International Journal of Current Pharmaceutical Research
International Journal of Current Pharmaceutical Research (Int J Curr Pharm Res) is a peer-reviewed, bimonthly (onward march 2017) open access journal. This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy and pharmaceutical sciences (Pharmaceutical Technology, Pharmacognosy, Natural Product Research, Pharmaceutics, Novel Drug Delivery, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest). The Journal publishes original research work either as a Full Research Paper or as a Short Communication. Review Articles on a current topic in the said fields are also considered for publication by the Journal.
INCIDENTAL DETECTION OF PRIMARY STRUMAL CARCINOID TUMOR IN A NORMAL SIZE OVARY: A RARE CASE REPORT WITH AVAILABLE REVIEW OF LITERATURE
Struma ovarii is an extremely rare type of malignant germ cell tumor and its incidence is 0.1% of all ovarian malignancies. Only 5 percent of carcinoid cancers originate in the ovary. The histopathology is a combination of carcinoid and thyroid tissue along with other components of mature teratoma. In this case, patient was presented with irregular menses only. No ovary related symptoms were seen. We are
Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
AUTOIMMUNE HAEMOLYTIC ANEMIA IN 40 Y FEMALE: A CASE REPORT
The uncommon disorder referred to as autoimmune hemolyticanemia (AIHA) occurs when the immune system mistakenly attacks red blood cells, leading to the production of autoantibodies by the patient's body that destroy erythrocytes. A 40 y old female presented with complaint of shortness of breath aggravated on exertion, chest pain, palpitation over chest for 15 d. At the time of admission, her Hb was 5.5 g/dl, She is a case of autoimmune hemolyticanemia, ANA immunoblot shows Ro 60 was positive.
The pandemic of Coronavirus Disease-2019 (COVID-19) still remains a threat. Its treatment led to the repositioning of many drugs. Piroxicam is one of the non-steroidal anti-inflammatory drugs, which inhibits prostaglandin synthesis and has antiviral activity against NRC-03-nhCoV. Lymphopenia is one of the severity indicators in COVID-19. Cytokine storm is responsible for significant morbidity and mortality in COVID-19. Piroxicam has been shown to induce bone marrow Lymphopoiesis and inhibit Tumour necrosis factor alpha (TNF-α), TNF-γ, actively involved in the cytokine storm.
PHARMACOLOGICAL EVALUATION OF ANTI-PARKINSON ACTIVITY OF DELPHINIUM DENUDATUM (JADWAR) FLOWERS ETHANOLIC EXTRACT IN MICE
Objective: This study aimed to evaluate the neuroprotective effects of ethanolic extracts of Delphinium denudatum (Jadwar) flowers in an MPTP-induced mouse model of Parkinson’s disease (PD). Methods: Parkinsonism was induced in Swiss albino mice using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Mice were divided into five groups: control, negative control (MPTP), standard drug (Levodopa+Carbidopa), and two test groups receiving low (200 mg/kg) and high (400 mg/kg) doses of the ethanolic extract. The extract was administered orally for 7 d, followed by MPTP injections for another 7 d. Behavioral assessments were conducted using rota rod test, hanging test, forced swim test, open field test, actophotometer, elevated plus maze, and catalepsy bar test. Results: The high-dose group (400 mg/kg) demonstrated significant improvement in motor coordination, grip strength, reduced immobility time, enhanced locomotor activity, and decreased cataleptic behavior compared to the MPTP group. These results were comparable to those observed in the standard treatment group, indicating a potential neuroprotective effect of the plant extract. Conclusion: Delphinium denudatum ethanolic flower extract showed promising anti-parkinsonian activity by mitigating MPTP-induced motor and behavioral deficits in mice. This suggests its potential as a complementary therapeutic strategy for managing Parkinson’s disease, warranting further clinical exploration.
Copyright (c) 2025 AKASHDEEP, AJEET PAL SINGH, AMAR PAL SINGH https://creativecommons.org/licenses/by/4.0
DEMOGRAPHIC DISTRIBUTION AND ADVERSE DRUG REACTION PATTERN OF ANTI-TUBERCULAR AND ANTIDIABETIC THERAPY IN PATIENTS OF TUBERCULOSIS WITH DIABETES MELLITUS: A PROSPECTIVE OBSERVATIONALSTUDY AT TERTIARY CARE HOSPITAL
Objective: The objectives of present study to evaluate the prevalence of diabetes mellitus among tuberculosis patient at a tertiary health care center and to study the adverse drug reaction due to simultaneous use of anti-tubercular drugs with anti-diabetic drugs. Methods: A prospective observational cohort study was conducted from March 10, 2021, to July 9, 2022, at a tertiary care hospital, involving a total of 134 patients. The patient was approached as per NTEP guidelines. Age, gender, occupation, weight, and socioeconomic position were among the demographics that were noted and thoroughly examined. The screening for diabetes mellitus was done in patients with newly diagnosed tuberculosis. The adverse drug reactions due to the simultaneous use of antitubercular drugs with antidiabetic drugs were observed and compared with patients with tuberculosis without diabetes mellitus according to outcome parameters. Results: Glycosylated hemoglobin (HbA1c) was used to screen for diabetes mellitus in a representative sample of TB patients. Patients who self-reported having DM or whose HbA1c was ≥6.5% were considered diabetics. Out of the 323 newly diagnosed TB patients that were examined, 67 (18%) had diabetes mellitus; 31 (8%) had DM that they had previously identified, and 36 (10%) had just received a diagnosis. Men, whose average age was 47, had a higher prevalence (P=0.00001). 31 (23.13%) of the 134 TB patients who had previously been diagnosed with diabetes mellitus had an HbA1c of 10%, which indicates inadequate glycemic management. In the summarized result, we can observe that the prevalence rate of DM is 20.74% among TB patients. Compared to other research, this is higher. Over the course of the study, 35 ADRs were identified, recorded, evaluated, and reported. Assessment of the severity of the suspected ADRs revealed that 28.57% of suspected ADRs were severe and 71.42% of ADRs were moderate in severity as per the Modified Hartwig and Siegel Severity Assessment Scale. On the causality assessment by the WHO scale, most ADRs were classified as “possible” among both groups. Most patients who experienced adverse drug reactions were older than 50. The most frequently impacted system was the gastrointestinal tract (9.7%). As per the Modified Schumock and Thornton Preventability Assessment Scale, the preventability of ADRs was assessed, and the results revealed that 11.19% of ADRs were preventable. Conclusion: This study emphasizes that all newly diagnosed tuberculosis patients should be screened for diabetes mellitus, as there is a high prevalence of diabetes mellitus in tuberculosis patients. The concomitant use of anti-tubercular therapy and anti-diabetic therapy can cause adverse drug reactions as each group interacts with the other. Also,anti-tubercular therapy and anti diabetic therapy alone can cause adverse drug reactions.
