World Journal of Current Medical and Pharmaceutical Research <p><strong>World Journal of Current Medical and Pharmaceutical Research </strong>(World Journal of Current Med and Pharm Research) is a double-blind peer-reviewed bimonthly open access international journal dedicated to the promotion of research in health and Pharmaceutical sciences. We define Open Access-journals as journals that use a funding model that does not charge readers. The journal publishes Research articles, Review article, Case studies and Short communication from broad areas like Medicine, Dentistry, Pharmacy, Anatomy, Physiology, Biochemistry, Neurology, Surgery, Orthopedics, Ophthalmol</p> en-US <p>Copyright © Author(s) retain the copyright of this article.</p> (WJCMPR) (Support Manager) Thu, 30 Apr 2020 00:00:00 +0530 OJS 60 Role of Clinical Pharmacist in the Management of Myocardial Infaraction: A Prospective Observational Study <p>The aim of the present study was to analyze myocardial infarction- Age related risk factors, complications and management.Valuation of age related risk factors in MI patients, identification of frequent type of myocardial infarction, Evaluating the effectiveness of thrombolytic therapy and primary intervention in patients with MI, Assessment of complications of MI and Studying the impact of concomitant diseases on different types of complications. A Prospective observational case series study with 130 cases of patients with myocardial infarction and this study were conducted in department of cardiology in maharaja institute of medical sciences and our work conducted for a period 6 months and we have strictly adhere the Inclusion and exclusion criteria. We concluded that males were more prone to develop MI than females. Incidence of MI was high in age group 51-60 yrs. Cigarette smoking was identified as a major risk factor indicating that life style plays a dominant role than concomitant disorders for early incidence of MI in present generations. Younger population were predisposed to unhealthy life style like smoking, alcohol, fatty diet and we also find out that TLT was effective in treatment of MI. Also, TLT reduced the need for PTCA, and the reason behind subjects required PTCA even after receiving TLT was advanced age. Older subjects were primarily treated with PTCA.</p> Prathyusha Behara, Rushi Tarra, Yerni Kumari Tippana Copyright (c) Thu, 30 Apr 2020 00:00:00 +0530 FORMULATION AND EVALUATION OF PHYSOSTIGMINE-TRANSDERMAL PATCH <p>In present study transdermal drug delivery of Physostigmine was developed to overcome the first pass metabolism and to reduce frequency of dosing compared to oral route. Matrix type of transdermal patches was developed by using polymers Eudragit-L100, HPMCk<sub>4</sub>M and HPMCk15M.Transdermal patches were prepared by employing solvent casting method. Propylene glycol and Tween80 were selected as permeation enhancer and plasticizer. Among all the formulations P6 formulation was found to be best and shown 96.5% drug release in 12 hours.&nbsp; For P6 formulation release kinetics were applied and it was observed that the formulation was following peppas mechanism of drug release.</p> RAJA NARENDER BONGONI Copyright (c) 2020 RAJA NARENDER BONGONI Tue, 14 Apr 2020 00:00:00 +0530 Side Effects Associated With Chemotherapy of Acute Lymphocytic Leukemia with Vincristine and Anthracyclines <p><strong>Background: </strong>Acute lymphocytic leukemia or acute lymphoblastic leukemia is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. It is characterized by the overproduction of immature white blood cells, called lymphoblast or leukemic blasts. Chemotherapy of cancer has many side effects. Use of vincristine and anthracyclines can lead to many side effects. It may limit the efficacy of work in daily life activities of the patient. <strong>Aim:</strong> The aim of this study is to evaluate the side effects associated with the use of vincristine and anthracyclines. <strong>Methodology: </strong>This study was conducted with the objective to assess and evaluate the side effects of vincristine and anthracyclines in MNJ Institute of Oncology and Regional Cancer Centre (RCC), Lakdikapul, Hyderabad. This study is observational in nature and the subjects enrolled under this study were about 64. Informed consent was obtained from all the subjects. Subjects recruited in this study were admitted as in patients in the hospital to receive chemotherapy. The assessment of quality of life is done by using EORTC QLQ- C30 questionnaire. <strong>Results: </strong>In this study, a total of 64 subjects with cancer were evaluated. Of 64 patients included, about 51.565 belong to age group of 0-14 years, followed by 18% in age group 15-24 years. Indicating the higher incidence of ALL in children’s specifically and the family history of non- specific cancer was found in 3 patients in the study. During the study most common side effects observed were nausea (24), vomiting (22), and shortness of breath (37) and chest pain (30) which ranges from mild to moderate in severity. <strong>Conclusion: </strong>Among 64 subjects undergoing CT for ALL, out of them ALL was dominantly diagnosed in males (89%). Of 64 patients studied, 57 patients experienced leukocytopenia, 38 experienced neutropenia, 46 experienced thrombocytopenia and anemia in 44 patients. Thus, increased rate of transfusions (45 in males, 5 in females) attributed to decreased quality of life of patients.1 male and 1 female died during the study, due to SOB due to bilirubinemia and non-adherence to the CT.