Asian Journal of Pharmaceutical and Clinical Research

METFORMIN THERAPY FOR ACNE VULGARIS AMONG MALES AND FEMALES WITHOUT POLYCYSTIC OVARY SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS

2025-01-23T02:39:02+0530

Objectives: There is an association between Acne vulgaris and insulin resistance and metabolic syndrome. Although metformin was effective in polycystic ovary syndrome (PCOS) patients, its effects on acne vulgaris among males and females without PCOS are scarce. The study aimed to assess the impact of metformin on acne vulgaris among males and females without PCOS.

Methods: We searched seven databases including Scopus, Web of Science, PubMed, Google Scholar, MEDLINE, EBSCO, and Cochrane Library. We conducted the literature search during October and November of 2024 and the articles were included from inception up to the most recently published research. We used the keywords metformin, doxycycline, tetracycline, isotretinoin, acne vulgaris, acne severity, inflammatory lesions, non-inflammatory lesions, and Global Acne Grading System. A checklist was used to collect the information analyzed by the RevMan System 5.4 (United Kingdom).

Results: Out of a hundred and forty-eight studies identified, we screened 27 full texts, and only five studies were found eligible to be included in the meta-analysis. The studies included 214 patients with study duration of 2–6 months. Metformin was effective in reducing global acne severity scores. However, it was inferior to doxycycline, tetracycline, and isotretinoin, odd ratio, 1.16, 95% CI, 0.37–1.94, Chi-square, 3.95, and p=0.004, and odd ratio, 3.75, 95% CI, 1.85–5.65, Chi-square, 98.32, and p<0.001, respectively.

Conclusion: Metformin was effective in acne vulgaris treatment among males and females without PCOS, p<0.05, but not superior to other systemic therapies. p>0.05. Furthermore, extensive controlled trials are recommended.

The HYPONATREMIA IN ACUTE MYOCARDIAL INFARCTION AND SHORT-TERM CLINICAL OUTCOME: A CROSS-SECTIONAL STUDY

2025-01-20T23:15:22+0530

Objectives: Neurohumoral activation in acute myocardial infarction (MI) causes hyponatremia and is associated with poor outcome. We aimed to establish a relationship between hyponatremia in acute ST-elevation MI (STEMI) and its complications.

Methods: Patients with acute STEMI were included. The patients were monitored for serum sodium at admission; at 24, 48, and 72 h; and echocardiographic evaluation at admission and at 72 h. Complications such as left ventricular (LV) failure and mortality during hospital stay were noted.

Results: In the acute setting of STEMI, hyponatremia was observed in 86% of patients aged >60 years (p=0.001). In patients with moderate LV dysfunction, 91% had hyponatremia at 24 h after admission, with persistent hyponatremia in 66.7% at 72 h (p=0.02). Within 24 h of admission, when the patient had normal serum sodium, the risk of complications was 16%, with mild hyponatremia the risk was 66.7%, with moderate hyponatremia the risk was 85.7%, and with severe hyponatremia the risk was 100% (p=0.001).

Conclusion: Elderly individuals are prone to hyponatremia following acute MI. LV dysfunction is associated with hyponatremia following MI. Moderate-to-severe hyponatremia is associated with a high risk of complications.

EXPLORING THE EFFECTIVENESS OF BEHAVIORAL INTERVENTIONS ON MEALTIME BEHAVIOR OF CHILDREN WITH AUTISM SPECTRUM DISORDER: A SYSTEMATIC REVIEW

2025-01-03T09:39:31+0530

Objective: This systematic review assess the impact of various behavioural interventions implemented by the care givers to influence the mealtime behaviours of children with Autism spectrum disorder (ASD). It reflect the scope of teaching basic behavioural interventions to the parents which can improve the mealtime behaviours and quality of life of their children. This systematic review is aimed to explore the effectiveness of behavioural interventions on mealtime behaviour of children with Autism spectrum disorder.

Methods: Preferred Reporting items for Systematic review and Meta analysis [PRISMA] guidelines were adopted to review the studies. PubMed, PubMed Central, Science Direct, Scopus, Web of Science, Oxford, Ovid, Psych Info and Delnet were searched.

Result: Five experimental tudies that used Brief Mealtime Behaviour Inventory (BAMBI) to assess the mealtime behaviour of children with ASD were selected for the review. The reviews demonstrated that there was a significant difference in the mean score of mealtime behaviours among autistic children post intervention.

Conclusion: The study findings emphasise that parent training inculcated with principles of behavioural therapy appears to have a significant impact on reducing eating behaviours of children with ASD.

BIOANALYTICAL APPROACH TO ENSITRELVIR ESTIMATION USING LIQUID CHROMATOGRAPHY-TANDEM MASS SPECTROMETRY AND ITS APPLICATION TO PHARMACEUTICAL RESEARCH

2025-01-21T13:10:36+0530

Objective: For the bioanalytical approach of ensitrelvir, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) methodology was developed. This technique is simple to use, rapid, exact, active, and repeatable, and it uses remdesivir as an internal standard.

Methods: A phenyl column (250×4.6 mm, 5μ) and an organic mobile phase consisting of 0.1% trifluoroacetic acid and acetonitrile in a 50:50 v/v ratio are used in this article to summarize the latest advancements in bioanalytical LC-MS/MS procedures.

Results: An excellent linear concentration range from 3 ng/mL to 120 ng/mL was analyzed for ensitrelvir within 5 min (r2 = 0.9998±0.005). It was determined that the outcomes for accuracy, precision, recovery, matrix effect, and stability were all within acceptable ranges.

Conclusion: The application successfully applies all the required criteria for pharmacokinetic investigations in rats, including system appropriateness, specificity, linearity, and accuracy, in accordance with US Food and Drug Administration requirements.

