Open Access Original Research Article

Frequency of Renal Involvement in Patients of Systemic Lupus Erythematosus

Abdul Rashid Dayo, Yar Muhammad Tunio, Shahzad Memon, Nasrullah Aamer, Rajesh Jamna Dass, Ruqayya Farhad

Journal of Pharmaceutical Research International, Page 1-6
DOI: 10.9734/jpri/2022/v34i8A35472

Objective: To determine the frequency of renal involvement in patients of systemic lupus erythematosus.

Methodology: This descriptive study was conducted at Department of Medicine, Ghulam Muhammad Mahar Medical College Teaching Hospital Sukkur, Pakistan, during six months after the approval of synopsis from October 30, 2018 to April 29, 2019. All the SLE patients fulfilling the clinical and laboratory criteria of the American Rheumatism Association, aged between 18 to 40 years and of either gender, who visited above stated study setting were included. Well-versed written consent was obtained after explaining the risks, procedure, and benefits of this study. Proven cases of Systemic Lupus erythematosus were assessed for renal involvement indicated by proteinuria >0.5 gm/24 hrs. or cellular casts (tubular, red, and granular cells) or serum creatinine >1.3 mg/dl. The study data was recorded electronically using proforma.

Results: Mean of patients’ age was 29.11±5.80 years. Mean ± SD of serum urea, serum creatinine, and serum albumin was 48.58±18.61, 1.28±0.43 and 3.44±0.42 mg/dL respectively. Mean of urine protein was 1448.88±1278.76 mg. Out of 95 patients, 37 were males and 58 were females. Renal involvement was noted in 34 (35.8%) patients.

Conclusion: In conclusion, renal involvement is very prevalent in people with systemic lupus erythematosus. Systemic lupus erythematosus patients should get a kidney biopsy as early as clinical indications of nephritis appear in order to expedite treatment decisions and reduce the risk of irreparable kidney damage caused by inflammation.

Open Access Original Research Article

Phytochemistry and Antimicrobial Activities of Crude and Diluted Leaves and Roots Extracts of Uvaria chamae on Selected Bacteria

Ogochukwu Mary-Theodora Barbara Ochiabut, Bright Chukwuebuka Unaeze, Edna Ifeoma Chukwura, Ngozichukwu Gertrude Uzoewulu

Journal of Pharmaceutical Research International, Page 7-18
DOI: 10.9734/jpri/2022/v34i8A35473

Plant metabolites are antibacterial. Antibacterial properties of aqueous, methanolic and n-hexane extracts of crude and diluted leaves and roots extracts of Uvaria chamae were studied to demonstrate its potential as achemotherapeutic agent. Test organisms include: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Salmonella typhi and Proteus vulgaris. Fresh tender leaves and roots of Uvaria charmae were collected, air- dried, grounded and soaked in methanol, n-hexane and aqueous solvents. Phytochemistry was done using standard procedures, antimicrobial activity was determined using agar-well diffusion method (punch hole) and MIC determined. Qualitative phytochemical analysis confirmed the presence of alkaloids, tannins, terpernoids, glycosides, saponins and flavonoids. Antimicrobial analysis of the plant parts using disc-diffusion method showed ten (10mg/ml) MIC concentration for aqueous extract of the leaves showed no activity, while root decoction inhibited only Salmonella typhi (14.00+0.47mm). Methanolic crude extracts of the leaves (UMLc) (400µg) exhibited antibacterial effects on all tested organisms, higher for Pseudomonas aeruginosa (23.67+ 0.27mm) than gentamycin(10µg) control (21.33+ 0.72) mm, while its 10-1 (40mg) dilution was active against Bacillus subtilis, Staphylococcus aureus and Pseudomonas aeruginosa. Only crude n-hexane leaf extract (UNLc) was active for Pseudomonas aeruginosa (13.00 + 0.47mm). Crude methanolic extract of the roots UMRc(400µg) was active against all tested bacteria and clearance for Proteus vulgaris (23.33±0.54mm) was greater than that in both controls (ciprofloxacin (5 µg) (22.33±0.72 mm) and (gentamycin 10µg) (16.67±0.72mm).UNRchad activity against S. aureus, B. subtilis and P. aeruginosa(25.00  0.47 mm, 22.00  mm, and 12.67  0.27mm), while its 10-¹ dilution (40mg) had effects on Bacillus subtilis and Staphylococcus aureus (11.00  0.82mm, 13  0.47mm) only. The 10-2 (4µg) dilutions of (UMR and UNR) had no activity. Comparison of inhibition size between UML (20.33+ 0.27mm) and UMR (23.33+ 0.54mm)against Proteus vulgaris was significantly greater than inhibition size of gentamycin(10µg) (16.67+ 0.72) p<0.05.Activity of UML against Pseudomonas aeruginosa(23.67+ 0.27mm) was comparable to both ciprofloxacin (25.33+ 1.15mm) and gentamycin (21.33+ 0.72mm) p>0.05.Aqueous extracts of Uvaria chamae roots could be modified and harnessed for eradicating Salmonella typhi, UMLc and UMR for Proteus vulgaris and UML for Pseudomonas aeruginosa. Uvaria chamae crude and diluted extracts of both parts are potential future antibiotics.

