##### Causes of Dysnatremia in Cancer Patients: A Review

Daniela Rădulescu, Ileana Adela Văcăroiu, Flavia Liliana Turcu, Carmen Bogeanu

Journal of Pharmaceutical Research International, Page 6-13
DOI: 10.9734/jpri/2022/v34i40A36251

Dysnatremias occur with high incidence in cancer patients and have negative impact on quality of life, survival, hospitalization length. Both cancer and its therapy are responsible; coexisting comorbidities may also be involved. Hyponatremia is the most common electrolyte disorder and is usually multifactorial. Hypernatremia, although more rare, is associated with poorer outcome. Diagnosis of true dysnatremias may be a challenge in patients with active cancer, as they must be often differentiated from spurious dysnatremias. Assessing the extracellular volume is the first step for establishing the cause of a dysnatremia; as such hypovolemic, euvolemic and hypervolemic dysnatremias have distinct etiology. The present article briefly reviews cancer-specific and treatment-specific causes of dysnatremias.

##### Impact of Serum Vitamin D Levels on the Preterm Rupture of the Membrane in Pregnant Women. A Cross-sectional Study

Erum Jahan, Sabahat Fatima, Saiqa Rashid, Uzma Sabir Aleem, Erum Saba, Ayesha Aleem Khan

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2022/v34i40A36250

Aim: To assess the association between premature rupture of membrane and maternal blood vitamin D levels.

Study Design: A cross-sectional study.

Place and Duration: Abbasi Shaheed Hospital, Karachi Medical and Dental College from April 2020 to April 2021.

Methodology: Over the duration of one year, a total of 100 patients with vitamin D levels, as well as obstetrical abnormalities and risk factors, were monitored. In 88 pregnant women, vitamin D deficiency was observed. Pregnant women who have a thyroid disorder, such as thyroiditis or Grave's disease, or who had calcium or parathyroid disease in the past, or who need cardiac medication therapy,& diuretic particularly calcium channel blockers were excluded from the study.

Results: Vitamin D deficiency was found in 88 pregnant women out of 100. It was more prevalent among housewives (86.36 percent) and multiparous women (68.0 percent). Pregnancy complications were present in 33.0 percent of cases such as preeclampsia, gestational hypertension, and diabetes, and PROM was less prevalent in the deficient group.

Conclusion: Our data indicate that pregnant females are at a greater risk of Vitamin D deficiency, and associated pregnancy complications. The correlation between maternal vitamin D levels & preterm rupture of the membrane was not statistically significant.

##### Study of Rare Hyperpigmented Lesions of the Skin in a Tertiary Care Centre in Western Maharashtra

Vidya Viswanathan, Ume Sumayya Patil, Arpana Dharwadkar, Shruti Vimal, Parul Bhandari, Padmakar Rajabhau

Journal of Pharmaceutical Research International, Page 14-28
DOI: 10.9734/jpri/2022/v34i40A36252

Objectives: Hyperpigmented lesions are a common presentation in the dermatology outpatient department and causes significant burden on the dermatologist. Though they are harmless and asymptomatic in most cases they are a cause for concern because it can lead to cosmetic deformity which can cause psychological upset in the patients. Rare lesions are often misdiagnosed clinically because of overlapping clinical features. The aim of this study was to diagnose rare hyperpigmented lesions with the help of skin biopsies and correlate he findings clinically.

Methods: All skin biopsies coming to the department of Pathology were processed and stained by routine H&E stain. Special stains were applied whenever required (Ziehl-Nelson, periodic acid Schiff, Congo red).

Results: 56 cases were studied of which 27 rare lesions were diagnosed. All the cases were subjected to analysis according to age, sex, site of lesion, duration of lesion and clinicopathological correlation. 75% of the cases showed histopathological correlation in our study. 25% of the cases did not show concordance.

Conclusion: Hence to conclude histopathological examination of skin biopsies forms the gold standard for the diagnosis of hyperpigmented skin lesions more so in the case of rare lesions as most of them have overlapping clinical features which can be mistaken for common lesions.

