International Journal of

Current Pharmaceutical Review and Research

e-ISSN: 0976 822X

NMC Approved

Peer Review Journal

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1. Nanomedicine and drug Delivery systems-Roles, Advantages and Disadvantages
Reyadh R Al-Rashidi, Wesam R Kadhum, Muqdad Alhijjaj, Radhi K Obaid
Nanotechnology is a new and rapidly evolving subject in the pharmacological and therapeutic professions. Nanoparticles have many advantages as medication delivery systems, including increased efficacy and fewer adverse drug reactions. This study investigated the roles of nanomedicine and drug delivery systems in the pharmaceutical industry, as well as the advantages and disadvantages of nanotechnology. The study used a qualitative research technique, with online survey questionnaires sent to medical professionals and experts in the field of nanomedicine. These surveys comprised open-ended questions that enabled respondents to record their responses in whatever way they deemed fit. The ten respondents were from a variety of medical and health institutes, as well as medical consulting firms. In terms of results, the research established that nanomedicine had been used in medical care for therapy and diagnostic purposes. They are being explored in clinical trials for several reasons. Nanoparticles are used to treat renal disease, Tuberculosis, skin problems, Alzheimer’s disease, and various types of cancer and to create COVID-19 vaccines. Further information about the study findings may be found in the results and discussion chapter.

DOI: 10.5281/zenodo.7536909

2. Study of Effect of Tobacco Smoking on Hemopoietic Markers at Tertiary Care Center of Udaipur, Rajasthan, India
Rashmi, A K Verma, Akanksha Menaria, Nirali Salgiya
Background: Smoking-induced hypoxia, inflammation, and oxidative stress result in impairment of hematological parameters. Contradictory evidence is found as far as the effect of smoking on blood cells and indices is concerned. Objectives: The objective of this study is to see the effect of use of tobacco smoking on serum vitamin-B12, S.Iron, S.TIBC  and S. Ferritin level and compare it with non-smoker healthy adults. Methodology: Total 300 patients were include in this study, in which patients ranging within age 20-40 years, they were further  categorized according to use of tobacco smoking. Group A- This group consist of tobacco smoker patients between ages 20- 40 years. (n=150).Group B-This group consist of tobacco non-smoker patients between ages 20-40 years. (n=150). 10 ml blood was drawn through vein puncture. From all collected blood samples S. iron, S. TIBC, S. ferritine, S.vitamin B12 and Liver function tests were measured. All collected data were analysed statistically to calculate p value to see the difference of significance. Results: The Mean concentration of S. Iron (mg/dL) in smoker  group was  162.12 ±48.76 while that of  Non-smoker control group 143.09 ±47.86  and the difference among them found to be  highly significant. The Mean concentration of S. TIBC (mg/dL) in smoker  group was  314.08 ±82.53  while that of  Non-smoker control group 230.22 ±79.17   and the difference among them found to be  highly significant. The Mean concentration of S. Ferritin (micrograms/lit) in smoker  group was  178.38 ±50.02  while that of  Non-smoker control group 66.73 ±35.65   and the difference among them found to be  highly significant. The Mean concentration of  S. Vit. B12 (pg/mL) in smoker  group was  288.78 ±108.60  that is low as compared to non-smokers group. Non-smoker control group 459.89 ±165.77   and the difference among them found to be  highly significant Conclusion: The results of this study suggest that there were low serum vitamin B12  concentrations in smokers compared with non-smokers, which might contribute to the development of vascular and cardiovascular diseases.  It may be concluded that there appears a link between smoking and alterations in hematological parameters.

DOI: 10.5281/zenodo.7536924

3. Study of Various Oxidants and Trace Elements in Cervical Cancer Patients at Tertiary Care Center of Udaipur, Rajasthan, India
Shilpa Sharma, A K Verma, Anita Yadav, Harpreet Kaur
Background: Cervical  Cancer  is  one  of  the  most  common  gynaecological  malignancy  worldwide.  Approximately, 5,00,000 new cases  are diagnosed  every year with a higher rate of incidence among women  of  lower   socioeconomic  status  especially  in  developing  countries. Objectives: The objective of this study is to measure the oxidant status. To estimate and compare serum levels of oxidant MDA (malondialdehyde) and  trace elements like Mg, Zn and their derangement in premenopausal and postmenopausal cervical cancer patients. Methodology: These case control studies consist of 150 patients of cervical cancer along with 150 healthy subjects of précised matched age within the institution. blood samples was collected from all participants and samples were analysed for oxidant MDA (malondialdehyde)and trace elements like  Mg and Zn. Results obtained were analyzed statistically to see the significance of differences. Results: The Mean concentration of S.MDA (nmol/L) in case group was 5.88 ±2.52 while that of cervical cancer, MDA, Mg, and Zn control group 2.92 ±0.70 and the difference among them found to be highly significant. Zinc and Magnesium levels were found to be low in cervical cancer patients as compared to control group. The Mean concentration of S. magnesium (mg/dL) was in case group was 1.30±0.44 and 1.91 ±0.29 control group and the difference among them found to be highly significant. Similar to that S. Zinc (mcg/dL) concentration in case group was 35.87 ±11.31 and in control group 118.26 ±29.41. And the difference among them found to be highly significant. Conclusion: We conclude that an imbalance between oxidant-antioxidant status of patients in case Group when compared to healthy controls. This imbalance plays an important role in the pathogenesis and progression of cervical cancer though the involvement of these parameters is altered in oxidative stress. The study found significantly lower concentrations of zinc and Magnesium in cervical cancer patients. Zinc and Magnesium supplements may therefore result in reduced cervical cancer occurrence among high risk women.