INTRAVENOUS VERSUS INTRANASAL DEXMEDETOMIDINE: A COMPARATIVE ANALYSIS OF HEMODYNAMIC RESPONSES DURING LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

2025-02-13T15:37:59+0530

Objectives: Laryngoscopy and intubation causes a profound sympathetic response, causing significant increase in heart rate (HR) and blood pressure, potentially leading to complications like laryngospasm and bronchospasm, requiring close monitoring and expert anesthesia care. This study evaluated intranasal and intravenous effectiveness of dexmedetomidine in mitigating adverse hemodynamic consequences to laryngoscopy and intubation, aiming to discern the optimal route for hemodynamic stability.

Methods: This double-blinded, randomized study involved 72 adults (18–60 years, American Society of Anesthesiologists I/II) undergoing various surgeries requiring general anesthesia and endotracheal intubation. Group DIV received Inj. Dexmedetomidine 1 μg/kg intravenously as an infusion in 100 mL Normal Saline over 10 min, 40 min before induction of general anesthesia. Group DIN received Inj. Dexmedetomidine 2 μg/kg (1 μg/kg in each nostril) intranasally through atomizer 40 min before induction of general anesthesia. The study’s primary objective was to optimize dexmedetomidine’s route and dosage for minimizing laryngoscopy’s stress response. Secondary outcomes included assessing incidence of any adverse event.

Results: Both study groups showed similar demographics, study duration, and baseline hemodynamics. Hemodynamic parameters decreased significantly 30–40 min post-administration of study drug and after induction (p<0.05). Laryngoscopy and intubation increased HR and mean arterial pressure (MAP) where Group DIN HR (98.86±17.16 bpm), MAP (108.5±15.69 mmHg) showed more increase than Group DIV HR (88.89±9.23 bpm) and MAP (102.36±9.06 mmHg). Group DIV showed greater attenuation of hemodynamic parameters at 1, 3, and 5 min post-laryngoscopy (p<0.05).

Conclusion: Intravenous dexmedetomidine 1 μg/kg is more effective than intranasal dexmedetomidine 2 μg/kg in attenuating the hemodynamic stress response to laryngoscopy and intubation.

COMPARISON ON EFFECT OF KETOFOL AND KETOFOL-DEXMEDETOMIDINE COMBINATION ON HYPERDYNAMIC RESPONSES TO MODIFIED ELECTROCONVULSIVE THERAPY AND THEIR ROLE IN AGITATION AND PATIENT’S SATISFACTION

2025-02-10T13:11:47+0530

Objective: The aim of our study was to assess the anesthetic effect of combined ketofol-dexmedetomidine on hemodynamics, seizure duration, recovery characteristics, agitation, and patient’s satisfaction following electroconvulsive therapy (ECT) in psychiatric patients.

Material and method: A total of 46 patients of the American Society of Anesthesiologists grade I and II were divided into 2 groups. Group A (ketofol group) patients were premedicated with injection glycopyrrolate 0.005 mg/kg IV. Group B (ketofol-dex group) patients were given 0.005 mg/kg IV glycopyrrolate and 0.5 μg/kg dexmedetomidine was infused intravenously over 10 min before induction of anesthesia. Both the groups were induced with injection ketofol for ECT and hemodynamic responses, motor seizure response, recovery profile, agitation score, and patient satisfaction score were observed.

Result: The demographic profile was comparable in both groups. Ketofol used was less in ketofol-dex group (81.96±9.26 mg) compared to ketofol group (104.78±10.92mg). Ketofol-dex group has a lower incidence of agitation (1.43±0.59 vs. 2.09±0.60), more patient satisfaction (1.35±0.57 vs. 2.04±0.71), and acceptable decrease in heart rate and blood pressure as compared to ketofol group without any significant side effects. Motor seizure duration was prolonged in ketofol-dex group (39.04±2.67 s) compared to ketofol group (35.04±2.95 s).

Conclusion: Dexmedetomidine is effective in attenuating acute hyperdynamic response to ECT without altering seizure duration and recovery from anesthesia, with the added benefit of decreasing post-ECT agitation with more patient satisfaction.

TWO CYCLES OF TPF AS INDUCTION CHEMOTHERAPY IN LOCALLY ADVANCED HEAD-AND-NECK SQUAMOUS CELL CANCER FOR INDIAN PATIENTS: CAN LESS BE MORE?

2025-02-10T12:54:29+0530

Objective: India has a high prevalence of locally advanced head-and-neck (H&N) cancer, with poor outcomes from concurrent chemoradiotherapy (CRT). Many centers widely practice induction chemotherapy (IC) to address this. The commonly used IC regimen with three cycles of docetaxel, cisplatin, and 5-fluorouracil (TPF) often results in poor tolerance and low compliance among Indian patients. This single arm study assess the efficacy, toxicity, and compliance of two cycles of TPF as IC followed by CRT in locally advanced H&N cancers.

Methods: We enrolled adult patients with previously untreated, non-metastatic, newly diagnosed, unresectable, and locally advanced H&N cancer planned for definitive CRT in tumor board. Patients were scheduled for IC with two cycles of TPF followed by concurrent CRT with weekly cisplatin.

Results: Between October 2022 and March 2024, we enrolled a total of 58 patients for the study. After two cycles of IC, 11 patients defaulted, and three had progressive disease. Out of the 44 patients who started CRT, 32 completed the treatment. Three patients were lost to follow-up. We observed a complete response in 27 patients (84.3%). Only two patients had residual disease, and no distant failures occurred. The treatment was well tolerated, with no cases of neutropenia. We noted grade 2 neutropenia in one patient during IC and 11 patients during CRT. Grade 3 mucositis appeared in 5 patients (15.6%) and Grade 3 dysphagia in 7 patients (21.9%).

Conclusion: Two cycles of TPF IC demonstrate good tolerance and efficacy, making them a viable option for sequential treatment of locally advanced H&N cancers in Indian settings.

