bluuebunny/crossref_metadata_2025 huggingface dataset:
INCIDENCE OF POLYPHARMACY AND DRUG RELATED PROBLEMS AMONG ELDERLY IN TERTIARY CARE HOSPITAL – A DESCRIPTIVE STUDY
Authors: SHARON TABITHA , VEMPARALA CHAITHRA , Kandukuri Sri Vasavi , Komati Madhuri , Gottapu Bhargavi
Published: September 2022

Objective: Drug-related problems are most common in Geriatrics. The increasing number of available drugs and drug users as well as more drug regimens led to many drug related problems which increases the health-care cost, mortality, morbidity, and also decreases the quality of life. The main objective of this study is to assess the incidence of polypharmacy and drug-related problems among elderly admitted in tertiary care hospital.
Methods: The study was conducted in a tertiary care hospital after obtaining ethical clearance from the Institutional Ethical Committee. The medication information along with medical data and patient demographics such as name of the patient, age, sex, chief complaints, laboratory data, diagnosis along with therapeutic data such as name of the prescribed drugs, dose, dosage, frequency, route of administration, duration of treatment, and any new or existing drug-related problems were noted in a case collection form by bed-side counseling, case sheets, laboratory reports and were documented. The drug-related problems (DRPs) were categorized using Pharmaceutical Care Network Europe classification v 9.0 classification. Statistical analysis was done using Chi-square test.
Results: of 151 Participants considered for the study 97 (64.24%) were males and 54 (35.76%) were females. The incidence rate of DRPs was found to be 86.09% and 1.45 DRPs per patient. In a total number of sample population, patients with DRPs were 120 and without DRPs were 21.
Conclusion: DRPs mostly observed in geriatric population as they receive multiple medications for multiple disease conditions and active role of clinical pharmacist is necessary to identify and resolve them. DRPs identified must be accepted by the physicians and cooperation of patients and physician is necessary to resolve DRPs. Further studies are required to prove that the polypharmacy plays a major role in developing DRPs.
STUDY OF METABOLIC SYNDROME IN INDIAN POPULATION WITH COMPARISON OF TWO DEFINITIONS
Authors: Rajwal Neha , Singh Jasjot , Neupane Nurakant
Published: September 2022

Objectives: Metabolic syndrome (MetS) is described as the collection of risk factors for cardiovascular disease such as hypertension, hyperglycemia/ insulin resistance, abdominal obesity, and dyslipidemia. In developed countries, MetS is highly prevalent among adults and is an emerging health problem in developing countries. In this study, we used the International Diabetes Federation (IDF) and National Cholesterol Education Program- Adult Treatment Panel-III (NCEP-ATP III) to define the Mets. The aim of this research was to evaluate the prevalence of MetS, its components, and its major risk factors among adults ≥20 in Jammu and Kashmir according to IDF and the NCEP ATP III criteria. Methods: The project was conducted in the Department of Biochemistry, Laboratory Medicine, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, and Jammu and Kashmir in 100 subjects between the age groups of 20 and 80 years old attending the OPD from 2 January to 30 April 2017. Results: MetS was diagnosed in 57% and 55%, gender-wise distribution came out to be 45.6% and 52.7% in men, and in women, we found 54.3% and 47.3%, according to IDF and the NCEP ATP III definition, respectively. Conclusion: In our study, IDF criteria were better for the early diagnosis of MetS. On the basis of gender prevalence in all parameters in IDF, females are at risk, and in NCEP ATP III, males are more at risk. According to the IDF, central obesity is the only the risk for women.
A COMPARATIVE STUDY OF EFFICACY, SAFETY, AND ONSET OF ACTION OF VILAZODONE WITH ESCITALOPRAM IN PATIENTS OF MAJOR DEPRESSIVE DISORDER AT TERTIARY CARE HOSPITAL
Authors: Ankushe Rohini D , DESHMUKH VINOD S , Chepure Ashish H , Jaju Jugalkishore B
Published: September 2022

Objective: To compare efficacy, safety, and onset of action of Vilazodone with Escitalopram in treatment of major depressive disorder (MDD).
Methods: A prospective, randomized, active-controlled, and parallel–group comparative open label study was conducted among 92 patients of MDD attending psychiatry OPD of a tertiary care center. They were divided into control and experimental groups receiving Escitalopram and Vilazodone, respectively. Hamilton depression rating scale (HAM-D), Hamilton anxiety rating scale (HAM-A), Montgomery-Asberg depression rating scale (MADRS), clinical global impression improvement (CGI-I), and CGI-severity (CGI-S) scores were assessed at the end of 1st, 2nd, 4th, and 12th weeks in both the groups.
Results: There was significant decrease in HAM-D, HAM-A, MADRS, CGI, and CGI-S scores in control as well as the experimental groups. Experimental group receiving Vilazodone showed significant decrease in the scores as compared to control group (p<0.001) at the end of 2nd and 4th week. Although the number of adverse effects were more in the Vilazodone group leading to higher score on UKU scale, the difference was not statistically significant.
Conclusion: The present study showed clinical advantages of use of Vilazodone over Escitalopram with improvement in all the scores. Significant reduction in scores was seen as early as 1 week in Vilazodone group which justifies its early onset of action and superiority over selective serotonin reuptake inhibitors.
A RARE CASE OF HEREDITARY MULTIPLE EXOSTOSES
Authors: PUNIA VPS , BHARTI AKASH , MITTAL SHAAVI , SHETTY APOORVA , MISHRA PRAVEEN RAMAN , JEYARAMAN MADHAN , CHAUDHARY DUSHYANT
Published: September 2022

