Journal of Pharmaceutical and Biomedical Sciences

440-448

Authors: D.DalyaThamer Ahmad*

Objective: The aim of this study was toinvestigate the association between prior miscarriages and the risks of placental dysfunction disorders, including preeclampsia, stillbirth, birth of a small for gestational age (SGA) infant, placental abruption, and spontaneous preterm birth. Study Design: In a population-based cohort study including 72 primiparous women, we estimated risks of placental dysfunction disorders for women with 1 (n = 24 ), 2 (n = 20 ) and 3 or more (n = 18 ) self-reported prior miscarriages. Risks were calculated as odds ratios by unconditional logistic regression analysis and adjustments were made for maternal age, early pregnancy body mass index, smoking habits, years of formal education, in vitro fertilization, chronic hypertension, pregestational diabetes, hypothyroidism, systemic lupus erythematosis and fetal sex . Results: Compared with women with no prior miscarriage, women with 1 prior miscarriage had almost no increased risks. Women with 2 prior miscarriages had increased risks of spontaneous preterm birth, preterm (<37 weeks) SGA infant, and placental abruption. The rates of all disorders were higher for women with 3 or more prior miscarriages compared with women without prior miscarriages: preeclampsia, 50% vs 30%; stillbirth, 22.22 % vs 0%, SGA infant, 22.22 % vs 10 %, placental abruption, 27.78 % vs 10 %; and spontaneous preterm birth, 27.78 % vs 10 %. The adjusted odds ratios for preterm (<37 weeks) disorders in women with 3 prior miscarriages were approximately 3.4, neonatal death, 11.11 % vs 0%. Conclusion: History of 2 or more miscarriages is associated with an increased risk of placental dysfunction disorders and should be regarded as a risk factor in antenatal care.

453-468

Authors: Nagaraj B Malipatil*, Kiran M Haridas, Shruthi D Prithvi

Currently, all biologics in India, including innovative and bioequivalent biologics (also known as similar biologics in India), are approved as new drugs. Recently in 2012, the Department of Biotechnology (DBT) and Central Drugs Standard Control Organization (CDSCO) issued the “guidelines on similar biologics”. The guidance outlined an abridged procedure for the regulatory requirements for marketing authorization of similar biologics in India. Due to limited R&D capabilities, most domestic companies manufacture simple biologics. However, companies have increasingly begun to shift their focus to the development of both novel and copy versions of monoclonal antibodies and second-generation biologics, which though more expensive and complex to develop can be priced at a premium, and compete in a much less crowded market than that faced by firstgeneration biologics. A number of factors facilitate the development and uptake of Biosimilars in India. Poor patent enforcement in India provides opportunities for domestic biologics manufacturers, while publicprivate sector partnerships promote biologics development. Since there are less stringent regulatory requirements and low R&D costs, domestic biologics are priced much lower in India compared to originators, further driving uptake, as well as offering huge potential for contract manufacturing of biosimilars and for exports. Domestic companies are also entering into partnerships to facilitate development of biologics for the Indian and global market. However, despite the low price of Biosimilars compared to originator brands, the domestic market is restricted by limited health insurance coverage and therefore poor access to biologic drugs. Also, issues regarding the quality and safety of some domestically manufactured biologics remain a concern among patients and physicians.

475-479

Authors: Bharath Bhushan, Anju Bhushan, Elizabeth Moirangthem*, Nitin Sharma, Neha Bhargava, Tarun Sethi, Chiranjeev Saini

Peripheral ossifying fibroma is one of many localized reactive lesions occurring on the gingiva which includes focal fibrous hyperplasia, pyogenic granuloma andperipheral giant cell granuloma. It is a solitary overgrowth of the gingiva known to arise from the cells of the periodontal ligament. As lesions with similar clinical presentation makes it difficult to diagnose, it makes histo-pathological investigation essential to positively identify the lesion. The present case report highlights the diagnosis and management of peripheral ossifying fibroma in the anterior mandible region of a female child patient.

