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
To study the preventability of adverse drug reactions in Tertiary Care Hospital in Assam
Background An adverse drug event (ADE) is any untoward medical occurrence in a patient who is administered a medicinal product and which doesn’t necessarily have a causal relationship with this treatment. Pharmacological adverse drug reactions (ADRs) happen when the plasma and (or) tissue concentration surpasses the "therapeutic window" or a patient's reactivity to the drug agent increases. Preventability assessment can be done to know if the occurred reaction was inevitable or not. Most ADRs can be prevented on the basis of already known adverse reactions to pharmacological products and procedures. Methods This study is a non-interventional, hospital-based, prospective, cross-sectional, observational study conducted at Diphu Medical College & Hospital on patients who presented with adverse reactions to both inpatient and outpatient department during the period of 1st July 2024 to 30th June 2025. A total of 123 reported cases of all age group was taken, out of which 99 cases were enrolled under the study. Results & Observation Preventability was assessed using Modified Schumock and Thornton Scale. 36.4% of the ADRs were “preventable”, 19.2% were “probably preventable” and 44.4% were “not preventable”. Hence most of the ADRs are not preventable. No ADR related mortality was recorded during the study period. Conclusion The study of assessment of preventability signifies that it is not always possible to preclude an ADR, but measures can be taken to decrease the occurrence of ADR and mortalities.
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EVALUATING PHYSICIAN’S AND PATIENT’S PERCEPTION AND CONCERN REGARDING GENERIC MEDICINES IN A TERTIARY CARE TEACHING HOSPITAL
Background: Generic medicines are cost-effective alternatives to branded counterparts, offering significant savings to patients and the healthcare system. However, their utilization is heavily influenced by the perceptions of key stakeholders: physicians (prescribers) and patients (consumers). This study aimed to evaluate the knowledge, attitude, and concerns of physicians and patients regarding generic medicines in a tertiary care teaching hospital. Methodology: This was a cross-sectional, observational study conducted in the Department of Pharmacology at BLDEU’s Shri B.M. Patil Medical College Hospital and Research Centre, Vijayapura, over two months. A target sample size of 400 subjects (Medical Officers, Residents, Specialists, and Patients) was planned using a structured questionnaire for physicians and a vernacular interview for patients. Results: The response rate was 92.5% (n=370). Physicians (n=120) generally acknowledged generics' cost-effectiveness (85%) and bioequivalence (78%). However, a significant minority (45%) expressed concerns about the quality and manufacturing standards of generic products, and 55% were reluctant to prescribe them for life-threatening conditions. Patients (n=250) largely agreed that generics were cheaper (75%), but a majority (60%) believed generics had lower efficacy and quality compared to branded medicines. Only 30% of patients reported asking their doctor for a generic alternative. Both groups identified the lack of public awareness and physician preference for branded drugs as major barriers. Conclusion: Despite a baseline understanding of generic medicine's financial benefits, both physicians and patients in the tertiary care setting harbor significant concerns regarding quality, efficacy, and safety. Targeted educational interventions for both prescribers (emphasizing bioequivalence data) and consumers (addressing quality mistrust) are crucial to increase the rational utilization of generic medicines.