Copyright (c) 2025 JEENAL MISTRY, ANITA SINHA, B. DIVAKAR, MRUGANK PATEL, NAYAN GAVLI https://creativecommons.org/licenses/by/4.0
COMPARATIVE ASSESSMENT OF ULTRASOUND-GUIDED BILATERAL ERECTOR SPINAE PLANE BLOCK AND LOCAL ANAESTHETIC INFILTRATION FOR PERIOPERATIVE PAIN MANAGEMENT IN LUMBAR SPINE FUSION SURGERIES
Objective: Effective management of postoperative pain is essential in lumbar spine fusion surgeries to promote early mobility and minimize side effects associated with opioids. This research evaluates the effectiveness of ultrasound-guided bilateral erector spinae plane block (ESPB) in comparison to local anesthetic wound infiltration for managing perioperative pain. Methods: A randomized, double-blinded, prospective study was carried out on 100 patients (ASA I and II) between the ages of 18 and 60, who were scheduled for elective lumbar spine fusion. Patients were divided into two groups: Group E was given bilateral ESPB consisting of 25 ml of 0.125% levobupivacaine and 4 mg dexamethasone on both sides; Group l received local infiltration with 25 ml of 0.125% levobupivacaine. Pain scores (NRS), duration until first rescue analgesia, total opioid usage within 24 h, Bruggemann Comfort Scale (BCS), and hemodynamic measures were documented. Results: Group E exhibited notably lower NRS scores at every time point (e. g., 2 h: 1.89±0.79 compared to 4.78±1.17; p<0.0001), extended duration until first rescue analgesia (8.15±2.85 h compared to 1.76±0.69 h; p<0.0001), and decreased tramadol usage (122.50±34.90 mg compared to 276.80±32.45 mg; p<0.0001). Group E demonstrated substantially improved BCS scores and hemodynamic stability. Conclusion: Bilateral ESPB is a reliable and efficient substitute for local infiltration, offering improved pain management and enhanced patient satisfaction following lumbar spine fusion.
Copyright (c) 2025 KANDIKONDA KOTESHWAR, KOTHAPALLI TEJA SRI RAKESH, NANNA VARUN KOUSHIK https://creativecommons.org/licenses/by/4.0
ANTIDEPRESSANT ACTIVITY OF PERICARPIUM GRANATI PEELS IN ALBINO MICE-A BENEFICIAL HERBAL TREATMENT STRATEGY
Objective: To evaluate Antidepressant Activity of ethanolic and aqueous peel extracts of Pericarpium Granatiin albino mice by using Forcedswim test (FST), Open field test (OFT) and tail suspension test (TST)) parameters. Methods: For the study, 25–40 g adult Laca albino mice of either sex, age between 4-5 mo procuredfrom Lala Lajpat Rai University of veterinary and animal sciences, Hisar (125004),India and were housed in polypropylene cage. They were maintained under standard laboratoryconditions (temperature 25±2º C with 12/12h night/dark cycle), were fed with standard pelletdiet and water ad libitum. Results: To evaluate the pharmacological effectiveness of various successive extracts of Pericarpium granati in Laca albino mice was investigatedin fourdifferent groups; Naive Control, Standard (Imipramine 10 mg/kg), Test Group-І, 200 mg/kg p. o. Pericarpium granati ethanolic extracts, Test Group-ІІ, 200 mg/kg p. o. Pericarpium granatiaqueous extracts. The numbers of parameters in relation to the depression were observed and thesignificant (P<0.01) decreased in the duration of immobility time were observed in Test Group-І(200 mg/kg) as compared to control group. Conclusion: This study clearly demonstrated that ethanolic extract of Pericarpium granati might serve as apowerful antidepressant agent in adult Laca albino mice without causing any serious toxiceffects.
Copyright (c) 2025 AMAN SHARMA, AJEET PAL SINGH, AMAR PAL SINGH, MAMTA KUMARI https://creativecommons.org/licenses/by/4.0
COMPARISON BETWEEN ISOFLURANE AND SEVOFLURANE IN THE MAINTENANCE OF HYPOTENSIVE ANAESTHESIA IN ENDOSCOPIC SINUS SURGERIES
Objective: To compare the efficacy of isoflurane and sevoflurane in maintaining controlled hypotensive anesthesia during ESS, focusing on intraoperative hemodynamics, blood loss, surgical field quality, recovery profile, and postoperative pain. Methods: This prospective randomized study included 80 ASA I/II patients aged 18–60 undergoing elective ESS. Patients were divided into two groups: Group I received isoflurane and Group S received sevoflurane. Hemodynamic parameters (MAP, HR), blood loss, surgical field visibility, recovery times, and postoperative pain (VAS scores) were recorded and analyzed statistically. Results: Sevoflurane significantly maintained lower MAP and HR during surgery (p<0.05) and was associated with reduced intraoperative blood loss (110.6±18.9 ml vs. 135.2±20.3 ml; p = 0.001) and improved surgical field scores (p = 0.002). Recovery was faster in Group S across all parameters, including eye opening, extubation, and orientation (p<0.001). Postoperative pain scores were consistently lower in the sevoflurane group during the early recovery period (p<0.05). Conclusion: Sevoflurane proved superior to isoflurane in achieving controlled hypotension, reducing blood loss, improving the surgical field, enhancing recovery profile, and minimizing early postoperative pain in patients undergoing ESS. It is therefore a preferred agent for maintaining hypotensive anesthesia in such procedures.
