International Journal of

Pharmaceutical and Clinical Research

e-ISSN: 0975 1556

p-ISSN 2820-2643

Peer Review Journal

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1. Oral Manifestations of Hypothyroidism
Subramanium P, Jagannathan N
The thyroid is a bilobular glandular structure which acts as a major regulator of metabolism regulating all the bodily functions. The oral cavity is prone to fluctuations in the hormone produced by the thyroid.  The oral findings and its complications should be understood by the dentist and endocrinologist before a treatment is initiated.  Patients with thyroid dysfunction also need proper risk management before certain dental procedures are performed to avoid medical emergencies. This review focuses on the pathophysiology of hypothyroidism and its implication in oral health.

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3. Comparative Chromatographic Fingerprint Profiles of Ethanolic Extract of Macrotyloma uniflorum L. Leaves and Stem
Priyanga Suriyamoorthy, Hemmalakshmi Subrhamanian, Devaki Kanagasapabathy
Macrotyloma uniflorum (L.) is belonging to the family fabaceae. Various parts of this plant used to cure ailments like heart conditions, asthma, bronchitis, leucoderma and in the treatment of kidney stones etc. The present study was focused to evaluate the HPTLC fingerprinting analysis of M.uniflorum leaf and stem. HPTLC fingerprinting profiles was done by using Hamilton syringe and CAMAG LINOMAT 5 instrument. HPTLC fingerprinting profile confirms the presence of alkaloids, glycosides, flavanoids, phenols, steroids and terpenoids. Among all the solvents in the phytochemical screening the ethanolic extract shows most of the secondary metabolites such as alkaloids, flavanoids, cardio glycosides, phenols, tannins, terpenoids, steroids etc. From the above results the ethanolic extract of M. uniflorum leaf shows better activity. So, that it can be used as therapeutic agent to treat various diseases due to the presence of enormous secondary metabolites.

4. Biological Effects of Chitosan against Bisphenol- A Induced Endocrine Toxicity and Androgen Receptor Gene Expression Changes in Male Rats
Mariam G. Eshak, Hala F. Osman
Bisphenol A (BPA) is an endocrine disruptor which can mimic estrogen and has been shown to cause negative health effects in animal studies. The aim of this work was to study the protective effect of chitosan against BPA. Forty male albino rats were randomly divided into four equal groups. Group I, animals served as control. Group II, animals were injected by bisphenol A, intra-peritoneal, at a dose of 5 mg/kg body weight daily for 3 weeks. Group III, animals were gavaged with chitosan at a dose of 30 mg/kg body weight for 3 weeks. Group IV, animals were injected by bisphenol A, intra-peritoneal, at a dose of 5 mg /kg body weight and after two hours animals were gavaged with chitosan at 30 mg/kg body weight for 3 weeks. At the end of the experiment, blood samples were taken for subsequent biochemical analyses. Testosterone, estradiol, AST, ALT, alkaline phosphatase (Alk. ph.), bilirubin, plasma glutathione peroxidase (GPx) and malondialdehyde (MDA) were determined. In addition, sperm abnormalities, expression of androgen receptor (AR) gene in testis tissues and caspase 3 activity in liver samples were evaluated. Testis and liver specimens were dissected for histopathological examination. The results indicated a decrease in testosterone hormone level while estradiol increased after rats were injected by BPA. However, chitosan treatment restored the testosterone level. It was apparent that BPA caused dysfunction to hormonally regulated body systems. However, chitosan treatment adjusted the metabolic functions and controled fertility. The levels of AST, ALT, Alk. ph. bilirubin and (MDA) enzymes were significantly increased while glutathione peroxidase was significantly decreased in group II after injection with BPA. Chitosan treatment counteracted the effects of BPA. Chitosan decreased the liver inflammation and necrosis. Moreover, the results indicated that the frequency of the sperm abnormalities, induced by BPA treatment, decreased significantly with chitosan administration compared with BPA treatment alone. Also, the expression of AR gene was up-regulated significantly with chitosan treatment combined with BPA compared with BPA treatment alone. Furthermore, the high level of caspase-3 activity induced by BPA in liver tissues was significantly decreased with chitosan treatment compared with BPA treatment alone. Histopathological analysis indicated that BPA induced testis tissues degeneration as well as liver apoptosis and necrosis. Chitosan treatment ameliorated testis and liver damage. In conclusion, chitosan seams to act as an antioxidant against toxicity of the endocrine system, sperm abnormalities, alteration in the AR gene expression and liver apoptosis. The potential biological effect of chitosan may be due to its active ingredients