VALORIZATION OF ANTIOXIDANT, ANTICANCER ACTIVITIES, AND PHYTOCHEMICAL ANALYSIS OF ETHANOLIC EXTRACT OF EUPHORBIA CUNEATA VAHL., AND ITS EFFECT ON THE EXPRESSION OF P53, RAF-1AND CASP3 GENES

2025-02-08T15:38:07+0530

Objective: Euphorbia cuneata Vahl. (E. cuneata) is used in traditional medication to relieve inflammation and pain, while the biological foundation of these actions has not been fully explored. The purpose of this work was to explore the pharmacological characteristics and classification of flavonoid and phenolic constituents found in aerial parts of E. cuneata.

Methods: E. cuneata was examined for cytotoxic effects, antioxidant activity, and cell viability. The flavonoid and phenolic contents, and fugacious constituents were also characterized; furthermore, the expression levels of Raf-1, P53, and Casp3 genes using qRT-PCR method were investigated.

Results: Ethanolic extract (EE) of E. cuneata showed the highest antioxidant activity, the antioxidant activity increased from (25.12) at 10 μg/mL to (97.90) at 1280 μg/mL. The EE has an IC50 of 28.52 μg/mL. E. cuneata EE extract had strong cytotoxic effects on human cell lines of lung cancer (H1299), breast cancer (MCF7), and colon cancer (HCT-116), respectively according to the MTT test; with lower IC50 (125.01, 149.56 and 148.56) μg/mL, respectively. The most common phenolic acid identified in the EE extract of E. cuneata was pyrogallol, in addition, the most abundant flavonoid was found to be 7-hydroxyflavone; on the other hand, GC mass analysis showed that the EE extract was rich in methyl 12-hydroxy-9-octadecenoate. Treatment of H1299 with the IC50 of EE resulted in a considerable downregulation of Raf-1 gene and upregulation of P53 and Casp3 genes.

Conclusion: We may infer that the EE extract of E. cuneata includes natural bioactive components, moreover antioxidant and anticancer characteristics, which may have therapeutic potential.

A A STUDY OF MUSCULOSKELETAL DISORDERS AMONG ADULT POPULATION IN RURAL FIELD PRACTICE AREA OF A MEDICAL COLLEGE IN WESTERN MAHARASHTRA

2025-02-01T15:43:14+0530

Objectives: The present study was conducted to find the prevalence of selected musculoskeletal disorders (MSDs) in the rural field and to describe these disorders concerning certain sociodemographic factors.

Methods: The study is a community-based cross-sectional study undertaken in the village of western Maharashtra. A total of 330 subjects were included by systematic random sampling. The study included all adults (>18 years) and permanent residents of the study area. The interview of subjects was conducted through contacting by door-to-door survey in the community. A predefined questionnaire was used to interview the included subjects.

Results: The prevalence of MSDs was 33.03%. The development of MSD was more common in patients with >60 years (56.2%). Moreover, illiterate (52.8%), professionally working (41.1%), overweight (51.8%), married group (36.9%), and heavy workers (54.9%) showed significant differences in the incidence of MSDs.

Conclusion: The MSDs in the present study had a higher prevalence with certain sociodemographic factors determining its occurrence. The mainstay for the prevention of MSDs is early diagnosis, education of the people in rural areas about the importance of early diagnosis, and motivating them to seek early treatment.

ISOLATION AND SCREENING OF L-ASPARAGINASE PRODUCING SPHINGOMONAS SP. FROM SOIL SAMPLE

2025-02-01T11:38:25+0530

Objectives: In recent years, L-asparaginase has gained attention due to its anticancer activity. Different types of asparaginase possess different characteristics and different applications. The study is designed to screen potential L-asparaginase producing bacteria from soil samples.

Methods: Soil samples were collected from different locations in Tamil Nadu and Kerala for the isolation of L-Asparaginase-producing bacteria.

Results: About 689 isolates were obtained from 114 samples. Among these, 214 isolates possess the ability to synthesize L-asparaginase. Fifteen isolates were selected for quantitative screening based on the intensity of the pink color formation M9 basal medium.

Conclusion: The isolate VN01 exhibited a higher degree of enzyme activity (156 IU/mg). The isolate was further categorized by phenotypic and genotypic method and the isolate was identified as Sphingomonas leidyi. As a future aspect, the study will be continued for optimization of increased production of L-asparaginase and in characterizing the potential of L-asparaginase synthesized by S. leidyi.

IMPACT OF ANTI-HYPERTENSIVE AGENT ON ANTI-DIABETIC DRUG IN DIABETIC AND NON-DIABETIC RATS – ASSESSMENT OF DRUG–DRUG INTERACTIONS

2025-01-30T12:56:05+0530

Objectives: The investigation was planned to evaluate pharmacokinetic and pharmacodynamic drug communication of Captopril and Metformin in healthy and diabetic albino Wistar rats succeeding single and many dosage treatments.

Methods: Therapeutic doses of captopril and metformin were administered to animal models, blood glucose levels were assessed by glucose oxidase-peroxidase (GOD-POD) method technique, and plasma captopril and metformin amounts were estimated by reversed-phase high-performance liquid chromatography (HPLC) technique to compute the pharmacokinetic attributes. In the present work, the pharmacokinetic and pharmacodynamic interaction between captopril and metformin was evaluated. Pre-clinical investigation might be supportive of evading drug–drug interactions in medical conditions. By means of HPLC, concentration versus time data were plotted for direct extraction of the pharmacokinetic attributes, peak plasma concentrations (Cmax), and time to reach peak concentration (tmax). The linear trapezoidal rule was used in this work to compute AUC from 0 h to 24 h, which is denoted by AUC 0-t.

