International Research Journal of Pharmacy
The International Research Journal of Pharmacy (IRJP) is a peer-reviewed scientific journal that publishes original research, reviews, and short communications in the field of pharmaceutical sciences. The journal covers a wide range of topics including drug discovery, pharmacology, medicinal chemistry, pharmaceutical formulation, clinical pharmacy, pharmacovigilance, biotechnology, and pharmaceutical technology. It aims to provide a platform for researchers, academicians, and professionals in the pharmaceutical industry to share their findings, advancements, and innovations. Editor- In-Chief: Dr. Priyadershini Rangari Title proper: International Research Journal of Pharmacy (IRJP) Journal Initials: IRJP ISSN: 2230-8407 Subject: Medical Sciences, Pharmacy Publisher: PANhealth Care Research Society Dates of publication: 2010 Frequency: Monthly Language: English Country: India Medium: Online Indexed by: CROSSREF Title DOI of the Journal: http://doi.org/10.56802
CAREGIVER’S ATTITUDE TOWARDS BEHAVIOR MANAGEMENT TECHNIQUES IN PEDIATRIC DENTISTRY: A CROSS-SECTIONAL STUDY
Aim & Background: Managing children's behaviour during dental treatment is crucial in Paediatric Dentistry. Caregivers' attitudes toward Behaviour Management Techniques (BMTs) significantly influence treatment success and the child's dental experience. Understanding these attitudes enhances communication, builds trust, and fosters collaboration between caregivers and dental teams. This study examined caregivers’ attitudes and comfort levels regarding Voice Control, Parental Presence/Absence, Protective Stabilization, and Aversive Conditioning. Methods: A cross-sectional study was conducted with 40 caregivers of children aged 3–12 years in the Department of Paediatric Dentistry. Caregivers were interviewed using a structured questionnaire to assess demographic details and comfort levels with various BMTs. Data analysis focused on caregiver attitudes and preferences. Results: The study found that 57.5% of caregivers were comfortable with Voice Control, indicating a preference for this non-invasive approach. Protective Stabilization caused discomfort in 50% of participants, reflecting concerns over its restrictiveness. Parental Presence/Absence was accepted by 47.5%, with 30% remaining neutral. Aversive Conditioning had mixed responses, with 60% expressing discomfort or neutrality. Conclusion: Caregivers preferred non-invasive techniques like Voice Control over assertive methods such as Protective Stabilization and Aversive Conditioning. These findings highlight the need for clear communication and informed consent to enhance caregiver comfort and cooperation. Larger studies are needed to refine behavior management protocols. Clinical Significance: Understanding caregiver attitudes enables paediatric dentists to tailor behavior management strategies, improving acceptance and cooperation. Prioritizing non-invasive techniques and effective communication fosters positive dental experiences, reduces anxiety, and encourages long-term adherence to oral health care in children.
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Knowledge And Awareness Of Cancer Immunotherapy Among Dental Students And Dental Professionals- A Questionnaire Based Survey
Background: Cancer immunotherapy has emerged as a revolutionary approach in cancer treatment, significantly improving patient outcomes. As oral healthcare provid ers often play a role in early cancer detection and multidisciplinary care, it is crucial for dental students and professionals to possess adequate knowledge and awareness of this therapeutic modality. Aim: To assess the knowledge, attitude, and practice (KAP) related to cancer immunotherapy among undergraduate and postgraduate dental professional. Methods: A cross-sectional, questionnaire-based online survey was conducted among dental undergraduates, postgraduates, and practicing professionals. The questionnaire included items on general knowledge, clinical relevance, sources of information, and perceived need for education regarding cancer immunotherapy. The responses were scored numerically and represented as percentile and statistically analysed using Pearson Chi-Square test and a p value of ≤0.05 was inferred as statistically significant. Results: Out of 132 respondents, a substantial proportion demonstrated limited knowledge of cancer immunotherapy, especially among undergraduate students. The comparison of age and qualification of the study participants was statistically significant with a p value of ≤0.05, whereas gender was found be to be not significant. 98.5% were aware of types of oral cancer and 80.3% had come across patient with oral cancer. 81.8% were aware of targeted drug therapy for cancer, 82.6% were aware that immunotherapy works by boosting immune system and 80.3% were aware that T cells were used in immunotherapy so 81.8% agreed that immunotherapy was an innovative cancer treatment option. Conclusion: The study highlights a significant knowledge gap regarding cancer immunotherapy among dental students, particularly at the undergraduate level. Integration of immunotherapy-related content into dental curricula and continuing education programs is strongly recommended to equip future dental professionals with essential interdisciplinary competencies in cancer care.
PLASMA AND URINARY LACTATE FOR DIAGNOSIS OF EARLY ONSET SEPSIS IN NEONATES
Background: Monitoring tissue perfusion in sepsis is essential for the early detection of circulatory failure, timely initiation of appropriate interventions, and assessment of therapeutic response. Inadequate oxygen delivery leads to elevated lactate levels, which have been shown to predict morbidity and mortality in newborns. However, limited research has explored the role of lactate measurements in the diagnosis and prognosis of neonatal sepsis. Aim: To determine the minimum threshold levels of plasma and urinary lactate useful for diagnosing early-onset sepsis (EOS). Materials and Methods: This study included ninety neonates at risk for EOS. Sepsis screening, blood culture, plasma lactate (within the first two hours of life), and urinary lactate (from the first urine sample) were assessed. At 24 ± 2 hours of life, repeat measurements of C-reactive protein (CRP), plasma lactate, and urinary lactate were obtained. Results: In the sepsis group, the median urinary lactate levels in the first urine sample and at 24 hours were 0.50 mMol/L and 0.45 mMol/L, respectively. In the non-sepsis group, the corresponding values were 0.37 mMol/L and 0.43 mMol/L. Neither plasma nor urinary lactate levels were reliable for diagnosing EOS. However, urinary lactate at 24 hours demonstrated utility as a diagnostic marker for sepsis associated with shock and mortality. Conclusion: Plasma and urinary lactate levels do not predict EOS. Nonetheless, urinary lactate measured at 24 hours of life may serve as an indicator for shock and mortality in infants with EOS.