Background: A rare genetic condition, hereditary multiple exostoses (HME), follows the autosomal dominant pattern of inheritance. It is evident by multiple bony elevations on the appendicular skeleton by the age of 2 years. Case Report: Here, we present the 42-years-old patient known case of CKD presenting with uncontrolled hypertension and breathlessness; however, incidentally, it was noted that there is bilateral swelling in the knee and further investigated for X-ray and blood parameters. On assessing the similar pattern in family members, it was noted such swelling over the shoulder in the daughter and swelling in the wrist joint in the younger brother. Conclusion: Hereditary multiple osteochondromas are a hereditary ailment that should be studied. Despite tremendous advances in recent years, the intricacy and unresolved difficulties associated with HME remain a challenge for academics and physicians.
EFFECT OF VESTIBULAR STIMULATION ON BEHAVIORAL CHANGES IN PARKINSON DISEASE-INDUCED MICE
Authors: Mohan Ram , Jayabal Mohan , Ramanathan Rashmi , Shanmugam Jeevithan , R Archana
Published: September 2022

Objective: This prospective study was conducted to provide an authoritative database for beneficial effects of vestibular stimulation, a simple non-invasive method to alleviate the behavioral changes in Parkinson’s disease (PD).
Methods: Vestibule is stimulated by caloric vestibular stimulation (CVS). Pesticide Rotenone is used to induce PD. Open field test and elevated plus maze were used to access learning, memory, and behavior.
Results: Behavioral scores were taken before and after stimulation of the vestibular system. The scores were significantly different between rotenone-induced PD, control, and hot water vestibular stimulation groups (p<0.05).
Conclusion: This study categorically confirms that CVS with hot water causes behavioral changes in PD. This study certainly merits further studies with higher sample sizes to confirm the effect of CVS for enhancement of learning, memory, and behavior in patients with Parkinsonism.
THE PATTERN OF DRUG USES IN PREGNANT WOMEN ATTENDING THE ANTENATAL CLINIC OF THE OBSTETRICS AND GYNAECOLOGY DEPARTMENT AT A TERTIARY CARE HOSPITAL
Authors: CHAURASIYA VIDYABRAT RAKESH
Published: September 2022

Objective: The aim of the study was to study and evaluate the pattern of drug use in pregnant women attending the antenatal clinic of obstetrics and gynaecology department at a tertiary care hospital.
Methods: A prospective observational study was conducted at the Department of Gynecology and Obstetrics in M.G.M. Medical College and Hospital, Kishanganj, Bihar. The study included 368 pregnant women who consented and provided written informed consent for participation in this study during the study period from January 2020 to November 2021.
Results: Time for seeking the first antenatal check-up was majorly in 1st trimester (48.10%), followed by 35.60% in the 2nd and 16.30% in the 3rd trimester. A total of 3054 drugs were prescribed in all three trimesters from all organ systems. The majority belonged to blood and bone-forming agents, followed by antimicrobials and gastrointestinal drugs. Analyzing the prescribing trend grossly depicts that the drug prescribing showed a gradual increase from 18 to 2nd trimester, followed by a slow drop in 3rd trimester. During the entire study period, there were 177 prescriptions for 1st trimester, 306 prescriptions for 2nd trimester, and 366 prescriptions for 3rd trimester.
Conclusion: Our study site revealed a greater tendency to prescribe by generic name rather than by brand name in our hospital, which is a good sign as it reduces the economic burden on the patients. In other previous studies, it was less. Prescribing percentage of antibiotics in all trimesters was on the high rise, while the percentage of encounters with injection was within acceptable ranges. The majority of prescribing corroborated with national drug policy and was in concurrence with the national drug formulary and NLEM 2015, which reflects the essence of rational prescribing of pregnancy drugs in our set-up.
COMPARATIVE EVALUATION OF EFFICACY OF CYANOACRYLATE AND SUTURE MATERIAL IN THE MANAGEMENT OF OPERATIVE SKIN WOUNDS
Authors: TRIPATHI SOMESH , DIXIT PRIYA
Published: September 2022

Objective: Closing wounds are a fundamental aspect of surgery. Both patients and surgeons hope that no scars remain once a wound has healed. This study examined the effectiveness of cyanoacrylate and suture material in closing operational skin wounds in terms of time required for closure of the operative incision and problems associated with it.
Methods: Forty-two individuals who had emergency surgery participated in this comparative analysis. The study evaluated how the identical patient’s abdominal incisions were closed on the skin. Relevant surgical information, such as signs of inflammation, discomfort, possible discharge, wound dehiscence, and sinus, was recorded both during and after the operation.
Results: In the adhesive application group, it took 1.5 min (95 s), but it took 4.1 min (248 s) in suturing group for the closure of a <5-cm incision. Of the 32 patients in the adhesive group, 4 (12.5%) showed erythema and warmth, 3 (9.3%) showed discomfort, and 6 (18.7%) showed discharge. All other problems, excluding dehiscence, were less severe in the sticky group.
Conclusion: For patients undergoing emergency laparotomies, cyanoacrylate appears to be a safe and cost-effective alternative to sutures. For a conclusive outcome, a high number of case groups are needed, but the observed results were only on a small number of case groups.
COMPARATIVE STUDY ON KNOWLEDGE OF HAND HYGIENE AMONG MEDICAL STUDENTS, RESIDENT DOCTORS, AND NURSES AT TERTIARY HEALTH INSTITUTION OF UTTAR PRADESH
Authors: NATH SOM , KUMAR NIDHISH , KUMAR RAJESH
Published: September 2022

