Open Access Original Research Article

Frequency of Teenage Pregnancy, Its Associated Risk Factors, Complications and Impact on Fetal Outcome

Nazia Azam Yousfani, Mehwish Zafar, Faisal Irshad, Faiza Syed, Shabnam Aijaz Khowaja, Fareeda Wagan

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2022/v34i39A36229

Aim: To determine the frequency of teenage pregnancy with associated risk factors and various complications, and to evaluate the obstetric and fetal outcome.

Methods: This cross-sectional study was conducted at the departments of Community Medicine, Pathology and Gynecology & Obstetrics, Peoples University of Medical and Health Sciences, Nawabshah, and Suleman Roshan Medical College Tando Adam, from January 2019- June 2020, consisting of 108 teenage mother group (13-18 years) and 108 adult primigravid reference mother group (19-22 years) that gave birth during the study period.

Results: The teenage group had mostly Spontaneous vaginal delivery 61.11% (n=66). Majority of the teenage mothers suffered from pregnancy complication of anemia 72. 2% (n=78) compared with the reference group 22.2% (n=24). 46.29% neonates of the teenaged group mothers developed complications including Low birth weight 52% (n=26), Preterm Birth 10% (n=5) and most serious complication Perinatal death 4% (n=2) compared to the reference group.

Conclusion: The teenage pregnancies are high risk pregnancies with potential maternal and fetal complications.

Open Access Original Research Article

Use the Complete Blood Counts and Esr as Biomarkers Prognostic Tool in Breast Cancer Patients Attending Surgery Department at Esut Teaching Hospital, Parklane Enugu Nigeria

N. Soronnadi Clara, N. C. Ibeh, F. O. Ugwuene, L. Maduka, O. Odurukwe, E. I. Aneke, M. Ajuba

Journal of Pharmaceutical Research International, Page 6-29
DOI: 10.9734/jpri/2022/v34i39A36230

Background: Full blood count is a prerequisite investigation requested from all breast cancer patients before and during treatment.Poor parameters adversely influence the outcome of cancers.

Objective: This study investigated the use of Complete Blood Count (CBC) and Erythrocyte Sedimentation Rate (ESR) as biomarker prognostic tool in breast cancer subjects.

Methods: The sample size comprised of 110 female subjects and controls with ages between 21-70 years. A longitudinal study method was used. The samples were collected from apparently healthy individuals as control, pre-treatment at diagnosis and the treatment samples at different stages of the treatment. Questionnaire used obtained other demographic information. The data was analyzed with IBM SPSS PC. Version 20.0; SPSS Inc., Chicago, III., USA.

Results: Results showed that increased Neutrophil/Lymphocyte Ratio (NLR) and decreased Lymphocyte / Monocyte Ratio (LMR) were significantly associated with increased hazard ratio (HR) and decreased OS at p<0.05 while Platelet/Lymphocyte Ratio ( PLR) had no significant difference at P>0.05 in Breast Cancer. In CBC and ESR, control, pre-treatment and treatment period, red blood cell (RBC) parameters and total white blood cell (TWBC) parameters decreased significantly at p<0.05 in treatment results compared to the pre-treatment and control results while others showed no significant increase at p<0.05 in treatment results compared to pre-treatment results. Treatment red cell distribution width (RDW) and mean platelet volume (MPV) observed a significant increase (p<0.05) compared to the control and pre-treatment results. Age group 21-30 years showed more susceptibility than other age groups with lowest mean±SD in CBC and ESR but with no significant difference at p>0.05.

Conclusion: This study supports the concept that biomarkers such as CBC and ESR can be used as a prognostic tool in early detection, treatment and monitoring of the disease progression in these subjects

Open Access Original Research Article

Formulation and Evaluation of Superporus Hydrogel Composite as a Gastro Retentive Drug Delivery for Cefditoren Pivoxil

D. Jeslin, K. Nithyakalyani, P. Panneerselvam, V. Padmaja, P. Suresh Kumar, S. Anand Kumar

Journal of Pharmaceutical Research International, Page 30-40
DOI: 10.9734/jpri/2022/v34i39A36231