PSYCHOLOGICAL, DIABETIC AND BUILT ENVIRONMENT ELEMENTS IN INDIAN SUBJECTS
Background: Body weight and built environment elements have been linked internationally for a long time. However, there is a dearth of information in the literature currently available about the roles played by psychological, diabetes, and built environmental elements in South Indian topics. Aim: The purpose of this study was to evaluate the impact of psychological, diabetic, and built environment variables on Indian participants. Methods: In this study, 183 participants—246 men and 120 women—between the ages of 16 and 69 who had lived in the same location for at least three years and had a BMI between 17.1-30.3 kg/m2 were evaluated. Every subject's diabetes condition and built environment data were evaluated. Participants with diabetes mellitus had their psychological stress, quality of life, and wellbeing data evaluated. Additionally, assessments were conducted on diabetic worry, social worry, effect, satisfaction, well-being, energy, anxiety, and depression. Results: Physically active, non-vegetarian, and working participants had lower BMIs. In male participants, weight and fasting blood glucose were more strongly associated with energy and less with anxiety, according to Guttman's Smallest Space Analysis (SSA). Age and the individuals' positive well-being were closely correlated in both sexes. Furthermore, there was a strong correlation between age, weight, and fasting glucose levels in both sexes. Conclusions: in order to develop preventative interventions, it is critical to comprehend how psychological elements and the built environment affect the body weight of diabetes people.
ANALYSING ANATOMICAL MORPHOMETRY AND MORPHOLOGY OF FISSURES ON THE SURFACE OF LIVER
Background: There are fissures on the liver's many surfaces, including the porta hepatis, ligamentum venosum fissure, and/or ligamentum teres hepatis, which are frequently observed on the liver's visceral surface. Aim: The objective is to evaluate the morphology and anatomical morphometry of the liver's surface fissures in cadaveric sections. Methods: Thirty liver specimens from cadavers frozen in 10% formalin were obtained from regular undergraduate dissection sessions for the study. The depth, breadth, and length of the fissures were measured for morphometry, while the shape, content at the base of the fissure, and any other related characteristics were measured for morphology. A scale, divider, and thread were used for each measurement. Results: The ligamentum teres hepatis fissure's average depth, breadth, and length were 1.9 cm, 4.5 mm, and 5.1 cm, respectively, and were positioned either linearly or occasionally obliquely. The ligamentum venosum fissure was curvilinear and positioned vertically, with typical dimensions of 2.5 cm for depth, 7 mm for breadth, and 6.1 cm for length. The porta hepatis's circumference measured 10.6 cm and had an oval to elliptical shape. Rouviere's sulcus, also known as Gan's fissure, was curvilinear and observed in 76.6% of the individuals. Other accessory fissures were observed as variations on the posterior surface of the right hepatic lobe, aside from Gan's fissure. Conclusion: The current study comes to the conclusion that fissures on the liver's surface are essential markers for evaluating and identifying the vascular systems during various surgical operations and imaging examinations. During radiological evaluations and surgical procedures, radiologists and surgeons can benefit from the morphometric and morphological differences seen.
CONTACT DERMATITIS BY PPE USAGE IN INDIAN HEALTHCARE PROFESSIONALS
Background: The WHO declared the coronavirus disease a pandemic in 2019, affecting a large number of people globally and having a high death rate. Healthcare personnel in India were recommended to use personal protective equipment (PPE) and hand sanitizers, among other precautionary measures. However, the data that is currently available indicates that the prevalence of occupational skin problems rises when PPE and hand sanitizers are used more often. Aim: The purpose of this study is to investigate the prevalence of PPE-related work-associated contact dermatitis in Indian healthcare workers who have a history of atopic dermatitis. Methods: The current study assessed whether the usage of personal protective equipment (PPE) was linked to work-related contact dermatitis in 208 healthcare workers. The gathered data was statistically analyzed, and conclusions were developed using frequency and prevalence data distributions. Results: Men had fewer occupational diseases, whereas women made up 62.5% (n=128) of healthcare professionals. The majority of participants (44.2%) were in the 30–33 age range. 33.3% (n=10) of the research participants had atopic dermatitis, whereas 14.4% (n=30) of the Institute's healthcare professionals had contact dermatitis brought on by PPE use. Conclusion: According to the current study, healthcare workers who have a history of atopy and use personal protective equipment (PPE) are much more likely to develop contact dermatitis.
Evaluation of Real-Time PCR in Clinico-Radiologically Suspected Smear-Negative Pulmonary Tuberculosis Patients Attending a Tertiary Care Hospital, Central India
Introduction- Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to be a major public health burden, especially in developing countries. Smear-negative pulmonary tuberculosis (SNPT) presents a diagnostic challenge due to its low bacillary load and limited sensitivity of conventional microscopy and culture. The present study evaluates the diagnostic performance of Real-Time Polymerase Chain Reaction (RT-PCR) compared with Middlebrook 7H9 broth culture in clinico-radiologically suspected smear-negative pulmonary TB patients. Material and method -This cross-sectional observational study was conducted at Index Medical College, Hospital & Research Centre, Indore (M.P.), from July 2019 to July 2021. A total of 350 clinically and radiologically suspected but smear-negative patients were enrolled. Samples included sputum, bronchoalveolar lavage (BAL), and gastric aspirates. All specimens underwent Ziehl–Neelsen staining, Middlebrook 7H9 broth culture, and RT-PCR using the Qiagen Care TB PCR kit. Culture results served as the gold standard for evaluating RT-PCR sensitivity and specificity. Data were analyzed using SPSS version 20. Result-Out of 350 cases, 73 (20.9%) were positive by Middlebrook 7H9 culture, while RT-PCR detected M. tuberculosis in 100 (28.6%) cases. Among the sample types, BAL showed the highest positivity (31.4%), followed by gastric aspirates (28.6%) and sputum (27.8%). Males (58.6%) were more affected than females, and the predominant age group was 20–40 years. Conclusion- RT-PCR demonstrated higher sensitivity than culture for detecting M. tuberculosis in smear-negative patients. Its rapid turnaround time and superior detection make it a valuable adjunct to conventional diagnostics, facilitating early diagnosis and improved patient management.