Objectives: Comparative study on knowledge of proper hand hygiene among junior resident doctors, junior nurses, and undergraduate medical students and recommendation to improve its awareness at the level of Tertiary Health Care.
Methods: An institution-based cross-sectional study conducted among undergraduate medical students, junior doctors, and junior nurses at the tertiary care hospital of government medical college, for a period of 3 months duration. The selection of study subjects was done by purposive sampling method from each respective group of health service providers. A self-structured closed-ended questionnaire related to hand hygiene knowledge with the help of the “WHO hand hygiene questionnaire for Health Workers” and the knowledge was assessed. Appropriate software SPSS version 21 applied for analysis.
Results: Overall response rate of participants was 95%. Moderate number (69.9%) of health-care providers knew about the “common route of transmission of microbes” while knowledge of “germs on or around the patient be frequent source of infection” was poor (21.8%). The knowledge of medical students (63.9%) and junior doctors (60%) was found to be significantly higher than nurses (5.6%), (p=0.001) for “both hand rub and hand washing are equally effective against microbes.” Overall, low level of knowledge for hand hygiene was among nurses (16.7%), doctors (14%), and medical students (34.7%).
Conclusions: Most respondents show moderate knowledge for hand hygiene but there is still need of raising awareness for proper hand hygiene while providing health-care services to patient.
INCIDENCE OF HEPATIC DYSFUNCTION IN PATIENTS WITH DIABETES MELLITUS ADMITTED IN DARBHANGA MEDICAL COLLEGE AND HOSPITAL
Authors: SHASHI SUDHA , PK SINHA
Published: September 2022

Objective: The objective of the study was to find out the difference in the severity of the disease, pattern of liver injury, and clinical and biochemical profile in patients with liver dysfunction with and without diabetes mellitus (DM) and metabolic syndrome.
Methods: It was an observational study, the study conducted in the Department of General Medicine, Darbhanga Medical College and Hospital. Fifty consecutive patients with liver dysfunction along with diabetes and 50 consecutive patients with liver dysfunction without diabetes who satisfied the following inclusion criteria and did not have any of the exclusion criteria were selected for the study during the study period from January 2020 to December 2021.
Results: The mean age in patients with and without D.M. was 52.54 years and 52.58 years, respectively, with no significant difference between the two groups (p=0.283). The causes of liver dysfunction were as follows: Alcohol in 40 patients (24 without D.M. and 16 with D.M.), cryptogenic in 41 (14 without D.M. and 27 with D.M.), hepatitis C virus in eight (three without D.M. and five with D.M.), and hepatitis B virus in 12 (nine in without D.M. and two in with D.M.). The D.M. group had a considerably higher frequency of patients with cryptogenic cirrhosis (p=0.007). Diabetic individuals exhibited a significantly higher frequency of anemia, hypoalbuminemia, and hypercreatininemia than non-diabetic patients, according to laboratory testing. The majority of the patients of both groups showed mild ascites (88% without D.M. vs. 82% with D.M.). It shows diabetic patients had significantly higher MELD and higher Child-Pugh scores (p=0.001 and 0.004, respectively).
Conclusion: D.M. is found all over the world, and there is a growing body of evidence associating it with cirrhosis. As a result, both are likely to rise in value. Coexisting diabetes appears to be linked to more severe liver injury and consequences preceding cirrhosis, as well as greater mortality once cirrhosis has developed.
EFFECT OF AQUEOUS EXTRACT OF CYNODON DACTYLON (DOOB GRASS) ON NORMAL AND IMPAIRED MEMORY IN MICE
Authors: KOTHARI SAROJ , SAHU MONIKA
Published: September 2022

Objective: Memory impairment in any age affects the quality of life, though this problem is common in old age. The present study was carried out to study the effect of aqueous extract of Cynodon dactylon (AECD) on normal and impaired memory in mice.
Methods: The gum acacia suspension of AECD was administered by gavage at the dose of 200 and 400 mg/kg for 30 days to evaluate memory-enhancing effect on normal and scopolamine-induced impaired memory in albino mice. Escape latency (EL) in Morris water maze (MWM) and transfer latency (TL) in elevated plus maze were recorded. Mice were given four trial sessions per day to locate the platform for 5 days in MWM model. Scopolamine 1 mg/kg was injected i.p. to produce memory impairment in mice.
Results: AECD at the dose of 200 mg/kg (p>0.05) and 400 mg/kg (p<0.05) showed reduction of EL and TL as compared to control group in normal mice. AECD 200 mg/kg (p>0.05) and 400 mg/kg (p<0.05) showed reduction of EL and TL as compared to negative control group in impaired memory mice. AECD 400 mg/kg was comparable to that of piracetam at the dose of 200 mg/kg in normal and scopolamine-treated mice. However, AECD showed better memory-enhancing effect in scopolamine-induced impaired memory model than in normal memory.
Conclusion: The study revealed that the chronic administration of AECD exhibited significant memory-enhancing activity against both normal and scopolamine-treated impaired memory mice groups.
SEPARATION AND IDENTIFICATION OF FORCED DEGRADATION PRODUCTS OF LOFEXIDINE BY USING LC-MS/MS
Authors: SK MASTANAMMA , ANJALI T SATYA , J TEJASWI , M CHIRANMAI , LATHA K HEMA
Published: September 2022