</p> Shareef Mohammed , Moizuddin Mohammed Copyright (c) Wed, 01 Apr 2020 00:00:00 +0530 A Comparison of the Efficacy of Gymnema Sylvestre 6 Ch and Gymnema Sylvestre Mother Tincture in Cases of Type 2 Diabetes Mellitus <p>Diabetes Mellitus is metabolic disorder characterized by hyperglycemia resulting from inadequate insulin secretion, insulin action or both and insulin resistance. Gymnema sylvestre have reported beneficial effect for treating in type 2 diabetes mellitus.</p> <p>Objective: A comparison of the efficacy of homoeopathic medicine gymnema sylvestre 6 CH and gymnema sylvestre mother tincture in the treatment of type 2 diabetes mellitus cases.</p> <p>Material and method: 30 cases of type 2 diabetes mellitus were selected and gymnema sylvestre mother tincture and 6 CH were prescribed for these cases and follow up was every one month, three months and six months.&nbsp;</p> <p>Results: Over a period of 6 months, there was significant reduction in blood sugar levels (fasting and post prandial blood sugar) in both groups. ANOVA repeated measures also showed significant difference P = 0.001.</p> <p>Conclusion:&nbsp; There is significant reduction in fasting blood sugar, post prandial blood sugar levels both groups (gymnema sylvestre 6 CH and gymnema sylvestre homoeopathic mother tincture) in type 2 diabetes mellitus cases. The results suggested that gymnema sylvestre 6 CH and gymnema sylvestre mother tincture has beneficial anti diabetic effective and warrants future investigation.</p> Basavaraj S Adi, Geeta B Adi, Arun Kumar Jamadade, Siva Rami Reddy E Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Drug Utilization Evaluation of Corticosteroids Indicatedfor Psoriasis and Dermatitis by Clinical Pharmacists at a Tertiary Care Teaching Hospital of Northcoastal Andhra Pradesh-A Prospective Observational Case Study <p>Background of the Study: The current focus of research is on corticosteroids thatcan improve skin conditions with its anti-inflammatory and immunosuppressive action.</p> <p>Objectives: To obtain information on number of drugs prescribed, their prescribing patterns, duration of treatment and rationality of drug use and side effects of corticosteroids.</p> <p>Study Design, Study Period &amp; Study Site: A prospective observational case series study was conducted from july- 2019- february -2020 at MIMS (Maharaja Institute of Medical Sciences) Nellimarla , Vizianagaram.</p> <p>Methodology: A total of 280 patients the study is being conducted in the department of dermatology. The participants enrolled in the study involve inpatients and outpatients only after filling a properly written informed consent. The data is collected in a pre-designed data collection form.</p> <p>Results: A total 280 prescriptions were analyzed having 275 corticosteroids and among them 32.1% were male and 67.9% were females. Majority of patients were between the range of 21-30 years (25.71%) and 31-40 years (14.2%) and 41-50 years (11.7%). Clobetasol was found to be the most prescribed drug (86%) followed by betamethasone (68%). Most drugs were prescribed rationally some factors like drug administration time were deviating from rationality.</p> <p>Conclusion: Although most of the drugs were prescribed rationally, involvement of clinical pharmacists in patient care can help in more rational prescribing along with prevention and early detection of side effects which can directly promote drug safety and better patient outcomes.</p> Reethika V, Bhargava Krishna Naik R, Krishna Vamsi M, Pinky K, Madhu CH Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Economic burden of diabetes in Telangana: A Cost of illness study <p>The purpose of this study is to analyze the economic burden on people in Telangana due to diabetes. In Telangana, a prospective observational study was conducted by collecting patient data. 252 patient’s data was gathered in 6 months period. This data includes health care costs and complications that is both microvascular complications (Neuropathy, Retinopathy &amp; Nephropathy) and macrovascular complications (Coronary heart disease, Congestive heart failure, Myocardial infarction &amp; Peripheral artery disease). The collected data consists of direct and indirect costs which was analyzed &amp; calculated average cost spent in the treatment of diabetic patients. All the type 2 diabetes mellitus patients who are on anti – diabetic drugs irrespective of their co- morbidities &amp; gender were included. Patients who are not on regular medication were excluded from the study. In this study , cost of illness of type-2 diabetes mellitus patients with &amp; without complications were compared. The total cost of treatment per annum in patients without complications was USD 374.77 &amp; in patients with complications was USD 497.763.