Open Access Original Research Article

Evaluation of Change in Knowledge, Attitude and Adoption Regarding Antibiotic Prophylaxis for Infective Endocarditis Before and After Health Education among Dental Interns in a Private Dental Teaching Institution in India

Y. Srilatha, B. R. Chandra Shekar

Journal of Pharmaceutical Research International, Page 1-11
DOI: 10.9734/jpri/2022/v34i38A36211

Background: There was paucity of data regarding updating of 2007 AHA (American Heart Association) guidelines among dentists in India.

Objective: To evaluate change in knowledge, attitude and adoption of AHA (2007) guidelines regarding Antibiotic prophylaxis for Infective endocarditis before and after health education among dental interns in a private dental teaching institution.

Materials and Methods: This was an interventional study conducted among dental interns in a teaching dental institution. Data was obtained using a validated questionnaire that finally had 32 items. Data was obtained by sharing an online link to complete survey. A reminder was also given one week later and participant responses obtained. Each correct response for a question was assigned a score of 1 while incorrect response was scored as zero. Total score was computed for each participant. Health education on AHA 2007 guidelines for antibiotic prophylaxis against infective endocarditis was offered to participants using power point presentation for about 30 -45 minutes on a scheduled day following baseline data collection. Immediately after health education, participants were again requested to fill the same questionnaire used at baseline. Mean knowledge score before and after health education was compared using paired sample t-test.

Results: 74 participants were considered with response rate of 91.4%. Mean knowledge score significantly increased from 11.5 ± 4.3 (Mean ± Standard deviation) at baseline to 22.9 ± 4.2 post intervention (p < 0.001).

Conclusion: Health education intervention was successful in improving knowledge, attitude and adoption of AHA 2007 guidelines for antibiotic prophylaxis against IE among dental interns.

Open Access Original Research Article

Development and Validation of the RP-HPLC Method for the Estimation of Chlorocresol and Betamethasone Dipropionate in Semisolid Dosage Formulation

Ashok Khatawakar, Sachin Sakat, Poonam Inamdar, Om Bagade

Journal of Pharmaceutical Research International, Page 12-22
DOI: 10.9734/jpri/2022/v34i38A36212

A simple, accurate, reproducible and cost-effective reverse phase HPLC technique for chlorocresol (CRC) as a preservative as well as betamethasone dipropionate (BTD) in bulk drug as well as semi-dose formulations. Snakes were developed during this research. In this method, Discovery HS (150x4.6 mm),was used as the stationary phase and an 80:20 mixture of water and isopropyl alcohol was used as the mobile phase A, and a mixture of acetonitrile plus tetrahydrofuran in the ratio. 70:30 ratio was used as mobile phase B in gradient mode to produce the final product. Approximately 1.00 ml/min of the solution is passed through the chromatograph by pumping it through. The UV detector operates at a wavelength of 240 nm. A validation study in accordance with the ICH Q2 (R1) guidelines is required to demonstrate that the new analytical method meets the reliability characteristics and these characteristics demonstrate the ability of a new analytical method. analysis in maintaining, over time, the basic validation criteria: selectivity, linearity, precision, precision, and specificity. When this method is used for quality control of commercial semi-solid dosage forms of betamethasone dipropionate throughout the day, the stability indicator technique can be used to measure the breakdown of the drug and its products it, as well as to evaluate the results of the tube homogeneity test.

Open Access Original Research Article

A Pilot Study of the Effects of Ajwa Date Seed Extract in a Diabetic Animal with Parallel Observations on Human Subjects

Shifa Felemban, Asmaa Fathi Hamouda

Journal of Pharmaceutical Research International, Page 23-33
DOI: 10.9734/jpri/2022/v34i38A36214

Background: most diseases are inequality of the antioxidants, pro-oxidants, and failure in resolved inflammation. Diabetes is a metabolic malfunction associated with inflammation and ends with organs failure. Alternative treatments for diabetes include a lifestyle and an anti-inflammatory diet.