Objectives: A rapid and reliable isocratic LC-MS/MS method was developed and validated for the separation and identification of stress degradation products (DPs) of lofexidine.
Methods: Lofexidine, a non-opioid centrally acting alpha2-adrenergic receptor agonist, was subjected to hydrolysis (acidic, alkaline, and neutral), oxidation, photolysis, and thermal stress as per International Council on Harmonization specified conditions. The drug showed extensive degradation under alkaline, acidic, oxidation, and photolytic stress condition.
Results: A total of 14 DPs were observed and the chromatographic separation of the drug and its DPs were achieved on waters symmetry C18 (150 × 4.6 mm, 3.5 μm) column using water and acetonitrile (75:25 v/v) as mobile phase. The DPs were separated and identified using LC-MS/MS. The LC-MS/MS method was validated with respect to specificity, linearity, accuracy, and precision.
Conclusion: The proposed method was used for impurity profiling and routine quality control tests of lofixidine.
ANALYTICAL METHOD DEVELOPMENT AND VALIDATION FOR THE ESTIMATION OF CYAMEMAZINE TARTRATE IN FORMULATION BY RP-HPLC WITH STABILITY INDICATING
Authors: KATOLKAR PARIMAL , JAISWAL SHREYA
Published: September 2022

High-performance liquid chromatography (HPLC) technique for cyamemazine tartrate (CYMT) was developed and validated according to the International Conference on Harmonization (ICH) Q2 (R1) guidelines. The developed and validated method for estimating CYMT from a bulk and its pharmaceutical dosage form was found to be a simple, precise, accurate, fast, and stable reverse phase HPLC (RP-HPLC) approach. For chromatographic separation, a Hypersil BDS C18 (250 mm × 4.6 mm, particle size: 5 μm) column was employed with a mobile phase of methanol and buffer (80:20 v/v) flow rate at 1.0 ml/min at room temperature. For detection, a wavelength of 270 nm was utilized. With a run period of 10 min, the CYMT was eluted at 4.38 min. With a correlation coefficient (r2) of above 0.9996, and limits of detection and quantitation (LOD and LOQ) of 0.27 and 0.80 μg, respectively, the method exhibited a dynamic linear response across 30–90 μg/ml. The repeatability of batch injections for intra- and inter-assay precision and accuracy testing was likewise satisfactory. The stability of CYMT was studied under thermal, acid, alkali, and oxidation conditions, as well as photodegradation conditions. The stability of the approach is demonstrated by the presence of CYMT and its breakdown products. The recommended technique exhibited great linearity, accuracy, precision, robustness, LOD, LOQ, and system suitability within the acceptance limit. The study’s findings indicate that the method is rapid, simple, accurate, exact, and linearly stable, implying that an HPLC method for CYMT has been developed and validated, and that it may be used for routine quality control analysis.
PHYSIOLOGICAL AND ANATOMICAL CHANGES OF PREGNANCY IMPLICATIONS FOR ANAESTHESIA – A RANDOMIZED CONTROLLED TRIAL
Authors: PANIGRAHI SARMISTHA , PEETHANI SANDHYA
Published: September 2022

Objectives: The article aims at gaining in-depth knowledge of physiological and anatomical changes in pregnancy.
Methods: A randomized controlled trial was done among 200 pregnant woman in Department of Obstetrics and Gynecology at Tertiary care institute and hospital for the period of 6 months (November 2021 to April 2022). Random Number table was used for selection of patients who were followed for pregnancy in the department. All demographic details and Pre-Anesthetic checkups were done. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) 22.0 version. This consecutive series of original research papers were reviewed for the reporting of ethics committee approval and patient consent.
Results: Respiratory physiology continues to change throughout pregnancy. Airway resistance decreases 50% due to the effects of progesterone on bronchial smooth muscle. With Minute ventilation, RR, Tidal volume, and Alveolar ventilation are increased. Anatomically, diaphragm elevates with cephalad pressure of the growing gravid uterus, and the chest wall diameter increases in the anteroposterior and transverse diameters. This leads to unchanged Total Lung Capacity, Vital Capacity, and CC, while Expiratory Reserve Volume, Residual volume, and Functional residual capacity seen a decreased in 20% in all patients. Blood volume increases early in gestation (at approximately 12 weeks), continues to increase rapidly during the second trimester and more slowly during the remainder of pregnancy. Cardiac output increases in early pregnancy with changes measurable by 8 weeks gestation.
Conclusion: Minute ventilation, RR, Tidal volume, and Alveolar ventilation are increased. Cardiac output increases in the early pregnancy with changes measurable by 8 weeks gestation. Cardiac output increases most rapidly (to approximately 35% above baseline) during the second trimester, then remains about the same until term. Output increases substantially with labor contractions; each contraction increases cardiac output an additional 10–25%.
CASE STUDY: ORAL HYPOGLYCEMIC DRUGS OVERDOSE INDUCED GENERALISED TONICCLONIC SEIZURES
Authors: KUCHIPUDI ANVESH KUMAR , PORANKI VATHSALYA
Published: September 2022

Metformin is an oral hypoglycemic agent of the biguanide class, and glimepiride is an oral hypoglycemic agent of the sulfonylurea class frequently used to treat Type-II diabetes mellitus. Under certain conditions, overdose or long-term use of metformin and glimepiride can cause lactic acidosis and hypoglycemia. Metformin overdose can cause severe hypoglycemia in the absence of other anti-diabetic drugs. Potential mechanisms of metformin-induced hypoglycemia include decreased hepatic glucose production, decreased glucose absorption, and low oral intake. Hypoglycemia, in turn, leads to loss of consciousness, headache, confusion, and neurological symptoms such as insomnia, delirium, and in rare conditions may lead to coma, seizures, and death. Here, this case study is of 23-years-old female patient and non-diabetic presented with alleged consumption of metformin (8 g), glimepiride (32 mg) with three-episodes of generalized tonic-clonic seizures (GTCS), fever with chills, and loss of consciousness. In general, diabetic patient’s hypoglycemia condition can be more often due to drug overdosage or dietary restrictions. However, in non-diabetic patients, hypoglycemia is considered a jeopardy situation because it may lead to several fatal effects.
DOUBLE PRIMARY – THE PATTERN OF CARE, AND EPIDEMIOLOGY: EXPERIENCE FROM A TERTIARY CANCER CARE CENTER
Authors: DUTTA SHATARUPA , BANERJEE SAPTARSHI , BERA ANJAN , MANDAL SRIKRISHNA , BANERJEE CHANDRIMA
Published: September 2022