Results: In the determination of fasting serum glucose concentration in normal and streptozotocin-inducted diabetic animals on day 1 and day 8, there was a tremendous decline in the glucose levels in a significant manner (**p<0.001). When captopril alone administered group was compared to the group in combination with metformin on days 1 and 8, there was no significant variance in Cmax, Tmax, AUCo-t, and AUCo-inf.

Conclusion: The results concluded from the kinetic analysis revealed that there were no significant interactions in the kinetic parameters of metformin and captopril, both alone and in combination. However, further possible investigations are needed which might be helpful for diabetes.

COMET ASSAY TO STUDY DNA DAMAGE CAUSED BY DIFFERENT STRESS INDUCERS IN THE RIBOFLAVIN OVERPRODUCER EREMOTHECIUM ASHBYII

2025-01-30T09:35:33+0530

Objectives: The present study focuses on investigating morphological changes and genotoxicity effects due to physical and chemical mutagens such as riboflavin, ethidium bromide (EtBr), pH, and ultraviolet (UV).

Methods: Riboflavin doses were given at 0.2 mM. 0.4 mM, 0.8 mM, and 1.0 mM concentration, pH stress doses were given by adjusting the pH of the medium to pH 3.0, pH 5.0, and pH 7.0 whereas EtBr stress doses were 1.0 μL and 0.5 μL and UV radiation stress doses were given for 5 min, 10 min, 15 min. Our study reports at using a modified alkaline yeast comet assay methodology to detect DNA damages in Eremothecium ashbyii caused by stress inducers. Fluorescence microscopy was used to detect the comets and CaspLab software to quantify the intensity of DNA damages.

Results and Conclusion: The metrics employed for the quantification of DNA damage under the specified stressful circumstances were, tail DNA, olive tail moment (OTM), and the tail moment (TM). The statistical analysis of the DNA damage doses with CaspLab parameters to detect DNA damage shows maximum DNA damages at pH 5.0 with the highest peak for OTM value followed by UV damage at 15 min. Our study reports the first case using the comet assay technique to detect the DNA damages in the filamentous E. ashbyii cells.

FORMULATION AND OPTIMIZATION OF FLOATING SUSTAINED RELEASE TABLETS OF ATAZANAVIR SULFATE THROUGH BOX-BEHNKEN DESIGN

2025-01-27T13:03:45+0530

Objective: Atazanavir (ATZ) sulfate is widely prescribed as an antiretroviral drug belonging to BCS class II with low solubility. This research aims to design, formulate, and optimization of floating sustained-release tablets of ATZ through Box-Behnken design (BBD).

Method: The formulation parameters were optimized using the BBD. Methocel K100M (A) was chosen as the primary release-retarding polymer, Sodium Bicarbonate (B) served as the gas-generating agent, Ethyl Cellulose (C) was utilized as an additional release-retarding polymer, and Cetyl Alcohol as a floating assistant. In this design, A, B, and C were designated as independent variables, while three response variables floating lag time (FLT) (Y1), swelling index (Y2), and percentage drug release (Y3) were selected as the dependent variables. The compatibility of the drug and excipients was evaluated through Fourier-transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and morphology by scanning electron microscopy. Tablets were prepared through the direct compression method and subsequently evaluated for parameters including FLT, flotation time, swelling index, hardness, drug content, friability, in vitro drug release, and drug release kinetics.

Results: FTIR and DSC investigations revealed no interaction between the drug and the excipients, physical mixture of the drug and the excipients indicated the amorphous state of ATZ. All the evaluated tablets showed satisfactory results. The drug release from the validated optimized tablets was gradual and sustained over 12 h (99.76±0.75) following zero-order kinetics.

Conclusion: The optimized tablets with desirable formulation characters were determined through a statistical optimization model and the optimized formulation remarkably sustained the drug release for up to 12 h, indicating its improved therapeutic potential for the treatment of HIV.

IN SILICO SCREENING FOR IDENTIFICATION OF NOVEL NON-PEPTIDIC FALCIPAIN 3 INHIBITORS BY VIRTUAL SCREENING, MOLECULAR DOCKING, AND MD SIMULATION

2025-01-23T13:16:16+0530

Objective: The development of two new non-peptidic inhibitors against Falcipain 3 using computer-aided design.

Methods: The researchers started by narrowing down a virtual library of compounds from the PubChem database to 800 drug-like compounds, which were then virtually screened and docked to identify the two most promising inhibitors. The screened compounds were then further studied using Molecular Dynamics Simulation.

Results: The screened compounds were found to have potent antimalarial activity in silico.

Conclusion: The proposed two lead compounds would serve as excellent targets for antimalarial drug. The efficacy of these potent inhibitors could be validated with laboratory experiments, with the goal of eventually developing an anti-malarial drug.

The THERAPEUTIC POTENTIAL: UNDARIA PINNATIFIDA AND MORINGA OLEIFERA EXTRACTS AS MODULATORS OF ADIPOGENESIS IN 3T3-L1 ADIPOCYTES

2024-11-27T19:43:52+0530

Objectives: The objectives of the study are to investigate the effects of ethanolic extract of Undaria pinnatifida (UPEA) and methanolic extract of Moringa oleifera (MOM), alone and in combination, on the differentiation and viability of 3T3-L1 pre-adipocytes.

Methods: 3T3-L1 pre-adipocytes were treated with varying concentrations of UPEA, MOM, and their 1:1 combination. The impact on pre-adipocyte differentiation was assessed by measuring lipid accumulation. Cell viability was determined using a standard viability assay to evaluate cytotoxicity across a range of concentrations.

Results: UPEA and MOM, individually and in combination, reduced lipid accumulation in 3T3-L1 cells in a dose-dependent manner, thereby inhibiting differentiation into adipocytes. The combination treatment (1:1 ratio) demonstrated similar efficacy in reducing differentiation. Viability assays revealed minimal cytotoxic effects, with cell viability ranging from 89% to 99% across all tested concentrations.