Cardiovascular changes in children and adolescents with Sickle cell disease admitted at Tertiary Care Teaching Hospital
Introduction: Sickle cell Disease (SCD) has a high prevalence in India, especially in the central and western regions, and poses a considerable health burden. Chronic anemia in SCD leads to hemodynamic changes to maintain perfusion. Chronic hemolysis and blood transfusion leads to iron overload. These changes are responsible for changes in cardiovascular system. Methods: Patients between age group of 9 to 18 years with different complications of SCD admitted in Dr BRAM Hospital were enrolled in the study.Data were analysed using SPSS software version 21.0. Results: Total 90 patients with SCD were included in study. 72.9% patients were having cardiothoracic ratio of less than 0.6. 29.2% patients had prominent bronchovascular marking on chest Xray. On echocardiography 13% patients had increased left ventricular muscle mass index. Conclusion: Early investigations can detect cardiovascular changes so that progression to cardiomyopathy can be prevented. Further cardiac damage can be prevented by modifying disease progression and treatment.
The effects of aerobic and resistance training on HRV parameters in individuals with type 2 diabetes mellitus
Background: Heart rate variability (HRV) is a non-invasive marker of autonomic nervous system (ANS) function and cardiovascular health, reflecting beat-to-beat fluctuations in heart rate. Exercise training is recognized as a potential modulator of HRV, particularly in individuals with type 2 diabetes mellitus (T2DM), a condition often associated with impaired autonomic function. Objective: This study aimed to compare the effects of aerobic and resistance training on HRV parameters in individuals with T2DM over a 12-week period. Methods: A total of 100 participants with T2DM were randomized into either an exercise group or a control group. Baseline and post-intervention assessments included anthropometric parameters (height, weight, BMI, waist circumference, body fat percentage), hemodynamic measures (blood pressure, resting heart rate), and HRV indices. Physical fitness outcomes, including handgrip strength, leg strength, maximal oxygen uptake (VO₂max), and muscle endurance, were also evaluated. The exercise group underwent a supervised 12-week program comprising combined aerobic and resistance training, performed three times weekly. Results: Compared with controls, participants in the exercise group demonstrated significant reductions in body weight, waist circumference, body fat percentage, and both systolic and diastolic blood pressure (p < 0.05). Improvements were also observed in VO₂max, handgrip strength, and bilateral leg strength. However, no statistically significant changes in HRV indices were detected between groups after 12 weeks. Conclusion: While combined aerobic and resistance training improved cardiovascular risk factors, muscle strength, and cardiorespiratory fitness in individuals with T2DM, it did not significantly alter HRV parameters within the study period. Larger and longer-term studies are warranted to further clarify the impact of structured exercise on autonomic regulation in this population and to explore the role of individualized training regimens for optimizing health outcomes.
INVESTIGATION OF THE EFFECTIVENESS OF WINDOW COLOSTOMY AS A MAJOR DIVERSION TECHNIQUE IN INDIVIDUALS WITH CONGENITAL SHORT COLON
Background: ARM (ano-rectal malformation) is associated with congenital short colon (CSC), an uncommon anomaly in which the shortened colon exhibits a pouch-like dilatation. The clinical and anatomical characteristics of CSC are clearly described by prior research, but treatment is still challenging and contentious. Aim: Assessing the effectiveness of window colostomy as a main diversion surgery in people with congenital short colon was the goal of the current investigation. Methods: During the specified research period during which window colostomy was performed, the study evaluated every CSC patient admitted to the Institute. A window colostomy was done on 250 of the 274 CSC individuals who were evaluated retrospectively based on the data records concerning complications related to window colostomy and treatment done. 10 patients had mortality before surgery. Transverse colostomy was done in 14 subjects with incomplete CSC. Results: The study included 172 participants who had window colostomy, experienced all phases of care, including ileostomy, coloplasty, and, finally, ileoplasty closure. There are a few upsetting side effects from the procedure, such as an overall mortality rate of 11% (n=28), significant periostomy excoriation in 36 subjects, significant pouch prolapse in 12 subjects that required revision, minor pouch prolapse in 38 subjects, and window colostomy stenosis in 44 subjects that required dilatation. When a congenital short colon has an initial window colostomy, it may lead to incomplete fecal diversion, where the pouch does not fully decompress, and issues are associated with the stoma itself. Conclusion: Nonetheless, the treatment is quick, simple, and life-saving. It gives enough time for weight growth and prepares the patient for second stage surgery, which eventually has no effect on the result for patients with congenitally small colons. Keywords: Anorectal Malformations, colostomy, Congenital Short Colon, CSC, Window Colostomy
ESTIMATING THE CLINIC-MYCOLOGICAL PROFILE IN INDIANS WITH DERMATOPHYTOSIS
Background: In India, the incidence of superficial dermatophytosis has grown throughout the summer and rainy seasons in both urban and rural regions, regardless of financial background, eating habits, or lifestyle. The literature reports diverse etiological patterns and illness distribution. However, there is limited information on the clinicomycological characteristics of dermatophytosis in India. Aim: The current study sought to examine the proportion of various fungal species related with dermatophytosis in Indian individuals attending tertiary healthcare institutions, as well as the potential relationship of various clinical characteristics with fungal species. Methods: The current study evaluated 782 people of both genders who were new dermatophytosis patients attending the Institute during the study period. All specimens were evaluated using direct microscopic inspection and in vitro cultivation. Fungi were identified using microscopic and macroscopic traits, as well as the urease test and lactophenol cotton blue staining. Results: The study results revealed a male tendency for dermatophytosis, with the bulk of the individuals falling between the ages of 21 and 40. Trichophyton schoenleinii was the most common fungal species seen in the study, accounting for 52.1% of study subjects produced in culture, followed by Trichophyton rubrum, which was found in 26.9%. Conclusion: The current study indicated that Trichophyton schoenleinii was the most prevalent isolated fungal species detected in Indian participants, followed by Trichophyton rubrum and Tinea corporis, which was the most common clinical manifestation in dermatophytosis patients. Keywords: Body surface area, dermatophytosis, Trichophyton, tinea corporis.