Method: we investigated the effects of dietary Ajwa dates seeds extract (AJSO) against alloxan monohydrate-induced biochemical changes. We analyzed the phytochemical components of AJSO with gas chromatography-mass spectrometry and inductively coupled plasma-mass spectrometry. We determined the effects of oral AJSO on biochemical changes caused by alloxan monohydrate in rats. We also observed biochemical changes in human volunteers with or without Ajwa seed as caffeine-free coffee replacements.

Results: the results and outcomes confirmed the improvement in the rats’ biochemical analysis due to AJSO constituents. The treatment of AJSO after alloxan monohydrate injection significantly (p ≤ 0.05) decline the studied parameters NO, MDA, Amyloid A, CRP, and glucose concentrations by 47.2%, 34.8%, 55.6%, 47.4%and 60.0%, respectively, compared to treatment only with alloxan monohydrate. The volunteers treated with Ajwa seed as caffeine-free coffee replacements(group2) showed significant amelioration of inflammatory and diabetes markers as compared to the untreated group1. Group 2 showed a significant decrease in the concentration of serum NO (34.7%), MDA (43.9%), amyloid A (79.6%), CRP (60.9%), HbA1c (33.8%), Troponin T (16.4%), serum total cholesterol (14.2 %), TG (28.1%), LDL-C (6.1%), AST 8.8%, and ALT (11.6%) compared to Group1.

Conclusion: AJSO had a healthy impact by decreasing the levels of amyloid a, c-reactive protein, lipid peroxidation, nitric oxide, and improving diabetes, lipid and liver profiles in both rats and human volunteers. Further long-term investigation of higher numbers and the different types and sexes is needed in progress to confirm and validate the results.

Open Access Original Research Article

In vitro Antimicrobial Activity Profile of Modified Pyrimidine Nucleosides Derivatives

Arshed Shihad, Maksim Khancheuski, Aliaksei Sysa, Evgeniy Gritskevitch, Evgeniy Kvasyuk, Viktar Lemiasheuski

Journal of Pharmaceutical Research International, Page 34-45
DOI: 10.9734/jpri/2022/v34i38A36216

Background: The increase in prevalence of antimicrobial-resistant bacteria (ARB) is currently a serious threat, thus there is a need for new classes antimicrobial compounds to combat infections caused by these ARB. The growth inhibition ability of derivatives of the components of nucleic acids has been well-characterized but not for its antimicrobial characteristics.

Aims: To evaluate in vitro antimicrobial activity profile of modified pyrimidine nucleosides derivatives.

Methodology: Modified nucleosides arabinofuranosylcytosine (cytarabine, ara-C), [1-(2',3',5'-tri-O-acetyl-β-D-ribofuranosyl)-4-(1,2,4-triazol-1-yl)]uracil (TTU), and nucleotides cytarabine-5′-monophosphate (ara-CMP), and O2,2′-cyclocytidine-5′-monophosphate (cyclocytidine monophosphate, cyclo-CMP) were synthetized and subsequentially checked for antibacterial activity. Bacterial cells characteristics were assessed by antiproliferative and the production of intracellular reactive oxygen species (ROS) assays.

Results: It was found that modified nucleosides ara-C, and TTU, and nucleotides ara-CMP, and cyclo-CMP were able to inhibit Escherichia coli, Sarcina lutea, Bacillus cereus, and Proteus mirabilis strains in a time and dose dependent manner via killing kinetics assay. Gram-negative (E. coli and P. mirabilis) bacteria stains were more sensitive to the exposure of TTU and cyclo-CMP and less sensitive to the exposure of ara-C and ara-CMP compared to gram-positive ones. The most effective cells growth inhibitor for gram-positive strains (S. lutea, B. cereus) was ara-CMP with ED50 = 5.2•10-5 M and 3.1•10-4 M, respectively. Sarcina lutea appeared to be the most sensitive bacteria strain to the exposure of all studied compounds. It was demonstrated that studied modified pyrimidine nucleosides derivatives enhanced the production of intracellular ROS over time (validated via DCFA-DA probe assay).