5. Isolation and Characterization of Antibiotic Producing Microorganisms from Soil Samples of Certain Area of Punjab Region of India
Satvinder Kaur, Jatinder Kaur, Pranay P Pankaj
Soil samples containing antibiotic producing organism are commonly employed for the production of suitable antibiotics. Isolated antibiotic may be bactericidal or bacteriostatic in nature. In the present investigation, antibiotics producing microorganisms were isolated from soil and tested against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Mycobacterium smegtitis, Proteus vulgris and Bacillus subtilis. Disc diffusion method, agar well method, streak agar method and biochemical methods have been employed to investigate the antibiotics producing microorganisms. Out of twelve isolates, two isolates; No. 5 and No. 6 were found suitable in inhibition of the growth of S. aureus and P. vulgris and zone of inhibition were found to be in ranging between 11 and 12mm respectively. The present work suggests that soil isolates, having antibiotic producing properties can be utilized commercially after proper standardization.

6. Acute Toxicity Evaluation of Rauvolfia tetraphylla Leaf Extract in Rat by Up and Down Method
Tamboli S. R., Pandit R. S.
The objective of this study was to evaluate the acute toxicity of the methanolic leaf extract of Rauvolfia tetraphylla via the oral route in female Sprague Dawley rats. In this study, dosing was initiated, based on OECD guideline 425, using the default dose level of 175 mg/kg and approximately 3.2 multiplier dose progression. Subsequent animals were dosed at 550 and 2000 mg/kg. Rats were observed for 14 days. Rauvolfia tetraphylla leaf extract produces signs of toxicity at 2000 mg/kg but no lethality at any of the dose (175, 550 & 2000 mg/kg) tested. There is no effect on the body weight. Necropsy examination did not reveal any treatment related changes. The median lethal dose (LD50) of this plant extract could be considered higher than 2000 mg/kg and classified as toxicity “Category 5” according to Globally Harmonized system of Classification.

7. Advances in Pulp Capping Agents
Pradeep Solete, Puthiriraj Pillai Vijaya
The procedure of pulp capping relies primarily on the ability of the pulpal health. Various factors affect this process namely: age, health of periodontium, root formation, size of exposure, nature of injury and microbial contamination all these only can decide the success of pulp capping. A wide range of materials has been tried to achieve the success. In this review recent advances of the pulp capping materials are been emphasized.

8. Synergistic Interaction of Different Extracts of Cassia javanica L. against Multi Drug Resistant Clinical Isolates ofStaphylococcus aureus
Parinita Neog, Shuvasish Choudhury, Amitabh Bhattacharjee, Pankaj Chetia, Manabendra Dutta Choudhury
The original prospective of this research is to find out the antibacterial activity of Cassia javanica L. in combination with Vancomycin against some multi drug resistant Staphylococcus aureus hospital isolates. Minimum inhibitory concentration for each extract of Cassia javanica L. was determined by agar dilution and broth macrodilution method. Antimicrobial combination therapy is the most effective future drug treatment with potential bioactivity to treat multi drug resistant bacteria. Methanol extract of bark, flower, leaves and ethyl acetate extract of bark showed excellent synergism with Vancomycin at a concentration of 0.25mg/ml and 0.51mg/ml. The best synergistic activity was observed between methanol extracts of bark and Vancomycin with four time fold reduction from the original MIC values and  found very much promising for further novel antibacterial drug discovery research.

9. Effectiveness of a 12-Week Yoga Program on Physiopsychological Parameters in Patients with Hypertension
Sujatha T, Judie A
Hypertension is a major a chronic lifestyle disease affecting one in three adults over 25 years or about one billion, thereby resulting in cardiovascular, cerebrovascular, and renal complications. In addition, it is an important contributor for increased cardiovascular morbidity and mortality in industrialized countries. Reports suggest that hypertension is rapidly increasing in the developing countries like India. Although medical management is effective in treating hypertension, owing to the side effects, alternative therapy such as Yoga practice is recommended. However, evidences on the efficacy of yoga practice in patients with hypertension are insufficient and further research is required.The study aimed to investigate the effectiveness of a 12-week Yoga program on physio-psychological parameters in patients with hypertension.