EVALUATING HOW AXIAL ELONGATION AFFECTS AST ANTERIOR SCLERAL THICKNESS IN MYOPIC PATIENTS
Background: Macular degeneration and glaucoma can become more common as a result of myopia. Myopia has significantly increased due to the recent rise in the usage of technological devices. Therefore, in order to better grasp potential myopia mechanisms and other diseases, it is essential to comprehend the characteristics of the anterior sclera of myopia. Aim: The purpose of this study was to evaluate how axial elongation affected the anterior scleral thickness (AST) of myopic patients. Methods: During the specified study period, 244 participants without any systemic illnesses or ocular conditions affecting ametropia were evaluated at the Institute. The subjects were split into three groups based on the diopter and AL (axial length): 80 people in the high myopia group, 80 people in the low to moderate myopia group, and 64 people in the emmetropia group. The collected data was statistically examined. Results: The superior side had the lowest AST, followed by the nasal side, lower side, and temporal side, with respective values of 550.74 ± 51.32 μm, 671.52 ± 61.74 μm, 692.30 ± 74.74 μm, and 716.43 ± 65.53 μm. The mean AST at four diameter lines and AL showed a link, with the nasal side showing the strongest correlation (p<0.001), followed by the upper, lower, and temporal sides. Age and mean ASE on the temporal, nasal, and upper sides were significantly correlated (p<0.001). AST and age showed a positive association, while AST and AL showed a negative correlation with p<0.05. Conclusion: The current study concludes that AL and measurement position affected the sclera thickness. Age and AST are positively correlated, but AL and AST are negatively correlated. Individuals with extreme myopia have a thinner anterior sclera than those with low to moderate myopia and emmetropia. AST is impacted by both myopia and posterior sclera thickness. Keywords: Anterior sclera thickness, AST, axial length, myopia, optical coherence tomography
A DESCRIPTIVE STUDY TO ASSESS ON BURNOUT WORK LIFE BALANCE, MARITAL SATISFACTION AMONG MARRIED FEMALE PROFESSIONAL
Background: - Work-life harmony the ability of an employee to sustain a positive balance between their personal obligations, job responsibilities, and family life is referred to as their "work life" balance. Businesses recognize the value of supporting their workers in striking this balance because a growing number of employees struggle with the tension between their personal and professional life. Objective:- To assess the level of burnout, working balance and level of marital satisfaction among married female professionals. Material and Methods:- A quantative research approach with descriptive study method was used .Participants in the study were 80 married working women. Hospitals, schools, corporate offices, and other professional establishmentsaree the places from which they are chosen. The sample was chosen by the investigator using a purposive and convenience sampling technique. This non-probability method involves selecting individuals who meet specific criteria relevant to the research purpose, such as being married, currently working, and willing to participate. Result:- In the overall burnout questionnaire response, the result shows respons of participants as 58% women elect always, 3% women select never, 5% women select rarely 9% women select sometimes 25% select ofen as there response. In section c result of questionarre response are as 62% women are not satisfied with theremarrietal and worklife balance 26% women are neutral and 12% women are satisfied with thereworklife and marrietal satisfaction. In combine response for worklife balance the percentage of distribution of result amonf options were 26% agree, 52% strongly agree, 3% strongly disagree, 14% eutral, 5% disagree toward questions of participants. Conclusion :-The findings highlight the critical requirement for personal coping mechanisms and organizational assistance in order to enhance mental health, increase marital happiness, and facilitate a better work-life balance. These difficulties are amplified in the nursing profession, where round-the-clock duties and emotional work are prevalent.
Analytical Method Development and Validation for Determination of Relugolix in Bulk Drug and Its Tablet Dosage Form Using HPLC Method
The present research focuses on the development and validation of a precise, accurate, and robust High-Performance Liquid Chromatography (HPLC) method for the quantitative estimation of Relugolix, a potent gonadotropin-releasing hormone (GnRH) receptor antagonist, in both its bulk drug and pharmaceutical tablet dosage form. Relugolix has recently gained prominence in the treatment of hormone-sensitive conditions such as advanced prostate cancer and uterine fibroids, necessitating a reliable analytical approach for routine quality assessment. The study aimed to establish a chromatographic method that ensures optimum separation, sharp peak symmetry, and reproducible retention time while maintaining simplicity and cost-effectiveness for laboratory applications. The chromatographic separation was achieved using a C18 reverse-phase column under isocratic conditions with a suitable mobile phase composition of acetonitrile and phosphate buffer in an optimized ratio, maintaining a flow rate of approximately 1.0 mL/min. Detection was performed at a wavelength specific to the λmax of Relugolix using a UV detector, ensuring adequate sensitivity and selectivity. The method was systematically validated according to the International Council for Harmonisation (ICH) Q2(R1) guidelines, assessing critical parameters such as linearity, accuracy, precision, specificity, robustness, limit of detection (LOD), and limit of quantitation (LOQ). Linearity was demonstrated within the selected concentration range, showing an excellent correlation coefficient (r² > 0.999), confirming the proportionality between concentration and peak area. Recovery studies at different levels established the accuracy of the method with recoveries within acceptable limits (98–102%), while precision studies confirmed its reproducibility with low %RSD values. The method exhibited significant sensitivity with low LOD and LOQ, enabling accurate detection even at trace levels. Robustness testing under slight deliberate variations of chromatographic parameters confirmed the stability and reliability of the analytical system. The developed HPLC method proved to be simple, rapid, and highly efficient for routine analysis of Relugolix in both bulk and tablet dosage forms. Its validation ensures suitability for use in quality control laboratories, pharmaceutical industries, and regulatory studies requiring accurate quantification of Relugolix. This analytical approach thus provides a strong foundation for future formulation development and stability assessment studies involving this therapeutic compound.
