208; 95% CI: 1.003–1.728), secondary and above educational level of mothers (AOR: 0.484; 95% CI: 0.294–0.797) were statistically significant determinants neonatal mortality.

Conclusions: In this study, sex of child, place of delivery, birth type, size at birth, mother’s educational level were found to be statistically significant determinants of neonatal death in Afar and Somalia regions, Ethiopia. Mothers with no education should be given health education and institutional delivery should be encouraged to improve the survival of the neonates in Afar and Somalia regions, Ethiopia.

Open Access Original Research Article

Neonatal Morbidity Patterns and Admission Outcomes: A Cross Sectional Study at a Tertiary Care Hospital in Pakistan

Muhammad Parial Shahani, Mohd Rizal Bin Haji Abdul Manaf, Azimatun Noor Aizuddin, Kaleemullah Abro, Vijia Kumar Gemnani, Abdul Rehman Shaikh, Zainab Shahani

Journal of Pharmaceutical Research International, Page 72-76
DOI: 10.9734/jpri/2022/v34i1B35799

Objective: To determine the neonatal mortality and ascertain the disease patterns at neonatal ward in a tertiary care hospital

Material and Methods:

Design: Hospital based cross sectional study.

Participants: Two thousand, two hundred and seventy five neonates were registered using retrospective data from 1st January 2020 to 31st Dec 2020. We recorded gender, birth weight, cause of admission, and admission outcome.  Data was analyzed using Microsoft excel data spread sheet.

Results: There were 2275 patients registered from CPDR (complete patient data record register) from 1st January 2020 to 31st Dec 2020.  The mean birth weight was 2.35 kg, with lowest birth weight of 0.9kg and highest birth weight of 4.8kg (SD 0.8 and SE 0.01, CI 0.025).  Out of 2175 admitted neonates 506 (23.2%) died, 1250 (57.4%) were discharged after desired improvement, most common presenting complaint and cause of admission was HIE grade 1 , followed by Sepsis, 418 (18.5%), 380(16.9%), respectively.

Conclusions: Hypoxic Ischemic Encephalopathy grade I is the most common morbidity pattern in our study, the mortality rate was observed very high, indicators of birth weight were also poor. There is a great need for improvement of antenatal care for mothers to enhance different measures of newborn welfare and wellbeing.

Open Access Review Article

Possible Mechanisms of Drugs Used in the Treatment of COVID-19: A Pharmacological Perspective

Ravindra Babu Pingili, Tanvija Kodali, Naveen Babu Kilaru, Vijaya R. Dirisala, Siva Reddy Challa, Akhila Kondru, Sirisha Koppula, Sravani Melike, Vyshnavi Toleti, Vara Prasad Saka

Journal of Pharmaceutical Research International, Page 43-57
DOI: 10.9734/jpri/2022/v34i1B35352

Coronaviruses are a type of virus that can infect both animals and humans. Coronaviruses are divided into thirty-nine species and twenty-seven subgenus in the family Coronaviridae, according to the current classification. Seven of these are known to induce respiratory infections, while four others can cause cold-like symptoms on a regular basis. SARS CoV, MERS-CoV, and SARS CoV-2 infection are three examples of viral rebound. They are to blame for SARS, MERS, and the most recent Coronavirus epidemic discovered in 2019. (COVID-19). The World Health Organization declared the respiratory sickness caused by the SARS-CoV-2 infection to be a pandemic (WHO). For this COVID-19, there are currently no properly shown managements. The virology of SARS-CoV-2 has yielded a large number of therapeutic targets. Remdesivir appears to be the most promising treatment. Currently, COVID-19 is treated with Dexamethasone, Tocilizumab, Remdesivir, Chloroquine and Hydroxychloroquine, Lopinavir, Favipiravir, Niclosamide, Azithromycin, Sarilumab, Baricitinib, Ruxolitinib, Ribavarin, Nitazoxanide, Umifenovir, Camostat, Ciclesonide, Darun They exert their effects through blocking receptors such as IL 6, TMPRSS2, CD147, and AAKI, as well as RNA dependent RNA polymerase, membrane fusion, endocytosis, and proteolysis. The authors of this study looked at the available literature on the SARS-CoV-2 virus and the COVID-19 virus in terms of therapeutic evidence. This in-depth and thorough examination provides an excellent overview of the most up-to-date information on the medications used to treat COVID-19.