487-490

Authors: Ali Mihsen Hussein Al-Yassiri*, Karrar Abdul-ZahraaMahdi

Background: Autism is a Kind of disorders that lead to severely failure of ability to communications, interact or adhesionwith other child or person and maintain appropriate contact with the outside society or world. Autism is consist of a complex group of neurobiological disorders caused by defects in developments of child's brain; that usually last throughout a lifetime and are classified as autism spectrum disorders (ASDs). These disorders are associated with hared routines and repetitive behaviors and communications. The aim of this study was to find, the type of communication betweenorofacial manifestations and autistic disorders. Materials and Methods: Children were selected from private specified centers for autistic disorders and special care in Hilla (Babylon) and Najaf cities of Iraq, by periodic visits. One hundred and twenty(120) subjects were incorporated in this study. All these Childs with age ranges (4.5-10.5) years, and were without any other systemic disease. All these patients were previously diagnosed by psychiatrists. Results: Prevalence of orofacial findings in child with autistic disorders (AD) were: Dental caries (71%), Dry mouth ( xerostomia) (51%), Bruxism (59 %), Delayed tooth eruption (47%), Bad oral hygiene ( 65%), dental traumatization ( 52%), Lip chelitis(44%). Conclusions: Oral health may compromise in children with autistic disorders. Oral manifestations of systemic diseases or communications abnormalities; can be found in different conditions. Oral health, may consider as a mirror of general health.

499-504

Authors: Midhun Moopil Mohanan, Moksha Nayak, Grishma Florence Noronha*, Jayanth Nambiar, Ramya M.K

This in-vitro study aimed to ascertain the mode of action of three desensitizing agents namely, Arginine-containing, Propolis-containing and Potassium Nitrate-containing dentifrices using scanning electron microscopy and energy-dispersive X-ray spectroscopy. Materials and methods: Ninety dentin slices from non carious human premolar teeth were used for the study. The teeth were randomly divided into three groups (n=30), according to the type of dentifrice applied: Group I: Arginine-containing paste, Group II: Propolis-containing paste and Group III: Potassium nitrate –containing paste. Each group was divided into two subgroups (n=15) for the assessment by two different techniques: Subgroup A: Scanning electron microscopy examination and Subgroup B: Energydispersive X-ray spectroscopy examination. SEM was used to assess the tubule occlusion and the change in the diameter of the dentinal tubules. EDXS was used to characterize the elemental composition of the occlusive material. Analysis of agents, both prior to and after application on dentine discs was performed for comparative purposes. Statistical analysis was done using one-way analysis of variance (ANOVA) and the Bonferroni post hoc test for multiple comparison. Results: The dentin discs treated with argininecontaining paste (93.220% by SEM) showed statistically (p<.001) highest mean percentage of occluded tubules followed by Potassium Nitrate–containing paste (34.777% by SEM) and Propolis-containing paste (13.580% by SEM). There was a strong evidence (p<.001) that group I(68%) was most effective in reducing the mean tubule diameter, while group II(47%) and III(44%) did not produce a significant reduction. The EDXS studies show that the dentin surface deposit and occluded tubule plugs contain high levels of calcium, phosphorus, fluorine, silica in group I and III treated specimens. Conclusion: The study presented shows successful dual action properties- tubule occlusion and nerve depolarization of arginine-containing paste and potassium nitrate-containing paste and partial tubule occluding property of propolis-containing paste as evaluated by scanning electron microscopy and energy-dispersive X-ray spectroscopy.

516-518

Authors: Satwant Kaur*, Harjinder Singh, Kumud Bala Gupta, Anupa Sood, Swaran Kaur

Objective: To find out the correlation between two modalities i.e. USG and DL used in diagnosis of chronic pelvic pain. Method: One hundred women with chronic pelvic pain attending Gynae OPD were included. They were examined clinically and subjected to USG and DL. Results: Among the 78 patients with abnormal findings on laparoscopy only 45 had positive USG findings. Though USG had a higher sensitivity for ovarian cysts, laparoscopy was more predictive for other positive findings. Conclusion: Diagnostic laparoscopy is more sensitive method for diagnosis of chronic pelvic pain.

S1-S4.