Development and Characterization of a pH-Sensitive Nanocarrier System for Targeted Delivery of Methotrexate in Rheumatoid Arthritis
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by joint inflammation and destruction. Methotrexate (MTX) is a frontline therapy but suffers from systemic toxicity and poor targeting. This study aimed to develop a pH-sensitive nanocarrier system for targeted MTX delivery to improve therapeutic efficacy and reduce side effects. Methods: pH-responsive nanocarriers were prepared using biocompatible polymers via ionic gelation and nanoprecipitation methods. The formulations were optimized for particle size, drug loading, and pH-triggered release. Characterization included dynamic light scattering (DLS), electron microscopy, encapsulation efficiency, and drug-polymer interaction analysis. In vitro drug release was evaluated under physiological (pH 7.4) and acidic (pH ~6) conditions, alongside cytotoxicity and cellular uptake studies in macrophage cells. In vivo efficacy was assessed using an adjuvant-induced arthritis rat model, measuring paw swelling, histopathology, and pro-inflammatory cytokine levels. Results: The optimized nanocarriers showed uniform nanosize (~150 nm), negative zeta potential, and high encapsulation efficiency (>85%). They exhibited sustained, pH-triggered MTX release, enhanced macrophage uptake, and reduced cytotoxicity compared to free MTX. In vivo, MTX-loaded nanocarriers significantly decreased inflammation, joint damage, and cytokine biomarkers compared to free drug and controls. Conclusion: The pH-sensitive nanocarrier system effectively targets MTX delivery to inflamed RA tissues, enhancing therapeutic efficacy while minimizing systemic toxicity. This approach holds promise for clinical translation in RA treatment, with further studies needed to address scale-up and long-term safety.
Phyto-fabricated Silver Nanoparticles for Antibacterial and Anticancer Activities: A Review
Green synthesis of silver nanoparticles (AgNPs) using plant-based materials has gained significant attention in recent years due to its eco-friendly, cost-effective, and sustainable approach. This review explores the recent advancements in the phyto-fabrication of AgNPs, highlighting their potential applications in antibacterial and anticancer therapies. Plant extracts serve as natural reducing and stabilizing agents, leading to the formation of nanoparticles with enhanced biological properties. The antibacterial activity of these nanoparticles is attributed to their ability to disrupt microbial membranes, generate reactive oxygen species, and interfere with cellular functions. In the context of cancer treatment, phyto-synthesized AgNPs have shown promising results in inducing apoptosis, inhibiting tumor growth, and enhancing drug delivery. This review consolidates findings from recent studies to provide a comprehensive understanding of the synthesis methods, characterization techniques, and therapeutic mechanisms of action, along with discussing current challenges and future perspectives in clinical translation.