</p> Hemanth kumar Annam, Priyanka Nomula, Harika Gorla Copyright (c) 2020 Fri, 01 May 2020 00:00:00 +0530 In Vitro Evaluation of Anti Inflammatory Activity of Methanolic And Ethanolic Leaf Extract of Psidium Guajava <p>The objective of the current research work was to determine the anti inflammatory activity of Psidium guajava by the Human Red Blood Cell membranes stabilization method. The methanol and ethanol leaf extract of plant Psidium guajava were investigated for their in<em>vitro </em>anti-inflammatory property by Human red blood cell membrane stabilization method. The prevention of hypotonocity induced HRBC membrane lysis was taken as a measure of a anti-inflammatory activity. The anti inflammatory activity of methanol and ethanol leaf extract of psidium guajava were compared to that of standard drug Diclofenac<em>.</em></p> Santanu Kumar Hotta, Neelima N Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Enhancement of dissolution of Cilostazole by complexation method using Cyclodextrins <p>The study was designed to investigate the effect of cyclodextrins (CDs) on the solubility, dissolution rate, and bioavailability of cilostazol by forming inclusion complexes. Natural CDs like β-CD, γ-CD, and the hydrophilic β-CD derivatives, DM-β-CD and HP-β-CD, were used to prepare inclusion complexes with cilostazol. Phase solubility study was carried out and the stability constants were calculated assuming a 1:1 stoichiometry. Solid cilostazol complexes were prepared by coprecipitation and kneading methods and compared with physical mixtures of cilostazol and cyclodextrins. Prepared inclusion complexes were characterized by Fourier transform infrared spectroscopy, differential scanning calorimetry (DSC), and X-ray diffraction (XRD) studies. <em>In vitro </em>dissolution study was performed using phosphate buffer pH 6.4, distilled water, and HCl buffer pH 1.2 as dissolution medium. The optimized inclusion complex was studied for its bioavailability in rabbit and the results were compared with those of pure cilostazol and Pletoz-50. Phase solubility study showed dramatic improvement in the solubility of drug by formation of complexes, which was&nbsp; further increased by&nbsp; pH&nbsp; adjustment. The <em>in vivo </em>study revealed that DM-β-CD increased the bioavailability of cilostazol with low variability in the absorption. Among all cilostazol–cyclodextrins complexes, cilostazol–DM-β-CD inclusion complex (1:3) prepared by coprecipitation method showed 1.53-fold and 4.11-fold increase in absorption along with 2.1-fold and 2.97-fold increase in dissolution rate in comparison with Pletoz-50 and pure cilostazol, respectively.</p> Flourence T, Malyadri T, Thejomoorthy K, Sreenivasa Prasanna P Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Evaluation of Risk factors for the Prevalence of Kidney Failure(CKD & AKD) and The Impact of Clinical Pharmacists Role in Improving the Medication Adherence in Kidney Disease Patients of A Tertiary Care Teaching Hospital <p>Aim : The aim of the study is to evaluate the risk factors for the prevalence of kidney failure (CKD &amp; AKD ) and to analyse the role of clinical pharmacist in improving the medication adherence.Methodology : A prospective&nbsp; interventional, analytical study was done on patients admitted in Maharaja Institute Of Medical Sciences Viziayanagaram ,AP, India . Information regarding the renal disease ,stages of CKD ,age ,gender ,causative factors ,serum creatinine ,dialysis, medication adherence ,reasons for non medication adherence ,were recorded in standerdquationnarie ( Case Report Form).</p> <p>Results :Total 220 patients were included in this study , out of them 158(71.8%)patients were diagnosed with CKD &amp;62 (28.1%) patients were diagnosed with AKD . Renal disease is high in male patients (63.1%) than in female patients (36.8%). Non medication adherence reasons and pharmacist counselling about medication adherence are the modifiable risk factore and got significant values in student T test (p value 0.0326 &amp; 0.0478) using SPSS Software.