EVALUATING THE CHARACTERISTICS OF PATIENTS WITH DUODENAL ULCERS WHO ARE ADMITTED TO INDIAN HEALTHCARE CENTER FOR SURGERY
Background: It is crucial to investigate this matter because perforation of duodenal ulcers is typically identified by the abrupt shedding of the ulcer's base, which is ascribed to a compromised blood supply that causes the duodenum or stomach contents to leak into the peritoneal cavity and cause an acute diffuse peritonitis. Aim: The purpose of this study was to evaluate the characteristics of patients with duodenal ulcers who were admitted to Indian Healthcare Center for surgery. Methods: During the specified study period, 120 patients with duodenal ulcer perforation who were admitted to the Institute were evaluated for this investigation. Operative information, including the kind and location of the surgery, was evaluated for each individual. Death following surgery was considered mortality. Results: The study's findings indicated that, out of all the participants evaluated, the diagnosis was made using a simple abdominal X-ray while the participant was upright. Pneumo-peritoneum was discovered in 110 (91.67%) of the 120 study participants who were evaluated for the research. Conclusion: According to the current study, duodenal perforation is a common finding among study participants, with a greater prevalence observed in those from lower socioeconomic groups. Keywords: Duodenal Ulcer, Perforation, Pneumo-peritoneum, ulcers
ASSESS THE RELATIONSHIP BETWEEN OVARIAN VOLUME AND FASTING PLASMA INSULIN RESISTANCE AND LEVELS IN WOMEN WITH POLYCYSTIC OVARIES
Background: Polycystic ovarian syndrome, or PCOS, is a lifestyle-related condition whose prevalence has been rising worldwide, including in India, and which calls for further research. Aim: The purpose of this study was to use a HOMA 2 model to evaluate how insulin resistance increases as ovarian size increases. Using hemostasis model assessment 2 (HOMA 2), the study evaluated the relationship between ovarian volume and fasting plasma insulin resistance and levels in females with polycystic ovaries. Methods: Transabdominal sonography was used to measure the ovarian capacity in 108 female PCOS patients. Blood samples were taken from each participant under very rigorous aseptic and sterile circumstances, and they were submitted to be tested for fasting plasma insulin levels and fasting blood sugar. Insulin resistance, insulin sensitivity, and beta cell function were evaluated using the HOMA 2 calculator. The collected data were subjected to statistical analysis. Results: The research participants' mean BMI was 25.55 kg/m2, and they were 26.1 years old. Male pattern pubic hair, clitoromegaly, acanthosis, acne, hirsutism, alopecia, and hoarseness of voice were observed in 1.85%, 48.15%, 75.92%, 12.96%, 59.26%, 72%, and 79.6% of their respective research participants. Insulin resistance and BMI (p=0.02), fasting plasma insulin and total ovarian volume (p=0.003), and fasting plasma insulin and BMI levels (p=0.02) all showed a significant positive connection. Additionally, a negative correlation between insulin sensitivity and ovarian volume and a positive correlation between insulin resistance and large ovarian volume were observed. Conclusion: The current study comes to the conclusion that in females with PCOS, an increase in ovarian volume may be interpreted as a sign of increased insulin resistance. Keywords: obesity, polycystic ovarian syndrome, PCOS, insulin resistance, and insulin sensitivity
INVESTIGATING THE IMPACT OF LOW-LEVEL LASER TREATMENT ON HAIR GROWTH AND SCALP HEALTH
Background: In terms of aesthetics, the look of the scalp and hair is critical, regardless of gender or age. However, a range of therapeutic procedures and medicines have been proposed for hair loss and scalp issues, but the results have been insufficient. Aim: The current study investigated the effects of low-level laser treatment on hair growth and scalp problems. Methods: The current study evaluated 100 participants over a 24-week period. For 24 weeks, all 100 research participants were exposed to a helmet-shaped device that emitted light at wavelengths of 630-690, 820-880, and 910-970 nm for 20 minutes every day. At baseline, 12 weeks, and 24 weeks, all research participants had their scalp sebum secretion, erythema index, Global Aesthetic Improvement Scale score, and photrichogram for hair thickness and density measured. Results: After 24 weeks of therapy, hair thickness and density increased significantly (p=0.01 and <0.1, respectively). There was a substantial reduction in sebum excretion from the vertex region (p<0.1). 73.47% (n=72) of the 98 research participants showed improvement in their overall scalp look. Conclusions: The current study shows that using a helmet-like low-level laser treatment equipment can assist improve the overall appearance of the hair by increasing the density and thickness of the hair. It can also help to promote scalp health by reducing sebum secretion. Keywords: Hair loss, low-level laser treatment, scalp, sebum, and bronchogram
COMPARISON OF INTRACERVICAL FOLEYS CATHETER WITH EXTRA AMNIOTIC PGF2 ALPHA INSTILLATION AND INTRACERVICAL FOLEYS CATHETER WITH PGE1 VAGINAL PILLS FOR SECOND-TRIMESTER ABORTION
Background: Pregnancy termination in the second trimester, or more specifically in women with scarred uteruses, is a very difficult scenario that is linked to a three to five times increased risk of maternal morbidity and death. Aim: Using an intracervical foleys catheter with additional amniotic PGF2 alpha instillation against an intracervical foleys catheter with PGE1 vaginal tablets for pregnancy termination starting in the second trimester was the goal of the current investigation. Methods: In order to meet inclusion and exclusion criteria, 80 subjects were randomly assigned to two groups of 40 subjects each. Group I subjects were induced using a Foley's catheter balloon and a vaginal PGE2 tablet, while Group II females were induced using a Foley's catheter balloon and extra amniotic instillation of PGF2α. In order to create a 2 ml solution equivalent to 0.50 mg PGF2α, 5 mg of 1 ml PGF2α was injected every hour for 48 hours or until expulsion. The injection was made with 19 ml of normal saline. The subjects' readiness for expulsion or induction was evaluated. Results: The mean product expulsion interval for Group II females was 18.2±3.8 hours, considerably shorter than that of Group I females (26.0±8.2 hours), with a p-value of <0.005. Additionally, it was observed that 32 out of 40 Group II participants had expulsion within 24 hours and using just one ampoule. Conclusion: The current study comes to the conclusion that the combination of Foley's catheter balloon and additional amniotic instillation of PGF2α is a safe and efficient way to end second-trimester pregnancies in women. Keywords: prostaglandins, Foley's catheter, extra-amniotic, and second trimester
KNOWLEDGE, ATTITUDE AND PRACTICE OF ANTIBIOTIC USAGE AND RESISTANCE AMONG THE MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY
Background: Antibiotics play one of the most important roles in treatment of multiple infections. Because of their repeated use antibiotic resistance has become an important threat. One of the solutions for this menace is to develop adequate knowledge and rational drug prescription. Aim: to assess the knowledge and attitude and awareness of antibiotic use in medical students who will be the future prescribers of these drugs. Methods: This was a cross-sectional questionnaire-based study. Medical students of 1st and 2nd professional year were given the questionnaire. The questionnaire had sections to assess the knowledge, attitude and practice about antibiotic use and resistance. Each section has respective responses ranging from true/false to qualitative responses. The data was analysed by using simple descriptive statistics & Chi-square test was used to determine any significant difference. Results: Majority of participants have adequate to good knowledge of antibiotic usage & resistance in bacterial infections. MBBS Phase-II students have significantly better knowledge towards efficacy of newer and costly antibiotics, inadequate and unnecessary antibiotic usage contributing to antibiotic resistance. Most of the participants were aware that antibiotics should not be used commonly. In context to irrational antibiotic practice and choice of higher antibiotics, group-II participants (i.e. MBBS Phase-II students) had significantly better attitude than the group-I participants (i.e. MBBS Phase I students). Both the study groups revealed good practice strategies. Comparatively group-II subjects show significantly better practicing principles in the present study. Conclusion: Majority of study participants have moderate to high level of knowledge, attitude & practice principles in our study. Educational programmes should be enhanced to increase the knowledge and also to practice the evidence based medicine in the curriculum.
INVESTIGATING PROCALCITONIN'S EFFECTIVENESS AS A STRONG BIOMARKER FOR NONSEPTIC BACTERIAL INFECTIONS
Background: The hormone calcitonin plays a critical role in maintaining calcium and phosphorus balance. Aim: Using a large sample of Indian participants, the current study assessed the procalcitonin test's capacity to distinguish between different bacterial (non-sepsis) aetiologies. Methods: During the designated research period, standard laboratory and clinical data collected from the Institute's Central Lab were used to evaluate the current study. The importance of serum biomarker C reactive protein was evaluated using the collected data. Total leucocyte count and procalcitonin test for early bacterial infection identification. Results: Compared to the population with gram-positive bacterial infections, the study found that a greater frequency of elevated procalcitonin levels was observed in instances of gram-negative bacterial infections, namely those caused by Klebsiella pneumoniae and Escherichia coli. Conclusions: The current study finds that, similar to a rise in TLC and CRP, which are considered the gold standard for blood biomarkers in any bacterial infection, there is an increase in PCT levels even in people with non-septic bacterial infections. It is also observed that, regardless of gender, the rise in these biomarkers is comparable in gram-positive and gram-negative infected people. Additionally, compared to gram-positive infections, gram-negative infections have greater elevated PCT.
Biomarkers in Gram-negative bacteria infection
Evaluation of systemic risk factors in diabetic retinopathy among patients with type 2 Diabetes Mellitus in a tertiary care hospital: An analytical study
Background: Diabetes mellitus (DM) is a major health concern in Southeast Asia, and diabetic retinopathy (DR) is one of its most debilitating complications. Aim: To investigate the association of systolic and diastolic hypertension, age, duration of diabetes, and glycemic control (HbA1c) with the occurrence of DR in patients with type 2 DM. Methodology: This case–control study included 500 patients attending the Ophthalmology Department of NCMCH, Israna, Panipat, Haryana. Patients with proteinuria were excluded to eliminate the influence of nephropathy. Participants were aged between 40–80 years and divided into two groups: Group A (with DR) and Group B (without DR). Clinical parameters such as systolic and diastolic blood pressure, fasting blood sugar, random blood sugar, and HbA1c were evaluated. Results: Patients with DR had significantly higher systolic blood pressure compared to those without DR (141.8 ± 11.01 vs. 124.5 ± 13.6 mmHg, P<0.001). No significant difference was observed in diastolic BP between groups. The mean age of patients with DR was significantly higher than those without DR (57.5 ± 7.9 vs. 55.1 ± 8.1 years, P<0.001). The mean duration of diabetes was also longer in the DR group (12.2 ± 5.1 vs. 7.9 ± 4.4 years, P<0.001). HbA1c levels were significantly higher in patients with DR than in those without DR (8.4 ± 0.8 vs. 7.5 ± 0.8, P<0.001), highlighting the role of poor long-term glycemic control in the development of DR. Keywords: Diabetes mellitus, diabetic retinopathy, hypertension, HbA1c, duration of diabetes
To determine pelvic incidence, sacral slope, and pelvic tilt in thoraco lumbo pelvic alignment in chronic low back pain patients in Central Indian Population
Background: Chronic low back pain (CLBP) is a prevalent condition significantly impacting quality of life, often associated with alterations in sagittal thoraco-lumbopelvic alignment. This study aims to analyze thoraco-lumbopelvic alignment parameters, including pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) in the Central Indian population. Aim: To determine pelvic incidence, sacral slope, and pelvic tilt in thoraco lumbo pelvic alignment in chronic low back pain patients in Central Indian Population. Materials & methods: The study is a cross-sectional cross-sectional study spanning 2021 to 2024, focusing on CLBP in patients aged 18-60 years. The sample size is calculated at a 95% confidence level, with a minimum of 127 samples required. The study includes participants with a history of LBP, spinal deformity, hip or pelvic disorder, and contraindications for radiographic exposure. The study will use a combination of clinical assessment tools and radiographic imaging to measure TLP alignment, including photogrammetry, spinal assessment tools, and X-rays to ensure minimal radiation exposure and ethical compliance. Results: Out of 198 incorporated, males occupied 56% (n=111) and female gender occupied 44% (n=87) of the total study population respectively. Whereas in the control group, male occupied 52% (n=103) and females 48% (n=95) respectively. CLBP patients exhibited significantly higher PI, PT and SS was significantly lower in CLBP patients. PT showed the strongest positive correlation with VAS scores (r = 0.50), indicating that higher pelvic tilt is associated with greater pain severity. Conclusion: The study reveals significant differences in thoraco-lumbo-pelvic alignment parameters in patients with Chronic Lobar Pain (CLBP), indicating the body's attempt to maintain balance and counteract biomechanical stress. Region-specific characteristics, such as genetics and occupational habits, influence these variations. Key words: Chronic low back pain; Sacral slope; pelvic incidence; pelvic tilt; thoraco-lumbo alignment; Ethnic populations.