COMPARATIVE EVALUATION OF CHIMERIC ANTEROLATERAL THIGH FLAPS AND STANDARD ALT FLAPS FOR MAXILLA-ALVEOLAR EXCISION REPAIR IN PATIENTS WITH HEAD AND NECK CANCER
Background: When oral malignant lesions appear at a locally advanced stage, the maxillary cavity is typically left open during the intricate surgical resection. Concerns including further operations, delayed adjuvant therapy, extended hospital stays, flap necrosis, fistula formation, and/or poor healing are brought on by the maxilla's continuous production. Several approaches have been tried to get rid of this, but each has its own challenges. Aim: The purpose of this study was to compare the chimeric anterolateral thigh flap with the standard ALT flap for the reconstruction of maxilla-alveolar excision in patients with head and neck cancer. Methods: In order to determine the benefits of reconstruction for maxillo-alveolar resections using chimeric ALT with VL (vastus lateralis) that were treated at the Institute throughout the specified study period, the study evaluated 80 individuals. These 40 participants were compared to another 40 age and gender-matched controls in the study, where standard ALT was used for reconstruction. The duration of adjuvant therapy, length of hospital stay, postoperative secretions, adequate maxillary sinus fill, intraoperative ease, and postoperative complications were analyzed using the modified Clavien-Dindo classification. Results: The study's findings demonstrated that chimeric ALT and VL provide more mobility for simple maxillary cavity plugging. Subjects in the chimeric arm with shorter mean hospital stays experience fewer problems. Adjuvant treatment was administered to the majority of individuals within their ideal time frame. Conclusion: The current study comes to the conclusion that chimeric ALT combined with vastus lateralis muscles is a dependable option for reconstructing complex deformities, especially in cavities with dead areas like the maxillary sinus. Effective maxillary sinus plugging for primary surgery improves patient outcomes and needs to be performed on a regular basis. Keywords: ALT flap, chimeric anterolateral thigh flap, head and neck cancer, maxilla-alveolar resection, surgical resections
EVALUATING THE CAUSE OF MEMBRANOUS TONSILLITIS AND THE EFFECTIVENESS OF EPIDEMIOLOGICAL AND LABORATORY CLINICAL INDICATORS IN DIRECTING ITS TREATMENT
Background: One of the most prevalent forms of acute tonsillitis in children is membranous tonsillitis. Despite the fact that different microorganism species have been linked to membranous tonsillitis, doctors believe that bacteria may be the cause, and they typically administer antibiotics from the penicillin class. Aim: The purpose of the current study was to evaluate the causes of membranous tonsillitis and the effectiveness of laboratory clinical and epidemiological factors in directing the treatment of membranous tonsillitis. Methods: The current study evaluated 846 patients with membranous tonsillitis who visited the institute's pediatric emergency department between the ages of 0 and 18 throughout the specified study period. Laboratory, clinical, and epidemiological parameters were evaluated and documented in every participant. Results: Of the 846 research participants, 31.2% (n=264) had Group A beta-haemolytic streptococcus identified, followed by EBV (Epstein-Barr virus) in 24.3% (n=206) and other viral etiology in 44.4% (n=376). Of the people who tested positive with EBV, 27% were prescribed antibiotics, and 98% had Downey cells. Appropriate antibiotics were administered to 7% of research participants who had positive throat cultures. Conclusion: the most often linked causal agents in patients with membranous tonsillitis were Epstein Barr virus and Group A beta-haemolytic streptococcus. The majority of diagnostic investigations in pediatric emergency rooms are peripheral blood smears and throat cultures, which guarantee the proper diagnosis and treatment of membranous tonsillitis. Keywords: membranous tonsillitis, throat infection, tonsillitis, Group A beta-haemolytic streptococcus
The relationship between maternal and cord blood iron status in women and their newborn pairs
Background: Iron sufficiency is crucial during the neonatal period. However, it remains unclear whether fetal iron acquisition is primarily driven by fetal demand or limited by maternal iron stores. Previous studies evaluating the relationship between maternal and neonatal iron status have reported inconsistent findings. Aim: To assess the impact of maternal hemoglobin levels on cord blood hemoglobin of newborns and to evaluate the correlation between maternal and neonatal iron status. Methods: This cross-sectional study was conducted in the Department of Pediatrics, Dr. KNS Memorial Institute of Medical Science, Barabanki, Lucknow, Uttar Pradesh, India, over a period of one year. A total of 110 mother–newborn pairs were enrolled after obtaining ethical approval and written informed consent. Maternal venous blood samples were collected during routine investigations. Cord blood samples were obtained immediately after delivery and prior to placental expulsion. Data were analyzed using Epi Info and Microsoft Excel. Results: The mean age of the mothers was 27.5 ± 4.7 years (range: 19–43 years). Most mothers (63.6%) were multigravida, while 36.4% were primigravida. The mean maternal hemoglobin level was 10.5 ± 1.25 g/dL; among anemic mothers it was 9.3 ± 1 g/dL, and among non-anemic mothers 11.9 ± 2.5 g/dL. The mean maternal serum iron level was 108.8 ± 4.6 µg/dL. Based on severity, 33.9% had mild anemia, 56.6% moderate anemia, and 9.94% severe anemia. The mean cord blood hemoglobin was 15.9 ± 4.3 g/dL, and the mean cord blood iron level was 150.1 ± 8.4 µg/dL. Cord hemoglobin levels were significantly lower in newborns of anemic mothers compared with those of non-anemic mothers (p < 0.01). Conclusion: Maternal iron deficiency may adversely influence neonatal hemoglobin and iron stores. Early detection and timely management of maternal anemia are essential to prevent adverse neonatal outcomes.
