Open Access Original Research Article

Extracellular Proteases Production in Methicillin Resistant Staphylococcus aureus Clinical Isolates

Abdul Nabi Jatt, Ameet Kumar, Shaista Bano, Sarfraz Ali Tunio, Nazakat Hussain Memon, Farhatullah Kandhro, Abdul Sami Dahri, Babar Aijaz Memon

Journal of Pharmaceutical Research International, Page 16-22
DOI: 10.9734/jpri/2022/v34i3A35382

Methicillin resistant Staphylococcus aureus (MRSA) bacteria are responsible for wide range of infections, while the treatment of such infections has become a challenge for public health. Moreover, the production of extracellular proteases by these pathogens has recently been considered as a major virulence factor as the staphylococcal proteases can inactivate and cleave several important host proteins, including elastin, proteinase inhibitors and heavy chains of all human immunoglobulins. The present study was carried out to isolate and identify MRSA strains from various clinical samples (pus, blood, urine and skin) followed by screening for the production of extracellular proteolytic enzymes. The identification of the clinical isolates was achieved by microscopic and specific biochemical methods. MRSA strains were identified by Kirby-Bauer disc diffusion method using cefoxitin antibiotic discs. The extracellular protease activity was detected using casein medium by agar plate and well-diffusion bioassay methods. A total of 114 MRSA clinical isolates were isolated and pure cultured from different (n=191) clinical specimens (pus, blood, urine and skin). It was observed that 51.7% (n=59) MRSA isolates were recovered from pus samples, while 23.7% (n=27), 16.7% (n=19) and 7.9% (n=09), were obtained from blood, urine and skin samples, respectively. The enzymatic analysis of the MRSA isolates showed that 68.4% of them were highly positive for the production of the extracellular protease enzymes. Extracellular protease production was frequent in the clinical isolates of MRSA suggesting a critical role of the production of extracellular proteases in pathogenesis of MRSA in humans.

Open Access Original Research Article

A Study to Determine an Association between ABO Blood Groups and Coronavirus Disease 2019

Sarita Mulkalwar, Zenia Aadil Elavia, Biswajit Chaklader, Tushar Patil, Abhi Patel, Sudhir Laxman Jadhav, A. V. Tilak

Journal of Pharmaceutical Research International, Page 23-28
DOI: 10.9734/jpri/2022/v34i3A35383

Introduction: The Coronavirus pandemic has led millions to succumb to the disease across the world, and overwhelmed the health care system. In this study we aimed at identifying whether the risk of Covid-19 infection is associated with ABO blood groups.

Methods: We obtained data of 7056 Covid-19 confirmed cases from Yashwantrao Chavan Memorial Hospital, Pune.

Results: The results showed that a significantly higher proportion of individuals with blood group A and AB tested positive for Covid-19, while a significantly lower proportion of individuals with O blood group tested positive for the same disease.

Conclusion: Routine ABO testing of Covid-19 patients could guide in decision-making and management of Covid-19.

Open Access Original Research Article

Effectiveness of Knotless Barbed Sutures for Intraoral Closure after Impacted Mandibular Third Molar Surgery: A Split Mouth Randomized Clinical Trial

Sneha Krishnan, Senthilnathan Periasamy, M. P. Santhosh Kumar

Journal of Pharmaceutical Research International, Page 42-50
DOI: 10.9734/jpri/2022/v34i3A35385

Objectives: The purpose of this clinical trial is to assess the efficiency of 3-0 knotless barbed suture (polydioxanone) with 4-0 polyglactin 910 (vicryl) in wound closure following impacted mandibular third molar surgery.

Methods: The split-mouth study involved 20 patients who were referred to the Oral Surgery Clinic at the Department of Oral and Maxillofacial Surgery for bilateral mandibular third molar impaction with equal difficulty index. Simple randomization was used to distribute the samples. Following extraction, the wounds were closed with 3-0 knotless sutures for the study group and 4-0 polyglactin 910 (vicryl) for the control group. Following surgical extraction in relation to infected mandibular molars under local anesthesia, the clinical outcome parameters that were measured were (1) time taken to achieve wound closure and hemostasis, and (2) post-operative wound healing using "Landry's wound healing index" on the 1st, 3rd, and 7th post-operative days.