10. Psycho Social Intervention – An Effective Strategy in Improving the Family System Strengths among the Caregivers of Stroke Survivors
Hemamalini. M, A. Judie
The presence of a serious and chronic illness in one family member usually has a profound impact on the family system, especially on its role structure and the family functions. Families play an important supportive role during the course of a client’s convalescence or rehabilitation. Most caregivers of stroke survivors find themselves in a stressful situation. Research has shown that taking care of stroke survivors creates burdens for caregivers and decreases their levels of well being. To evaluate the effect of psycho social intervention on family system strengths among the care givers of stroke survivors. The study designed involved true experimental pretest and posttest design. The study was conducted in Kattankulathur Block, Tamilnadu. The study included 240 caregivers of stroke survivors. The experimental group received psychosocial interventions such as individual counseling and  enrollment in self-help groups,. After 3 months, there was significant difference in the family system strengths between the experimental group and control group at t = 37.58 and p value of 0.001. The present study concluded that family coping intervention programme is an effective nursing intervention  recommended for the caregivers of stroke survivors to strengthen the family system.

11. Antidiabetic Potential of whole Plantof Adiantum capillus veneris Linn. in Streptozotocin Induced Diabetic Rats
Vadi Ranjan, Manisha Vats, Neha Gupta, Satish Sardana
The present study aims at investigation of the antidiabetic efficacy of aqueous and methanol extracts of whole plant of Adiantum capillus veneris Linn. in streptozotocin induced diabetic rats. Adiantum capillus-veneris L. (Family Adiantaceae) commonly known as hansraj is a terrestrial fern occurring throughout the India in moist shady places especially on damp old walls and crevices of rocks. Plant leaves and stem were found to contain higher amount of fats, flavonoids, triterpenoids, phenols, tannins, saponins and fats. After 72 h of STZ (45 mg/kg bw, i.p.) administration, animals showing serum glucose level more than 250 mg/dl were considered as diabetic rats. Aqueous extracts at dose of (100, 200 and 400 mg/kg, orally) and methanol extracts at dose of (200 and 400 mg/kg, orally) in distilled water were administered daily for 21 days and metformin (50 mg/kg b.wt.) was taken as the standard. FBG were measured by glucose oxidase method on 0th day (after 72h of STZ), 10th, 21st day. The serum was separated by centrifugation at 4000 rpm for 10 min. Improvement in the FBG indicates that Adiantum capillus veneris Linn. has very good antidiabetic potential with very low side effects and provides a scientific rationale for the use as an antidiabetic agent, thus justifying its traditional usage. From the phytochemical analysis, it was found that the major chemical constituents of the extract were flavonoids and tannins. On the basis of the above evidences it is possible that the presence of flavonoids and tannins may be responsible for the observed antidiabetic activity.

12. HPLC-Analysis of Polyphenolic Compounds and Free Radical Scavenging Activity of Pomegranate Fruit (Punica granatumL.)
Sami I. Ali, Farouk K. El-Baz, Gehan A.E. El-Emary, Ekhlaque A. Khan, Amal A. Mohamed
Pomegranate fruits have been commonly used in herbal remedies by local healers in many countries. In this work, total phenolic, flavonoid and anthocyanin contents of different parts of pomegranate fruit (peel, flesh, seeds, and whole fruit) were evaluated using two different solvents  (methanol and ethyl acetate). The highest total phenolic and flavonoid contents were detected in peel methanol extract (103.2 mg/g dw and 132.4 mg/g dw) respectively. Also, the highest anthocyanin content was detected in peel extract (3.86 mg/g fw). HPLC coupled with diode-array detection was used to investigate the major phenolic compounds in peel methanolic extract. Among the phenolic compounds, chlorogenic acid, rutin and coumaric acid are present predominantly in the peel extract. Furthermore, the peel methanol extract exhibited the highest antioxidant activities using 2,2-diphenyl-1-picrylhydrazyl radical scavenging  activity (DPPH) and the ferric reducing antioxidant power (FRAP) assays. The high antioxidant activities of peel extract may be attributed to its high contents of total phenolic and total flavonoid. The results clearly indicate that pomegranate peel extract appeared to have more potential effects as a health supplement rich in natural antioxidants than other parts.