Authors: Sandeep Khadda, Ashok Parmar, Anwar Ali1, Ajay Kumar Yadav, Jitendra Kumar Sakhrani, Akhil Kapoor*

Gall bladder perforation is very unusual presentation of enteric fever with high morbidity and mortality if diagnosis is delayed. We report a case of an adolescent who had enteric fever with generalized peritonitis,radiograph of abdomen is not suggestive of bowel perforation. The patient was intra-operatively diagnosed as acalculous gall bladder perforation complicating enteric fever. He was managed with cholecystectomy and appropriate antibiotic coverage. Patient recovered uneventfully. Acalculous gall bladder perforation in enteric fever is a rare surgical complication. Enteric fever is common in developing and poor countries because of poor hygiene and sanitation condition as it spread through faecal-oral route. Investigation like sonography and CT-scan lacks specificity for gall bladder perforation.In our case gall bladder perforation diagnosed intra-operatively and managed with cholecystecomy. In enteric fever with generalized peritonitis diagnosis of gall bladder perforation should be look with high suspicion if bowel perforation is not identified pre-operatively or intraoperatively. Cholecystectomy is procedure of choice to prevent high morbidity/mortality.

380- 384

Authors: Adithi S Shetty, Harish Shetty, Divya Hegde, B. Suresh Kumar Shetty, Jagadish Rao Padubidri*

Objective: This study was undertaken to determine if there were different abortion rates between normal and abnormal yolk sacs between 5-10 weeks of gestation, its association with pregnancy outcome and correlation with other parameters Materials and Methods: In this study, the yolk sac characteristics of 95 consecutive pregnant women, of 5-6.5 weeks gestation, with normal body mass index (BMI) were prospectively evaluated. All patients underwent two-dimensional transvaginal ultrasonography, which was performed by the same sonographer. We considered the following yolk sac characteristics as normal for classification: diameter: 2- 5 mm; round shape; absence of degenerative changes. Yolk sacs that had diameters smaller than 2 mm or larger than 5 mm; a shape that was not round (i.e., oval or distorted); the presence of degenerative changes. The outcome is statistically analyzed. Results: A total of 100 cases were evaluated. Five cases were excluded. 81(85.3%) continued beyond 20 weeks and the rest 14(14.7%) ended in abortions. About 95.7% of the pregnancies showed the presence of a yolk sac, while in 4.3% of them a yolk sac was absent. Pregnancies with large yolk sac diameter ended with abortions. The sensitivity of predicting normal outcome with regular yolk sac is as high as 94.2%, while specificity is 34.5%. Conclusions: Abnormalities of the yolk sac size or shape, and absence can be used as a reliable indicators of early pregnancy.

385-393

Authors: AL- Bayati LAA*

The complement C3 and C4 fractions as well as the cytokines Interferon and Interleukine 6 were estimated in serum samples of women during contraceptive intake. These estimations were made in an attempt to evaluate them as a diagnostic battery for detection of immune status in these women's. The C3 concentration means were; 154.553 ± 12.084, 149.816 ± 10.423, 130.216± 6.147, 159.966± 8.583 and a 8.125± 21.570 mg/dl for pills , depot injection, IUDC, nonusing and virgin controls, respectively. In comparison C4 levels were ; 42.825± 4.293, 34.583 ± 2.801, 32.466± 3.688, 33.025± 3.025 and 26.441± 6.680 mg/dl for pills, injection, IUDC, nonusing and virgin controls respectively.The interferone gama concentration were; 55.169±8.962, 80.266±3.630, 66.171±3.973, 26.499± 3.482 and 74.760±2.930 pg/ml accordingly. The interleukine 6 concentration means were found as; 28.399± 8.517 for pills, 36.380±8.63 for injection, 25.733± 3.899 for IUCD, 76.499± 3.482 for non using women and 91.219±5.001 pg/ml for virgin controls. Thus, they seems to be suitable as an assessment battery for immune status of women on contraception intake.