Objectives: The importance and relevance of double primary are increasing with time as the increasing use of advanced diagnostic investigation and an increasing number of cancer survivors lead to an increase in double primary malignancy.
Methods: We have collected data retrospectively from our own departmental patient’s record section from January 2011 to December 2021. All the details such as histopathology of both the malignancy, site of primary and secondary cancer, the time gap between the two cancer, clinical stage, and treatment received, along with demographic details have been recorded. Patients are divided into two categories either synchronous or metachronous when a second tumor develops either simultaneously or within 6 months of the diagnosis of the first tumor or 6 months after the diagnosis of the primary malignancy, respectively.
Results: The total number of registered cases in one decade at our institute was 25,638 and among them were 41 double primary cases (0.16%). Twenty-two cases were metachronous (59%) and 19 cases (41%) were synchronous double primary. The most common site of double primary site was the head and neck region (38 %) followed by the lung, and esophagus (13% each), and the least common site was the colon (<1%). In the case of metachronous double primary, the mean time interval (the time gap between two cancer devolvement) was 7.4 years with a range of 2–19 years. The majority of the patients are treated with curative intention.
Conclusions: The incidence of double primary is increasing over time. The management of double primary should be supervised by a multidisciplinary tumor board and more research is needed in the areas of epidemiology and treatment.
A PROSPECTIVE STUDY ON PREGNANCY COMPLICATED WITH JAUNDICE AND FETOMATERNAL OUTCOME
Authors: WARRIER HARIDAS GOVINDA
Published: September 2022

Objectives: The aim of the study was to determine biochemical factors and maternofetal outcome in women with jaundice during pregnancy and to study its association with jaundice in pregnancy.
Methods: It was an observational study done among 60 pregnant patients with abnormal liver functioning. Laboratory parameters were studied which mainly includes liver function tests. Demographics and the detailed clinical history were recorded. The detailed laboratory investigation was carried out to study the complications concerning biochemical parameter. SPSS (Version 22.0) was used for analysis.
Results: HELLP syndrome was the most common etiology (45%). Decreased levels of hemoglobin observed in 75%, increased total leukocyte count observed in 26%, and low platelet count observed in 34%, respectively. Among mothers, most common adverse outcome was requirement of emergency lower segment cesarean section (45%). Maternal outcomes were significantly associated with raised direct bilirubin, raised serum glutamic pyruvic transaminase, raised alkaline phosphatase, and thrombocytopenia (p=0.03, p=0.01, p=0.02, and p=0.01, respectively).
Conclusion: Hepatic dysfunction during pregnancy is associated with adverse events for both the mother and the fetus.
FORMULATION AND EVALUATION OF FAST DISINTEGRATING TABLET OF PROPRANOLOL HYDROCHLORIDE USING MODIFIED TAMARIND SEED GUM AS A NATURAL SUPERDISINTEGRANT
Authors: Rani Nisha , DEV DHRUV
Published: September 2022

Objective: The present study was carried out for the preparation of modified Tamarindus indica seed gum as a natural superdisintegrant and assessed various parameters for preparing a fast disintegrating dosage form. Methods: The extracted gum from tamarind seeds was chemically modified by the carboxymethylation method. Then, calcium complexation of carboxymethyled tamarind seed gum was done. Fast disintegrating tablets were prepared by the direct compression method. The change in the functional groups of the extracted gum, Carboxymethyl tamarind seed gum, and the calcium complexed tamarind seed gum was studied by FT-IR spectrophotometer. DSC studies of calcium complexed tamarind seed gum showed alterations in the melting point without undergoing any modification. Results: The pre-formulation studies such as physical appearance, swelling index, and viscosity of calcium complexed tamarind seed gum were characterized. From the studies, it was concluded that modified Tamarind seed gum was acidic and hydrophilic. The pH of the extracted tamarind seed gum was found to be 5.4. The fast disintegrating tablets were evaluated for hardness, friability, disintegration time, thickness, and in-vitro dissolution study. In the present study, the disintegration time of calcium complexed tamarind seed gum-containing tablets was compared with the marketed formulation of croscarmellose sodium as a synthetic superdisintegrant. The F5 formulation of calcium complexed tamarind seed gum showed a disintegration time of 37±2 s whereas the marketed formulation of croscarmellose sodium showed a disintegration time of 48±2 s. Conclusion: It can be concluded that a fast disintegrating tablet prepared using calcium complexed Tamarind seed gum improves the disintegration time of the tablet.
A RETROSPECTIVE STUDY: ANALYSIS OF ADVERSE DRUG REACTION IN PEDIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL
Authors: MATHUR SUNIL KUMAR , JAIN SAURABH KUMAR , MISHRA AMUL
Published: September 2022