FUNCTIONAL OUTCOME OF PLATING IN TIBIAL PLATEAU FRACTURES CLASSIFIED THROUGH MODIFIED SCHATZKER CLASSIFICATION
Introduction: Tibial plateau fractures make up about one percent of all bone fractures and are responsible for roughly eight percent of fractures in older adults; thus, they are frequently encountered in clinical practice. These injuries can present in numerous forms, affecting either the medial, lateral, or both sides of the plateau, with varying degrees of joint surface depression and displacement. The essential goal when surgically fixing tibial plateau fractures is to accurately restore both the joint surface and the overall alignment of the leg. Objective: This research aims to evaluate clinical findings after surgical treatment of tibial plateau fractures using plates and to identify fracture types using three-dimensional imaging. Results: Our study demonstrated that the use of 3D imaging simplified preoperative planning and led to positive functional and radiological patient outcomes. Notably, in Schatzker types IV, V, and VI, posteromedial plating was performed for select patients with posteromedial fragments that were missed with standard x-rays. Conclusion: Employing the modified Schatzker system allows for a more detailed view of the fracture, which supports more precise case-by-case treatment.
Preparation and Characterization of Surface-Modified, Magnetically Targeted Nanocarriers for Enhanced Transdermal Delivery of a Hydrophilic Anti-Inflammatory Drug via Iontophoresis
Background Transdermal delivery of hydrophilic drugs remains a major challenge due to limited permeability through the stratum corneum. To overcome this, magnetically responsive nanocarriers integrated with iontophoretic enhancement were developed to improve the localized and controlled delivery of a model anti-inflammatory drug, Diclofenac sodium. Methods Magnetic nanoparticles (Fe₃O₄) were synthesized via a co-precipitation method and surface-modified using chitosan and PEG to enhance biocompatibility and stability. The drug was loaded through adsorption, yielding an encapsulation efficiency of 78.6 ± 2.3 %. The nanocarriers were characterized for particle size (132.5 ± 5.8 nm), zeta potential (+27.8 mV), morphology (TEM/SEM), magnetic behavior (VSM), and chemical interactions (FTIR, DSC). In-vitro drug release and transdermal permeation studies were performed under magnetic and iontophoretic conditions using Franz diffusion cells and rat abdominal skin. Results The developed nanocarriers exhibited superparamagnetic behavior with saturation magnetization of 54.2 emu g⁻¹, confirming responsiveness to external magnetic fields. Controlled biphasic release was observed, with 88 % cumulative release in 24 h under magnetic influence, compared to 70 % without the field. In transdermal permeation studies, the flux of Diclofenac increased from 14.8 µg cm⁻² h⁻¹ (passive diffusion) to 108.6 µg cm⁻² h⁻¹ under combined magnetic + iontophoretic conditions, representing a 7.3-fold enhancement ratio. Skin deposition also improved markedly (from 18.5 % → 55.2 %) compared to conventional gel. The results demonstrated synergistic enhancement due to polymeric surface modification, magnetic targeting, and iontophoretic propulsion. Conclusion The proposed PEG–Chitosan–Fe₃O₄ nanocarrier system, when coupled with iontophoresis, offers an efficient and non-invasive strategy for the transdermal delivery of hydrophilic anti-inflammatory drugs. The integration of magnetophoretic guidance and electro-driven transport provides controlled release, improved bioavailability, and enhanced skin retention—highlighting its potential for localized therapeutic applications in pain and inflammation management.
A study of association of lipid profile with primary open angle glaucoma in non-obese patients
Background: Hyperlipidemia has been linked to glaucoma and elevated intraocular pressure (IOP). Aim and Objective: To evaluate the association between serum lipid profile and Primary Open Angle Glaucoma (POAG) in non-obese patients. Materials and Methods: This case–control study was conducted after approval from the Institutional Ethics Committee (IEC) and obtaining written informed consent. A total of 120 adults (>40 years) were enrolled: 60 non-obese POAG patients (cases) and 60 age-matched non-glaucoma subjects (controls). Serum lipid profiles were assessed using Vitros 5600, in accordance with the Declaration of Helsinki. Results: Mean total cholesterol and triglyceride levels were significantly higher in non-obese POAG cases compared to controls (p<0.05), while mean high-density lipoprotein (HDL) levels were significantly lower (p<0.001). Elevated cholesterol levels were found to be significantly associated with POAG in non-obese patients (p<0.001). Conclusion: Serum lipid abnormalities, particularly increased cholesterol and triglycerides with reduced HDL, are significantly associated with the risk of POAG in non-obese individuals.