STUDY TO INVESTIGATE THE ANXIOLYTIC EFFECT OF RUBIA CORDIFOLIA LINN IN MICE
Objective: To evaluate anxiolytic activity of extracts of Rubia cordifolia in albino mice by using Actophotometer (locomotor activity), Elevated Zero maze, Mirrored Chamber and biochemical estimation like estimation of plasma corticosterone levels. Methods: Healthy, Swiss Albino mice weighing 20-35 g and aged 6-8 w were maintained under standard laboratory conditions with controlled temperature (25±2 °C), humidity (40±10 %) and 12 h light and dark cycles each. The animals were fed with standards rodent pellet diet and water ad libitum. Rubia cordifolia extract will be administered p. o.. to mice daily in two different doses (300 and 600 mg/kg/p. o.) for 14 d. All the animals will be evaluated for behavioral parameters, i. e. Actophotometer (locomotor activity), Elevated Zero maze, Mirrored Chamber and biochemical estimation like estimation of plasma corticosterone levels will be performed. Results: In the present study, we have undertaken the anxiolytic activity of extracts of Rubia cordifolia in Swiss albino mice, at the dose of (300 and 600 mg/kg/p. o.) with oral administration respectively. Conclusion: In conclusion extracts of Rubia cordifolia have shown significant results as anxiolytic activity using locomotor activity), Elevated Zero maze, Mirrored Chamber.
Copyright (c) 2025 ANKUSH CHAUHAN, AJEET PAL SINGH, AMAR PAL SINGH https://creativecommons.org/licenses/by/4.0
EFFICACY OF ULTRASOUND-GUIDED SAPHENOUS NERVE BLOCK USING BUPIVACAINE ALONE VERSUS BUPIVACAINE WITH TRIAMCINOLONE ACETONIDE IN OSTEOARTHRITIS KNEE PAIN
Objective: Knee osteoarthritis (OA) is a prevalent cause of chronic pain and functional impairment. Ultrasound-guided saphenous nerve block has emerged as a promising non-surgical treatment modality. This study evaluates the comparative efficacy of bupivacaine alone versus bupivacaine with triamcinolone acetonide in ultrasound-guided saphenous nerve block for OA knee pain. Methods: A prospective, randomized, double-blind study was conducted involving 80 patients aged 30–80 y with chronic OA knee pain (Grade II or III). Patients were allocated to two groups: Group T received 4 ml of 0.5% bupivacaine+40 mg triamcinolone acetonide; Group B received 4 ml of 0.5% bupivacaine alone. Both solutions were diluted to 10 ml with normal saline. Pain intensity (VAS), functional disability (WOMAC index), and patient satisfaction were assessed at baseline, 1 h, 1 w, 2 w, 1 mo, 3 mo, and 6 mo post-block. Results: Both groups showed significant reductions in VAS and WOMAC scores over time (p<0.05). However, Group T showed superior pain relief and functional improvement at all follow-up points (p<0.05). Grade II OA patients in both groups had better outcomes compared to Grade III. No significant procedural complications were noted. Conclusion: Ultrasound-guided saphenous nerve block using bupivacaine with triamcinolone acetonide provides prolonged and superior analgesia and functional improvement compared to bupivacaine alone in patients with OA knee. This technique is safe, effective, and minimally invasive, warranting consideration in non-surgical OA knee management.
Copyright (c) 2025 ARJUN PIRKAD, SUHEELA TAXAK, DRPOONAM SINGH https://creativecommons.org/licenses/by/4.0
EVALUATION OF SERUM PROLACTIN LEVEL IN CIRRHOSIS OF LIVER AND ITS CORRELATION WITH CHILD-TURCOTTE-PUGH SCORE
Objective: The objective of this study was to determine serum prolactin levels in patients with liver cirrhosis and evaluate its correlation with the Child-Turcotte-Pugh (CTP) score. Methods: This observational cross-sectional study was conducted at the Department of General Medicine, School of Medical Sciences and Research, Sharda University, Greater Noida. A total of 50 cirrhotic patients fulfilling the inclusion criteria were enrolled. Each participant provided informed consent, followed by a detailed clinical assessment and biochemical tests. Results: The majority of patients fell within the 41–50 age group. Alcohol was identified as the most prevalent cause of cirrhosis, followed by Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Non-Alcoholic Steatohepatitis (NASH). The mean prolactin levels observed for Child-Pugh grades A, B, and C were 25±2.83, 44.30±9.52, and 76.35±33.84 respectively. A statistically significant correlation (p<0.05) was found between prolactin levels and the Child-Pugh score (r=0.42, p=0.002), indicating that higher disease severity corresponded with elevated prolactin levels. Conclusion: Serum prolactin levels demonstrated a strong association with the Child-Pugh score, signifying their potential as an early marker for liver cirrhosis seveCirrhosis of liverrity and prognosis.