Open Access Original Research Article

A Cross-sectional Study on the Development of Diabetic Cardiovascular Complications in Type 2 Diabetes Mellitus in a South Indian Tertiary Care Hospital

Ravindra Babu Pingili, Lavanya Nalluri, Madhavi Mannam, Thanvija Kodali, Naveen Babu Kilaru

Journal of Pharmaceutical Research International, Page 19-32
DOI: 10.9734/jpri/2022/v34i8A35474

Background: Diabetic cardiovascular complication is a familiar macrovascular complication of Type 2 Diabetes mellitus (T2DM). Cardiovascular disease (CVD) is the major cause of morbidity and mortality for people with diabetes.

Objective: The aim of this study was to evaluate the parameters related to diabetic cardiovascular complication in patients with T2DM.

Methodology: This study was conducted on 530 subjects (171 with or 359 without diabetic cardiovascular complication). Prevalence of diabetic cardiovascular complication was measured, risk factors for diabetic cardiovascular complications, and drug utilization pattern was assessed.

Results: Cardiovascular complication was significantly higher in the subjects who are poorly educated, nature of work (house wives) and risk factors were pre-existing conditions (Hypertension, Cardiac, endocrine and other diseases), habit of smoking (past smoker), tea/coffee (twice without sugar), poor glycemic control, elevated triglyceride levels, elevated creatinine levels, duration of diabetes (5-10 years; >10 years).

Conclusion: Combination of Glimepiride and Metformin (35.10%), Metformin (34.04%), combination of insulin isophane and insulin regular (23.40%), Insulin Regular (11.70%) were the anti-diabetic drugs widely prescribed to the T2DM patients with cardiovascular complications. Significant risk factors for development of diabetic cardiovascular complication were multiple.

Open Access Original Research Article

Determining the Impact of Coronavirus (COVID 19) on General Surgical Practice in India

Aditya D. Patel, Nitin R. Nangare, Tanmay Mehta

Journal of Pharmaceutical Research International, Page 33-38
DOI: 10.9734/jpri/2022/v34i8A35475

Background: The increased risk of contracting Covid 19 has proved to be a major professional hazard for surgeons working through the coronavirus pandemic that started in 2019, the aim of this study is to examine the effect of covid 19 on the general surgical practice in India. After the high number of worldwide cases, Covid 19 was officially proclaimed to be pandemic on March 11, 2020. The Indian government announced the implementation of a 3 week long nationwide lockdown on March 24 in an effort to curb the escalation of the Covid 19 crisis, as the number of people who tested positive reached 563.

Methodology: A list was obtained of members of the Indian Association of Gastro intestinal endo-surgeons (IAGES) and email id was collected. Pre formed semi structured questionnaire was sent to email id of all 6000 doctors. Out of which One hundred and forty surgeons

Had responded. The survey involved questions about the practice of surgery prior to COVID19 and implications of COVID 19 in the current practice and financial of surgery. The answers were compiled and analyzed statistically.

Results: The larger part (40%) had practiced for over 20 years; 36.4% worked in various private medical centres Of those that took the survey it was found that 40 % had a largely laparoscopic practice wherein they saw approximately an average of 24 patients a day and 40 cases/month as planned surgical cases. After the blockade, step by step technique. Hydroxychloroquine (HCQ) chemoprophylaxis was represented by 54% of subject matter experts. Individual guarded equipment (PPE) was used by 58.2% in all cases, 72.3% communicated that there was insufficient course for future cautious work on concerning prosperity. 53% of experts saw a reduction of more than 75% in their month to month pay, while 21% saw an abatement of 50-75%. A third (33%) of respondents own a crisis facility and anticipate that a month should month money related charge of 2.30 million rupees.

Conclusion: Covid 19 has  radically lessened the load of the current surgical practice and elective surgical treatments. This study warrants the need for the establishment of clear guidelines to ensure the safety of specialists in the conduction of surgical practices, and to set in place a plan to overcome the financial liability brought about by COVID 19.

Open Access Original Research Article

Comparative Contact Angle Analysis of 1% Chlorhexidine and 2% Metronidazole Mouthgel - An In Vitro Study

Apurva Choudhary, S. Balaji Ganesh

Journal of Pharmaceutical Research International, Page 56-61
DOI: 10.9734/jpri/2022/v34i8A35477

Introduction: Chlorhexidine is considered to be gold standard drug in treating various oral infections. Metronidazole is effective for treating various anaerobic infections, including dental abscess and periodontal abscess. In current technical applications and material sciences, contact angle is a thermodynamic characteristic that describes the wettability of solid surfaces. The aim of this study is to compare the contact angle of chlorhexidine and metronidazole mouth gel.

Materials and Methods: Total 10 samples of gel was used, involving 5 samples of 1% chlorhexidine gel and 5 samples of 2 % metronidazole gel. The contact angles were measured with the Ossila Goniometer after each sample was dispensed from a microsyringe on the facial surface of the microtomed tooth. The obtained values from the samples were determined, and the data was statistically analysed using SPSS software version 20.0. The paired t test was used to analyse the data.