The purpose of this work was to incorporate superporus hydrogels for cefditoren pivoxil by using polymer like poly acrylic acid aqua cc polymer and composite agent like cross linked sodium carboxy methyl cellulose in the presence of N,N-methylene-bis-Acrylamide as crosslinking agent. Pluronic F-127 as a stabilizer and ammonium per sulfate and tetramethylene diamine as a initiator pair. Poly acrylic acid aqua cc polymer-cross linked sodium carboxy methyl cellulose superporus hydrogels of cefditoren pivoxil were incorporate by gas blowing technique. The reaction  of pH on the swelling ratio was decisive. Swelling reversibility research was also achieve. Fourier transform infrared spectroscopy analysis and scanning electron microscopy studies were assume to indicate the drug loaded superporous hydrogels, while dissolution studies were achieve to assess release characteristics. Swelling was hugely depending on the term of crosslinking and the quantity of the polymer existing in formulation. The huge amount of cross-linking agent reduced the swelling ratio. The superporous hydrogels were hugely perceptive to pH of swelling medium, and exhibit reversible swelling and de-swelling behavior during still keep their mechanical stability. Apparent density was reliant on the amount of the superporous hydrogels and reduced with developing crosslink density. Degradation kinetics reveals that poly acrylic acid aqua cc polymer superporous hydrogels had good water holding potential. Drug release was similar to quantity of cross-linking agent. The studies report that poly acrylic acid aqua cc polymer superporous hydrogels can be used as a Gastroretentive drug delivery system in view of their swelling characteristics in acidic pH.

Open Access Original Research Article

Quantitative Determination of the PARP Inhibitor Olaparib (AZD 2281) in Rat Plasma using LC-MS/MS: Application to Pharmacokinetic Studies

Revu Baby Nalanda, Atla Srinivasa Rao, S. Kapileswar, B. Srivani

Journal of Pharmaceutical Research International, Page 41-48
DOI: 10.9734/jpri/2022/v34i39A36232

Purpose: Olaparib, a highly selective PARP inhibitor in advanced treatment of ovarian cancer. The method describes a simple, rapid, sensitive, specific LC-ESI-MS/MS assay for the simultaneous detection and accurate measurement of olaparib in rat plasma using telmisartan as an internal standard as per the regulatory guidelines.

Methods: Chromatographic separation was carried out on a Liquid Chromatography with tandem mass spectrometry (LC-MS/MS) unit with a Kinetex EVO C18 column (50 × 4.6 mm, 5 µ) using a gradient mobile phase of acetonitrile and 5mM ammonium acetate in water. No endogenous interfering compounds were discovered at the retention time of olaparib (1.66 min) and telmisartan (IS, 1.77 min).

Results: The MS/MS detection was performed in positive mode and MRM transitions were m/z 435.22→366.96 and 515.21→276.16 for olaparib and IS, respectively. This method was assessed to be stable, selective and no matrix effect in three concentrations (4, 500, 800 ng/mL). The intra and inter-day precisions were less than 7.55 % and accuracy ranged from 98.00 % to 106.38 %. The extraction recovery was within acceptable limits. Additionally, the method had good linearity in the range of 1-1000 ng/mL.

Conclusion: The validated method was successfully applied to the pharmacokinetic study of rats through oral and intravenous administration routes.

Open Access Original Research Article

Effectiveness of Standardized Nursing Care Protocol among Post Cardiac Catheterization Patients to Reduce Hematoma Development

Saeeda Sania, Afshan Nazly, Shamim Siddiqui, . Raja

Journal of Pharmaceutical Research International, Page 49-58
DOI: 10.9734/jpri/2022/v34i39A36234

Background: Hematoma development is the most common vascular access complication among post-cardiac catheterization patients. It requires safe and standardized nursing care protocol, as well as qualified and skilled healthcare providers to obtain good outcomes of management. The vascular access complications were severe and increased the length of stay in the hospital. Timely recognition and management can diminish their burden.

Objectives:

  1. To evaluate the effectiveness of Standardized Nursing Care Protocol among Post cardiac catheterization patients to reduce hematoma development.
  2. To assess the association of hematoma development between procedure site (radial and femoral) and comorbidities (diabetes, hypertension, and obesity) among post-cardiac catheterized patients.