13. Mobility is An Adjuvant Approach for Intrapartum Care – A Clinical Randomized Interventional Study
Vaijayanthimala.M, Judie A
In this highly technological medical scenario immobility during intrapartum period has become common issue associated with child birth. Though the benefits of movements and position changes to facilitate labour process have been discussed in literature for decades, controversial opinions, on movements and positions during labour still exits. Additionally lack of resources and accurate information to these issues depicts that need for an hour to be discussed and analyzed to find evidenced based practice intervention and to maintain sense of normality and make birth “as nature intended”. To evaluate the effectiveness of mobility during labour on birth outcome  among  primi parturient mothers. Additionally this study also tested the maternal satisfaction a with child birth. 240  low risk  primi parturient mothers  who were in active stage of labour with uncomplicated pregnancy recruited and were allocated by Simple random sampling technique into the two arms of the study, but only 106 in study and 105 in control group participants completed the trial. Movements like walking, rocking, swaying were provided to experimental and not to control group. Both the groups were received hospital routine care. In active stage of labour (3-6 cm of cervical dilatation) the women completed the demographic and obstetrical information and pain was measured by 0- 10 numerical rating scale and  labour process and outcome are assessed by using partograph. Maternal satisfaction was assessed by rating scale. This study revealed that pain and other labour process parameters are significant at p=0.05 level between study  and control group. Mothers in study group had less number of fetal distress and caesarian section, shorter duration of first stage , less need for augmentation and pain medication  and higher satisfaction  than control group  at p=0.001 level of significance.

14. Preparation and Characterization of Spherical Crystals of Embelin to Improve the Solubility and Micromeritic Properties
Gadhave MV, Banerjee SK
Embelin, a chemical constituent obtained from Embelia ribes Burm. Having several therapeutic activities like anthelmintic, antimicrobial, enzyme inhibitory, hepatoprotective, antihyperlipidemic, etc. The poor water solubility and poor micromeritic properties of Embelin lead to low dissolution rate and poor flow during tabletting. The aim of present study was to enhance solubility, dissolution rate and improvement of micromeritic properties of the poorly soluble drug. The spherical agglomerate of Embelin was prepared by solvent change method in the presence of hydrophilic polymer in different concentration. The solvent system used was acetone, water and dichloromethane as good solvent, anti-solvent and bridging liquid respectively. Spherical agglomerates were subjected for determination of percent drug content and particle size analysis. The agglomerates obtained evaluated using by Differential Scanning Calorimetry (DSC), Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Powder Diffraction (XRD) and Scanning Electron Microscopy (SEM) analysis. The FTIR and DSC study showed no interaction between drug and polymer. XRD studies showed a decrease in crystallinity of agglomerates. Spherical agglomerates showed improvement in solubility, dissolution rate and micromeritic properties in comparison to that of the pure drug. The SEM also showed that the agglomerate possess a good spherical shape.