Objective: The objective of this study was to analyze various parameters such as admission type, demographics, type of reaction, organ system classification, drugs involved, action is taken, reaction outcome, causality assessment, severity assessment, and the preventability of Adverse drug reactions (ADRs) in pediatric patients.
Methods: This retrospective observational study was conducted during the period of September 2017 to June 2020 (34 months) at the ADR monitoring center, Department of Pharmacology, Jawaharlal Nehru Medical College, Ajmer, Rajasthan. All spontaneously reported ADRs were evaluated using various parameters such as type of reaction, causality assessment, preventability, and severity.
Results: In the present study, 72 (7.27%) ADRs were reported in relation to 65 pediatric patients. In this study, more ADRs were reported in male (53.85%) as compared to female (46.15%) pediatric patients. The majority of ADRs were considered type B (63.89%), probable (87.5%), moderate (51.39%), and definitely preventable (88.89%) in nature. The majority of ADRs were reported due to antimicrobial classes of drugs, including anthelmintic drug (Albendazole), followed by glycopeptide antibiotic (Vancomycin) and third-generation cephalosporin antibiotics (Ceftriaxone, Cefotaxime, and Cefixime). The organ systems most commonly affected were skin and subcutaneous tissue disorders (47.22%), followed by general disorders and administration site conditions (20.83%) and gastrointestinal disorders (16.67%).
Conclusion: The present study 30 different types of suspected ADRs that were reported with multiple frequencies, with included 34 different categories of drugs and combinations of drugs. The majority of patients recovered, with associated ADR, after necessary medical intervention and management. Our purpose is to minimize the incidence rate of ADRs in the pediatric population.
TOTAL AND DIFFERENTIAL LEUKOCYTE COUNT IN HEALTHY NEWBORNS
Authors: Kumar Ashwani , Yadav Meetu , Charan Gopal Singh , SARANGAL PANKAJ
Published: September 2022

Objectives: The objectives of the study were to establish normal reference values of total and differential leukocyte count (DLC) in Indian neonatal population.
Methods: The study was conducted on 200 healthy newborns admitted to neonatology section of Department of Paediatricsa. Maternal and Neonatal data was recorded on a pretested pro forma. Thin-layer chromatography (TLC) was done by manual method (hemocytometer method) using improved Neubauer Chamber. For calculating DLC smear was made from the EDTA blood and was stained by Leishman stain (Romanowsky group). DLC was done in body and tail part of the stained smears by following Z pattern.
Statistical Analysis: Descriptive statistical analysis was carried out in the present study. Mean, standard deviation, t-test, and analysis of variance tests were used to test the significance of the differences among sample means.
Results: Mean TLC at various period of gestations were 4500/cumm at 31 weeks, 7627±2320/cumm at 33 weeks, 8325±1943/cumm at 34 weeks, 8141±1538/cumm at 35 weeks, 8455±904/cumm at 36 weeks, 8840±658/cumm at37 weeks, 9380±896/cumm at 38 weeks, 10143±1369/cumm at 39 weeks, 9155±2444/cumm at 40 weeks, and 11750±353/cumm at 41 weeks.
Conclusion: TLC showed increase with gestation except at 35 weeks and 40 weeks. Neutrophils shows increase with gestation except at 35 weeks and 40 weeks lymphocytes shows increase with gestation except at 34 weeks, 39 weeks, and 40 weeks.
KNOWLEDGE AND PRACTICE TOWARDS COSMETICS AND THEIR ADVERSE REACTIONS AMONG UNDERGRADUATE MEDICAL, PHARMACY, AND PHYSIOTHERAPY STUDENTS
Authors: K GIRISH , K VASUNDARA , R JYOTHI , ARUNNAIR VIJAYAMATHY
Published: September 2022

Objectives: The objectives of the study were to evaluate the knowledge, practice, and pattern of cosmetic use and their adverse reactions amongst medical, pharmacy, and physiotherapy undergraduates. Methods: This was a cross-sectional, questionnaire-based study conducted among 202 2nd-year medical (113), Pharmacy (51), and Physiotherapy (38) students of KIMS, Bangalore, India for a period of 1 month. Results obtained were analyzed using descriptive statistics. Results: About 75.2% of students were aware of cosmetics and their adverse reactions, still 36.7% of students will continue using them because they were convinced about them. Pharmacy students had less knowledge of the animal, alternate testing, and preventive measures compared to medical and physiotherapy students. Overall n=71, (35.1%) of students had adverse reactions from cosmetic usage, the most common product being fairness cream and the adverse reactions include itching, acne, and rashes. Conclusion: Overall, the undergraduate medical, pharmacy, and physiotherapy students had good insight and practice toward cosmetics and their adverse reactions, nevertheless the awareness of pharmacy students was comparatively less than medical and physiotherapy students. Hence, educational intervention on the effective, safe, and proper use of cosmetics in the future needs to be implemented especially among pharmacy students.
PREPARATION AND EVALUATION OF TMC LOADED VORICONAZOLE NANOPARTICLES
Authors: YADAV DEEPIKA , AGGARWAL PANKAJ , YADAV MAMTA , SINGH ANAND
Published: September 2022

Objective: Ocular diseases affect a growing number of people across the globe. Hence, the present research work focused to prepare and evaluate voriconazole (VCZ) nanoparticles containing trimethyl chitosan (TMC) for ophthalmic drug delivery with primary goal is to develop topical ocular delivery systems with improved ocular bioavailability and reduced systemic side effects while maintaining the dosage form’s simplicity and convenience.
Methods: In the present study, the nanoparticles are prepared using ionotropic gelation method. The physiochemical interactions between drugs and selected excipients were studied using various techniques such as FTIR, DSC, XRD, and H-NMR. The physiochemical properties of the nanoparticles such as size, PDI, pH, and drug content/entrapment efficiency were determined. The in-vitro drug release properties were characteristics and examined for the formulations. The synthesize form of chitosan, that is, tri-methyl chitosan is used due to solubility issue.
Result: The comparative study was done using TMC and cyclodextrin as a polymer out of which TMC polymer gives better results. The optimization is done using 32 factorial design using design expert software. The optimized batch follows the zero order release kinetics.
Conclusion: TMC loaded VCZ nanoparticles show better result with improved solubility and permeability.
ANALYSIS OF GENITAL TRACT MALIGNANCIES IN POSTMENOPAUSAL FEMALES – A HOSPITAL-BASED STUDY
Authors: PRIYANKA TIWARI , BHARTI PARIHAR , RAVIKANT ARJARIYA
Published: September 2022