</p> <p>Conclusion: Hypertension Is The Major Riskfactor For Developing of Kidney Failure . More Patients Are Prone To Ckd When Compared To Akd .Kidney Failure Is Mostly Observed In Men Than In Women And They Are Mostly Diagnosed With Ckd Stage 5 .Lack Of Symptoms Is The Primary Factor For Non-Medication Adherence Among People. As There Is A Clear Evidence Seen Based On Data Obtained After Performing Patient Counselling And Patient Education ,We Conclude Clinical Pharmacists Could Play A Vital Role In Improving The Medication Adherence Among Ckd &amp; Akd Patients Which Wil Ultimately Make The Patients Free From Ckd &amp; Akd .</p> Manogna Gayatri R, Ujwala M, S.Madhuri A, Uma Sankar Viriti Copyright (c) Fri, 01 May 2020 00:00:00 +0530 PHYTOCHEMICAL SCREENING AND INVITRO ANTI-INFLAMATORY ACTIVITY OF ETHANOLIC EXTRACT OF Centella asiatica <p>In ayurvedic medicine <em>Centella asiatica</em> is a valuable medicinal herbaceous creeper which has been valued for hundreds of years. Phytochemical analysis of <em>Centella asiatica </em>(Apiaceae) plant extracts revealed the presence of varied biochemical compounds like alkaloids, flavonoids, glycosides, phenolic compounds, triterpenoids and saponin etc. Since phenolic compounds, triterpenoids and flavonoids have remarkable anti-inflammatory, anti-arthritic and antioxidant activities, so our present work aims at evaluating the in vitro anti-inflammatory activity by Human Red Blood Cell (HRBC) membrane stabilization. To measure the anti-inflammatory activity, the inhibition of hypotonicity induced HRBC membrane lysis was used. The percentage Haemolysis was experimented from concentration of 50µg/ml to 2000µg/ml and the values reduced from 32.25% to 5.02%, on the other hand percentage Stabilisation in the same concentration range increased from 67.74% to 94.97%. Diclofenac sodium was used as the standard drug and the same experiment conducted in the same concentration range and the values of percentage haemolysis reduced from 47.18% to 1.24% and the percentage stabilisation increased from 52.81% to 98.76%. The results show that the extracts of <em>Centella asiatica</em> exhibited anti-inflammatory activities. <em>Centella asiatica</em> may be a profusely branched prostate herb consisting of active principles like Vallarine, Asiaticoside, Sitosterol, Tannins, Oxy asiaticoside. Asiaticoside is used in the treatment of leprosy. Sitosterol and tannin possess antiprotozoal and spasmolytic property. According to Siddha literature, the leaves <em>of Centella asiatica </em>are used for the treatment of syphilis, elephantiasis, all kinds of fever, abdominal disorder of children and hydrocele and these features are highlighted in this article.</p> Ms.Sini Baby Ms.Sini Baby, Antony Varghese Antony, Biniya John, Deepa Jose Copyright (c) 2020 Antony Varghese Antony Mon, 04 May 2020 16:03:46 +0530 A New Stability Indicating Analytical Method Development And Validation for The Quantitative Determination of Emitricitabine And Lamivudine By RP-HPLC <p>A novel stability indicating, precise, accurate and ecofriendly reverse phase high performance liquid chromatographic method was developed and validated for the quantitative determination of Emtricitabine and Lamivudine in pure and pharmaceutical dosage forms. Estimation of drugs in this combination was done with a C18 column [Kromasil C18column. 5mm, 4.6´250 mm]using mobile phase of compositionMethanol and phosphate buffer (40:60 v/v, pH 4).The flow rate was 1.0 ml/min and the effluents were monitored at 261 nm. The retention time of LamivudineandEmtricitabine were2.810 min and 4.727 min respectively. The linearity was found to be 40-80mg/ml for Lamivudine and40-80mg/ml forEmtricitabine.The stability parameters were evaluated by injecting the stressed sample and it was proved that there was no degradants. The established method was validated according to ICH guidelines.</p> Venkata Geetha K, Thejomoorthy K, Sreenivasa Prasanna P Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Isolation of Antibiotic Producing Microorganisms from Two Soil Samples of Phirangipuram,Guntur <p>Antibiotics are chemicals, that kill or inhibit the growth of bacteria and are used to treat bacterial infections. They are produced in nature by soil bacteria and fungi. Soil is the outer region of earth crust consisting of loose material. In this, soil samples from two areas were collected (vegetable dump area(A), street soil(B)) and analysed, different bacterial colonies from soil samples was formed and tested for antimicrobial activity. The isolated and subcultured strains showed permanent zones of inhibition. The inhibitory activity of the organism was checked&nbsp; against important microbial flora. In the present study a trail was done to find out a new antimicrobial agent, producing bacteria from soil samples collected from two places.