403-407

Authors: Rajendra K Gupta*, Gautam L Nagori, Poonam Nagori, Ram P Patidar

Objective: To study the pattern of co-morbidities in children having Severe Acute Malnutrition in MTC attached to a teaching hospital. Methods: In a span of two years all the children (421), admitted in MTC of SRG Hospital Medical College Jhalawar, were studied for presence of one or more comorbid conditions along with severe acute malnutrition. Results: Out of the 421 children who were admitted to Malnutrition Treatment Corner (MTC), acute respiratory infection is the most common (37.3%) co-morbidity in children with Severe Acute Malnutrition. Followed by acute gastrointestinal infection. Significant number of children was having urinary tract infections. Tuberculosis was diagnosed in 23% of children. Pyogenic skin infections were found in 14.7% cases. As micronutrient deficiencies present as part of Protein Energy Malnutrition, vitamin deficiencies of all vitamins A, C, D and B group were found in 28% of children and 87% of children were having anemia. Malaria and measles were also diagnosed in few study subjects, but they were not considered as significant co-morbid conditions Conclusions: It is imperative to suspect and anticipate co-morbid condition in these children. High index of suspicion for these co-morbidities is the key to reduce mortality and better outcome in children having acute severe malnutrition.

419-423.

Authors: Lavanya Kollapu*, Suseela Kumari Pamu

Brucellosis is a zoonotic disease of worldwide distribution and has great economic concern. It is a contagious disease of ruminant animals but also effects human beings. The duration of the disease can vary from a few weeks to many months. Materials and methods: A total number of 200 samples tested for RBPT and STAT by using phenol saline as diluent to know the IgG titre and 2-mercapto ethanol was used as diluents to know the IgM titre. ELISA test was performed for all positive samples in RBPT, to know the presence of IgM antibody. All the results were analysed statistically. Results: Of the200 serum samples, highest proportion of positive cases were slaughter house workers 21.05% and lowest proportion was with PUO cases 6.97%.case distribution according to positivity of RBPT and STAT highest proportion in slaughter house workers 13.5% and lowest proportion in PUO cases 6.97%. Conclusion: Prevention of human brucellosis focuses mainly on elimination of infection among farm animals. Cooperation is recommended between public health and veterinary officials to overcome the failure of controlling disease among both animals and humans.

429-435

Authors: Svensson, Travis K. RN, MD, PhD

The Food and Drug Administration (FDA) approved the NeuroStar Transcranial Magnetic Stimulation Therapy system for the treatment of major depressive disorder in the fall of 2008. Since that time more than 175 devices have been placed in both public and private practice settings. Transcranial Magnetic Stimulation (TMS) therapy requires psychiatric prescription and supervision, however there are no specific standards articulated by the FDA, the State Boards of Medicine or the State Boards of Nursing regarding TMS Operator qualification. Neuronetics, the manufacturer of the NeuroStar TMS Therapy systems holds that the device is so safe and well tolerated that anyone may be trained to be an effective and safe TMS Operator. Registered Nurse (RN)/Medical Doctor (MD) TMS Operators predominate in hospital, academic and institutional settings, whereas unlicensed allied health workers predominate in private practice settings. Using both quantitative and qualitative research methodologies, this study demonstrated the safety and tolerability of TMS therapy provided by non-RN/MD TMS Operators in our communities. This study suggests a role for a future prospective randomized controlled trial to demonstrate the efficacy of TMS provided by non- RN/MD TMS Operators.

272-275.

Authors: Venkata N Kakaraparthi*, Khalid Alahmari, Irshad Ahmed, Jaya S Tedla

Q-angle is considered an important factor in the development of a variety of soft tissue conditions. An abnormal high or low Q-angle has been repeatedly cited as predisposing to anterior knee pain syndrome common among young active individuals.The objective of this study is to assess the normal Q- angle values in asymptomatic young adultsin Abha, Asser region, Kingdom of Saudi Arabia. The methodology adopted for this study, One hundred (100) male subjects, age range (18-25) years participated in the study. The Q-angle of the subjects was measured in the supine lying position with quadriceps relaxed, with knees extended by using a universal goniometer. The results showed the average Mean Q angle and S.D for 100 subjects who participated in the study was 13 ± 2.16. This study also assessed the correlation between Age and Q angle. The study concluded that the normal Q-angle values vary between different ethnic groups. Therefore, it is recommended that Q-angle assessment should be an essential component of the physiotherapy management of knee joint pathology.

