##### Costus afer Ker Gawl (Costaceae): A Review on Its Medicinal uses with Focus on Potential Anti-Inflammatory Effect

Jean-Paul Nzambi Divengi, Assumani Zabo Idrissa, Dorah Mwenyi Kabasele, Patience Lunkondo Mbuyi, Innocent Shongo Walle, Victorine Mbo Lesse, Randy Isaya Kiala, Philipe Sansi Nzinga, Richard Mananga Bongo, John Za nza Ntezolo, Florent Biduaya Mukeba, Benjamin Mbenza Longo, Paulin Kapepula Mutwale, Gauthier Kahungu Mesia, Gaston Lutete Tona

Journal of Pharmaceutical Research International, Page 6-23
DOI: 10.9734/jpri/2022/v34i41A36269

More than 80% of the population in Africa by the World Health Organization (WHO) leans on endogenous knowledge to solve their primary health care problems. In this study, we examined the relevance of Costus afer Ker Gawl, a plant called ginger lily, spiral ginger or bush cane. It is believed to be used in traditional medicine practice (TMP) to treat and manage many conditions including diabetes mellitus, stomach ailments, arthritis, inflammation. These alleged traditional incited large researchers to conduct studies on the plant to amass scientific evidence. However, these results are sparse, and thus, an inventory through the present search using online search engines such as Google Scholar, PubMed, Science Direct, Web of Science, Scopus and Chemical Abstracts for the period from 1990 to 2021; provides a bibliographic actualization on the plant, taking into account its traditional uses, phytochemical and nutritional constituents, pharmacological activities and toxicological effects. The online search included the use of the keywords, "Costus afer Ker-Gawl" or "Costus afer". It should be noted that the stem and leaves of the plant contain consistent amounts of micronutrients and macronutrients. The leaves, stem, rhizomes of C. afer contain several steroidal sapogenins, aferosides, dioscin and paryphyllin C and a flavonoid glycoside, kaempferol-3-O- $$\alpha$$-L-rhamnopyranoside. Experimental studies on various parts of the plant have shown biological activities such as anti-hyperglycemic, hepatocellular protection, cardioprotection, nephroprotection, CNS depressant, analgesic, antiarthritis, antibacterial and antioxidant. This wide range of biological properties of Costus afer Ker Gawl would be largely attributed to the essential oil compounds such as Sabinene, $$\beta$$ -pinene and $$\beta$$ -caryophyllene which are among the major compounds of this plant. Based on these obvious data, it is concluded that the plant could be used as an alternative and complementary therapy for many diseases related to oxidative stress so will guide us future research on the use of Costus afer Ker Gawl as an anti-inflammatory.

##### Impact of Comorbid Conditions in COVID-19 Treatment

Touseef Ahmed, Toqeer Hussain, Maryem Arif, Nadeem Iqbal, Zubair Ahmed Khoso

Journal of Pharmaceutical Research International, Page 30-37
DOI: 10.9734/jpri/2022/v34i41A36272

In 2019, an outbreak known as SARS-CoV-2 spread all over the World from China city Wuhan. This epidemic rapidly spread throughout the world from that day, affecting 180 nations. Individuals of all ages were involved in this outbreak, and this spread at a high rate. COVID-19 is thought to lead to death due to its increasingly fast and severe course in people with serious health issues and complications. In this paper the impact of comorbid condition in COVID-19 treatment was investigated. To conduct an automated literature review, statistical information from published articles was gathered between January 20 and April 20, 2020. Immunocompromised patients might be more prone to acquire COVID-19 compared to healthy individuals. Additionally, people with dementia, those 65 years and above, who had comorbidities and COVID-19 had more chance of getting admitted to ICU and dying. That is why immunocompromised patients need more care and attention so that they might not be affected by this outbreak, which may lead to their death.

##### Effectiveness of Oral Probiotics in Prevention of Necrotizing Enterocolitis in Preterm Infants

Naheem Ahmed, Tayyaba Siddique, Muhammad Aftab, Kiran Ashfaq Ahmed, Amna Mateen, Rashada Bibi

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2022/v34i41A36268

Objective: To determine the efficacy of probiotics in the prevention of necrotizing enterocolitis in preterm infants.