</p> Naga Sowjanya C.H., Rama Brahma Reddy D, Ramya K, Lakshmi Sravya K, Vandana Diamond K, Bangaaru Lakshmi, Bangaaru Lakshmi Copyright (c) Fri, 01 May 2020 00:00:00 +0530 EVALUATION OF ANTHELMENTHIC ACTIVITY& PHYTOCHEMICAL SCREENING OF THEPEELS OF Citrussinensis & RHIZOMESOFCurcumalonga <p>Phytochemicals are secondary metabolites produced by all plants in which some have medicinal uses. The phytochemical analysis of peel &amp; rhizome extracts in aqueous, ethanol, acetone, hexane, and chloroform extracts of indigenous medicinally important plants of citrussinensis (peels) &amp;curcumalonga(dried rhizomes) were investigated. The phytochemical analysis revealed the presenceofactive constituents such as carbohydrates, flavonoids, alkaloids, terpenes, phytosterols, tannins, steroids, saponins, glycosides, phenols, and anthraquinones. This research supports the local use of the peel and rhizome extracts of orange and turmeric to show the potent nature of the sealants when using din combination to treat helminthiasis. These plants belong to family rutaceae &amp; zingiberaceae<strong>&nbsp; </strong>respectively. The present study provides evidence that the solvent extract of citrussinensis and curcumin along contains medicinally important bioactive compounds and this just if is the use of these plants in combination to treat helminthiasis &amp; control mode growth in intestines.</p> Santanu Kumar Hotta, Sri SaiPrakash P, Nirupa P, Devi N Copyright (c) 2020 Thu, 30 Apr 2020 00:00:00 +0530 INCIDENCE OF SWITCHING TO SECOND LINE TREATMENT AMONG HIV PATIENTS RECEIVING ANTI-RETROVIRAL THERAPY <p><strong>Aim: </strong>The main aim of this study is to estimate the incidence of switching to second line Anti-Retroviral Therapy (ART) among HIV patients.</p> <p><strong>Objective: </strong>The primary objective of this study is to determine the reason for switching to second line ART. The secondary objective of the study is to estimate the rate of treatment failure among HIV patients receiving first line ART. To determine the factors responsible for first line treatment failure.</p> <p><strong>Methodology: </strong>A Retrospective Observational study is conducted at a tertiary care hospital, Ongole, Prakasam District, Andhra Pradesh. Incidence of switching to second line ART among 4,187 HIV patients is assessed.</p> <p><strong>Results: </strong>In our study, we have collected ART cards of 4,187 patients living with HIV/AIDS. Out of which 3,419 patients are excluded from the study. 768 patients are included for the study who met the inclusion criteria. Of these patients, 739 members are receiving first line regimen and 29 patients are switched to second line Anti-Retroviral Therapy (3.77%).</p> <p><strong>Conclusion: </strong>Our study concluded a low incidence of switching to second line ART with an incidence rate of 1.01 per 100 persons a year. Out of 29 patients, failure of first line treatment is majorly observed with AZT+3TC+NVP (Zidovudine+Lamivudine+Nevirapine) among 13 patients (44.82%). Reasons for failure are determined majorly as a result of immunological and virological failure (37.93%). These reasons are associated with decreased adherence of 80-90% among 21 patients (72.41%).</p> Sumavi Sekhar J, Joseph Samuel Jyothula, Kusuma S, Aamani Sk, Divya T, Santosh Kumar V Copyright (c) 2020 Thu, 30 Apr 2020 00:00:00 +0530 Histone Modifications: The Double Edged Sword in Gynaecological Cancers <p>Gynaecological cancers are one among the fatal cancers that affects women worldwide. It includes endometrial, ovarian, cervical, vaginal and vulvar cancers. Epigenetic aberrations play a crucial role in the development and progression of such cancers, which includes global genomic hypomethylation, Cytosine-Guanine (CpG) island promoter hypermethylation, changes in histone modifications and changes in chromatin-modifying enzymes. This review aims at elaborating the significance of epigenetic changes specifically the histone modifications, at H3K9, H3K27, H3K4 and others involved in gynaecological tumourigenesis.&nbsp; They can independently or synergistically act along with DNA methylation for repression of the tumour suppressor genes and possibly for the activation of various oncogenes like CLDN3, CLDN4, GATA4, etc. in gynaecological cancers. These modifications may pave the way in the future for the identification of biomarkers in early diagnosis and prognosis with an opportunity for targeted drug delivery. A systematic review was done using Internet&nbsp; based scientific databases. Relevant clues about the role of Histone modifications like acetylation, deacetylation, mono/di/trimethylation, demethylation of the histone tails (H3/H4) involved in tumour development and progression were reviewed.