DOI: 10.5281/zenodo.7536957

4. Development and Optimization of Cubosomal Econazole Nitrate
Surabhi Satheesan, Krishnananda Kamath K, Shabaraya A.R.
Cubosomes are nanoparticle, more accurately nano structure particles of a liquid crystalline phase with cubic crystallographic symmetry formed by the self-assembly of amphiphilic or surfactants like molecule. This study is to investigate the potential of cubosomes as lipid nanocarrier to improve the controlled release of Econazole Nitrate used for treatment of dermatophytes. Econazole Nitrate cubosomes were prepared by Top-down approach employing GMO as lipid phase vehicle, Poloxamer 407 as stabilizer and distilled water as aqueous phase. The resultant cubosomes dispersion were characterized by encapsulation efficiency, in-vitro drug release, particle size, zeta potential and FTIR. Best formulation (F4) showed a maximum drug release of 93.96 % in 8 hours, particle size of 230.1 nm and zeta potential of -19.1 mV. The best formulation was chosen on the basis of Optimization by Design of Expert software which will be incorporated into the carbopol 934 gel for the proper and feasible application of the formulation on skin.

DOI: 10.5281/zenodo.7536971

5. The Role and Correlation of Music Intervention to Alleviate Pain and Anxiety: A Systematic Review and Meta-Analysis
Ravi Patidar, Neelam Balekar
Many studies suggest that Music Therapy (MT) can help calm nervous system and lower cortisol levels, both of which can help reduce stress and anxiety. The objective of the study was to find out the potential correlation between music, anxiety and pain by locating all research and merging their findings. A literature search on PubMed, Web of Science, Global health, Medline & Cochrane review of journals databases was performed on the recent 10 years of data. Randomized controlled trials (RCT) studies included patients with anxiety and pain and accumulated data on music intervention therapies with the help of Revman software. The quality of evidence was assessed using the modified Jadad scale and was found to be 5.3 in a scale of 9. It was evaluated that patient’s anxiety levels decreased and their blood pressure, oxygen saturation level, and heart rate values improved when on music therapy. It raised the stress threshold and reduced discomfort. For the MT group, the analysis produced a moderate effect of anxiety with a statistically significant result (RD= -0.01, 95%CI, -0.04-0.03, p=0.832, I2=0%). The Hamilton Anxiety Rating scale measured anxiety, Visual Analogue Scale (0–10) measured pain which was found to be 1.The outcome of the study was that patient with anxiety and pain have benefited from MT though effect of MT on anxiety was greater as compared to pain.

DOI: 10.5281/zenodo.7537013

6. A Systematic Review & Meta-Analysis on Interrelating Comorbid Conditions and Breathing Practices
Khan Afrin, Balekar Neelam
Background & Objective: Previous studies have suggested that there is a correlation between cardiovascular and respiratory disorders. The current review was carried out to comprehensively examine the probable relationship between cardiovascular disorder, respiratory disorder, and breathing habits by locating all relevant research & combining their findings. Methods: A literature search on PubMed, Science Direct databases was performed on past 10 years data. For randomized controlled trials (RCT) studies included cardiovascular & respiratory disorder and accumulated data on breathing practices. The modified Jadad scale was used to evaluate the quality of the evidence. The random effect model was used to compute the mean difference (MD), standardised mean difference (SMD), and 95% confidence interval (CI) for the continuous outcome. Results: A total of 20 RCT studies with 1,333 participants with age group of 18-85 years were included in these studies. On the basis of heterogeneity breathing practices showed a positive effect on respiratory disorder in COPD (SMD = -0.29,95%CI: -0.74, -0.15) than low positive effect on cardiovascular disorder (SMD = -0.24,95%CI: -0.48, -0.55). The assessed quality of the studies based on the modified Jadad scale was high (5.2). Conclusion: In current systematic review & meta -analysis found to discover the correlation between respiratory diseases (COPD & asthma) and cardiovascular diseases (hypertension) and breathing practices.  The outcome of the systematic review and meta-analysis conformed that breathing exercises are more effective for the adult age group over 26 years for cardiovascular and respiratory diseases.