##### Pulsatile Delivery of Methylphenidate Hydrochloride Pulsincap by Box-Behnken Design

S. Ramadevi, Javeria Tamkeen, Aisha Rahman, D. Prasanthi

Journal of Pharmaceutical Research International, Page 29-43
DOI: 10.9734/jpri/2022/v34i40A36254

The objective of this study was to prepare and evaluate Methylphenidate hydrochloride pulsatile drug delivery system using pulsincap technique by applying Box-Behnken design. The drug is a central nervous system (CNS) stimulant used in the treatment of attention deficit hyperactivity disorder (ADHD). Pulsincap system was prepared by using formaldehyde cross linked capsules. Capsules were filled with methylphenidate hydrochloride granules and hydrogel plug made of HPMC K100M is placed over granules to achieve desired drug release after lag time. The untreated cap was then fitted and sealed using 5% ethyl cellulose ethanolic solution to the formaldehyde treated capsule body. Granules were prepared by wet granulation technique using two polymers Ethyl cellulose and Eudragit RS100. Box-Behnken design was applied for optimization in which three independent variables, X1 = Drug: polymer ratio, X2 = Polymer: polymer ratio (Ethyl cellulose: Eudragit RS 100) and X3 = Plug weight were selected. Two dependent variables Y1 = lag time and Y2 = percent release were selected. The empty formaldehyde treated capsules were evaluated for physical appearance, solubility, capsule dimensions and formaldehyde content. Hydrogel plugs were evaluated for hardness & thickness of the plug, lag time and swelling index. Granules were evaluated for percentage yield, assay and flow properties. The prepared pulsincap formulations were evaluated for weight variation, content uniformity, capsule lock length, in-vitro dissolutions studies, drug kinetics and stability studies. Contour plots and Response surface plots indicated that with the increase in X1 and X3 there is increase in Lag time and decrease in % drug release and whereas with the increase in X2 the lag time was at moderate level and % drug release was increased. From this observation, formulation F11 was optimized as it provided desired lag time of 4.2$$\pm$$0.27 hours and least drug release of 72$$\pm$$0.09% for 8 hrs. The formulations were found to be physically compatible with excipients and stable.

##### Psychological Distress as a Predictor for Weight Self-Stigma among Youth in Jazan Region, Saudi Arabia: A Cross-Sectional Survey

Mohammed O. Shami, Ahmad Y. Alqassim, Bayan H. Khodari, Abdellh A. Names, Joudi A. Shami, Afnan A. Alamer, Azhar M. Moafa, Reem O. Hakami, Ghaida S. Almuhaysin, Reem M. Shajry, Abdulaziz H. Alhazmi, Mohammad Jareebi, Monera A. Abdulhaq

Journal of Pharmaceutical Research International, Page 44-53
DOI: 10.9734/jpri/2022/v34i40A36255

Background: Weight-related self-stigma has well-known psychological consequences. There is growing evidence that psychological problems, including depression, anxiety, stress, predict the existence of weight stigma. The purpose of the present survey was to examine the association between weight self-stigma and psychological distress among Saudi young adults in Jazan region.

Objectives: The rationale of this study was to investigate the correlation between weight self-stigmatization and psychological distress in young adults In Jazan region, Saudi Arabia.

Materials and Methods: We performed a cross-sectional investigation using the wight-self stigma questionnaire (WSSQ) and the depression, anxiety, and stress scale 21 (DASS 21) in a convenience sample of 399 participants. The statistical analysis included descriptive analysis, independent-samples t-test, analysis of variance (ANOVA), and linear regression.

Expected Results: We hypothesize that there is correlation between weight self-stigma and psychological distress among young people In Jazan region, Saudi Arabia.

Results: The mean age was 21.12 years ± 2.91 years. Stigmatization of oneself weight (both self devaluing and enacted stigmatization concern) was significantly associated with respondents' body mass index (BMI) (p < .001), depression, anxiety, and stress (p < .001). There was a significant correlation between respondents' scores on the WSSQ and DASS 21. The main predictors for weight self-stigma were BMI (p < .001) and psychological distress (p < .001).

Conclusion: The study revealed a strong association between weight self-stigma and psychological distress among young adults in Jazan region, Saudi Arabia. Further epidemiological and clinical studies on the national level are warranted.

##### Parents’ Knowledge and Attitude toward Childhood Vaccination in Qassim, Saudi Arabia

Mugahid A. Mobark, Hossam Essa Alhazmi, Waleed M. Altowayan

Journal of Pharmaceutical Research International, Page 54-62
DOI: 10.9734/jpri/2022/v34i40A36256

Introduction: Childhood vaccination programs participate greatly in reducing the spread of vaccine preventable diseases. Beside the noticeable success of vaccination, there are still parents’ questions and hesitancy regarding childhood vaccination.

Aims: This study evaluated the knowledge and attitude of parents in Qassim region                       towards childhood vaccination with the aim to measure the degree of the local community acceptance of childhood vaccination with aspiration to add an effective literature information in this field.

Study Design:  A cross sectional survey study using a Google form designed questionnaire.

Place and Duration of Study: This study was conducted in Qassim in Saudi Arabia from October 2020 to December 2020.