Design and Evaluation of Hydrophilic Polymer-Based Matrix Tablets for Extended Release of Metoprolol Succinate: A Comparative Study of Natural and Synthetic Polymers
Purpose: The objective of this study was to design and evaluate extended-release (ER) matrix tablets of Metoprolol Succinate using natural and synthetic hydrophilic polymers. The study aimed to compare the effect of polymer type and concentration on physicochemical properties, drug-release behavior, and release kinetics. Methods: Matrix tablets were prepared using natural polymers (guar gum, xanthan gum) and synthetic polymers (HPMC K4M, HPMC K15M, Carbopol) via direct compression and wet granulation. Preformulation studies including FTIR and DSC were performed to assess drug–excipient compatibility. Powder blend flow properties and post-compression parameters were evaluated according to pharmacopeial standards. In-vitro dissolution was performed using USP Apparatus II in 0.1 N HCl and phosphate buffer pH 6.8. Drug-release data were fitted to zero-order, first-order, Higuchi, and Korsmeyer–Peppas models to determine kinetics and mechanism.
A study of Haemoglobin and serum ferritin levels in newborn babies born to anaemic women
Background: This study aimed to assess the association between mode of delivery and the haemoglobin and serum ferritin levels of newborns, by comparing these parameters in vaginally delivered and caesarean-delivered neonates of non-anaemic mothers and mothers with iron deficiency anaemia (IDA). Methods: A total of 120 full-term pregnant women aged 18–40 years, admitted through the OPD or labour room of the Department of Obstetrics and Gynaecology, were recruited. All participants had full-term newborns without prenatal or perinatal complications. The study was conducted at a tertiary care hospital in eastern India. Results: Eighty percent of the cases had not taken iron–folic acid (IFA) supplementation during pregnancy, compared with 20% among the controls, and this difference was statistically significant. A strong correlation was observed between maternal and neonatal haemoglobin and serum ferritin levels. As the data were not normally distributed, the Spearman-Rho correlation test was applied, yielding significant results. Newborns of mothers with IDA had markedly lower haemoglobin and ferritin levels compared to those born to non-anaemic mothers, indicating that maternal IDA adversely affects neonatal iron stores. An independent t-test confirmed statistically significant differences in haemoglobin levels between cases and controls. Conclusion: Maternal IDA appears to negatively influence the iron reserves of newborns. Optimal placental iron transfer is essential for fetal development and for ensuring adequate iron stores at birth to support early infancy. When maternal iron stores are depleted, fetal iron requirements may be only partially met. Further research is warranted to explore how lower cord serum ferritin levels relate to iron status and developmental outcomes later in infancy. Keywords: Serum Ferritin Levels, Pregnancy, Iron Deficiency Anaemia, Newborn Iron Status
The risk factors for unconjugated hyperbilirubinemia and readmission jaundice in intramural neonates ≥35 weeks
Background: Neonatal hyperbilirubinemia is a common condition that is typically benign, although in some cases it may progress to kernicterus. Because neonatal jaundice is both preventable and treatable when detected early, identifying risk factors for developing severe hyperbilirubinemia is essential. Materials and Methods: A prospective observational study was conducted to examine the risk factors associated with significant neonatal jaundice and hospital readmission for jaundice. Results: A total of 600 neonates were enrolled. Among them, 15% (n = 90) developed significant jaundice prior to discharge, and 2.5% (n = 15) required readmission. Maternal risk factors for significant jaundice included primigravida status with maternal age between 23 and 27 years, blood group O, conception by in vitro fertilization and embryo transfer (IVF–ET), antenatal oxytocin use, and lower-segment cesarean section. Neonatal risk factors included late-preterm male infants with birth weight between 2 and 2.5 kg and delayed cord clamping (DCC). Maternal risk factors for readmission included young primigravida women with blood group O from North India, antenatal oxytocin use, and gestational diabetes mellitus. Neonatal risk factors for readmission included low birth weight, DCC, twin pregnancy, and discharge between 48 and 72 hours after birth. Conclusion: The statistically significant factors (P<0.05) associated with an increased risk of developing significant hyperbilirubinemia requiring readmission were low birth weight, gestational age of 35–36⁶⁄₇ weeks, DCC, and conception via IVF–ET.