ANALYSIS OF BLOOD DONOR DEFERRAL PATTERN AT BLOOD CENTRES OF TERTIARY CARE HOSPITAL IN CHENNAI, TAMIL NADU-A RETROSPECTIVE CROSS SECTIONAL STUDY
Objective: Even though blood transfusion is a life-saving procedure, selecting a blood donor whose blood is safe for the recipient patient while avoiding adverse donor reaction is paramount in blood transfusion services. During this process, donors can get deferred which leads to loss of precious blood units. This cross-sectional retrospective study was designed to learn and analyze the reasons for deferral of blood donors at tertiary care hospital blood centres. Methods: This was a retrospective cross-sectional study with analysis of data for one year (April 2024 to March 2025) in May 2025. Blood donor details from Kalaignar Centenary Hospital blood centre and Government Royapettah Hospital blood centre at Chennai, Tamil Nadu were collected from Donor questionnaire forms and deferred donor register. Data was entered in Microsoft excel and analysed. Results: Among 7877 blood donors who had registered at the blood centres during study period, donor deferral rate was 2.73%(n=215/7877) which was more common in males (78.6%, n=169/215). Most common reason of temporary deferral was low Haemoglobin (28.1%, n=43/153) followed by Hypertension (12.42%, n=19/153). Among the permanent deferrals who were all males (100%, n=62/62), the most common reason was seroreactivity to Hepatitis B virus (62.9%, n=39/62). Conclusion: Our study findings suggest that more awareness about donation criteria and health education in population are needed, to avoid blood donor deferrals. Effective measures need to be established to bring back the temporarily deferred donors into blood donation donor pool.
BIOCHEMICAL ALTERATIONS IN MUSCLE AND RENAL MARKERS IN THYROID DISEASE: A CROSS-SECTIONAL STUDY
Objective: The study aimed to assess and compare serum levels of CK, LDH, and creatinine in patients with hypothyroidism and hyperthyroidism with those in euthyroid (healthy) controls, to elucidate the metabolic alterations and their clinical relevance. Methods: This was a hospital-based cross-sectional study conducted on 90 participants, divided into three groups: Group I: 30 patients with hypothyroidism, Group II: 30 patients with hyperthyroidism, and Group III: 30 age-and sex-matched healthy controls. Fasting venous blood samples were analyzed for CK, LDH, and serum creatinine using standard enzymatic colorimetric methods. Results: CK and LDH levels were significantly elevated in hypothyroid patients compared to controls (p<0.001), reflecting subclinical myopathy. In contrast, hyperthyroid patients showed moderately elevated LDH but not CK. Serum creatinine levels were higher in hypothyroidism and lower in hyperthyroidism compared to controls, suggesting thyroid state-dependent renal function modulation. Pearson correlation showed a negative correlation between TSH and eGFR, and a positive correlation between TSH and CK levels in hypothyroid subjects. Conclusion: Thyroid dysfunction significantly alters muscle and renal biomarkers. Routine assessment of CK, LDH, and serum creatinine can aid in early detection of subclinical myopathy and renal involvement in thyroid patients. This may provide insights for better metabolic monitoring and management of thyroid disorders.
ROLE OF THERAPEUTIC PLASMA EXCHANGE IN YELLOW PHOSPHOROUS POISONING – A SINGLE CENTRE RETROSPECTIVE STUDY FROM SOUTH INDIA
Objective: Yellow phosphorus, a rodenticide, is used as a suicidal agent that causes hepatotoxicity and acute liver failure (ALF) with increased mortality. The only definitive management is liver transplantation. Therapeutic plasma exchange (TPE) could alleviate the symptoms of yellow phosphorus by removing the poison and its metabolite from the body. Aim of this study was to determine the role and effectiveness of Therapeutic plasma exchange in yellow phosphorus poisoning. Methods: This was a retrospective observational study conducted from January 2023 to December 2024. The study included patients who developed ALF due to yellow phosphorus poisoning requiring TPE. Patient demographic details, clinical features, quantity of consumption and laboratory values before and after TPE were noted. Statistical analysis was performed with Microsoft excel. Results: 12 patients (M: F=2:1) who developed ALF, due to yellow phosphorus poisoning, were included for analysis. A total of 30 TPE sessions were performed (Mean=2.5 sessions). Mean age group of the patients was 29.3 years. Nine patients (75 %, M: F – 3.5:1) had recovery from ALF, out of which six had consumed<10 gm of yellow phosphorus. Among patients who recovered, mean time to admission was 2.8 days and mean time for initiation of TPE was 3.5 days. Three patients failed to show recovery and expired. Conclusion: This study revealed that the patient outcomes were better with earlier initiation of TPE, but was also dependent on factors such as the quantity of poison consumed and time of hospitalization. Thus, TPE could potentially bridge the gap between medical management and liver transplantation in cases of yellow phosphorus poisoning.
PERCEPTION AND ATTITUDE OF POSTGRADUATE STUDENTS TOWARDS DISTRICT RESIDENCY PROGRAMME
Objective: The District Residency Programme (DRP) for postgraduate medical students has been made mandatory by the national medical commission of India (NMC). As part of the course curriculum, it includes a compulsory three-month rotation in District Hospitals or within the District Health System. The objective of this study is to assess the perception and attitude of postgraduate students towards the DRP at Government Medical College, Anantapuramu, Andhra Pradesh, South India. Methods: A total of 158 postgraduate students who had attended DRP postings were included in the study. Among them, 98 were second-year students and 60 were third-year students. Data regarding their perceptions and attitudes toward the DRP postings were collected through a structured questionnaire using Google Forms. Results: Data analysis was carried out using Microsoft Excel. Among the second-year and third-year postgraduates, 55% and 56% were male, while 45% and 44% were female, respectively. The overall perception and attitude of the students revealed that the majority held a neutral opinion regarding the DRP postings. Conclusion: The district residency programme in the postgraduate curriculum does not appear to offer significant perceived benefits to the students. Furthermore, accommodation and food facilities provided during the postings were reported to be inadequate.