Introduction: Female genital tract malignancy is common carcinoma. In the developed countries, ovarian cancer is the most common cancer and in developing countries, carcinoma cervix is the most common malignancy. Menopause does not cause cancer, but the risk of developing cancer increases as women ages. Therefore, women who have been through natural menopause are more likely to develop cancer because they are older. A woman who experiences menopause after age 55 has increased risk of ovarian, breast, and uterine cancers. The risk is greater if women also began menstruating before age 12. This is because a woman who menstruates longer than normal during her lifetime is exposed to more estrogen and has more ovulation. Hence, aims and objectives of our study are: (1) To determine the incidence of different genital malignancies in postmenopausal females and (2) to analyzes diagnosis and treatment of genital malignancies in postmenopausal females.
Methods: 1. Data were collected using predesigned proforma; consent was taken from every participant, 2. After collection of data, it was tabulated. Statistical calculation and subsequent analysis was made has been presented in the form of Tables and graphs.
Results: A total of 401 cases reported to the institute during a period of 1 year. Out of which, 107 patients were that of genital carcinoma. Incidence of female genital tract carcinoma was 26.68%. Approximately 73.87% (82 patients) of cases were that of cervical cancer.
Conclusion: Hence, from above study, the most of the patients were diagnosed in advanced stage of malignancy. Carcinoma cervix was the most common female genital tract cancer with ovarian cancer taking the second rank. This is unfortunate as cancer cervix is preventable to a large extent as it takes a decade or more to progress from pre-invasive to invasive lesion, there are various screening modalities to diagnosed the cervix in pre-invasive age, that is, when it still curable.
STUDY OF FASTING PLASMA GLUCOSE AND LIPID PROFILE IN POSTMENOPAUSAL WOMEN
Authors: FARHA ALI  , BINDRA MANINDER
Published: September 2022

Objectives: The study was designed to determine fasting plasma glucose (FPG) and lipid profiles in postmenopausal women.
Methods: 200 postmenopausal women were enrolled for the study and were compared to 100 normal healthy women of the same age from the Outdoor Patient Department of LN Medical College and research center of Bhopal city. Those fulfilling inclusion and exclusion criteria were enrolled for the study and the blood samples were analyzed for lipid profile and FPG.
Results: Significant higher concentrations of total cholesterol (p<0.001), triglyceride (p<0.001), low-density lipoprotein (LDL) (p<0.001), very LDLs (p<0.001), and FPG (p<0.001) were demonstrated in postmenopausal women when compared with normal healthy women. A significantly lower concentration of high-density lipoprotein (p<0.001) was demonstrated in postmenopausal women when compared with normal healthy women.
Conclusion: Menopausal transition and the related changes in the hormonal milieu (e.g., decreased systemic estradiol (E2) levels) are linked with adverse changes in several indicators of metabolic health. For instance, during the menopausal transition elevated blood glucose levels and adverse changes in serum lipids have been reported.
ASSOCIATION AND CORRELATION OF MEAN PLATELET VOLUME AND PLATELET COUNT IN ACUTE ISCHEMIC STROKE
Authors: YASH PATEL  , VINOD KUMAR MEHTA  , RENU KHAMESRA  , AYUSHI JAIN  , VYAS KK
Published: September 2022

Objective: Role of platelets in the pathogenesis of the atherothrombosis and ischemic stroke has been documented. Mean platelet volume (MPV) and platelet count (PC) could be important predictors of acute ischemic stroke (AIS), its severity; therefore we investigated the correlation of MPV & PC in AIS patients.
Methods: We studied MPV and PC of 52 AIS patients consecutively admitted in Neurology department at Geetanjali Medical University, India. Platelet variables were measured and compared with control of similar age, sex and without vascular events.
Results: Out of 52 patients, 30 (57.69%) had Thirty (57.69%) patients had significantly higher MPV in AIS group (12.45fL compared with normal range of 6–11 fL in control,p<0.001). No significant differences were found between male and females, but the total mean was elevated. The mean of PC was 1.76×105 cells/cumm (normal range) and there was no correlation between the change in PC and AIS in both sexes. Repeated measurements of MPV and PC were also recorded on follow-up which showed no significant changes from the acute phase; however, MPV remained elevated. The comparison of MPV in patients with mRS score 2 versus 4, 2 versus 5, 3 versus 4 and 5, and 4 versus 5 were found to be statistically significant (p<0.05).
Conclusion: Increased MPV has an independent association with AIS and its severity and it could not change after acute treatment. It is possible that these changes precede the vascular event, and further studies are warranted to unravel the underlying mechanism.
A CROSS-SECTIONAL STUDY TO ESTIMATE THE PREVALENCE OF HYPERTENSION IN URBAN FIELD PRACTICE AREA OF MEDICAL COLLEGE IN METROPOLITAN CITY OF INDIA
Authors: SHARMA SHIREEN , KUMAR SINGH SHRAWIN , BARANWAL PANKAJ KUMAR , SINGH DHANANJAY KUMAR , KALE VISHAL
Published: September 2022

