Open Access Case Study

Neurofibroma of the Median Nerve Managed With Ultrasound Guided Nerve Block: A Case Report

Jeshnu Prakash Tople, Shilpa Shankar

Journal of Pharmaceutical Research International, Page 1-4
DOI: 10.9734/jpri/2022/v34i14B35652

Background: Median nerve neurofibroma can mimic carpal tunnel syndrome. In unilateral carpal tunnel syndrome, wrist imaging is suggested to exclude tumors. Diagnosis and management of peripheral nerve sheath tumors can be challenging.

Case: This is a case report of 42-year-old female with median nerve neurofibroma who presented with excruciating pain as the main symptom. Though surgical excision is the preferred treatment, it is associated with the risk of functional deficit. In this case, patient was unwilling for surgery. This report highlights the evaluation of neurofibroma and the role of median nerve block in the symptomatic as well as functional improvement.

Conclusion: Nerve block can be effective if neurofibroma presents with pain as the main symptom without any impairment of motor function or daily activities.

Open Access Minireview Article

Intestinal Invaginations in Adults

Hasan Zafer Acar, Arkin Akalin

Journal of Pharmaceutical Research International, Page 23-27
DOI: 10.9734/jpri/2022/v34i14B35679

Intestinal invaginations in adults are rare phenomenon . The most critical etiological causes are malignancies. The most common symptoms are abdominal pain, nausea, vomiting, inability to pass flatus and defecation, and distention in the abdomen due to intestinal obstruction. On physical examination, abdominal distention, decreased bowel sounds and sometimes a mass may be palpable on deep palpation.

In direct radiography, air-liquid levels can be seen. A mass can be detected in the invagination area on ultrasonography. Definitive diagnosis is usually made by computerized tomography.

Treatment of intestinal invaginations in adults is usually surgery. It can be done by laparoscopic or open surgery.

As a result, we think that when a definitive diagnosis is made in adults, intestinal invagination should be treated surgically under oncological principles since the etiological factor is mostly malignancy.

Open Access Original Research Article

The Effect of Conventional Lumbar Spine Surgery on the Lumbar Multifidus Fat Infiltration

Seyed Shahab Ghazi Mirsaeid, Ahmad Porashiedy Basharabadi, Ehsan Fallah, Mohammad Mansouri Nasab

Journal of Pharmaceutical Research International, Page 5-11
DOI: 10.9734/jpri/2022/v34i14B35653

Aims: Low back pain is considered as a common problem that affects most adults at least once in their lives. Almost 90% of people experience back pain during their lifetime. The total cost of treating chronic low back pain in the United States is estimated at more than $ 100 billion annually. Hence, the present study aimed to investigate the effect of lumbar spine surgery on the lumbar multifidus fat infiltration in the patients referred to Imam Reza Hospital in 2020.

Study Design: Prospective study.

Place and Duration of Study: Department of Neurosurgery, AJA University of Medical Sciences (AJAUMS), Imam-Reza Hospital, Tehran between January 2020 and January 2021.

Methodology: In the present prospective study, patients with disk herniation or lumbar spine canal stenosis referred to the neurosurgery clinic of Imam Reza Hospital in 2020 that underwent surgery were enrolled. After six months, they underwent lumbosacral MRI again. Multifidus muscles in primary MRI and sixth month MRI were compared at L4-L5 and L5-S1 levels and the changes were recorded.

Results: A total number of 288 patients were enrolled in the present study during the study period. Based on the results, moderate fat infiltration (grade II) have had the highest frequency amongst the patients, and 52% of patients were in the moderate state in terms of adipose tissue infiltration in multifidus muscle postoperatively.

Conclusion: Increased adipose tissue infiltration in the postoperative period was high and can be considered as a cause of disability and severe pain in patients after surgery. Due to the muscle atrophy six months post-surgery owing to intraoperative muscle injuries and consequently postoperative movement restriction, some exercises and physical therapy can be suggested to correct movement patterns and further reduce pain in the patients.

Open Access Original Research Article

Possible Protective Role of Aqueous Tomato Extract on Hemato-Biochemical Parameters against Sodium Arsenite Toxicity in Albino Rats

Suman Sharma, Saroj Rani

Journal of Pharmaceutical Research International, Page 12-22
DOI: 10.9734/jpri/2022/v34i14B35662

Due to rapid industrialization and technological development, humans are constantly exposed to heavy metals at minimum to maximum tolerable levels. Arsenic is ubiquitously distributed and most concerned element now-a-days, inorganic arsenicals mainly enter into the body via the route of lungs and gastrointestinal tract and 55-95% of it gets absorbed. Sodium arsenite poisoning leads to disturbance in hematological and biochemical processes. In the present study, toxic effects of sodium arsenite on the hematological parameters, serum transaminases and possible modulatory role of aqueous tomato extract were studied. Female rats were allocated into four different groups: 1. Control (given normal diet), 2. Sodium arsenite treated (10mg/kg B.W.), 3. Combination of sodium arsenite (10 mg/kg B.W.) and aqueous tomato extract (50 mg/kg B.W.) treated rats 4. Only aqueous tomato extract treated (50mg/kg B.W.) rats. It was observed that arsenic significantly decreased the total erythrocytes count (RBC), hemoglobin concentration (Hb), hematocrit value (HCT) and platelets (PLT), whereas significantly elevated the total leucocytes count (TLC) and activities of serum transaminases such as ALT and AST. Supplementation of aqueous tomato extract to arsenic treated rats showed decrease in values of WBC, ALT and AST which almost matched to values of control rats. So, from this study it can be concluded that antioxidants and vitamins present in the aqueous tomato extract showed protective role against arsenic toxicity in albino rats.