Conclusion: This study has revealed the mechanism of action of cytarabine, cyclocytidine monophosphate, and TTU as an antimicrobial agent for the first time, and has shown that these pyrimidine derivatives enhanced might be able to combat infections caused by Escherichia coli, Sarcina lutea, Bacillus cereus, and Proteus mirabilis in the future.

Open Access Original Research Article

Studies on the Efficacy of Various Antimycotic Drugs on Emerging and Reemerging, Superficial, Cutaneous and Subcutaneous Mycotic Infections

C. M. Ezenwa, C. N. Obum-Nnadi, Dennis Amaechi, V. N. Unegbu, K. S. Nwokorie

Journal of Pharmaceutical Research International, Page 46-50
DOI: 10.9734/jpri/2022/v34i38A36217

Introduction: The efficacy of five systemic and topical antifungal medications, Voriconazole, clotrimazol, beclometasone, Itraconazole, and Fluconazole, on dermatomycosis, which affects the superficial layers of the skin, nails, foot, and hair, was tested with 180 patients.

Methods: Included were specimen collection, processing, microscopy, and culture, as well as antifungal susceptibility testing using the E-test method. The Candida species were confirmed and their susceptibility to Voriconazole and Fluconazole was tested using the automated Vitek 2.

Results: The final strain identification indicated 41 dermatophytes (69.49%), 11 non-dermatophytic molds (NDM) (18.64%), and 7 yeasts (11.87%). (candida). Candida was the most prevalent nondermatophyte species found. Trichophyton rubrum was the most prevalent species isolated in Tinea corporis, T. cruris, T. capitis, and T. faciei. When tested with the E strips, all dermatophyte strains showed the greatest vulnerability to beclometasone and clotrimazole (MIC range of 0.04–0.64), but homogeneous resistance to Fluconazole (i.e. MIC 32 g/ml).

Conclusion: Variation in species distribution was shown to be statistically significant (p = 0.001) in terms of clinical presentation.

Open Access Original Research Article

Correlation of Serum Thiamine with Physical and Biochemical Parameters among Type 1 and Type 2 Diabetes

Sana Bilal, Lubna Raza, Muhammad Sajid Khan, Raheela Adil, Ambreen Bari, Adnan Anwar, Ahsan Ali Siddiqui

Journal of Pharmaceutical Research International, Page 51-57
DOI: 10.9734/jpri/2022/v34i38A36218

Objective: Thiamine or vitamin B1 is a fundamental vitamins and minerals and enzyme cofactor that are needed for most of the anabolic and catabolic reaction that occurs in organisms. Deficiency of Thiamine has been associated with numerous complications in diabetes mellitus (DM) patients. Therefore, this study was intended to assess various biochemical and anthropometric parameters with serum thiamine levels in patients with type I and type II diabetes.

Methodology: This was a case-control study carried out in outpatient department (OPD) of Diabetes Department of Jinnah post graduate medical institute, Karachi by using non-probability convenient sampling technique. This study comprised of 6 months duration after approval of synopsis. A total of 60 participants with type I and II diabetes mellitus of both genders with age < 25 to > 46 years were selected; 30 participants with type I diabetes whereas 30 participants had type II diabetes. The Pearson’s correlation test was used to interpret correlation between thiamine levels and height, weight, heart rate, temperature, Total cholesterol, Triglycerides, creatinine, urea in type I and II diabetic patients.

Results: The results showed that among type I diabetics, none of the patient characteristics studied were significantly correlated with the thiamine levels of these patients. On the other hand, among type II diabetics, significantly negative correlation was observed between height and thiamine level (p=0.045) where patients with greater height had lower thiamine level and vice versa. Moreover, both heart rate and total cholesterol were marginally insignificantly correlated with thiamine level (p=0.065 and p=0.069), respectively.