Results: In this study, we discovered that the average time taken to approximate a wound was 2.69 minutes for the study group and 4.27 minutes for the control group. The research and control groups had a statistically significant difference in suturing time (p-value< 0.05). On all postoperative review days, wound healing in the study group was shown to be better and statistically significant than in the control group (p-value <0.05).

Conclusion: Within the limitations of the present study, knotless barbed suture is a promising alternative to conventional sutures for intra-oral wound closure as it reduces suturing time and facilitates effective wound closure following surgical removal of impacted mandibular third molars.

Open Access Original Research Article

Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis

Ijeoma Leticia Okoroiwu, Emmanuel Ifeanyi Obeagu, Queen Braxton N. Anaebo, Olivia Walter

Journal of Pharmaceutical Research International, Page 29-34
DOI: 10.9734/jpri/2022/v34i3A35560

Background: Human immunodeficiency Virus (HIV) and Tuberculosis (TB) are the leading infectious diseases with high morbidity and mortality in the developing countries; it has been known to be associated with some coagulation abnormalities especially as the disease progresses.

Aim: The study aimed at evaluating the effect of HIV- Tuberculosis co- infection on some haemostatic parameters (APTT & PT). It was carried out at Federal Medical Centre Owerri, Imo state.

Materials and Methods: Sixty (60) subjects were sampled comprising fifteen (15) HIV positive subjects, fifteen (15) TB positive subjects, fifteen (15) HIV-TB co-infected subjects and fifteen (15) HIV and TB negative subjects (Control). Activated Partial Thromboplastin Time (APTT) and Prothrombin Time (PT) were analyzed using standard techniques.

Results: The results showed that HIV positive subjects showed a significant values of PT (15.45±1.44sec, P < 0.05) when compared with control subjects (12.45 + 1.23) and a non-statistically significant values of Activated Partial Thromboplastin Time (APTT) (33.33± 6.27sec, P > 0.05) when compared with the control subjects (29.05+2.19). TB subjects showed statistical significant values of PT (15.84±0.98scc, P < 0.05) when compared with control subjects (12.45 + 1.23) and non- statistical significant values of APTT (33.55+5.26 sec P > 0.05) when compared with the control subjects (29.05+2.19 sec). Both the PT and APTT of HIV- tuberculosis Co-infected subjects showed significant values (17.03±1.46sec; 37.59±4.69sec, P < 0.05) compared with the control subjects (12.45+ 1.23sec; 29.05+2.19). One way analysis of variance showed no significant difference of a PT of TB patient (15.84+0.98) compared to PT of HIV patients (15.45+1.44 sec). PT of HIV- TB co-infected subjects higher values (P< 0.05) when compared with HIV patients but not significantly (P> 0.05) higher than compared with TB patients. Also there is a significant increase in APTT of TB patients (P<0.05) when compared with HIV patients. APTT of HIV-TB Co-¬infected subjects were not significantly elevated when compared with HIV and TB patients (P> 0.05).

Conclusion: HIV infections have been shown to affect both the Activated partial thromboplastin time and prothrombin time. There is significant alteration in coagulation parameters (particularly PT and APTT) on tuberculosis, lesions as a result of the mycobacterial infection can induce pro- coagulant tissue factor expression which can lead to coagulation defects.

Open Access Original Research Article

Impact of TheraNow Telehealth Physical Therapy Program on Hospital Readmission Rate Post Major Joint Replacement Surgery

Richa Kohli, Ashok Gupta

Journal of Pharmaceutical Research International, Page 35-41
DOI: 10.9734/jpri/2022/v34i3A35561

Background: Hip and knee replacement are two of the most commonly performed major joint replacement surgeries in orthopedic surgery. Both procedures successfully eliminate pain, correct the deformity, and improve patient mobility to regain quality of life and perform daily life activities. Rehabilitation and recovery are crucial during the 12 weeks following any major joint replacement surgery. Most people are discharged from the hospital 2–3 days after surgery to continue rehabilitation. Specific exercises aim to improve the joint’s mobility, improve strength and restore patient function.