Objectives: The objectives of the study were to estimate the prevalence of hypertension in people above 35 years and to study the sociodemographic profile of the study subjects.
Methods: The study was a cross-sectional study conducted in urban field practice area of medical college. Five chawls were selected by simple random sampling out of 42 chawls. Males and females above 35 years of age living in study area formed a sample frame. Sample size was calculated and it was 667. As per the protocol, informed written consent and demographic details with clinical data were obtained from the patients.
Results: A total of 667 participants were included from five chawls. Maximum number of participants, that is, 37%; were from the age group of 35 to 44, consisting of 41% males and 59% females. Around 67% of study respondents belonged to the age group of 35–54 years. Around 3/4th of study respondents had studied up to primary school and secondary and high school. Out of 263 males, 37%, that is, 98 respondents were hypertensive, and out of 404 females, 152, that is, 38% were hypertensive. Hence, the total prevalence of hypertension in this study was 37.5%.
Conclusion: Hypertension is the new era pandemic which is the leading cause of morbidity and mortality in the world and is ranked third as a cause of disability-adjusted life years. To control hypertension, it is imperative to identify and modify its risk factors.
OPTIMIZATION, DEVELOPMENT, AND SAFETY EVALUATION OF OLIVE OIL NANOEMULSION FOR TOPICAL APPLICATION: A RESPONSE SURFACE METHODOLOGY
Authors: Wan Ishak Wan Maznah , Zulfakar Mohd Hanif
Published: September 2022

Objective: Nanoemulsions consist of fine oil-in-water dispersions, with droplets covering the size range of 50–500 nm. Olive oil is frequently utilized in cosmetic and pharmaceutical topical product for its healing, protecting, and moisturizing properties due to its high fatty acid and antioxidant content. In the present work, a nanoemulsion composed of olive oil, Span 80 as surfactant, and Labrasol as cosurfactant was developed using a high-pressure homogenization method and was evaluated for its physicochemical characteristics. Methods: Response surface methodology was utilized to investigate the influence of the main nanoemulsion components: olive oil (X1), Span 80 (X2), and Labrasol (X3) on the droplet size (Y1) and polydispersity index (PDI) (Y2). A total of 17 formulations were generated by the Box-Behnken model. Results: The model was found to be highly significant with R2 values of 0.9833 and 0.9382 for droplet size and PDI, respectively. The optimized nanoemulsion presented the droplet size of 144.2±0.8 nm and PDI of 0.105±0.014. Span 80 seems to be the most influential factor that determines the droplet size as it has higher significant linear and interaction effects. The developed nanoemulsion was, further, evaluated with an in vivo skin irritancy study using the rat model. Conclusion: Results indicate that the developed nanoemulsion did not demonstrate any skin irritations in gross and histological examinations, suggesting that it is safe for topical applications.
COST ANALYSIS OF ORAL ANTIHYPERTENSIVE DRUGS: ASSESSING THE EFFECT OF DRUG PRICE CONTROL ORDER IN INDIA
Authors: Sharma Himanshu , Kumar Amit , Kaur Samarjeet , Singh Jayvardhan , Sharma Garima
Published: September 2022

Objective: The study focuses on cost analysis of different available brands of oral antihypertensive drugs in India and assesses compliance with their ceiling prices fixed by drug price control order (DPCO).
Methods: This is an observational study conducted in the Department of Pharmacology, GSVM Medical College Kanpur, from May to June 2022. The ceiling price of oral antihypertensive drugs was obtained from the DPCO price list 2021 and dosage and prices of the different brands of antihypertensive drugs available in India were obtained from medguideindia.com and Current Index of Medical Specialities-CIMS (Jan–April 2022 edition, India). Thereafter, data analysis of oral antihypertensive drugs was done on Microsoft Excel Office 2019 version.
Results: Our study found a total 1575 brands of oral antihypertensive drugs available in market, 34% brands were having prices more than DPCO recommended ceiling price. Maximum price violation was noticed with capsule nifedipine 10 mg (83.33%) and tablet telmisartan 80 mg (60.98%). The maximum cost variation and cost ratio was seen with tablet propranolol 10 mg, that is, 3233.33% and 33.33, respectively, followed by tablet amlodipine 5 mg, that is, 2123.33% and 22.23.
Conclusion: Stringent regulation and monitoring of the DPCO price list should be done to ensure that all drugs and especially oral antihypertensive drugs are not sold above the ceiling price set by the order so that the compliance for the drugs is optimized and India could achieve its objective of reducing the prevalence of hypertension to <25% by 2025.
EFFECT OF MENOPAUSE AND LIFESTYLE FACTORS ON SERUM VITAMIN D STATUS IN POSTMENOPAUSAL WOMEN
Authors: ALI FARHA , TIWARI SURYA
Published: September 2022

Objectives: The study was designed to determine the effect of menopause and lifestyle factors on Serum Vitamin D levels in postmenopausal women.
Methods: The present study comprises 100 healthy women treated as controls and was compared to 200 postmenopausal women as cases. Those fulfilling inclusion and exclusion criteria were enrolled for the study and blood samples were analyzed for Vitamin D and Estrogen.
Results: Significant lower concentration of Vitamin D (p<0.001) and estrogen (p<0.001) was found in postmenopausal women when compared with healthy women.
Conclusion: Vitamin D is a steroid hormone known for its essential role in maintaining calcium homeostasis, promoting and maintaining bone health, and improving immune function. During the menopausal stages, there is a gradual reduction in estrogen levels this decline in estrogen production promotes Vitamin D deficiency.