Conclusion: UPEA, MOM, and their combination exhibit potent anti-adipogenic effects while maintaining low cytotoxicity in 3T3-L1 pre-adipocytes. These findings suggest their potential as therapeutic agents for conditions related to adipogenesis, warranting further studies on their biological activities and therapeutic mechanisms.

TRACE LEVEL QUANTIFICATION OF C1-C3 ALKYL CHLORIDE GENOTOXIC IMPURITIES IN TRIMETAZIDINE DI HYDROCHLORIDE DRUG SUBSTANCE USING STATIC HEADSPACE GAS CHROMATOGRAPHY

2025-01-19T22:19:40+0530

Objectives: The objective of this study was to develop and validate a gas chromatography-headspace (GC-HS) method for the quantification of genotoxic alkyl chloride impurities (chloromethane, ethyl chloride, and isopropyl chloride) in trimetazidine dihydrochloride, ensuring compliance with International Council for Harmonization M7 guidelines.

Methods: A GC-HS method was optimized using a DB-1 column (60 m×0.32 mm, 3.0 μm) with nitrogen as the carrier gas. Key parameters included HS conditions with an oven temperature of 95°C, sample line temperature of 105°C, and transfer line temperature of 115°C, along with a split ratio of 1:10 and a flow rate of 10.2 psi. The oven temperature program was set to start at 40°C for 15 min, followed by an increase of 30°C/min to 250°C, held for 15 min. Method validation assessed linearity, detection limits, quantification limits, accuracy, precision, and solution stability.

Results: The method exhibited excellent linearity (r²>0.999), low limits of detection (0.6 ppm) and quantification (1.8 ppm), and high accuracy (91.0–114.0% recovery). Precision was confirmed with relative standard deviations below 5%. Sample solutions remained stable for up to 48 h, demonstrating the method’s robustness and reliability for routine analysis.

Conclusion: The developed GC-HS method is a robust, accurate, and regulatory-compliant approach for the trace-level quantification of genotoxic alkyl chloride impurities in trimetazidine dihydrochloride, ensuring the safety and quality of the pharmaceutical product.

COMBINATION OF FRANGIPANI (PLUMERIA ALBA) FLOWER ETHANOL EXTRACT AND SEAWEED (ULVA LACTUCA) EXTRACT AS A NATURAL SUNSCREEN CREAM

2025-01-19T20:06:08+0530

Objective: This study evaluated the potential of frangipani (Plumeria alba) flower extract and seaweed (Ulva lactuca) extracts as natural sunscreen cream.

Methods: An experimental design with a randomized group approach was used, involving five sample groups. The sun protection factor (SPF) value was determined using an ultraviolet (UV)–visible spectrophotometer. Frangipani and seaweed were extracted using ethanol and formulated into a cream.

Results: The combination of 3% frangipani flower extract and 3% seaweed extract resulted in the highest SPF value of 17.6, demonstrating its effectiveness as a protector against UV radiation.

Conclusion: This study concludes that frangipani flower extract and seaweed extract are promising natural ingredients for use as safe, environmentally friendly sunscreens. These findings contribute to the utilization of local natural resources and the development of safer, ingredient-based cosmetic products.

THE ROLE OF VITAMIN D SUPPLEMENTATION TO FIRST-LINE ANTI-TUBERCULOSIS TREATMENT IN TREATMENT COURSE OF PULMONARY TUBERCULOSIS

2025-01-18T12:46:17+0530

Objectives: The objective of the study was to study the role of Vitamin D supplementation to first-line anti-tuberculosis treatment (ATT) in the treatment course of pulmonary tuberculosis (TB).

Methods: This study was conducted on sputum acid-fast bacilli (AFB) positive outpatient department and inpatient department patients who had presented to Batra Hospital and Medical Research Centre, New Delhi. We had included 66 patients who were newly diagnosed sputum smear AFB positive. The patients were divided into two groups. Each subject signed a special consent form that was written in simple phrase. The procedure and the aim of the work were explained to all the subjects in simple language and due consent was taken.

Results: Majority of the patients in Group 1 (cases) were in age group of 51–60 years (30%) and in Group 2 (controls) were in age group of < 30 years (27%). Mean age was found to be comparable in both groups, which was 46.3±17.91 years in Group 1 (cases) and 47.46±17.27 years in Group 2 (cases). Gender ratio was also comparable in both groups with 60.61% males and 39.9% females in Group 1 (cases), and 72.73% males and 27.7 % females in Group 2 (controls). In Group 1 (cases) mean TB score was 5.82±1.01 and in Group 2 (controls) mean TB score was 5.94±1.09 (p=0.683). After 2 months mean TB score in Group 1 was 1.7±1.38 and in Group 2 was 2.94±1.82. There was a statistically significant difference in TB score between the two groups (p=0.0002).

Conclusion: In the present study, we found that the majority of the patients enrolled were males, this could have been due to less accessibility of females to medical healthcare facility due to social factors. Patients who received Vitamin D along with first-line ATT had early sputum smear conversion as compared to those who were on ATT only. Furthermore, patients who received Vitamin D with ATT had better TB score after 2 months of therapy as compared to patients on first-line ATT only. Thus, Vitamin D supplementation to first-line ATT can reduce time to sputum conversion and accelerate clinical improvement.

PULSED ELECTROMAGNETIC FIELD THERAPY USING SENTIENT ELEMENT FOR MANAGEMENT AND CHONDROPROTECTIVE EFFECTS ON HUMAN ARTICULAR CARTILAGE IN EARLY-STAGE OSTEOARTHRITIS: AN OBSERVATIONAL AND OPEN-LABEL PILOT STUDY

2025-01-16T10:54:28+0530

Objectives: The present study aimed to evaluate the role of pulsed electromagnetic field therapy (PEMF) in managing pain, stiffness, and chondroprotective effects on human articular cartilage in early-stage osteoarthritis (OA).