</p> Janice Jacson M, Bharat Mishra Copyright (c) Fri, 01 May 2020 00:00:00 +0530 A Review on Risk Factors,Staging and Survival Rates of Endometrial Cancer in Both Black and White Women in Infertility Patients in USA <p>This article is focused mainly on risk factors,staging and survival rates of endometrial cancer in infertility patients in both black and white women in United States, These risk factors split in to two groups&nbsp; such as exogenous&amp; endogenous. Exogenous mainly (fertility treatment clomiphene, tamoxifen, human chorionic gonadotropins,human menopausal Gonadotropins&amp; Birth control pills, intra uterine devices) These factors which increases the concentrations of unopposed estrogen for a short periods of time but&nbsp; successful leads to fertility, long-term leads to endometrial cancer, and endogenous risk factors includes mainly (Poly cystic ovary syndrome, Obesity,Diabetes, and Hypertension) these risk factors in infertility women may lead to increased unopposed estrogen in the body may leads&nbsp; to development of endometrial cancer over a period of time. It is the commonest reproductive cancer. Our objective was toassess association between exogenous and endogenous risk factors, in infertility patients staging and survival rates in infertility patients which leads to an endometrial cancer .It is estimated that by 2030, endo metrialcancer will become the 6th most common cancer overall, and the 3rd most common among women. In addition, five year survival after an EC diagnosis is lower for black women when compared to white women at every stage of diagnosis. “Early detection leads to early prevention”.</p> Randeep Raj V.C, Prameela Jogi, Omkar Bolem, Emmanuel Gujju, Akhila Sanaboina Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Novel Coronavirus: A Recent Out Break <p>The novel Coronavirus was recognised as causative pathogen of coronavirus outbreak in 2020. First case reported in Wuhan. Phylogenetic analysis suggests that an animal sold at seafood market is the host of new virus. Thousands of people already contracted with new coronavirus. The WHO declared the outbreak “public health emergency of international concern”. Coronavirus belongs to large family of virus which are zoonotic in nature. Signs of infection by this virus: respiratory diseases, fever, cough, dyspnoea, headache, hypoxemia, pneumonia, sore throat. Mode of transmission of SARS-CoV [2002] &amp; MERS-CoV [2012] was by cat and dromedary camels. Coronavirus is causing severe acute respiratory syndrome indicated by elevated levels of aminotransferase and lymphopenia; alveolar damage can occur. Etiologic agents of respiratory diseases are human coronavirus: HKUI &amp; HCOU-NL63 and for common cold, it is coronavirus OC43 &amp; 229E. Murine coronavirus exhibit various levels of virulence and tropisms. Antibody &amp; cell mediated responses needed for its prevention. Porcine coronavirus are cause of viral enteritis &amp; foetal diarrhoea. The coronavirus spike protein- mediators cell-cell transmission. 1) Spike cleaves by proteases. 2) then enter cells by plasma membrane route. 3) finally replicate to particular cell based on ability to bind with receptors [2019 n-CoV – can bind to ACE-II receptors]. The demographic states: male: female sex ratio is 2.7-1 and age range 1-76 among the infected. Prevention include: regular hand washing, cover mouth while coughing, thoroughly cook meat and egg. The company Reckitt &amp; Benckiser says that Dettol can kill some CoV strains.</p> Camila A Carlman, Bharat Mishra Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Micro Emulsions: An Overview And Pharmaceutical Applications <p>Micro emulsions are clear, stable, isotropic mixtures of oil, water and surfactant, frequently in combination with a co-surfactant. Micro emulsions act as potential drug carrier systems for oral, topical, and parenteral administration. They offer the advantage of spontaneous formation, ease of manufacturing and scale-up, thermodynamic stability, and improved drug solubilization and bioavailability. Knowledge of the various methods available to thoroughly characterize a microemulsion system is essential. While microemulsion is used in several fields, in this review the pharmaceutical applications are emphasized. Micro emulsions are one of the best candidates as novel drug delivery system because of their long shelf life, improved drug solubilization with ease of preparation and administration. They have emerged as novel vehicles for drug delivery which allow controlled or sustained release for ocular, percutaneous, topical, transdermal, and parenteral administration of medicaments. The main objective of this review paper is to discuss Micro emulsions as drug carrier system with other possible applications.</p> Azad Sk, Nagul Meeravali Sk, Chinna Babu P, Ravi Kumar Konda, Vasu Naik V Copyright (c) Fri, 01 May 2020 00:00:00 +0530 A Review on Stem Cellstherapyis A New Era in Type 2 Diabetes <p>Diabetes is one of the most leading cause of death worldwide. Around 40 million diabetics are reported in India. Stem cell therapy is a branch of medicine that involves introducing stem cells into a diseased tissue which triggers the body’s ability to heal itself. Stem cell therapy is a latest technique which can be used to treat diabetes mellitus. In India the success rate of stem cell therapy in diabetes mellitus is approximately 70 - 80 %. As this stem cells may be harvested from the bone marrow, umbilical cord and matured adult. In the present review we are discussing about the use of stem cell therapy in type 2 diabetes and how it works. Type 2 diabetes mellitus results from combination of insulin resistance and dysfunction of insulin producing beta cells which cannot be reversed by existing therapeutic strategies, transplantation of stem cells which are differentiating into insulin producing cells is one of the most promising strategy for treating type 2 diabetes.