The primary cause of hospital readmissions after major joint replacement is infection and can hinder the patient’s functional recovery. Therefore, a comprehensive program is essential to reduce infections and promote recovery. The virtual rehabilitation program is an evolving approach to optimize care and compliance. One such program is the TheraNow telehealth physical therapy program. TheraNow integrates artificial intelligence-powered tools and highly trained physical therapists in a care-navigation platform specially designed for rehabilitation after major joint replacement surgery. The objective of this study was to evaluate the impact of the TheraNow Telehealth Physical Therapy program on patient rehabilitation and hospital readmission rate following major joint replacement surgery.

Materials and Methods: Forty patients participated in this particular post-joint replacement virtual rehabilitation program on TheraNow application for an online and in-home physical therapy program. The program incorporated three phases of rehabilitation: pre-rehabilitation, post-surgical rehabilitation, and functional rehabilitation. A licensed physical therapist evaluated the patient via a synchronous video conferencing visit, at which time the Physical Therapist developed a customized program for each patient. Every patient booked appointment according to their own choices of time slots, and the same licensed physical therapists administered the entire program from start to finish for each patient. Physical Therapists provided customized therapy to every patient with a duration of 45-60 minutes of the personalized session. In addition, this study tracked and identified all hospital readmissions within 30 days of discharge from the patients’ medical records.

Results: The overall mean age of the study population was 65.20+8.41. Out of the 40 enrolled patients, 3 (7.50%) are 41-50 years old, while the majority (42.5%) belonged to 61-70 years of age followed by 71-80 years (27.5%) and 51-60 years (22.5%). 23 (57.5%) were female, while 17 (42.5%) were males. Only one re-admission happened due to surgical site infection in the first 30 days after the surgery under the program brought the readmission rate to 2.5%.

Conclusion: The study reported lower hospital readmission rate after major joint replacement surgeries. The TheraNow Telehealth Physical Therapy program reported a 2.5% readmission rate in the first 30 days of the physical therapy program for major joint replacement surgeries as compared to the previous literature where they have reported hospital readmission rate of 3.3%- 5.6% in 30 days post-surgical follow-up.

Open Access Review Article

Branches of a Rotten Tree - Trending Variants of COVID-19 and their Oral Manifestations

Sakshi Bhandwalkar, Priyanka Paul Madhu, Kumar Gaurav Chhabra, Amit Reche

Journal of Pharmaceutical Research International, Page 1-9
DOI: 10.9734/jpri/2022/v34i3A35380

Coronavirus was first originated in the city of Wuhan, China, in late 2019 however the flare-up spread rapidly across the globe in the primary long stretches of 2020. It was announced a worldwide pandemic by the WHO on 11 March 2020.  WHO's present approaches and defends are as yet viable against viral strains found since the episode started. The Delta variety of the Covid, which causes COVID-19, causes a greater number of diseases and spreads speedier than prior variations of the infection. The Delta variation is profoundly infectious, over 2x as infectious as past variations. On November 24, 2021, another variation of COVID-19, B.1.1.529, was accounted for to the planet Health Organization (WHO). On November 26, 2021, WHO named the B.1.1.529 Omicron and arranged it as a Variant of Concern (VOC). The Omicron variation probably will spread more effectively than the primary SARS-CoV-2 infection and the way effectively Omicron spreads contrasted with Delta stays obscure. Acute Corona viral infection, along with related treatment approaches, might cause negative oral health effects. The spectrum of COVID-19 symptoms on the oral cavity has been deemed of broad and current interest since the prevalence of clinical manifestations is unclear. As well as establishing general wellbeing and contamination control measures to forestall or decrease SARS-CoV-2 transmission, inoculation to forestall SARS-CoV-2 disease in networks all through the world is basic to forestalling this worldwide pandemic [1].

Open Access Review Article

Splinting in Periodontics: An Update

Harshita Sinha, Priyanka Jaiswal

Journal of Pharmaceutical Research International, Page 10-15
DOI: 10.9734/jpri/2022/v34i3A35381

Establishing a stable or proper occlusion enhances the retention of teeth and the maintenance of periodontal health. Mobile teeth with good periodontium can be managed alone with occlusal equilibration; whereas mobile teeth with compromised periodontium can be stabilized by using splints. Splinting increases the life expectancy of loose teeth by providing support for the periodontium to reconnect as well as improving comfort, function, and aesthetics. From ancient times splinting has been used to control the tooth mobility but still it remains poorly understood and disputable areas of dental therapy. This article discusses splinting, its principles, rationale, indication, contraindication, prerequisite, history, and classification.