Methodology: This quasi-experimental (post- test only) study was conducted at Coronary Care Units at tertiary care hospitals in Karachi. In this study, a total of 108 post-cardiac catheterized patients were participated. The patients were divided into two groups; the interventional group and the control group. In the control group, 54 post-cardiac catheterized patients were selected and data were taken based on inclusion criteria who received routine holistic nursing care post-procedure and have been discharged. Besides 54 patients participated in the interventional group who received Standardized Nursing Care Protocol post-cardiac catheterization including proper patient assessment, compression techniques, interventions pre, during and post sheath and TR-band removal to discharge instruction by the principal investigator (PI). The data was collected through patients’ assessment sheets and hematoma scales for the identification of hematoma development rate among post-cardiac catheterized patients. The non-probability consecutive sampling technique was accomplished for the collection of data.

Findings: The rate of hematoma development in the (control) group was reflected at 18 (33.3 %) while after the implementation of the standardized nursing care protocol the rate of hematoma development was 9 (16.6%) in the (interventional) group out of 54 (50%) post-cardiac catheterized patients. There was a significant difference between the (control) and (interventional) groups regarding the rates of hematoma development among post-cardiac catheterization i.e. the P values were 0.037 ˂ 0.05. Thus, the standardized nursing care protocol among post-cardiac catheterization was effective in the reduction of hematoma development. Furthermore, the radial site procedure reflected fewer rates of hematoma development 8 (14.81%) as compared to the femoral site procedure 19 (35.1%) among post-cardiac catheterized out of 54 (50%). The P-value was 0.058 > 0.05 there was no association between hematoma development and procedure site in the (interventional and control) groups post-cardiac catheterization. Similarly, the P-value was greater than 0.05 hence there was no association between hematoma development and comorbidities (diabetes, hypertension, and obesity) post-cardiac catheterization.

Conclusion: The implementation of Standardized Nursing Care Protocol among post-cardiac catheterization was effective for the reduction of hematoma development in the (intervention) group while there was an association of hematoma development between the (control and interventional) groups. However, there was no association between hematoma development and site procedure (radial and femoral) and comorbidities (diabetes, hypertension, and obesity) post-cardiac catheterization patients.

Open Access Original Research Article

14-Day Outcome of Treatment Protocol Given to Patients with COVID-19 Admitted in FIC/HDU Karachi

Muhammad Yahya, Saima Ghaus, Kiran Saleem, Baakh Nusrat, Samreena Ishrat, Maira Masaud

Journal of Pharmaceutical Research International, Page 59-67
DOI: 10.9734/jpri/2022/v34i39A36236

Aims: To observe outcomes in patients admitted to the High Dependency Unit (HDU) at the Field Isolation Centre Karachi after 14 days of COVID-19 treatment protocol.

Patients and meth­ods: This cross-sectional study was conducted at HDU/FIC Karachi at Expo Centre. The duration of the study was from 1st December 2020 to 10th March 2021. All patients diagnosed as cases of COVID-19, of both genders with age ranging from 18 to 91 years were included.

Methodology: All patients were treated according to the protocols set as under:

Anti-viral drug Remdesivir was given in all patients aged less than 75 years, with moderate to severe disease (based on clinical classification released by National Health Commission of China). Dexamethasone 6mg IV once daily was initiated in all oxygen dependent patients and increased to twice daily if Ferritin levels were greater than 1000ug/L. As a supportive treatment, patients with moderate or severe disease were given Injection Enoxaparin in prophylactic dose and in therapeutic dose for patients with elevated D-Dimer levels. Along with this, superadded bacterial infections were covered with broad-spectrum antibiotics and adjusted as per culture and sensitivity. Patients were also given Famotidine (H-2 receptor blocker), and anti-hyperlipidemic drug Fenofibrate based on initial supportive literature. But in patients with known liver diseases or with deranged ALT levels ≥ 5 times upper limits of normal, Fenofibrate and Remdesivir were discontinued.

All data regarding the medications given, oxygen demand, disease severity and co-morbid conditions and the outcome on 14th day of admission was collected through the online HMIS database and patient files, on pre-approved Performa. Patients’ confidentiality was ensured.