Conclusion: This study concluded that all anthropometric and biochemical parameters were insignificantly correlated with thiamine levels in type I and II diabetes patients. However, height had significant negative correlation with the thiamine level among type II diabetics reflecting patients with more height had lower thiamine level.

Open Access Original Research Article

Sociodemographic and Clinical Pattern of Thyroid Nodules in Sindh, Pakistan: A Prospective Analysis from a Tertiary Care Centre

Ghansham ., Najeeb Ullah, Saba Patoli, Vijay Kumar, Hazrat Bilal Burki, Al Farah Rehmat Ullah

Journal of Pharmaceutical Research International, Page 58-65
DOI: 10.9734/jpri/2022/v34i38A36219

Objectives: To study the sociodemographic and clinical patterns of thyroid lesions in Sindh, Pakistan.

Methodology: A prospective observational study was conducted at the department of Surgery, Ward - 26, Jinnah Postgraduate Medical Centre, Karachi between March 2018 to 2020. All patients presenting with complaints of thyroid nodule as diagnosed clinically and by ultrasound imaging were included in the study. Patients with deranged thyroid hormone levels were excluded. Sociodemographic, clinical, and pathological parameters were recorded in a predefined pro forma. Statistical Package of Social Sciences v.26 (SPSS) was used for data analysis.

Results: A total of 330 patients were evaluated for thyroid lesions. Out of these, only 81 patients were diagnosed with thyroid nodules. Mean age was 35.14 ± 12.28 years. We had 37 patients (11.2%) with a diagnosis of thyroid carcinoma. This included papillary and follicular carcinoma majorly. Among patients diagnosed with carcinoma, 31 (83.8%) were females.

Conclusion: We presented a significantly higher rate of thyroid carcinoma on histopathology in our centre as compared to previous studies. The majority of the lesions were diagnosed among females. This highlights the increasing incidence of thyroid carcinoma in our population.

Open Access Original Research Article

Study of Early Lactate Clearance as an Independent Predictor of Survival in Patients with Presumed Sepsis

Parth Patel, Naimesh Shah, Dipak Shukla

Journal of Pharmaceutical Research International, Page 66-74
DOI: 10.9734/jpri/2022/v34i38A36220


Aim: Measurement of serial serum lactate levels in patients presenting with sepsis and correlating with 1. early lactate clearance with mortality. 2. Early lactate clearance vs. first (baseline) lactate level in mortality prediction. 3. Early lactate clearance vs. ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II score in mortality prediction. 4. Early lactate clearance vs. non lactate clearance in mortality prediction.

Place and Duration of Study: Department of General Medicine, SMIMER, Surat, Gujarat between December 1st 2017 and November 25th 2019.

Methodology: 50 patients (36 male, 14 females; age more than 18 years) Patient with sepsis were selected from Medicine ICU by using ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II score ≥ 12 points. Lactate levels at 0, 6, 12, 24 and 48 hours were measured by using ABG done by ABL 800 basic analyzer. ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II score was calculated on admission. Lactate clearance was calculated (<10% OR >10%) and was correlated with mortality (< 7 days or > 7 days).

Results: Among 50 patients studied, 39 patients were in lactate clearance group and 11 patients were in lactate non-clearance group. In lactate clearance group 35 (89%) patients survived and 4 (11%) patients expired. In lactate non-clearance group 9 (81%) patients expired and 2 (19%) patients survived. On observing the lactate trend, Serial serum lactate levels were decreasing in survived patients while serial serum lactate levels were static or increasing in expired patients. There was no correlation between serum lactate at 0 hour and mortality in the study group (p value > 0.05). There was correlation between serum lactate at 6, 12, and 24 hours with mortality (p value <0.05). There was strong correlation between serum lactate clearance and mortality (p value < 0.01).

Conclusion: Study confirmed the prognostic value of serial serum lactate monitoring and its clearance for prediction of mortality. We concluded that early lactate clearance could be used as an independent predictor of survival in patients with presumed sepsis.