Methodology: We included 403 parents. The data was collected using a questionnaire divided in to three parts; socio-demographic, knowledge and attitude, and side effects. The knowledge was evaluated by seven items with answers set in to ‘Yes’, ‘No’ and ‘Don’t know’. The attitude by seven items with fixed-answers of ‘Agree’, ‘Neutral’ and ‘Disagree’. In the third part side effects like fever, pain, diarrhea, skin rash and seizures were directly asked. Descriptive and inferential statistics were used in the analysis of data.

Results: Among 403 participants, the majority were young adult female with a bachelor degree. The parents have good levels of knowledge and attitude towards child hood vaccination and the levels are significantly differed among various demographic variables. The parents’ attitude is linearly influenced by their level of knowledge (P-value is <0.001).

Conclusion: Beside the good parents’ knowledge that positively influenced by their attitude toward childhood vaccination with a considerable local public awareness in this field, parents recommended more awareness campaigns on vaccination’s benefits and risks.

##### Post-traumatic Stress Disorder amongst Surgical Residents of Lahore

Noor Ul Ain Fatima, Sania Tariq, Sidra Rasheed, Saba Zulfiqar, Sadia Batool, Syed Usama Hussain

Journal of Pharmaceutical Research International, Page 63-68
DOI: 10.9734/jpri/2022/v34i40A36257

Introduction: The psychological state of the doctors independently is a danger that is frequently undervalued and neglected in many clinical environments. Whilst also treating patients in intense pain and existence injuries, doctors could feel afraid and acute stress in either themselves.

Objectives: To regulate the occurrence of PTSD between surgical trainees also correlation of PTSD with demographic profile and well-being in Lahore and Islamabad.

Methods:  A questionnaire-based study was conducted in Surgery and allied departments of Mayo Hospital, Services Hospital, Ganga Ram Hospital, Lahore General Hospital, Gulab Devi Hospital, Sheikh Zaid Hospital, Punjab Institute of Cardiology and Jinnah Hospital, Lahore, on 207 surgical trainees. It was a cross sectional descriptive study and stratified random sampling was used to collect data. Our current research was organized from April 2018 to April 2020. Non-surgical and non-Pakistan based surgeons were excluded from the study. Questionnaires were designed with PTSD Checklist for DSM-5 and WHO well-being index. SPSS v25 was used for data analysis.

Results: For 164 returned surveys average age remained 29.2 (SD 2.9) years; 100/164 respondents remained male. Average years in training remained 2.66 (SD 1.4). Average PCL-5 score remained 14. 31/164 respondents had cut off score ≥ 33. 38/164 respondents met the diagnostic criteria for PTSD. Females were more likely to have PTSD p=0.016(<0.05). Correlation between PCL-5 score and WHO well-being index was found to be significant at the 0.000 level, showing a -0.332 Pearson correlation value.

Conclusion:  PTSD will be much more prevalent in surgical interns than in the general public. Recognizing and managing this threat is critical for trainee psychological health and quality care.

##### A Survey of Knowledge and use of Modern Contraceptives among Female Students in a Public University in Ghana

Charles Owusu-Aduomi Botchwey, Linda Takyiwaa, Agartha Afful Boateng, Richmond Opoku, Michael Afari Baidoo, Francis Acquah

Journal of Pharmaceutical Research International, Page 69-76
DOI: 10.9734/jpri/2022/v34i40A36258

Introduction: Studies have shown that knowledge of contraceptives, especially among undergraduate female students, remains limited and the rate of premarital unprotected sexual activity, unwanted pregnancies, and illegal abortions remain higher among university students in Ghana.

Aim: This study was carried out to assess the knowledge and use of modern contraceptives among female undergraduate students at the University of Education, Winneba, Ghana.

Methodology: A descriptive survey design was adopted as the framework for the study. A purposive sampling method was used to deploy 108 sexually active female undergraduate students from a department in the Faculty of Science Education using structured questionnaires. Data were analysed using Statistical Package for Social Science (IBM SPSS, Version 25) and presented using quantitative metrics.

Results and discussion: The results of the study showed that the majority of the respondents (89.8%) have heard about a modern contraceptive method. 57.4%  of the respondents reported that they used contraceptives in the past, while 36 (58.1%) were current contraceptive users. The most popular methods of contraception used were pills (96.9%), female condoms (72.2%), and injectable (52.6%). The main sources of information about contraceptives were found to be social media and followed by peers, radio/TV, and health workers. Reasons that most influenced the decision of respondents to use modern contraceptives included knowledge of modern contraceptives, availability of service points, partner support, and religious beliefs. Even though participants were sexually active, the rate of contraceptive use was found to be relatively low.

Conclusion: Even though the majority of the respondent knew of a particular contraceptive, a significant number of them were found not utilising it. There is the need for active promotion of modern contraceptives among female university students to bridge the gap between knowledge and use.