</p> Firoz Firoz, Sumavi Shekar J, Pavani Tanniru, Mounika Kilaru Copyright (c) Fri, 01 May 2020 00:00:00 +0530 A CASE REPORT ON CEFTRIAXONE INDUCED MACULOPAPULAR RASH <p>Ceftriaxone, a third-generation cephalosporin, is being commonly prescribed since 1984. It is used as an antibiotic across almost all specialties for various conditions. Ceftriaxone induces different hypersensitivity type of reactions and maculopapular rash is one among those adverse drug reactions. This is a case report of 50year old female patient who was admitted in medical ward with a chief complaint of fever since 2 months and also the patient was NACO +ve since one month and now she is diagnosed as cervical TB lymphadenitis. Before diagnosing as TB based on patient’s symptoms, physician prescribed Inj. ceftriaxone as a prophylactic treatment along with Inj. piperacillin + tazobactum and both of the drugs administrated simultaneously. As a clinical pharmacist intervention, it was a mechanism duplication therapy and the ADR was induced by one of the suspected drugs and because of that ceftriaxone was stopped and they continued treatment symptomatically for ADR and after 5 days symptoms are cured and finally they were diagnosed by the dermatologist as maculopapular rashes. We conclude that ADR might have been possible with same dynamic activity medication duplication therapy of ceftriaxone and piperacillin + tazobactum. We should monitor the prescription always with drug relevant problems (DRP’s) to avoid drug induced complications in a patient. This prescription monitoring will assure us to give safest and effective therapy with best economic cost.</p> Hari Krishna Allu, Upajna vamaraju, Mahesh Pavan K, Navya Deepika B Copyright (c) 2020 Upajna vamaraju Thu, 30 Apr 2020 00:00:00 +0530 case report on metronidazole induced rash <p>Metronidazole is a synthetic nitroimidazole. It acts by disruption of DNA and inhibition of nucleic acid synthesis. Hypersensitivity reactions, including urticaria, pruritus, erythematous rash, and flushing have been reported; however, the frequency of reactions is not known. This is a case report of 7 year old female Child patient who was admitted in paediatric ward in King George Hospital, Visakhapatnam with a chief complaint of fever with vomiting and loose stools since 7 days. On the 2<sup>nd</sup> day of her treatment, she developed rashes and facial flushing associated with redness of face. Metronidazole was stopped after 3 days of appearance of these complaints so we suspect that it is a condition of metronidazole induced rash. Physician must suspect if such reactions occur during the treatment with metronidazole and must cautiously evaluate such drug-associated rashes.</p> Hari Krishna Allu , mahesh pavan kontheti, Navya Deepika B, Upajna V Copyright (c) 2020 Hari Krishna Allu , mahesh pavan kontheti, Navya Deepika B, Upajna V Fri, 27 Mar 2020 00:00:00 +0530 Case Report on Liposomal Doxorubicin Induced Anaphylaxis <p>Objective: To report a case of liposomal doxorubicin induced anaphylaxis.</p> <p>Case Summary:&nbsp; A 43 year old female patient with metastatic carcinoma of endometrium was admitted to the hospital with chief complaints of abdominal pain, distention and vomiting. Due to the disease progression she was planned for chemotherapy with liposomal doxorubicin. But she developed anaphylactic reaction in the 1<sup>st</sup> dose and drug was stopped. Therapy was discontinued and she got recovered.</p> <p>Discussion: Liposomal doxorubicin is a formulation of doxorubicin packed in a liposome with a polyethylene glycol covering. The anaphylaxis occurred may be due to the surface component of the liposome itself and not due to the actual drug. The mechanism of reaction is probably due to complement activation.</p> <p>Conclusion: Anaphylaxis is a serious, sometimes life threatening condition which may require immediate intensive care support. Pre-treatment with diphenhydramine, dexamethasone and famotidine is found to be useful following liposomal doxorubicin infusion. Sometimes chemotherapy needs to be discontinued to avoid risk for patients.