291-295

Authors: Suprita Gupta, Archana Jayan, Amit Chandra Jha, Narayan Gautam*

To estimate HbA1c (%) in type 2 Diabetes mellitus (DM) patients to calculate estimated average blood glucose (eAG) and to correlate them with fasting and post prandial blood glucose level. Materials and methods: HbA1c was estimated in hemolysate by nephelometric method followed by National Glycohemoglobin Standardization Program (NGSP) protocol with MISPA-I2 smart card system in 104 type 2 DM patients. FBG and PPBG were simultaneously determined in serum of patients. The calculation was done by using formula eAG (mg/dl): (28.7*HbA1c)-46.7 given by NSGP/DCCT guideline. The categorization of glycemic control was made as HbA1c ≤5.9% (very good glycemic control), HbA1c between 6.0 and 6.9 % (good glycemic control), HbA1c between 7.0 and 7.9 % (poor glycemic control), HbA1c ≥ 8% (bad glycemic control). Results: The age-wise categorization of type 2 DM shows maximum frequency of patients of 21 (20.19 %) comprising 10 (9.61 %) male and 11(10.57 %) female respectively in age group 41-60 whose HbA1c and eAG were (7.6 ± 2.9 %) and eAG (172.66 ± 81.79 mg/dl) respectively. The statistically significant correlation was observed between HbA1c/eAG with FBG and PPBG (p<0.001). Conclusion: The high frequency of patients in categories >8.0 % HbA1c and increased eAG signifies the bad glycemic control and project to the complication associated with DM later in life.

300-307

Authors: M. Sakthibalan*,Maruti Sripati Sawadkar

The anthracycline antibiotic, Doxorubicin has beenproved very effective in a broad range of haematogenous and solid human malignancies. Its use is limited by its irreversible degenerative cardiomyopathy. This has driven us to find novel treatment modalities to reduce its cardiac side effects without conceding its anti-cancer effect. Objective: To evaluate the anti cancer effect of Doxorubicin when given in combination with cardioprotective agents like N-acetlycysteine, Enalapril and Vitamin c in Ehrlich ascites tumor inducedwistar rats. Methodology: The male adult wistar rats selected for investigate, divided into six groups with six rats in each group. Rats bearing Ehrlich ascites tumor were selected for the study. The rats in the control group and toxic control were administered sterile water and Doxorubicin respectively on day 5. N-Acetylcysteine, Enalapril and Vitamin c administered orally for seven days as dual drug and triple drug combinations. On day seven, the rats were sacrificed and blood was collected for estimation of cardiac stress markers and cardiac tissue was sent for histopathological estimation. The Peritoneal fluid was aspirated and the volume and viable tumor cell count assessed, using trypan blue exclusion technique. Statistical Analysis: Student ‘t’ test and one way ANOVA followed by Bonferroni test is applied. Result and conclusion: The tumor volume and cell count at the end of the experiment was measured and it was found out that the anti-cancer effect of doxorubicin is not compromised on instilling various cardioprotective drugs in various combinations to treat doxorubicin induced cardiotoxicity.

312-316

Authors: M.Johnson Gritto, V.Nanadagopalan, A. Doss*

The present study was carried out to identify the phytocomponents present in the methanolic extract of Hildegardia poplifolia by GC-MS analysis to learn it’s usage by the traditional healers as ‘a plant possessing medicinal properties’. Eighteen compounds were identified. The major constituents are 3, 7, 11, 15-Tetramethyl-2-hexadecen-1-ol (43.96%), Olean-12-ene (11.55%) n-Hexadecanoic acid (10.56%) and 4-Pyrimidinamine, 2, 6-dimethyl- (4.34%). Many of them are used in pharmacy for various uses like antioxidant, anti-diabetic, malaria, anti-inflammatory, anti-cancer and antimicrobial.