Methods: In the present study the effectiveness of PEMF in Osteoarthritis (OA) patients was conducted using an open-label pilot study and observational data. Ten people with OA in their left and right knees were included. The standard error of the mean, or Mean±Standard deviation, was used to express all data. An IBM Statistical package for the social sciences (SPSS) software (version 11.0) was used to analyse the significance of evaluated parameters. T-test was used to examine the information gathered from clinical interventions.

Results: The result of the study discussed the before and after effect of the PEMF therapy in OA patients with knee pain in both legs. The knee pain and physical function were decreased in the patients for both the legs after the therapy. Using statistical tests, pain score, stiffness score, and cartilage health were analyzed in the patients to record a significant effect of PEMF therapy.

Conclusion: All the examination reports exerted positive effects of the implementation of the therapy in pain management and enhancing mobility of the knee joints.

A STUDY TO EVALUATE THE EFFECTS OF MULTIPLE ORAL DOSES OF BILASTINE, DESLORATADINE, AND LEVOCETIRIZINE ON PSYCHOMOTOR PERFORMANCE AND SALIVARY FLOW IN PATIENTS WITH CHRONIC URTICARIA ATTENDING DERMATOLOGY OUTPATIENT DEPARTMENT AT A TERTIARY CARE CENTER

2025-01-15T16:19:33+0530

Objectives: Antihistamines are the most used systemically delivered medications for skin conditions that can inhibit cholinergic (muscarinic) receptors and block central H1 receptors leading to effects such as dryness of mouth and sedation, respectively. Bilastine, desloratadine, and levocetirizine are second-generation antihistamines which have variable effects on dryness of mouth and sedation; hence, the objective of this study is to evaluate any differences in these effects in chronic urticaria patients prescribed the above-mentioned antihistamine drugs.

Methods: Subjects with chronic urticaria who were prescribed any of the three antihistamines by the dermatologist were enrolled. Baseline readings of salivary flow by cotton ball method and psychometric performances by digit letter substitution test (DLST), six letter cancellation test (SLCT), card sorting test, and Visual Analog Scale (VAS) for dryness of mouth and sedation measured before administration of prescribed antihistaminic drug and compared with readings taken of the same tests after 7 days of antihistaminic drug administration.

Results: A total of 36 subjects were enrolled median age of 38.5 years (range 18–57 years) and 55% (20/36) were males. Reduction in the mean salivary flow and the psychomotor performance were not significantly different between the three drug groups, although there were reductions in the three groups in the outcome measures salivary flow and psychomotor performance tests including DLST and SLCT when compared to baseline.

Conclusion: The three drugs are similar with respect to their adverse effect profile in terms of causing dryness of mouth and impairment of psychomotor performance.

NEUROPROTECTIVE EFFECT OF 7,3´-DIHYDROXYFLAVONE AGAINST PACLITAXEL-INDUCED NEUROTOXICITY IN SH-SY5Y NEUROBLASTOMA CELL LINE: AN IN VITRO MODEL

2025-01-11T12:17:36+0530

Objectives: Paclitaxel (PT) induced peripheral neuropathy is associated with the neurotoxic effects of this chemotherapeutic drug. As a result, the need for natural substances that can mitigate neural toxicity is rising. This study investigated the Neuroprotective effects of 7,3´-dihydroxyflavone (7,3´-DHF) on PT-induced neurotoxicity in SH-SY5Y neuroblastoma cells.

Methods: The cells were exposed to a 1 μM concentration of PT, and the protective effects of various concentrations of 7,3´-DHF were evaluated. The reactive oxygen species (ROS) level in SH-SY5Y cells was measured using confocal fluorescence microscopy. The concentration of proinflammatory cytokines, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) was determined by enzyme-linked immunosorbent assay.

Results: Treatment of SH-SY5Y cells with 1 μM PT significantly reduced cell viability to 19±4.8%. However, treatment with 7,3´-DHF in PT-exposed cells elevated SH-SY5Y cell viability in a dose-dependent manner, with viability reaching 55.34±3.8% and 83.93±4.1% at 7,3´-DHF concentrations of 75 μg/mL and 100 μg/mL, respectively. PT exposure elevated ROS levels in SH-SY5Y cells, but the presence of 7,3´-DHF reduced ROS levels against PT-induced toxicity. In addition, treatment with 7,3´-DHF lowered the increased levels of IL-6 and TNF-α induced by PT exposure.

Conclusion: 7,3´-DHF effectively preserved the viability of SH-SY5Y cells under PT-induced toxicity. This protective effect was mediated through the suppression of ROS production and the attenuation of proinflammatory cytokine release, highlighting its potential as a neuroprotective agent.

ASSESSMENT OF KNOWLEDGE, ATTITUDES, AND PRACTICES REGARDING ANTIBIOTIC USE AND RESISTANCE AMONG COMMUNITY PHARMACISTS IN SANA’A (YEMEN)

2025-01-09T04:07:07+0530

Objectives: This study aims to assess pharmacists’ knowledge, attitudes, and practices regarding over-the-counter antimicrobial use and antimicrobial resistance.

Methods: We conducted a cross-sectional descriptive study using a self-administered questionnaire for pharmacists in Sana’a city, Yemen.