</p> Sanjana Sanjana, Mariyam Johny Neethu , Sara Johny, Jobin Kunjumon Vilapurathu Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Case Report of Placenta Accreta: Successful Management with Conservative Surgery <p>The incidence of placenta accreta spectrum (PAS) disorders has increased over the last decades due to increase in cesarean deliveries, resulting in increase in cesarean hysterectomies , maternal mortality and morbidity but since last few years there has been a gradual shift towards the idea of conservative management. Conservative management of PAS is known to reduce major obstetric hemorrhage and salvage hysterectomy. We present a case of placenta accreta diagnosed by ultrasound where management of post-partum hemorrhage was accomplished by conservative surgery. The concise steps taken in management of placenta accreta before and during cesarean section were: Availability of 4 donors with cross match; Stark cesarean section; atraumatic clamps around uterine arteries; ureterotonic drugs; external (B-Lynch suture); and application of diathermy where required. This experience indicates that few selected cases of PAS could be managed conservatively who are at risk of intra-partum hemorrhage and post-partum hemorrhage.</p> berkheez shabir, Dr. Zahoor Hussain Daraz Copyright (c) 2020 berkheez shabir, Dr. Zahoor Hussain Daraz Mon, 04 May 2020 16:09:16 +0530 Case Report on Fournier's Gangrene <p>Fournier's Gangrene is a rare condition marked by fluminent polymicrobial necrotising fascitis which involves scrotum and penis, or both with occasional extensions upto the an abdominal wall. Pre disposing factors includes Diabetes mellitus,Immuno compromised patients, Alcoholism, Tobacco, Chemotherapy, Radiography etc. Fournier's Gangrene occurs at any age&nbsp; and it effects mostly in men but also effects women too. We present a case of Fournier's Gangrene - A 40 years old male patient was admitted in emergency department with the complaints of pain over the Testicular region, Itching, Ulcerative over the scrotal region with foul smell &amp; pus discharge and fever. This symptoms have started five day prior to the presentation but symptoms are rapidly progressive in nature since 24 hours of admission. His past medical history reveals that he has Diabetes mellitus type-1 and on medication. He had undergone surgery of hydrocelectomy one month back.The management steps Includes Resustation , Broad spectrum Antibiotics, Surgical debredment and skin grafting. As the patient is known diabetes the chances of infection is more. So early presentation, diagnosis and treatment plays a major role in preventing further complications. In order to do this, we have to provide awareness about the disease among the people.</p> Krishna Gowtham V, Vaishnavi A, Bhargav Narendra. J Copyright (c) Fri, 01 May 2020 00:00:00 +0530 Case Study on Guillain Barre Syndrome – A Rare Auto immune Inflammatory De-myelinating neuropathy observed at Tertiary Care Teaching Hospital <p>Autoimmune cell activation causes damage to different cells of the human body. In rare cases, this autoimmune cell activation destroys the Myelin sheath which wraps around the long nerve cell bodies and leads to the development of extremely rare nerve cell-related autoimmune disorder known as Guillain-Barre syndrome. The present case of 34 years old male patient who was admitted in the general medicine department of a tertiary care teaching hospital with complaints of arthralgia, generalized weakness mediated with tingling sensation started at feet progressing upwards. Treatment included antibacterial agents and steroidal autoinflammatory agents. After the continuous treatment for a period of 13 days, the patient was found to be normal with no major complaints and so, the pharmacist when performed discharge counseling and patient was discharged with a 2-week drug regimen after discharge.</p> Jaya Radha Madhavi Bonala, Swarna Latha Surakala, Tushara Bammidi Copyright (c) Thu, 30 Apr 2020 00:00:00 +0530 Onychomadesis Following Hand-Foot Mouth disease Prospective Observational Study on 33 cases of Hand Foot Mouth Disease <p>In 2019, an outbreak of hand, foot and mouth disease (HFMD)occurred in Maldives and many patients presented with onychomadesis following HFMD. Here we present a study of 33 cases out of which a total of 06 cases developed onychomadesis. Patients varied in clinical presentations ranging from mild to severe form of HFMD and during follow up 06 cases presented with peroidic shedding of nails involving both fingernails and toenails. All the patients were observed 4 to 6 weeks after diagnosis of HMFD was made. It was observed that onychomadesis developed was not related to the severity of the disease. Patients required only symptomatic treatment for HFMD and observation with assurance for onychomadesis as course was self-limited. Nail changes were temporary in nature and spontaneous regrowth occurred after shedding of the nails. Parental counselling played a cruicial role in management.</p> Zahoor Hussain Daraz, Berkheez Shabir, Rehana Afshan, Pramesh Kumar Yadav, Adnan Bacha Copyright (c) Fri, 01 May 2020 00:00:00 +0530