A STUDY OF SCREENING OF GESTATIONAL DIABETES MELLITUS IT’S RISK FACTOR, PERINATAL OUTCOME AND MANAGEMENT
Background: Gestational diabetes mellitus (GDM) is a transient form of glucose intolerance with onset or first recognition during pregnancy. It constitutes a major and growing public health concern worldwide, with a global prevalence ranging from 2% to 6%, and up to 20% in high-risk populations. Women diagnosed with GDM have an increased risk of adverse maternal and fetal outcomes; therefore, early diagnosis and appropriate management are essential to improve fetomaternal health. Objective: To assess the prevalence, risk factors, and fetomaternal outcomes associated with gestational diabetes mellitus. Materials and Methods: A prospective hospital-based study was conducted in the Department of Obstetrics & Gynecology, Shri Balaji Institute of Medical Sciences, Raipur, Chhattisgarh. A 75-g oral glucose load was administered irrespective of meal status, and plasma glucose estimation was performed after 2 hours. GDM was diagnosed when the 2-hour plasma glucose level exceeded 140 mg/dL, as per DIPSI criteria. All women diagnosed with GDM were followed and managed using dietary modification and/or insulin therapy until delivery. Maternal and fetal risk factors and outcomes were recorded. Results: The prevalence of GDM in the study population was 8%. A significant proportion of women with GDM had a prior history of delivering a large baby, stillbirth, or spontaneous abortion. Maternal complications included pregnancy-induced hypertension (41.7%) and polyhydramnios (33.3%), while 61.7% underwent caesarean section. Preterm labour occurred in 8.3% of cases. No complications were noted in 11.7% of women. Among newborns, 21.7% had a birth weight >3.5 kg, and 16.7% weighed <2.5 kg. Conclusion: Women with GDM are at increased risk of obstetric and fetal complications. The DIPSI single-step testing method is a simple and cost-effective approach for screening and diagnosing GDM, enabling timely management to reduce adverse outcomes.
A comparative study on maternal and fetal outcomes in emergency versus elective caesarean section
Background: The incidence of caesarean section has progressively increased worldwide over the past few decades. Alongside this rise, the number of indications—many of them unnecessary—has also expanded, resulting in indiscriminate use. Caesarean section is performed as an emergency or elective procedure depending on maternal and fetal conditions. Evidence suggests that the risk of surgical complications is higher in emergency caesarean sections than in elective ones. Materials and Methods: This retrospective study was conducted to evaluate maternal and fetal outcomes in elective versus emergency caesarean sections performed at our hospital from July 2024 to July 2025. Results: Among 1,980 total deliveries, 1,158 were normal vaginal deliveries, 102 were instrumental, and 720 were caesarean sections. Of the caesarean deliveries, 350 were emergency and 370 were elective. Overall operative complications were observed in 85 cases (11.8%), with the majority occurring in the emergency group. Conclusions: Elective caesarean sections are associated with fewer maternal and perinatal complications compared to emergency caesarean sections.