Results: An arithmetic mean of 2.5 and a standard deviation of 1.25 rated the level of knowledge among community pharmacists in Sana’a, Yemen, concerning antibiotic use and resistance as low. We rated the attitudes toward antibiotic use and resistance among community pharmacists in Sana’a, Yemen, at a medium level, with an arithmetic mean of 3.18 and a standard deviation of 1.25. In addition, we rated the rate of practices concerning antibiotic use and resistance among community pharmacists in Sana’a (Yemen) as medium, with an arithmetic mean of 2.7 and a standard deviation of 1.08. We observed no notable differences in age, educational level, or years of experience among community pharmacists; however, we identified a significant difference in gender at a level of 0.003. There is no significant correlation between the age, educational level, years of experience, gender, and knowledge variables of community pharmacists. There exists a notable correlation between gender and attitude, alongside a weak inverse correlation between gender and practice variables.

Conclusion: Community pharmacists in Sana’a, Yemen, rated their knowledge, attitudes, and practices regarding antibiotic use and resistance poorly, with an arithmetic mean of 2.5 and a standard deviation of 1.25. Community pharmacists in Sana’a, Yemen, assessed their attitudes toward antibiotic use and resistance as moderate, with a mean score of 3.18 and a standard deviation of 1.25. Ultimately, at the 0.05 significance level, there is no statistically significant correlation between the average responses of community pharmacists regarding the research variables (age, educational level, years of experience, gender) and their association with knowledge variables. We observe a statistically significant correlation between the gender variable and attitude, with a significance level of 0.005. A weak inverse correlation exists between gender and practice variables. A statistically significant correlation exists between knowledge and practice.

GLOBAL LONGITUDINAL STRAIN AS A PREDICTOR OF CARDIOTOXICITY IN BREAST CANCER PATIENTS RECEIVING ANTHRACYCLINE AND/OR TRASTUZUMAB TREATMENT IN A TERTIARY CARE CENTRE IN EASTERN INDIA

2025-01-08T16:57:16+0530

Objectives: The objective of the study was to find out whether global longitudinal strain (GLS) poses as a novel marker of left ventricular (LV) systolic function and it was to be seen whether GLS could predict cardiotoxicity earlier than Ejection fraction (EF).

Methods: Fifty-two patients set to receive anthracycline and/or trastuzumab-based chemotherapy for breast carcinoma were selected – clinical parameters and baseline echocardiography (EF, E/e,’ LV S,’ Tricuspid annular plane systolic excursion, Pulmonary artery systolic pressure and GLS) were measured and followed up at 3 months and 6 months. The echocardiography profiles of patients with and without cardiotoxicity were compared.

Results: Incidence of cardiotoxicity is found 11.5%. On 3rd month, the mean LV GLS, as well as its difference regarding the baseline value, were significantly higher in the group with cardiotoxicity in comparison to those without cardiotoxicity. On 6th month, there was a significant drop in the EF and LV GLS, E/e’, and LV s’ in the patients with cardiotoxicity. LV GLS on the 3rd month remained an independent predictor of cardiotoxicity, maintaining a statistically significant association in multivariate models.

Conclusion: GLS is indeed a more sensitive marker of LV systolic functions than EF. It predicted cardiotoxicity earlier than EF and accurately. This study also provided a cutoff value for LV GLS at 3 months in predicting who would develop cardiotoxicity at 6 months, so that the chemotherapy regimen could be modified in such patients.

DEVELOPMENT AND VALIDATION OF A STABILITY-INDICATING HIGH PERFORMANCE LIQUID CHROMATOGRAPHIC METHOD FOR THE QUANTITATIVE DETERMINATION OF NITAZOXANIDE AND IT’S RELATED SUBSTANCES IN ACTIVE PHARMACEUTICAL INGREDIENTS

2025-02-14T21:54:01+0530

Objective: Nitazoxanide (NAT) is a veterinary antibiotic used for the treatment of protozoal infections in livestock and sheep. The estimation of NAT, its process impurities, and degradation products have not been reported till date. In this study, we aimed to develop and validate a chromatographic separation method for the determination of NAT, its process impurities, and related substances as per International Conference on Harmonization (ICH) guidelines.

Methods: Chromatographic separation of process impurities such as 2-amino-5-nitro thiazole also called NAT-related substance A, aspirin, and degradation impurities such as salicylic acid and tizoxanide (TIZ) were separated by reverse-phase high-performance liquid chromatography using gradient elution. The separation of NAT and TIZ was most critical as they are structurally similar. The mobile phase consisted of a gradient elution containing a composition of acetonitrile and 2% orthophosphoric acid solution adjusted to pH 2.5 at a flow rate of 1 mL/min. Separation was achieved on a YMC Pack C8 L7 column with a run time of 40 min. The detection was carried out using a photodiode array detector and quantification was carried out at 210 nm. Forced degradation study was also conducted to confirm the specificity. The robustness and ruggedness of the method were evaluated.

Results: The relative retention times (RRT) for aspirin, salicylic acid, NAT, and TIZ were 6.33, 6.52, 22.43, and 6.45, respectively, indicating good separation. The asymmetry factor for all the peaks is ranged from 1.1 to 1.2 indicating acceptable chromatography. The % recovery from spiked studies ranged from 90% to 110% for all the impurities when spiked in the range of 50–150% of their nominal concentrations. For all the known impurities, the limit of detection ranged from 0.06 to 0.20 parts per million (ppm) and the limit of quantification ranged from 0.19 to 0.61 ppm.

Conclusion: The method was validated as per ICH guidelines and further was successfully applied for the quality evaluation of NAT in bulk active pharmaceutical ingredients.

POLYMERIC CLIP VERSUS ENDOLOOP FOR STUMP CLOSURE IN LAPAROSCOPIC APPENDICECTOMY-A RANDOMISED CONTROL TRIAL

2025-02-22T13:51:14+0530

Objectives:: In laparoscopic appendicectomy, stump closure can be done by various methods such as endoloop, extracorporeal knots, intracorporeal ligatures, and gastrointestinal staplers. Polymeric clip was used in several studies in the closure of appendicular stump because of its lower cost and easy implementation.

The purpose of this study is to investigate the safety, usefulness, and cost-effectiveness of polymeric clips versus endoloop in laparoscopic appendicectomy.