Postoperative Cognitive Dysfunction: Incidence and Predictors in Elderly Patients Under General Anaesthesia
Aim: To ascertain the prevalence of postoperative cognitive dysfunction (POCD) and identify its predictors in elderly patients undergoing surgery under general anaesthesia. Methodology: A prospective observational study was performed from January 2023 to December 2024 involving elderly patients undergoing surgery with general anaesthesia. Cognitive function was evaluated preoperatively and postoperatively utilising standardised instruments, while potential predictors, including age, comorbidities, type and duration of surgery, and anaesthesia specifics, were documented. The incidence of postoperative cognitive dysfunction (POCD) was computed, and statistical analysis was conducted to ascertain significant predictors. Results: In the examined cohort, X% of patients manifested POCD. Individuals over 70 years of age, undergoing extended surgical procedures, and possessing comorbid conditions exhibited a significantly elevated risk of postoperative cognitive dysfunction (p<0.05). Early detection and monitoring facilitated prompt intervention in affected patients. Conclusion: POCD is a prevalent complication in elderly patients undergoing general anaesthesia, with advanced age, extended surgical duration, and comorbidities identified as significant predictors. Preoperative evaluation and perioperative interventions can mitigate cognitive deterioration and enhance postoperative results.
A CLINICAL REVIEW ON CHRONIC OBSTRUCTIVE PULMONARY DISEASES AFTER COVID 19 PANDEMIC
Introduction: Chronic obstructive pulmonary disease (COPD) is a common, persistent inflammatory illness of the airways characterized by persisting respiratory symptoms and irreversible airflow limitation. Worldwide, COPD is the third leading cause of death, following ischemic heart disease and cerebrovascular illness, due to elevated morbidity and mortality rates. Aim: Respiratory failure (RF), particularly hypercapnic respiratory failure (HRF), commonly manifests in the majority of people with severe or end-stage chronic obstructive pulmonary disease (COPD). Methods: Chronic Obstructive Pulmonary Disease exacerbated by Respiratory Failure (COPD+RF) exacerbates treatment challenges, leading to a diminished prognosis. Although the pathophysiology of RF in COPD remains unclear, abnormal immune activation and systemic inflammation are significant factors. Results: The systemic immune-inflammation index (SII) is an integrative inflammatory marker calculated from peripheral lymphocyte, neutrophil, and platelet counts. Neutrophils, platelets, and synthesized cytokines are mostly associated with nonspecific immune responses. Conversely, lymphocytes are predominantly associated with immune-related pathways in COPD patients. Conclusions: Chronic Obstructive Pulmonary Disease (COPD) is a significant airway disorder that necessitates attention and the development of therapeutic formulations for its treatment.
A Comparative Study of Serum Creatine Kinase Levels in Patients with Alcohol Dependence Syndrome having Complicated Withdrawal (Seizures/Delirium) and Uncomplicated Withdrawal
Alcohol dependence syndrome encompasses physiological, behavioral, and cognitive symptoms, prioritizing alcohol use to an extreme degree. Withdrawal complications, such as delirium tremens (DT), pose significant health risks, with DT being potentially fatal in up to 37% of cases, typically manifesting 72hours after alcohol cessation. Early AWS complications such as seizures and delirium tremens represent deadly risks to patient health so dependable biomarkers must be available for timely detection and management. The biochemical marker CK stands as a possible choice because it shows relationships with muscle injury and physiological stress. Research examined CK biomarker levels in alcohol dependent patients experiencing complex withdrawal syndrome (n = 48) and simple withdrawal syndrome (n = 54). The data revealed higher CK biomarker levels in patients experiencing complex withdrawal indicating potential usage as a cheap screening instrument for identifying high-risk groups. Results demonstrated significantly higher CK levels in complicated withdrawal (mean 298.14) compared to uncomplicated withdrawal (mean 130.48), with a p-value of 0.001. Additionally, CIWA and SADQ scores were notably higher in the complicated group, each with statistically significant p-values of 0.001. A strong correlation was observed between serum CK levels and CIWA scores (p = 0.001), highlighting serum CK as a potential marker for identifying withdrawal severity. This suggests that routine CK measurement upon admission could serve as a rapid, supplementary diagnostic tool to guide timely clinical interventions for varying states of alcohol withdrawal.
clinical institute withdrawal assessment for alcohol scale revised (CIWA-Ar)
scores and severity of alcohol dependence questionnaire (SADQ)
STUDY OF THE HEALTH SEEKING BEHAVIOUR OF ELDERLY PEOPLE WITH NON-COMMUNICABLE DISEASE ATTENDING IN SGMH REWA
Background: Improvements in healthcare infrastructure and living conditions have significantly enhanced life expectancy, particularly among individuals affected by non-communicable diseases (NCDs). This has led to a growing elderly population managing chronic health conditions. Objective: To evaluate the health-seeking patterns of elderly individuals and determine the primary factors that influence their healthcare decisions. Materials & Methods: A cross-sectional study was carried out in the Medicine Outpatient Department (OPD) of Sanjay Gandhi Memorial Hospital, affiliated with Shyam Shah Medical College, Rewa. The study involved 310 elderly participants (aged 60 years and above), who were interviewed using a semi-structured questionnaire. The data included details on healthcare utilization, history of illnesses, and socio-demographic characteristics. Results: Among the 310 respondents, the majority (211, 68.06%) were aged between 60 and 70 years. The sample consisted of 176 males (56.8%) and 134 females (43.2%). More than half (167, 53.9%) had no formal education. A large proportion (239, 77.10%) reported living with chronic health conditions, with hypertension being the most common (113, 36.4%), followed by locomotor issues (81, 26.12%). Private healthcare services were preferred by 177 individuals (57.10%), and 183 participants (59.03%) reported undergoing regular medical check-ups. A significant number (231, 74.52%) were financially reliant on their children, and 232 (74.88%) indicated that the nearest health center was located over 5 km from their residence. Most healthcare costs were borne by their children, with health insurance covering a smaller portion (56, 18.06%). Age emerged as a significant factor affecting their healthcare-seeking behaviour. Conclusion: The study reveals that a majority of the elderly population falls within the 60–70 age group. There is a critical need to increase awareness about aging-related health conditions. Many chronic diseases such as hypertension, diabetes, and osteoarthritis remain either undetected or inadequately treated in this demographic.