Open Access Original Research Article

Determination of Real-world Single-center Experience with Direct-acting Antivirals for Improvement of Liver Fibrosis after Chronic Hepatitis C Treatment

Anum Mari, Mohammad Masood Khoso, Alina Saeed, Sana Ahmed, Kiran Mari, Riaz Hussain

Journal of Pharmaceutical Research International, Page 28-35
DOI: 10.9734/jpri/2022/v34i14B35680

Background and Aims: Chronic Hepatitis C virus is the leading cause of morbidity and mortality. Conversion to liver fibrosis and decompensated liver cirrhosis is common if left untreated. Direct-acting Antiviral agents (DAA) may help in liver fibrosis associated burden. Considering the fact, this study aims to determine the comparative effect of combination therapy (Sofosbuvir and Daclatasvir vs. Sofosbuvir and Ribavirin) on liver fibrosis improvement using noninvasive marker AST platelet ratio index (APRI) score.

Methods: A retrospective cross-sectional study was conducted on secondary data of patients who visited a private gastroenterology clinic during the year of 2017 and 2018 in Karachi, Pakistan. Our sample comprised of a total of 300 patients who presented for the first time to the clinic from various provinces.

Results: Among all, 163 (54.3%) patients were treated with Sofosbuvir and Daclatasvir while 137 (45.6%) treated with Sofosbuvir and Ribavirin. The overall mean age and SD of patients was 41.1 ± 13.4 years and among them 64.6% (n = 194) were males. In both groups, treatment response showed negative HCV viral load after treatment, p <0.001. Levels of hemoglobin were significantly reduced in patients treated with Sofosbuvir and Ribavirin, 12.8gm/dL (11.5-14.2) vs. 11.4gm/dL (10.8-12.8), p value 0.03. Levels of total bilirubin significantly improved in patient received Sofosbuvir and Daclatasvir, 1.2mg/dL (0.4 - 1.8) vs. 0.6mg/dL (0.2 - 0.6), p value 0.001. Patients who treated with Sofosbuvir and Daclatasvir had significant improvement in APRI score (pre-treatment 1.26±0.17 vs. post-treatment 0.63±0.09, p value <0.001) in comparison with who treated with Sofosbuvir and Ribavirin (pre-treatment 0.92 ± 0.07 vs. post-treatment 0.43 ± 0.05, p value <0.06).

Conclusion: In present study, we report that the value of APRI improved significantly after treatment with DAA particularly those who treated with Sofosbuvir and Daclatasvir, which may indicate that regression of fibrosis is achievable after removal of the causative agent.

Open Access Original Research Article

In-vitro Antioxidant, Antidiabetic Activities and Phytotoxic Profile of Alkanna tinctoria (Boraginaceae)

Rahmat Ali Khan, Aamir Khan Awan, Mushtaq Ahmed, Huda Alkreathy, Alia Gul, Amir Muhammad Khan, Arshad Mahmood, Asif Khan, Muhammad Nisar Ul Haq, Khalid Saleh Alzahrani

Journal of Pharmaceutical Research International, Page 36-42
DOI: 10.9734/jpri/2022/v34i14B35681

Plants are the most important source of biological compounds that are used to achieve biological activity. The originating of crude extracts of plants is broadly used as therapeutic drugs to treat various infectious damages. The present study was arranged to investigate the potential of Alkanna tinctoria Tausch, roots extract, collected from district Bannu, Pakistan in contradiction of various human pathogenic infections, resistant and antioxidant activities like DPPH (2, 2- diphenyl-1-picrylhydrazy) free radicals scavenging, hydrogen peroxide scavenging, ABTS [2, 2-azinobis (3- ethylbenzthiazoline-6-sulphonic acid)] scavenging activity and phytotoxicity effect. The current study was focused on the phytochemical investigation and pharmacological activities of methanolic extract of Alkanna tinctoria. The plant extracts were examined for antioxidant scavenging assay by using DPPH & ABTS free radicals, Hydrogen peroxide, alpha amylase and Phytotoxicity. Ascorbic acid was taken as standard. Methanolic crude extract showed high phenolic contents and significant antioxidant activity (DPPH, H2O2 and ABTS). All the concentration of Alkanna tinctoria also showed phytotoxicity effect and was found to have significant antioxidant potential. From the findings of the present study it was concluded that the methanol extract of Alkanna tinctoria have various antioxidant, anti-diabetic and phytotoxic activities. Furthermore, analysis is needed to investigate its mechanism of pharmacological activities.