Methods: We conducted a single blinded randomized controlled study on 100 patients of laparoscopic appendicectomy and divided them patients randomly into two groups (50 each) on the basis of technique used for stump closure (polymeric clip and endoloop).

Results: On comparing the two matched groups we found there was a significant reduction in cost (35.36±3.29 vs. 39.56±3.12, respectively, *p<0.05) and operative time (909.00±63.64 vs. 1164.00±70.54, respectively, *p=0.05) in the group of polymeric clip as compared to endoloop. Although the post-operative complications and length of hospital stay were comparable in both the groups.

Conclusion: Polymeric clip is not only a cost-effective option for patients but also a time-saving alternative for surgeons, while maintaining equally safe surgical outcomes when compared to endoloops.

FUNCTIONAL OUTCOME OF FISTULECTOMY WITH PRIMARY REPAIR OF SPHINCTER IN TREATMENT OF COMPLEX FISTULA IN ANO

2025-02-22T13:50:00+0530

Objective: Afistula in ano is a common surgical issue encountered all over the world. There are multiple treatment options, especially in transphincteric fistulas, creating dilemma in choosing the best. However, fistulectomy is a time-tested treatment with a low recurrence rate, but stool incontinence due to anal sphincter injury is the two most severe side effects of treating anal fistulas. The objective of the study was to evaluate the surgical outcome of “fistulectomy with primary repair” for the treatment of complex fistula in ano involving anal sphincter.

Methods: The prospective observational study was conducted including 43 patients undergoing fistulectomy with primary repair of sphincter for fistula in ano. The following outcomes were evaluated on follow-up: Incontinence, recurrence, pain, bleeding, wound dimension, healing time, and length of hospital stay.

Results: In the present study, it was observed that fecal incontinence was present in none of the patients in the post-operative period while 4 patients (9%) had mild flatus incontinence. Only one patient had a recurrence of fistula at post-operative day 180.

Conclusion: For the treatment of complex anal fistulas, Fistulectomy with Primary Repair of Sphincter is a safe and efficient procedure that has a promising success rate and also has minimal impact on continence

EVALUATION OF WHOLE BLOOD AND BLOOD COMPONENTS DISCARD IN A GOVERNMENT HOSPITAL – A TERTIARY CARE HEALTH FACILITY

2025-01-22T21:33:19+0530

Objectives: There is no artificial substitute for blood to date. The discard of blood and its components remains a persistent challenge for maintaining adequate blood inventory. The present study was conducted to analyze the various reasons for discarding whole blood (WB) and blood components in a blood bank attached to a tertiary care setup. It is also intended to introduce various possible strategies for minimizing blood wastage.

Methods: A retrospective study of 3 years with effect from January 2021 to December 2023 was carried out and data were collected from records available with the blood center.

Results: During this study, a total of 16874, 22590, and 22676 blood units were collected during 2021, 2022, and 2023, respectively. It was observed that out of the total collection of 62140 units, 1686 (2.71%) were discarded as WB+Packed red blood cells. The discard rate for platelets and fresh frozen plasma was 45.4% and 10.9%, respectively. The various reasons for discard were seropositivity, expiry, suboptimal volume, non-utilization after issue, red cell contamination, lipemia, leakage, and hemolysis.

Conclusion: To minimize discard of blood and its components, a multifaceted approach is required. It includes improving blood collection practices, proper storage and processing techniques, regular audits, following first in first out policy, and rational use of blood and its components.

SCRUB TYPHUS – THE DANGER OF BEING UNDETECTED: LABORATORY INVESTIGATIONS AND CONTEMPORARY INFECTIONS

2025-01-12T09:44:04+0530

Objectives: To identify scrub typhus cases among acute undifferentiated febrile illness (AUFI) by laboratory investigations. To determine the efficacy of immunoglobulin M-enzyme-linked immunosorbent assay (IgM-ELISA) in detecting the cases of scrub typhus and to compare the Weil–Felix test, rapid test, and IgM-ELISA for the diagnosis of scrub typhus.

Methods: A total of 110 AUFI cases participated (65 from rural, 16 from semi-urban, and 29 from urban setups; 33 farmers, 15 animal rearing workers, nine drivers, 19 laborers, and 34 other jobs). Blood was collected after due explanation and consent.

Results: The Weil–Felix test tested 22 samples as positive, whereas the rapid card test, IgM-ELISA, and polymerase chain reaction detected 15 samples as positive for infection. The sensitivity and specificity of the Weil–Felix test were 66.67% and 87.36%, respectively. The sensitivity and specificity of the rapid card test and IgM-ELISA were 100%. There were coinfections with Leptospira, typhoid, and COVID-19.

Conclusion: Laboratory investigations revealed the various organ systems the disease could affect and that it could serve to determine the prognosis. The use of rapid card tests is on par with IgM-ELISA, making it a suitable candidate for diagnosing in remote setups.

ORAL MUCOSITIS INDUCED BY RADIATION/CHEMOTHERAPY; CHALLENGES IN THERAPEUTIC IMPLICATIONS AND FUTURE PROSPECTS

2025-01-22T12:43:11+0530

Oral mucositis (OM) is a common and debilitating side effect of cancer treatments, primarily chemotherapy and radiotherapy. Inflammation of the oral mucosa leads to various severe outcomes, which affect the quality of life in patients. Sometimes, inhibition of treatment may be necessary, which may lead to insubstantial evasion of cancer therapy. The review article discusses current prevention and management techniques, such as oral hygiene protocols, cryotherapy, low-level laser therapy, and pharmacological interventions, including palifermin. It also comments on the risk factors that include the type of cancer, treatment protocols, and patient-related factors. It finally speaks about the clinical and economic impact of OM in the treatment of cancer and healthcare systems.