Results: A total of 183 patients were included in the study. There were 66.7% male and 33.3% female patients with a mean age 59.01±14.83 years. Majority (72.1%) of patients were of more than 50 years of age. Among 183 patients, 2.2% were smokers, 51.9% were hypertensive and 41% were diabetic while 5.5% had ischemic heart disease, and 3.8% were found with asthma. We found 84.7% with shortness of breath, 67.8% of patients with fever, 57.9% with cough, 17.5% with myalgia, 14.8% with fatigue, 4.9% with diarrhea, 2.7% with nausea and 1.6% with vomiting. In our study, 35% of patients expired. Out of 183 patients, 147 patients needed oxygen at the time of admission, which was reduced to 45 patients after 2 weeks, while 26 patients need NIV at admission, reduced to 21 patients on NIV after 2 weeks. We found significant mean difference of age (p=0.000) while significant association of outcome was found with Remdesivir given (p=0.039), cough (p=0.025), intubation after 2 weeks (p=0.006), Oxygen need at admission (p=0.000), Oxygen need after 2 weeks (p=0.000), NIV Need at admission (p=0.000) and NIV Need after 2 weeks (p=0.000).

Conclusion: This study revealed various characteristics (age, supplemental oxygen requirement and comorbid conditions) of COVID-19 patients to be associated with poor outcome at 14th day of admission. Remdesivir was found to decrease mortality, especially in patients with moderate to severe disease.

Open Access Original Research Article

Frequency of Hypophosphatemia in Children Presenting with Sepsis in a Tertiary Care Hospital: A Cross-sectional Study

Kashif Habib Qadri, Muhammad Saad Raza, Yousuf Yahya, Suneet Kumar, Rumana Sangi, Aliya Kemal Ahsan, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 68-73
DOI: 10.9734/jpri/2022/v34i39A36238

 

Aim: To determine the frequency of hypophosphatemia in the children presenting with sepsis in a tertiary care hospital.

Study Design: A cross-sectional study.

Place and Duration: Department of paediatric, civil hospital, Karachi, Pakistan from october 2020 to april 2021.

Methodology: A total of 190 children with clinical sepsis were included in the study. Serum phosphate level, CBC, CRP, and blood culture of all children were sent within 24 hours of admission. Serum phosphate level less than 2.5mg/dL was labeled hypophosphatemia. It was categorized as mild, moderate and severe at level of 2-2.5 mg/dL), 1-2 mg/dL), and < 1 mg/dL respectively.

Results: Mean ± SD age of study participants was 2.69±3.19 years. Out of 190 patients 106 (55.8%) were male while 84 (44.2%) were female. Hypophosphatemia was found in 36 (18.9%) patients among them. Mild and moderate hypophosphatemia was noted in 18 (50%) of the children from each category of patients.

Conclusion: This study concluded that hypophosphatemia was documented in considerable number of children who presented with clinical sepsis. Serum phosphate levels should be checked in children who present with sepsis. To avoid the issues of a double burden of disease in these patients, strategies to prevent these diseases should be supported.

Open Access Review Article

Green Chemistry and Microwave Irradiation Technique: A Review

Shashank Tiwari, Shreya Talreja

Journal of Pharmaceutical Research International, Page 74-79
DOI: 10.9734/jpri/2022/v34i39A36240

Green Chemistry is a term used for the process of making chemical substances in a sustainable way. The aim of green chemistry is to minimize the hazardous footprint on the environment produced by manufacturing and production of various chemical compounds. Green chemistry focuses on using less toxic materials in synthesis of chemicals by increasing efficacy of chemical synthesis and minimizing waste production. The way forward with green chemistry includes use of various potent techniques like microwave irradiation technique. The use of microwave assisted technique has brought a revolution in the field of chemical study and manufacturing. Through this technique even minute compounds and molecules can be synthesized in a fraction of time. The microwave is primarily used in heating the chemical material by conduction and dipolar polarization. The use of microwave irradiation technique is regarded as a crucial element of green chemistry because it produces clean compounds without any residual toxins. The compounds produced are very efficient as they have higher yields and better reactivity and selectivity. The microwave irradiation technique is widely used in the field of nanotechnology as well.