A COMPARATIVE STUDY OF FUNCTIONAL OUTCOMES OF FIXATION OF INTERTROCHANTERIC FRACTURES WITH DYNAMIC HIP SCREW FIXATION OR PROXIMAL FEMORAL NAILING FIXATION
Objective: Intertrochanteric fractures are one of the most common and most devastating injuries in the elderly. With the tremendous improvements achieved in the field of medicine over the decades, life span of an individual has also increased. Treatment of intertrochanteric fracture is by both non-operative and operative methods. Methods: This is a prospective study of 30 cases of intertrochanteric fractures treated by early surgical fixation with Dynamic hip screw fixation or proximal femoral nailing. The period of survey and follow-up extends from oct 2020 to march 2022. Harris Hip Score (HHS) was used to assess functional outcome. Results: The mean age of the PFN group was 61.9+10.49 years, whereas the mean age for DHS group was 61.63+9.02 years. The PFN group had a higher HHS score in the current investigation and an intergroup comparison of the Harris Hip score between the PFN and DHS groups revealed significant differences at each follow-up period. Conclusion: The PFN is a better alternative of fixation in patients with intertrochanteric femur fractures in terms of functional outcome.
IMPACT OF 'SIP TILL SEND' HYDRATION PROTOCOL ON PREOPERATIVE PATIENT COMFORT AND POSTOPERATIVE OUTCOMES: A CONTROLLED STUDY
Objective: The primary objective was to estimate actual fasting durations for solid foods and clear fluids. Secondary objectives included assessing preoperative thirst using the Perioperative Thirst Discomfort Questionnaire, recording the incidence of postoperative nausea and vomiting (PONV), measuring patient satisfaction, and evaluating the safety of the 'Sip Till Send' (STS) hydration protocol. Methods: A controlled trial using the Plan-Do-Study-Act (PDSA) model was conducted over six months at Maharshi Vashishtha Autonomous State Medical College, Basti, Uttar Pradesh. Adults (18–65 y) scheduled for elective surgery under general anaesthesia were included, excluding emergencies and high-risk cases. A total of 1350 elective surgical patients were included in the study. The intervention group received the 'Sip Till Send' (STS) protocol, allowing sips of fluids until operating room transfer; the control group followed standard fasting. Outcomes included fasting duration, thirst scores, patient satisfaction, postoperative nausea and vomiting (PONV), and safety. Data were analysed using SPSS (p<0.05). Results: A total of 1,350 patients participated (STS: n=772; control: n=578). The STS group demonstrated a significant reduction in median fluid fasting time (3.5±1.0 h vs. 7.5±1.5 h, p<0.001). Perioperative thirst discomfort was markedly lower in the STS group (mean score 3.1±2.4 vs. 7.1±2.9, p<0.001).98% patients of the STS group and 60% in the control groupdid not complain of nausea and vomiting in the postoperative period. Patient satisfaction scores improved correspondingly. No pulmonary aspiration events were reported, confirming the safety of the protocol. Iterative PDSA cycles improved adherence and clinical outcomes. Conclusion: The 'Sip till Send' protocol effectively reduces preoperative fluid fasting duration, alleviates patient thirst, and enhances satisfaction without compromising safety. These findings support wider implementation of STS as a perioperative hydration strategy to improve patient comfort and outcomes.
COMPARING 0.75% ROPIVACAINE VS 0.5% LEVOBUPIVACAINE FOR SPINAL BLOCK IN PCNL SURGERIES: A RANDOMIZED STUDY
Objective: To evaluate the effectiveness, onset time, duration, and quality of both sensory and motor block, along with hemodynamic stability and postoperative pain relief, between 0.75% hyperbaric ropivacaine and 0.5% hyperbaric levobupivacaine during subarachnoid block in patients undergoing percutaneous nephrolithotomy (PCNL) procedures. Methods: This prospective, randomized, observer-blinded study compared the efficacy of 0.75% hyperbaric ropivacaine and 0.5% hyperbaric levobupivacaine for subarachnoid block in 150 patients undergoing percutaneous nephrolithotomy (PCNL) surgeries. Patients were randomly allocated into two groups: Group R (n=75) received 4 ml of 0.75% hyperbaric ropivacaine, and Group l (n=75) received 4 ml of 0.5% hyperbaric levobupivacaine intrathecally. The onset and duration of the sensory and motor blockade, analgesia, perioperative hemodynamic variations, side effects, and complications were evaluated. Results: Group l showed significantly earlier onset times for sensory (7.96±1.13 min vs. 9.99±2.57 min; P<0.0001) and motor blocks (2±0.62 min vs. 2.74±0.9 min; P<0.0001) compared to Group R. The duration of sensory block (83.33±10.18 min vs. 59.57±8.15 min), analgesia (145.49±7.93 min vs. 127.8±6.22 min), and motor block (287.25±40.72 min vs. 199±24.38 min) were significantly longer in Group l (P<0.0001). The hemodynamic parameters remained stable in both groups, with no significant differences between the groups. The incidence of side effects was comparable between the groups. Conclusion: In conclusion, 0.5% hyperbaric levobupivacaine provides a faster onset and prolonged duration of sensory and motor blockade, as well as extended analgesia, compared to 0.75% hyperbaric ropivacaine for subarachnoid block in PCNL surgeries, with a similar safety profile.