Materials And Methods: This randomized controlled trial was conducted at the paediatric department of CMH Muzaffarabad AJK. All preterm bottle and NG-fed neonates with an age of more than 24 hours and both genders were included. All the study subjects were divided into two groups randomly as group-A and group-B.  Group-A was given probiotics (named Bifidobacterium prophylactically, hiflora, or gutcare, one sachet per day), while in Group-B probiotics were not given. All the cases were taken under observation. If they needed any critical or intensive care, they were excluded from the study and other treatments were given as per hospital protocol. Patients were followed for 7 days. Efficacy in both groups was measured in terms of no occurrence of NEC during one week. All related data was collected on a study proforma.

Results: The average age of the neonates in the probiotic group was 11.77 $$\pm$$ 6.52 days, and in the control group it was 13.41 $$\pm$$ 6.86 days. There were 42.1% boys and 57.9% girls were in the probiotic group, while 54% of males and 46% of females were in the control group. The frequency of NEC was statistically higher in control group 28 (11.9%) compared to the probiotic group 5 (2.1%), indicating the oral probiotic showed significant efficacy (p- 0.001).

Conclusion: Oral probiotics have been found to be efficacious, noninvasive, and beneficial in the prevention of NEC. Probiotics must be utilized to prevent necrotizing enterocolitis in preterm newborns in the future, in order to lessen the associated complications and infant mortality.

##### Rapid Rehabilitation in Urological Surgery with Psychological and Preoperative Care

Muhammad Abbas, Wang Zhe, Hafiz Usman Ghani, Rafi Ullah, Hammad ur Rehman, Zeeshan Bashir

Journal of Pharmaceutical Research International, Page 24-29
DOI: 10.9734/jpri/2022/v34i41A36270

Urological surgery patients will be studied to see whether a combination of rapid recovery surgery and psychological nursing might help them recover more quickly. Methods There were 74 patients identified and treated in our urological surgery department between April 2020 to April 2022, and they were separated into two groups: the control group and the observation group, with 37 cases in each. During the preoperative period, the control group received regular nursing care, whereas the observation group was exposed to the quick recovery surgical concept in conjunction with psychological nursing care. In the end, here's what happened: Patients in the observation group spent less time getting out of bed and tiring themselves during the first hour after insertion of the drainage tube than those in the control group (P0.05). A larger percentage of the observation group's nurses were satisfied with their work than the control group's nurses, at 94.59 percent (P0.05), while the observation group's complication rate was lower than the control group's (at 18.91 percent) at 8.11 percent (P0.05). Fast recovery surgery coupled with psychological nursing may help patients recover from surgery, minimize the time it takes for them to get out of bed and indwell the drainage tube, enhance their psychological condition, and lower their risk of problems. As a nursing intervention strategy, it is both effective and practical.

##### Prevalence of Maternal Complications after Caesarean Section in Women with Abnormal BODY MASS INDEX (BMI)

Shahida Karamat, Sana Mubarik, Naeem Akhtar Khokhar, . Resham, Asifa Abdul Jabbar, Nusrat Khatoon

Journal of Pharmaceutical Research International, Page 38-43
DOI: 10.9734/jpri/2022/v34i41A36275

Objective: To determine the frequency and maternal complications of cesarean section in women with BMI >25 kg/m2.

Methodology: This descriptive Case series was done at the Gynaecology  and Obstetric Unit III, Civil Hospital Karachi for 6 months i.e. May - Nov 2013. Total 164 obese pregnant women who presentedat gestational age >37 weeks, singleton pregnancy with cephalic presentation were included. Data consists of information on demographic items, gestational age, and parity. BMI was calculated by taking weight in kg divided by height in m2. Patients were monitored for progress of labour and mode of delivery was recorded. Maternal complications were identified and noted in pre design proforma.

Results: Frequency of maternal complications in women with BMI >25 kg/m2 was found in 57.14%women.Induced labour was the commonest i.e. 35.1% women followed by primary post-partum hemorrhage (PPH) 13% and shoulder dystocia was observed in 9.1%.

Conclusion: The burden of overweight and obesity in pregnant females belong to local population is high. So it is concluded that pre pregnancy normal body weight females with high BMI during pregnancy require special follow-ups and counselling sessions during pregnancy and delivery.

##### Frequency of Cardiomyopathy in Children having Thalassemia Major: A Cross-Sectional Study

Abdul Rauf Jamali, . Mujeeb-u-Rehman, Ram Chand, Dilawar Khan Jokhio, Naseem Ahmed Kubar, Naseer Ahmed Memon, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 50-56
DOI: 10.9734/jpri/2022/v34i41A36277

Aim: To determine the frequency of cardiomyopathy in children having Thalassemia major diagnosed on the basis of Echocardiography.