IDENTIFICATION OF POTENTIAL PROGNOSTIC FACTORS AFFECTING THE OUTCOME OF PAEDIATRIC HUMERAL CONDYLE FRACTURES
Background: In children with mildly displaced or non-displaced LHCF (lateral humeral condyle fractures), problems such as non-union and displacement are frequently observed. Nevertheless, there is a dearth of writing on the subject in the Indian context. Aim: The purpose of this study was to determine the possible prognostic factors influencing the course of pediatric humeral condyle fractures. Methods: The current study evaluated 178 individuals with a history of trauma who were admitted to the Institute throughout the specified study period. Demographics, the side of the injury, the fracture's displacement, its treatment, its further displacement, non-union, and other consequences were all recorded. Based on basic radiographs, the fractures were categorized using Jakob's classification, and the displacement was measured in millimeters using lateral and AP (anteroposterior views). Results According to the study's findings, 20% of the participants had Jacob II and 80% had Jacob I, with a mean age of 6.2±2.8 years. 81% of the participants received non-surgical therapy, whereas 19% underwent surgery. Of the individuals, 27% (n=48) had complications. Non-union, lateral condyle hypertrophy, and alignment disruption were all significantly correlated with higher initial displacement degree. A displacement of more than 1.5 mm was shown to require surgical intervention. Conclusion: lateral humeral condyle fractures that are minimally displaced or non-displaced exhibit future displacement and non-union. The degree of initial fracture displacement in these fractures is associated with non-union incidence, lateral condyle hypertrophy, and alignment abnormalities. Surgical management is required for displacement more than 1.5 mm.
MANAGEMENT OF PLANTAR FASCIITIS CONCERNING STRUCTURAL CHANGE, FUNCTIONAL IMPROVEMENT AND PAIN REDUCTION BY DIFFERENT DRUGS
Background: Plantar fasciitis affects a large percentage of people worldwide, including in India, and primarily affects middle-aged people and sports. It is a prevalent cause of heel discomfort. Corticosteroid injections have been used to relieve symptoms in patients with plantar fasciitis; however, worries about risks have grown, prompting research into alternate treatments such dextrose injections. Aim: The purpose of this study was to compare the safety and effectiveness of steroid injection and 25% dextrose infection for the treatment of plantar fasciitis in terms of pain relief, functional enhancement, and structural alteration. Methods: Participants with a diagnosis of plantar fasciitis who were treated at the Institute over the specified study period were evaluated in this study. Individuals with a verified diagnosis of plantar fasciitis were split into two groups at random and administered either corticosteroids or dextrose injections. The American Foot and Ankle Score (AFAS) for functional improvement, the Visual Analogue Scale (VAS) for pain, and an ultrasound-based evaluation of plantar fascia thickness prior to and following a 12-week course of treatment were the clinical outcomes assessed. Results: The study's findings demonstrated that both groups' functional outcomes had significantly improved and their pain levels had decreased. While individuals in the dextrose group experienced long-term advantages, those in the steroid group experienced acute pain alleviation. Plantar fascia thickness decreased to a comparable level in both groups at the 12-week assessment, with no statistically significant difference between the two groups. Conclusion: The current study comes to the conclusion that injections of steroids and dextrose were both effective in treating plantar fasciitis. Although steroids relieve symptoms more quickly, dextrose exhibits less side effects and long- term advantages, making it a viable option for long-term care.
Metformin's role in the treatment of breast fibrocystic illness
Background and Objectives: - Fibrocystic Disease of the Breast is one of the commonest benign breast diseases associated with hormonal disturbance. Thus, this study aims to assess the role of Metformin in treating the presenting complains of Fibrocystic Disease of the Breast compared to Placebo. Methodology: A prospective double-blind Randomized clinical trial among cases with Fibrocystic disease of the Breast. The cases were collected from the Breast assessment clinic in Azadi Teaching Hospital and a privet clinic in Duhok City, Kurdistan region, Iraq. The study took a total duration of 12 months. A total of 100 cases were fit and were enrolled in the study, 50 cases on placebo with watchful waiting and 50 cases on metformin 500 mg twice daily; 2 cases were excluded due to adverse effects from the treatment. Results: Nearly 2/3 of the cases showed response were on metformin compared to 1/3 on Placebo; indicating clinically the superiority of Metformin in reducing the cyst size, P = 0.002. Metformin was associated with 8.4% reduction in Nipple discharge and 54.0% reduction in Mastalgia vs 18% and 54%, respectively for Placebo, both showing significant impact, P < 0.001, with a higher Odd for Placebo in both symptoms, 1.7 vs 3.5 and 11.7 vs 23.5. Conclusion: Compared to Placebo, Metformin is associated with a significant reduction in the size of the cysts. While there is no significant difference in pain management and decreasing nipple discharge in both groups, with higher odds for Placebo over Metformin in the latter symptoms. Additionally, both Metformin and Placebo were associated with nearly 54% reduction in Mastalgia.
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.
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