ROLE OF VARIOUS ORAL ANTIHISTAMINES AS ADJUNCT TO TOPICAL STEROID and ANTIHISTAMINE IN THE MANAGEMENT OF PERENNIAL ALLERGIC RHINITIS
Objective: Perennial Allergic Rhinitis (PAR) is a chronic inflammatory condition of the nasal mucosa, causing year-round symptoms like nasal congestion, sneezing, rhinorrhea, and itching, significantly impairing quality of life. Intranasal corticosteroids (INCS) combined with topical antihistamines are first-line therapy, but oral antihistamines are often used as adjuncts. This study evaluates the efficacy and safety of various oral antihistamines alongside standard intranasal therapy in PAR management. Methods: A randomized controlled trial was conducted on 100 PAR patients, aged 18–60 y, divided into five groups (n=20). All groups received intranasal fluticasone propionate (27.5 mcg) and azelastine (140 mcg) twice daily for 12 w. Additionally, groups received one oral antihistamine daily: Levocetirizine (A), Desloratadine (B), Bilastine (C), Ebastine (D), or Olopatadine (E). Efficacy was assessed using Total Nasal Symptom Score (TNSS), symptom-specific scores, and Quality of Life (QoL). Data were analyzed with ANOVA; p<0.05 was significant. Results: All groups showed significant TNSS reduction (p<0.001). Maximum improvement was in Groups B (6.5) and E (7.0) compared to A (4.5), C (4.2), and D (4.3). Symptom-specific analysis revealed superior outcomes in sneezing, nasal itching, and rhinorrhea for Groups B and E (p<0.05). QoL improved most in Groups B (22.5) and E (23.4). No serious adverse events were reported; mild sedation and dry mouth were infrequent and comparable across groups. Conclusion: Desloratadine and Olopatadine as adjuncts to intranasal therapy provided superior symptom control and QoL improvement in PAR without significant adverse effects, supporting their role in combination therapy.
HISTOPATHOLOGICAL SPECTRUM OF GASTROINTESTINAL LESIONS: CORRELATING BIOPSY WITH ENDOSCOPY FINDINGS
Objective: To assess the spectrum of histopathological findings in gastrointestinal (GI) lesions and correlate them with endoscopic impressions to evaluate diagnostic accuracy and concordance. Methods: This retrospective observational study was conducted in the Department of Pathology at a tertiary care center from January 2021 to March 2024. A total of 76 endoscopic GI biopsy samples were analyzed after applying inclusion and exclusion criteria. Endoscopic features were documented from requisition forms and compared with corresponding histopathological diagnoses. Sensitivity, specificity, predictive values, and diagnostic concordance were calculated, and statistical analysis was performed using the Chi-square test and Cohen’s Kappa. Results: Out of 76 cases, 55 (72.3%) were non-neoplastic and 21 (27.6%) were neoplastic. The most common non-neoplastic diagnosis was non-specific inflammation (38.2%), while carcinoma was the predominant neoplastic lesion (76.2% of neoplastic cases). Endoscopic growths were most predictive of malignancy, while mucosal changes and ulcerations were often associated with benign conditions. Endoscopy showed a sensitivity of 80.9%, specificity of 72.7%, and diagnostic accuracy of 75% in identifying neoplastic lesions. The concordance rate between endoscopic and histopathological findings was 67%, with a Cohen’s Kappa value of 0.67, indicating substantial agreement. Conclusion: Endoscopy remains a valuable initial diagnostic tool, but histopathological confirmation is essential, especially for distinguishing benign from malignant GI lesions. This study highlights the importance of integrating both modalities to improve diagnostic confidence and guide appropriate clinical management.
THYROID PROFILE IN PATIENTS WITH LIVER CIRRHOSIS AND ITS CORRELATION WITH SEVERITY AND ETIOLOGY OF LIVER DISEASE
Objective: Liver cirrhosis is associated with various endocrine abnormalities, including thyroid dysfunction. The liver plays a crucial role in thyroid hormone metabolism, and cirrhosis may alter thyroid function tests (TFTs). This study aimed to evaluate thyroid function in cirrhotic patients and correlate it with disease severity and etiology. Methods: A cross-sectional study was conducted on 54 patients with liver cirrhosis. Thyroid profiles (TSH, FT3, FT4) were assessed and correlated with Child-Pugh and MELD scores. Etiologies included alcohol, viral hepatitis (HBV, HCV), and non-alcoholic fatty liver disease (NAFLD). Statistical analysis was performed using SPSS v26. Results: Thyroid dysfunction was present in 40.7% of patients, with sick euthyroid syndrome (low FT3) being the most common (29.6%). Hypothyroidism (elevated TSH) was seen in 11.1%. FT3 levels inversely correlated with Child-Pugh (r =-0.52, p<0.01) and MELD scores (r =-0.48, p<0.01). Viral hepatitis-related cirrhosis showed more thyroid dysfunction (55.5%) compared to alcoholic cirrhosis (33.3%). Conclusion: Thyroid dysfunction, particularly low FT3, is common in cirrhosis and correlates with disease severity. Viral etiology is associated with a higher prevalence of thyroid abnormalities. Routine thyroid screening in cirrhotic patients may aid in better management.
HOSPITAL-BASED STUDY TO ANALYSE PREVALENCE, PRESCRIBING PATTERN AND MANAGEMENT OF ALCOHOL DEPENDENCE SYNDROME
Objective: Alcohol dependence syndrome (ADS) is a chronic, progressive disorder that significantly impacts physical health, mental well-being, family, and social life. This study aimed to evaluate the demographic profile, prescribing trends, and liver function changes in patients with ADS. Methods: A prospective observational study was conducted over six months at a tertiary care hospital in Mangalore. A total of 100 patients with ADS who fulfilled the inclusion criteria were enrolled. Data on demographics, alcohol consumption, prescribing patterns, and liver function tests (LFTs) were collected and analyzed. Results: Among 100 participants, 99% were males and 1% was female. The majority (53%) belonged to the 41–50 y age group, followed by 24% in the 31–40 y group. Regarding alcohol consumption, 40% reported intake of 60 g/day, while 32% consumed 81–90 ml/day. Long-term use was common, with 34% consuming alcohol for more than 22 y. The prescribing analysis revealed frequent use of vitamins (92%), benzodiazepines (75%), anti-craving drugs (65%), antipsychotics (55%), antiepileptics (45%), and PPIs (42%). Lorazepam (83%) was the most commonly prescribed benzodiazepine, while Baclofen (84%) was the preferred anti-craving drug. Olanzapine (36%) was commonly prescribed for affective disorders. Two-thirds (66%) were treated only for ADS, while 34% had comorbidities such as depression, seizures, and psychosis. LFTs showed significant abnormalities, including elevated AST and ALT levels and altered albumin, globulin, and bilirubin levels. Conclusion: ADS predominantly affects middle-aged males and is linked to long-term, high-quantity alcohol consumption. Significant liver dysfunction and psychiatric comorbidities highlight the need for early detection, comprehensive management, and preventive measures to reduce the overall burden of ADS.