Results: From the data collected it was found that the average contact angle of the mouth gels that is chlorhexidine and metronidazole gel were 51.58 & 67.04 respectively. T test showed p value of 0.157, (p value < 0.05). Hence, it is statistically not significant. Chlorhexidine gel had a lower average mean of contact angle than metronidazole gel, which means chlorhexidine gel had got better wettability when compared to metronidazole gel.

Conclusion: Thus, it can be concluded that chlorhexidine gel has a better tendency to wet the tooth or oral cavity surfaces when compared to metronidazole gel, thereby it can have better action in treating various oral conditions.

Open Access Original Research Article

Comparison of Outcomes of Laparoscopic and Open Appendectomy in Management of Appendicitis

Shahbaz Zahoor Mirza, Sikandar-e-Azam Yousfani, Saifullah Brohi, Humaira Muhammad Yousuf, Sarang Tagar, Nawaz Ali Dal

Journal of Pharmaceutical Research International, Page 62-69
DOI: 10.9734/jpri/2022/v34i8A36082

Objective: To compare the outcomes in relations to postoperative pain and complications, and hospital stay of laparoscopic versus open appendectomy in management of appendicitis.

Study Design: Cross sectional study.

Place and Duration of Study:    This study was conducted in department of surgery Unit III of PUMHS Nawabshah and Suleman Roshan Medical College Tando Adam, Sindh Pakistan, from January 2020 to December 2021.

Methodology: This study consisted of 136 consecutive cases of either gender, aged between 13 to 60 years, that were enrolled during study period and matching with the inclusion and exclusion criteria. After the permission of ethical committee, a detailed history was taken from all the patients with special regard to the pain in RIF, Pain starting around umbilicus, nausea, vomiting, fever and altered bowel habits. All the cases were randomly divided into  Group A comprising of 68 cases which were operated by conventional open appendectomy (OA) and other group B also comprising of 68 cases which were operated by laparoscopically appendectomy (LA). All the clinical and demographic data was collected on a proforma designed for the study, and analyzed by using Statistical Package for Social Science (SPSS) software version 22. Effect modifier like age, gender was controlled by stratification and chi-square test was applied to see the effect of these on both open versus laparoscopic appendectomy outcome variable. P <0.05 was taken as significant.

Results: In open appendectomy group male:female ratio of 1.2:1 and in laparoscopically appendectomy group male:female ratio of 1.5:1. The mean age was 31.28±4.30 years for OA group and 35.47±3.23 years for LA group (p 0.02).Alvarado score was showed <4 Score 0% in both groups, where as 4-7 Score in 9(13.23%) patients of OA group and 8(11.76%) patients of LA group, and > 7 Score was seen in 59(86.76%) patients of OA group and 60(83.23%) patients of LA group.  The mean time in OA group was 45.21±12.1 minutes and LA group was 43.44±9.4 minutes (p 0.026).Mild pain was felt in 7(10.29%) patients of OA group and 39(57.35%) patients of LA group, Moderate pain was seen in 31(45.58%) patients of OA group and 26(38.23%) patients of LA group, severe pain was described by 30 (44.11%) patients in OA group and 3(4.41%) patients in LA group (p 0.005).The common complications seen in this study Ileus was 29(42.64%) patients in OA and 18(26.47%) patients in LA group) followed by wound infection 10(14.70%) patients in OA and 1(1.47%) patients in LA group. The duration of hospital stay was longer about 3-4 days in 58(85.29%) of OA patients as compared to LA cases where majority 65(95.58%) were discharged within 2 to 3 days.   

Conclusion: We conclude that laparoscopic appendectomy procedure has a low rate of complications, earlier mobilization, implies a shorter hospital stay and offers the patient a more comfortable postoperative period than open appendectomy procedure.

Open Access Review Article

Nanobiotechnology and its Application in Vaccine Delivery

Reem Farsi

Journal of Pharmaceutical Research International, Page 39-55
DOI: 10.9734/jpri/2022/v34i8A35476

The term " Nanobiotechnology " refers to the use of nanotechnology in biological fields. Nanotechnology is a multidisciplinary area that is currently recruiting approaches, technologies, and capabilities from traditional and advanced engineering, physics, chemistry, and biology. Vaccination has made a huge difference in human health. Despite advances in this area, there is no effective vaccine for a large number of diseases, and some of the available ones do not offer long-term immunity. Numerous studies have been conducted recently to determine the feasibility of using nanostructures as an effective method for vaccine delivery, and the initial findings have been encouraging. So, in the present review, we will address which types of nanoparticles are appropriate for vaccine delivery and reveal and discuss the significance of virus-like particles (VLPs), liposomes, polymeric-based nanoparticles Polyanhydride-based nanoparticles for vaccine delivery. It is crucial to understand their size, shape, charge, porosity, and hydrophobic properties. In conclusion, nanotechnology will help to have a brief understanding of nanotechnology in the delivery of vaccines.  So, it could also motivate new strategies for human disease prevention or treatment.