Study Design: A cross-sectional study.

Place and Duration: Paediatric department at Peoples medical college hospital (PMCH), Nawabshah from September 2019 to March 2020.

Methodology: A total of 236 Thalessemic children visiting as outpatients or inpatients meeting inclusion criteria were enrolled. Informed consent was taken from the patients or their attendants. All demographic variables that included age, gender, address, educational status, family history, age of diagnosis of the disease, start of treatment and number of transfusions graded as none, occasional, were included. Echocardiography findings were performed and then recorded.

Results:  Mean age of the patients was 10.60±4.064 (5-18) years, 110(49.1%) study subjects were female and 126(50.8%) were male patients. While 75(31.78%) study subjects have family history of thalassemia. A total of 87(36.9%) study subjects have left ventricular dysfunction, 13(14.9%) have global dysfunction, 11(12.6%) have isolated systolic dysfunction and 63(72.4%) have isolated diastolic dysfunction.

Conclusion: In -thalassemia, heart disease is the key determinant of prognosis and survival. In this study we found a significant number of thalassemia children having cardiac involvement and ventricular dysfunction.

##### Assessment of the Compliance of Statin Treatment in Hyperlipidemic Patients and its Association with Socioeconomic Status

Noreen Irum, Masood Ahmed Unar, Kamlesh Kumar Ahuja, Waseem Raja Memon, Muhammad Umair Farooqui, Anwar Ali Jamali, Arslan Ahmer

Journal of Pharmaceutical Research International,
DOI: 10.9734/jpri/2022/v34i41A36278

Objectives: To assess the compliance of statin treatment in hyperlipidemic patients and its association with Socioeconomic Status in Nawabshah, Sindh, Pakistan.

Methodology: This was a retrospective cross-sectional study using convenient sampling technique conducted in collaboration with Department of Cardiology & Medicine People Medical College Hospital (PMCH) Nawabshah, Sindh, Pakistan during January to June 2015. A total of 100 patients suffering from Hyperlipidemia (diagnosed) were recruited from out patients department (OPD) of Cardiology & Medicine department. The data was collected by administering the questionnaire to Hyperlipidemic patients after a written consent. All the variables related to socioeconomically class on per designed questionnaire were registered by filling the designed Proforma.

Results: Out of 100 patients enrolled the mean age of the patients was 49.45$$\pm$$9.72 years. The mean cholesterol levels were 231.83$$\pm$$15.9 mg/dl. Statin therapy compliance was compared with socioeconomic status. Statin therapy compliance was achieved in socio-economic status which revealed > 80% proportion of days covered (PDC) response however results statistical significance was P-value 0.056.

Conclusion: Hyperlipidemic patients have shown a good compliance to statins. Compliance in both lower and middle class was more than in higher class.

##### US FDA Regulatory Framework for Generic Peptides Referring to rDNA Origin Reference Products

Ankit Chincholkar, Deepak Khobragade, Swanand Pathak

Journal of Pharmaceutical Research International, Page 44-49
DOI: 10.9734/jpri/2022/v34i41A36276

Peptides are polymeric molecules having 40 or less amino acids. Peptides have been used as therapeutic compounds for the treatment of various disorders since 1920s. Initially, these were isolated from animals. Currently, most of the therapeutic peptides are either synthetic or produced by recombinant DNA technology. Given the continuously improving synthesis technology and availability of robust characterization tools, it is now possible to synthesize a generic therapeutic peptide for a reference product which is of rDNA origin. The manufacturing of synthetic generic peptides is generally considered more advantageous than recombinant generic peptides due to low risk of immunogenicity and absence of host cell derived biomolecules.  This article compares the approval process of generic peptides for a reference product of recombinant DNA origin in the United States especially in light of US FDA guideline “ANDAs for certain highly purified synthetic peptide drug products that refer to listed drugs of recombinant DNA Origin”. This guideline provides recommendations for evaluating whether an Abbreviated New Drug Application submission is appropriate for a synthetic peptide referring to previously approved glucagon, liraglutide, nesiritide, teriparatide, and teduglutide of recombinant DNA origin. The requirements for Abbreviated New Drug Application submissions for synthetic generic peptides and 505(b) (2) submissions for generic peptides of recombinant DNA origin are compared.