Therapeutic Potential of Medicinal Plants and Unani Formulations in Tuberculosis
Tuberculosis (TB) remains a global health crisis with 8.2 million new cases recorded in 2023, while multidrug-resistant and extensively drug-resistant strains pose unprecedented challenges to conventional treatment. This comprehensive review evaluates the therapeutic potential of medicinal plants and Unani formulations in TB management through systematic analysis of ethnobotanical, phytochemical, and pharmacological evidence from 2010-2024. Traditional medicine systems have historically employed diverse plant species including Allium sativum, and Myrsine africana, demonstrating minimum inhibitory concentrations of 15.6-250 μg/mL against Mycobacterium tuberculosis. The Unani system contributes sophisticated multi ingredient formulations like Qurs Kafoor and Habb-e-Sil, targeting multiple mycobacterial pathways through alkaloids, phenolics, terpenoids, and quinones. These compounds exhibit diverse mechanisms including cell wall synthesis inhibition, membrane permeabilization, DNA gyrase inhibition, and immunomodulation. While preliminary studies show promising antimycobacterial activity and reduced cytotoxicity compared to conventional drugs, standardization challenges and limited clinical trials remain significant barriers. Integration of traditional knowledge with modern scientific methodologies offers unprecedented opportunities for developing novel anti-TB therapeutics with improved safety profiles and reduced resistance potential.
Characterization and speciation of fungal isolates of different clinical samples from a teritiary care centre, Hyderabad.
Fungal infections are major health concern, especially in critically ill and immunocompromised patients. This study was conducted to understand the pattern and seasonal trends of fungal infections at tertiary care Hospital, Telangana, over a period of one year from January to December 2023. A total of 1032 clinical samples were collected from OPD and IPD patients. All samples were examined using KOH microscopy, followed by fungal culture on SDA and other differential media. Results: Out of 1032 samples, 152 (14.72%) were positive on KOH microscopy, and 118 (77.63%) were culture positive. Fungal infections were more common in males (n=72) than females (n=46), with highest number of cases in 21–40-year age group. Most infections occurred during winter, November to February. Skin samples had highest positivity (22.88%), followed by nail (19.49%), nasal cavity (13.56%), sinus (12.71%), biopsy (11.02%), polypoidal mass (5.93%), lung tissue (3.39%), hair and ear canal (2.54% each), BAL and sputum (1.69% each), and FESS, oral swabs, and tonsils (0.85% each). A total of 25 different fungal species were isolated. The most common were Aspergillus flavus and A. niger (11.86% each), followed by A. fumigatus (10.17%). Among dermatophytes, Trichophyton rubrum (9.32%) was most common, followed by T. tonsurans, T. mentagrophytes, and Microsporum gypseum. Other fungi included Candida albicans, Candida tropicalis, Penicillium, Fusarium, Mucor, Malassezia, and others in smaller numbers. Conclusion: This study highlights the wide range and seasonal pattern of fungal infections. Early detection through microscopy and culture helps in starting appropriate antifungal treatment and reducing unnecessary antibiotic use.
PREPARATION AND EVALUATION OF MELOXICAM SOLID DISPERSIONS BY SOLVENT EVAPORATION METHOD
Meloxicam (Class ΙΙ drug according to Biopharmaceutical Classification System) is a highly potent non-steroidal anti-inflammatory drug of the enolic acid class of oxicam derivatives. The low solubility of Meloxicam in water and biological fluids results into its poor bioavailability. The aim of this study is to improve the solubility of Meloxicam, and hence bioavailability, by using solid dispersion technique. Nine physical mixtures of Meloxicam (PMMs) were prepared in three different proportions of MEL-to-carrier (PEG 4000, PEG 6000, and poloxamer 407). Solid dispersions of MEL (SDMs) were prepared by solvent evaporation method using the polymers mentioned above. Solubility studies for both PMMs and SDMs were conducted in a phosphate buffer (pH 6.8). The prepared SDM formulations were subjected for percentage of practical yield and drug content analysis. Fourier Transform Infra-Red (FT-IR) spectrophotometric and Differential Scanning Calorimetric (DSC) studies were also conducted to evaluate both PMMs and SDMs. Among all the prepared formulas the ratio of 1:5 MEL-to- poloxamer 407 was considered the best, which showed significant enhancement (p < 0.05) of the drug solubility for both PMM-9 and SDM-9. Good results were also observed concerning the drug content analysis and percent of practical yield for SDM-9. FT-IR studies confirmed the compatibility between MEL and poloxamer 407 for both PMM-9 and SDM-9. Moreover, according to DSC studies, there was a perfect change of MEL crystallinity to the amorphous state. Overall, results suggest that SDM-9 containing poloxamer 407 (Pluronic®F-127) as a carrier in a proportion of 1:5 drug: carrier was a successful resolution for the limited solubility of MEL.
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Outcomes of Non-Operative Management in Blunt Abdominal Trauma: An Observational Study from a Tertiary Care Center
Aim: To evaluate the results of non-operative management (NOM) in a tertiary care centre for patients with blunt abdominal trauma who are haemodynamically stable. Methodology: Between January 2020 and December 2024, 120 patients participated in this observational study. Analysis was done on demographic, injury mechanism, imaging, and outcome data. Close observation, serial imaging, and supportive care were all part of NOM; surgery was only performed in the event that NOM failed. Results: The mean age of the 120 patients was 32.6 years, with 86 of them being men. The most common injuries were hepatic (32.5%) and splenic (45%). 15% of patients needed surgery, while 85% of patients had success with NOM. The NOM group had a lower mean hospital stay and a 3.3% mortality rate, mostly from high-grade injuries. Conclusion: NOM reduces the need for needless surgery in patients with stable blunt abdominal trauma, especially those with low-to-moderate grade solid organ injuries.