15. Reduction of Risk on Newly Detected Gestational Diabetes Mellitus by Multi Model Intervention- A Hospital Based Study
Abirami.P., A.Judie
Gestational diabetes mellitus is one of the most common complications of pregnancy, and it is associated with significant maternal and fetal morbidity. GDM can be controlled by the multi model intervention which is the holy grail of health care.  It is the key to patient adherence – a prerequisite to achieve better outcomes. It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them. The aim of the present study was to evaluate the effectiveness of patient engagement package on glycemic control in Gestational Diabetes Mellitus. Prospective interventional study was conducted at a Government Hospital, Tambaram. Antenatal mothers (n = 212) with GDM were randomized into study group (n = 104) and Control groups (n = 108). Power analysis and nonprobability-purposive sampling technique were applied to analyze sample size and sample selection, respectively. Quasi-experimental time-series design was adopted. The study group received patient engagement package which includes Counseling on diet, exercises, and regular monitoring of blood glucose level, Insulin therapy based on the blood glucose level and regular dose of Iron, folic acid and Calcium tablets  and adjunct therapy as Yoga which includes Yogic sukshma vyayama(20 -25 mts), Nadishodana pranayama(5-10 mts) and Dhyanam(5 mts).They were instructed to follow up the visits regularly in the antenatal outpatient department.The Control group (n = 108) received only the standard care. Fasting and postprandial blood glucose levels were continuously monitored from 24th week to till delivery. At 24th week statistically no significant difference was found between mean and standard deviation of blood glucose level of Gestational Diabetes Mellitus in study group and control group ( t=0.29 p=0.76 ).Statistically positive improvement was found between study group and control group  in the post test which was done at 28th ,32 and 36th week and the “t” values were respectively t=3.41 p=0.001*** , t=4.82 p=0.001***, t=6.34 p=0.001*** which was having very high significance at p= 0.001*** in blood glucose level of Gestational Diabetes Mellitus. Our findings show that multi model intervention brings marked reduction in blood glucose level of Gestational Diabetes Mellitus and yoga can be used as an adjunct therapy to control and maintain the blood glucose level of Gestational Diabetes Mellitus. If patient engagement package practiced regularly by the antenatal mothers with Gestational Diabetes Mellitus will provide beneficial effect in terms of reduction in the fasting, postprandial blood glucose.

16. Study of Viamin D Level in Pre-dialysis Chronic Kidney Disease (CKD) Patients
Meera Shivasekar, Ramachandran K, Suganya, Ebenezer William
Chronic Kidney Disease (CKD) is emerging as one of the most powerful predictors of premature cardiovascular disease. It has been reported that progression of CKD and many of the cardiovascular complication is linked to vitamin D. The study group consisted of 50 predialysis CKD patients and 50 age and sex matched healthy control. The serum 25-OH Vitamin D, Calcium, phosphorous, urea, creatinine, plasma glucose were estimated by standard enzymatic method and eGFR by calculated method. Vitamin D and eGFR were found to be significantly decreased in pre-dialysis CKD patients whereas other biochemical parameters were significantly increased in pre-dialysis patients when compared to healthy control. A positive correlation between vitamin D and eGFR were observed.Therefore the study of the vitamin D level in CKD patients when detected early can halt the growing epidemic of the deficience particularly in high risk patient.

17. Hypertension in Renal Transplant Patient
Dharmik Patel, Ketan Modi, Anil Patel
Newer potent immunosuppressive medications show marked improvements in short-term allograft function but long-term allograft survival continues to be inadequate. Non immunological factors have been increasingly identified as potentially important mediators of reduced long-term renal allograft function known as chronic allograft nephropathy. Hypertension is considered as one of this non immunological risk factor for progressive graft dysfunction. Hypertension is common after transplantation and is present in 50% to 90% of renal   transplant recipients. Increasingly severe post-transplantation hypertension is associated with increasing risk of graft loss, and control of hypertension is associated with improved graft survival. Hypertension  is  a  risk  factor  for  both  CV  disease  and  kidney graft failure.  Here we discussed about post transplant hypertension and its impact on graft function. We also discussed about causes of HT following renal transplant with special emphasis on role of immunosuppressive medication in development of hypertension. At the end we have reviewed management of post transplant HT

18. Microsponge: A Drug Delivery System
Veer S. U., Gadhve M. V., Khedkar A. N.
Microsponges are porous, polymeric microspheres that are mostly used for prolonged topical administration. Microsponges are designed to deliver a pharmaceutically active ingredient efficiently at minimum dose and also to enhance stability, reduce side effects, and modify drug release profiles. The Microsponge Delivery System (MDS) is a unique technology for the controlled release of topical agents and consist of macro porous beads, typically 10-25 microns in a diameter, loaded with active agent. When applied to the skin, the Microsponge releases its active ingredient on a time mode and also in response to other stimuli (rubbing, pH, etc.). MDS technology is being used currently in cosmetics, over the counter (OTC) skin care, sunscreens and prescription products. Conventional preparations have some disadvantages like unpleasant odour, greasiness and skin irritation. These problems are overcome by microsponge delivery system. Microsponge based drug delivery system produces controlled released action. It also produces site specific and target organ action produced. Microsponge (MDS) mainly developed in topical drug delivery as well as oral controlled delivery system. It also used in cosmetic formulations.

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