328-331

Authors: Amrit Anand*, Rajesh Kumar Padhy, Sameer Golder

Objective: To find out the accuracy of FNAC and its comparison with histopathology in diagnosing thyroid malignancy. Materials and Methods: This prospective study was conducted in 56 patients attending the ENT and Head & Neck Surgery, Out Patient Department, HI-TECH MEDICAL COLLEGE AND HOSPITAL BHUBANESWAR ORISSA from August 2012 to June 2014. Clinically diagnosed thyroid swelling patients were subjected to FNAC. Based on clinical findings and FNAC, patient underwent appropriate surgery, then the FNAC finding was compared and correlated with the final HPE report. Results:The majority of cases were in their third decade (30.36%), with female predominance, female to male ratio was 6:1. The maximum number of cases was diagnosed to have colloid goitre (60.71%) by FNAC, followed by papillary carcinoma thyroid (30.36%) and benign proliferative thyroid disease (5.36%).However, histopathology confirmed the predominant cases to be of papillary carcinoma thyroid (48.21%) followed by colloid goitre (32.14%). The overall prevalence of malignancy was 62.5% by HPE and 37.5% by FNAC. Accuracy score was 82.14% in the prediction of neoplasia. Conclusion: FNAC is a simple preoperative test commonly done in diagnosing thyroid swelling. In cases of clinically suspicious malignancy of thyroid, FNAC is suggested before definitive surgery so as to plan adequate surgery at the first sitting itself. When compared to the final HPE report, sensitivity of FNAC was 62.96% while specificity was 100%; accuracy was noted to be 82.14%. Predictive value of a positive test and negative tests was 100 % and 74.35% respectively.

338-343

Authors: Rebecca Singh*, Priyanka Bisoi, Shiv Narayan Mohanty,Purna Chandra Debata

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It is always a subjective experience. Pain has been a major concern of human kind and it has been the object of ubiquitous efforts to understand and to control it. Regional anaesthesia of the extremities and of the trunk is a useful alternative to general anaesthesia in many demanding situations. The main drawback of long acting local anaesthetic drugs such as Bupivacaine was delayed onset of action. Methods: This is a prospective, randomized, double-blind, placebo-controlled study of 100 orthopaedic cases of upper limb surgery to study the effect of adding dexmedetomidine to bupivacaine for supraclavicular brachial plexus blocks on the onset time and duration of motor and sensory blocks Results and conclusion: From our study, we conclude that, the addition of Dexmedetomidine (1μg/kg) as an adjuvant to bupivacaine (0.5%) has following effects: Faster onset of sensory block, Faster onset of motor block, Longer duration of sensory block, Longer duration of motor block, Less number of rescue analgesics in post-op 24 hours and no significant difference in haemodynamic variables i.e., pulse rate, systolic BP, diastolic BP and O2 saturation.

351-354

Authors: Senthilkumar Rajagopal*, Supraj Raja Sangam, Shubham Singh

High voltage-gated calcium (CaV) channels are the major source for Ca2+ influx that underlies Ca2+ - dependent response in excitable cells. Protein kinase C (PKC) is families of protein kinases enzymes that are play important roles in several signal transduction cascades. Ca2+, CaV channels and PKC are involved in the processes of pain, insulin secretion, glucose homeostasis, smooth muscle physiology, response to neuro-chemicals, receptor sensitization, in modulating membrane structure events, in mediating immune response, in regulating cell growth, and in learning and memory. The identification of the roles of these proteins will provide us significant knowledge for the understanding of the complexity of the ion channel physiology and regulation of many diseases. In this short communications, we discuss the contribution of PKC in the modulation of calcium channels in Xenopus oocytes model.

365-371

Authors: FENG Xiaofei, LI Linlin, LUO Rui, HE Ying, LIANG Wenli, XU Zhenxia, ZHAO Wen, LI Sha*

Objectives: Diclofenac sodium, an arthritis drug of wide clinic use, shows good solubility, quick absorption and short half life, and is susceptible to generate high blood concentration fluctuation. In order to improve the weakness, hydrophilic matrix tablets of DS were prepared by using hydroxypropylmethyl cellulose (HPMC) as matrix material. The tablets were prepared by direct compression, and the polymer sort and proportion, the amount of microcrystalline cellulose (MCC), and the hardness of tablets were screened to optimize the formulation and process. The results showed that the ratio of matrix material to drug was the chief factor influencing the release behavior of DS from hydrophilic matrix tablets. With the decrease of matrix material, the drug release became faster and more complete. The addition of MCC changed the release of DS to some extent, especially reducing the burst release within 2 h. The influence of pressure was not so much great that distinct difference in drug release was only observed when the pressure was too high to be 11.5 kg. The optimal matrix tablets of DS showed no apparent burst release, and less than 30% of drug was released at 2 h. The drug continuously released slowly to an accumulative release of 94.3% at 12 h. The Higuchi equation and Ritger-Peppas equation fitted the drug release data well, which indicated a typical sustained release of DS controlled by both diffusion and erosion.