Copyright (c) 2025 Shrijal M Rao https://creativecommons.org/licenses/by/4.0
“HOSPITAL-BASED STUDY TO ASSESS THE EFFECTIVENESS AND SAFETY OF ANTIDIABETIC MONOTHERAPY IN CONTRAST TO COMBINATION THERAPY”
Objective: This study aims to compare the effectiveness and safety of antidiabetic monotherapy versus combination therapy in managing T2DM. Methods: A prospective, observational study was conducted over six months in the general medicine department, involving 152 inpatients with T2DM. Patients aged 18 or above, with HbA1c ≥ 6.5% and/or GRBS ≥ 200 mg/dl, and on either monotherapy or combination therapy were included. Data were collected from patient records and caregivers. Results: The results indicated that combination therapy demonstrated superior glycemic control compared to monotherapy, which was statistically significant (p<0.05). Monotherapy was prevalent, with biguanides and sulphonylureas being the most prescribed drugs. However, combination therapy showed a higher incidence of adverse drug reactions (ADRs), particularly among older patients. Metformin was identified as the safest oral hypoglycemic agent (OHA). The study also revealed significant cost savings when using Jan Aushadhi medications compared to branded alternatives. Conclusion: The findings underscore the necessity for regular blood glucose monitoring and personalized treatment plans to manage T2DM effectively. The study highlights the economic advantages of prescribing low-cost generics, which can improve medication adherence and health outcomes, especially in financially constrained patients. The integration of lifestyle modifications with pharmacotherapy is crucial for enhanced glycemic control. This study emphasizes the importance of combination therapy for better glycemic control in T2DM while acknowledging the increased risk of ADRs. It advocates for the economic benefits of Jan Aushadhi drugs, suggesting a cost-effective approach to diabetes management. Healthcare providers must focus on comprehensive care, integrating clinical guidelines and promoting interdisciplinary collaboration to improve patient outcomes.
Copyright (c) 2025 OLIVER STEEVO PINTO, RAKSHITH SHETTY, U. Y. FAREENA FAIZAL, ASHNA K. P., CHRISTY T. CHACKO, A. R. SHABARAYA https://creativecommons.org/licenses/by/4.0
DEMOGRAPHIC AND CLINICAL PROFILE OF ORGANOPHOSPHORUS POISONING CASES IN A TERTIARY CARE HOSPITAL
Objective: To assess the demographic patterns, clinical manifestations, and prognosis of patients admitted for organophosphorus poisoning in a tertiary care institution. Methods: A prospective observational study was conducted over a 12 mo period at a tertiary care institution. Data pertaining to patient demographics, presenting clinical features, and subsequent clinical outcomes were meticulously recorded and analyzed. Results: A total of 161 patients with acute organophosphorus poisoning were studied. The majority 39.75% were aged 21–30 y, followed by 29.19% in below 20 y age group. Males accounted for 61.49% of cases, while females made up 38.51%. Most patients 77.64% were from rural areas. Clinical manifestations included miosis in 60.25%, nausea in 25.47%, vomiting in 20.50%, and diarrhea in 11.80% of cases. The overall mortality rate was 31.06%, with 68.94% of patients surviving. Conclusion: The highest incidence of organophosphorus poisoning was observed in the 21–30 y age group. Males were predominantly affected, with a significantly higher number of cases reported in rural areas. Common symptoms included nausea and vomiting, while miosis was the most frequent clinical sign. The mortality rate was high, highlighting the importance of early recognition and timely management to improve patient outcomes.
DEMOGRAPHIC PROFILE AND CLINICAL OUTCOMES OF ALUMINUM PHOSPHIDE POISONING: A PROSPECTIVE STUDY
Objective: To analyze the demographic distribution, clinical presentation, and outcomes of ALP poisoning cases admitted to a tertiary care hospital in Bhopal, Madhya Pradesh. Methods: A prospective observational study was conducted on 44 patients diagnosed with ALP poisoning over a one-year period. Data were collected on age, gender, domicile, clinical symptoms, and outcomes. Results: The majority of cases occurred in the 21–30 age group (56.82%), with males (56.82%) slightly more affected than females (43.18%). Rural and urban populations were equally affected (50% each). Common symptoms included nausea (38.64%), vomiting (34.09%), and diarrhea (22.73%). Mortality was high, with (72.73%) of patients succumbing to the poisoning. Conclusion: ALP poisoning continues to be a serious public health issue in both rural and urban India. The high fatality rate underscores the need for tighter control on its sale and improved clinical management strategies.
STUDY OF ASSESSMENT OF CLINICAL PROFILE AND ETIOLOGY OF PATIENTS OF SEVERE ANEMIA ADMITTED AT TERTIARY CARE CENTER
Objective: To study the clinical profile, determine aetiological factors, and assess contributing variables among patients with severe anaemia in a tertiary care setting in Central India. Methods: This observational study was conducted over one year (March 2024–February 2025) at Gandhi Medical College and Associated Hospitals, Bhopal. A total of 150 adult patients with haemoglobin<7 g/dl and undiagnosed anaemia were enrolled. Patients underwent detailed clinical evaluation and comprehensive laboratory investigations. Results: Females comprised 64.7% of the cohort, with a mean age of 53.91±21.62 y. Pallor (100%) and dyspnoea (100%) were universal symptoms. Nutritional anaemia was the predominant cause (83.33%), with iron deficiency anaemia accounting for 60%, followed by vitamin B12 deficiency (20%). Other causes included leukaemia (7.3%), haemoglobinopathies (4.7%), haemolytic anaemia (2.6%), infections (1.3%), and aplastic anaemia (0.7%). mean haemoglobin was 4.47±1.51 g/dl. SGPT levels varied significantly with anaemia severity (p=0.013), while MCV approached significance (p=0.051), indicating hepatic stress and microcytosis in severe cases. Conclusion: Severe anaemia in hospitalized adults is predominantly nutritional in origin, underscoring the need for early detection, nutritional interventions, and public health strategies. Focused community screening and comprehensive management protocols are vital to reduce the anaemia burden and its complications.
PROPOLIS AND ITS ADVANCED FORMULATIONS: CURRENT PERSPECTIVES IN DENTAL APPLICATIONS
Objective: To provide a detailed summary of advanced formulations of propolis for dental applications, focusing on strategies designed to enhance its therapeutic efficacy, solubility, stability, and overall clinical utility. Methods: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Embase databases. Studies were included if they investigated propolis-based formulations relevant to dentistry, particularly those involving nanoparticles, nanoemulsions, mouth rinses, liposomes, or propolis incorporated into composites and sealants. Results: Findings from the reviewed literature indicate that advanced delivery systems significantly improve the solubility, bioavailability, and biofilm penetration of propolis while prolonging its antimicrobial activity. Nanoparticles and nanoemulsions enhance propolis’s stability and therapeutic efficacy, whereas formulations such as mouth rinses, liposomes, and dental composites contribute to improved patient compliance, ease of administration, and usability. Collectively, these approaches support the role of propolis in dental caries prevention and overall oral health maintenance. Conclusion: Advanced formulations of propolis successfully overcome limitations related to its natural form by enhancing stability, therapeutic performance, and patient-friendly delivery. Continued research should focus on clinical validation and the development of standardized propolis formulations for consistent and effective use in dental practice.
STUDY OF HEPATIC DYSFUNCTION IN DENGUE PATIENT
Objective: To evaluate the prevalence, severity, and clinical outcomes of hepatic dysfunction in dengue patients admitted to the Department of General Medicine at MGM Medical College and LSK Hospital, Kishanganj, Bihar. Methods: A cross-sectional analysis was conducted on dengue-confirmed patients. Liver function parameters, including serum AST, ALT, bilirubin, and alkaline phosphatase levels, were assessed. Demographic and clinical data were analyzed to identify correlations between hepatic dysfunction and disease severity. Results: Elevated AST and ALT levels were observed in 83.3% and 80% of patients, respectively, with severe elevations in 16.7% (AST) and 13.3% (ALT). Mild hyperbilirubinemia occurred in 26.7% and ALP elevation in 33.3% of cases. Jaundice was uncommon (6.7%), predominantly affecting younger adults (18–30 years), with males more frequently involved. Liver enzyme elevations correlated positively with disease severity, peaking in dengue shock syndrome (DSS) cases. Conclusion: Hepatic dysfunction is a frequent and clinically significant complication of dengue fever. Liver enzyme elevations may serve as valuable markers of disease severity. Early recognition and monitoring of hepatic involvement are essential for improving patient outcomes. Further multicenter studies are needed to validate these findings and elucidate underlying mechanisms.
MODIFIED RELEASE MULTI-UNIT SYSTEM: A REVIEW
Modified release multiunit dosage forms (MUFs) have emerged as a promising approach to achieve controlled and site-specific drug delivery with improved therapeutic outcomes. Pelletization, particularly via extrusion–spheronization, offers numerous formulation advantages, including uniform size, excellent flowability, and enhanced drug release control. This review provides a comprehensive overview of pelletization techniques with an emphasis on extrusion–spheronization, detailing its critical process parameters, formulation variables, and evaluation methods. Additionally, the classification of modified release systems and the comparative advantages of MUFs over single-unit systems are discussed. The integration of these technologies supports the development of patient-centric and robust drug delivery platforms with greater safety, efficacy, and compliance.
Copyright (c) 2025 JYOTI G. RATHOD, SHASHIKANT N. DHOLE, NILESH S. KULKARNI https://creativecommons.org/licenses/by/4.0
A COMPREHENSIVE REVIEW ON DOSAGE FORM FOR ANTICOAGULANT DRUG
Thromboembolic disorders are a major global health issue, requiring effective therapies rooted in understanding thrombophilia and the coagulation cascade. Warfarin, though widely used, presents challenges like dietary restrictions, narrow therapeutic index, and constant monitoring. New generation oral anticoagulant like hirudin, bivalirudin, argatroban, apixaban, and rivaroxaban offer improved safety and pharmacokinetic profiles. To further optimize their clinical use, advanced drug delivery systems have been developed. Formulations like hydrogels, microspheres, micellar nanocomplexes, nanoparticles, and fast-dissolving oral films enhance bioavailability and therapeutic efficacy. These systems also provide targeted or sustained drug release and reduce systemic side effects. Hirudin-based hydrogels and microspheres maintain prolonged thrombin inhibition. Bivalirudin micelles and hydrogels offer localized anticoagulation with minimal bleeding. Rivaroxaban and apixaban in film and nanoparticle forms ensure rapid absorption and patient-friendly administration. Such innovations improve both clinical outcomes and patient compliance in anticoagulant therapy.
Copyright (c) 2025 MAHESHWARI M. NAVGHARE, NILESH S. KULKARNI, VAISHNAVI K. DESHMUKH https://creativecommons.org/licenses/by/4.0