DOI: 10.5281/zenodo.7537030

7. Randomized Controlled Trial on the Effect of Yoga and Meditation on Cognitive Function: A Systematic Review & Meta-analysis
Jain Shivangani, Balekar Neelam
Background & Objective: Yoga is a potentially beneficial form of physical exercise, but limited research has been done into its effects on the brain and its function. The objective of this study was to investigate the impact of yoga and meditation on cognitive function using randomized controlled trials (RCT) studies. Methods: A literature search was performed using Pub Med and Google Scholar databases over the past 10 years for RCT studies that contained articles on the effects of yoga and meditation on cognitive function. The risk of bias was assessed using modified jadad scale. For each outcome mean difference (MD) & standard mean difference (SMD) with a 95% confidence interval (CI) was assessed. Adjusted point estimates from each study was extracted and combined using the random effect model to determine the heterogeneity of studies. Results: Twelve RCT studies with 1,089 participants were included. The mean jadad score was 5.3 with a 0.6 standard deviation. The studies reported significant positive effect of yoga on cognitive function (MD = 0.38, 95 per cent CI: 1.21 to 0.45, P=0.37) between the experimental and control groups. Meditation exhibited a statistically significant effect compared to standard care control in cognitive function (SMD =2.21, 95% CI [3.99, 0.43], p <.001), with significant heterogeneity (I2 = 97%, p = 0.01). Conclusion: This systematic review and meta-analysis of RCTs suggested that yoga & meditation showed significant improvement in many cognitive domains of attention and executive functioning of verbal working memory, auditory attention & short-term retentive capacity. The research findings support the notion that yoga practices were more effective on cognitive function than mindfulness meditation.

DOI: 10.5281/zenodo.7537049

8. The Anticonvulsant Activity of Mucoadhesive Buccal Films of Sodium Valproate in Pentylenetetrazole-Induced Seizure Rat Model
Iwan Setiawan, Anas Subarnas, Yoga Windhu Wardhana
Buccal preparations are currently gaining interest in the study of drug delivery systems. These preparations can adhere to mucosal surfaces, hydrate, and deliver the drug across the buccal membrane. Based on the Biopharmaceutics Drug Disposition Classification System (BDDCS), the drug compound Sodium valproate Sodium valproate belongs to class 1 which has excellent solubility and permeability. Therefore, by developing into a mucoadhesive buccal dosage form, a faster onset of action will be obtained, increased bioavailability and ease of use. In partial epilepsy, bipolar disorder (psychosis), and migraine therapy, sodium valproate is the first-line anticonvulsant. Therefore, this study aims to develop sodium valproate into a mucoadhesive buccal film dosage form using the solvent casting method. The preparations were then tested for antiepileptic activity, and the pharmacokinetic profile analysis was conducted in test animals induced with the pentylenetetrazole compound using a Post Randomized Controlled Group Design. The results showed an anti-epileptic activity with a longer duration of onset, shorter duration of seizures, and lower seizure frequency when compared to the experimental animal group administered sodium valproate tablets. The pharmacokinetic profile of sodium valproate included absorption parameters of Ka, Tmax, Cmax, Vd, T1/2 el, and Kel of 0.0033 Hr-1, 3.93 Hr-1, 4.55 mg/L, 3.03 L, 21.8 minutes, and 0.0053/minute, respectively. Based on the results, sodium valproate mucoadhesive buccal film preparation can be developed into an anti-epileptic preparation with a delayed release profile, and a relatively fast onset, making it a breakthrough for antiepileptic therapy.

DPI: 10.5281/zenodo.7537057

9. Qualitative Phytochemical Analysis of Ethanolic Extracts of Hibiscus laevis Flowers and Euryale ferox Seeds
Mohd. Shahid Khan, Pankaj Arora, Naresh Kalra, Namita Arora, Arushi Purva, Neha Sharma
The purpose of the research was to determine whether or not H. laevis and E. ferox had any potential in the field of phytochemistry. Ethanol was the solvent of choice for the extraction process of both the flowers of H. laevis and the seeds of E. ferox. There is evidence of the presence of alkaloids, glycosides, carbohydrates, phytosterols, gum, and mucilage in the ethanolic extract of H. laevis. On the other hand, there was a lack of steroidal compounds, protein and amino acids, tannins, saponins, oil, and lipids. The ethanolic extract of E. ferox, on the other hand, reveals the presence of alkaloids, glycosides, tannins, carbohydrates, and phytosterols. On the other hand, there was a notable lack of steroids, proteins and amino acids, gum and mucilages, saponins, and oil and fats. Because of the presence of a variety of secondary metabolites, both of the plant extracts have the potential to be further investigated for appropriate pharmacological activity.

DPI: 10.5281/zenodo.7612822

10. Formulation And Evaluation of Antidandruff Herbal Shampoo Using Petroleum Ether Extract of Lantana camara Linn. Leaves.
Laxmi Kant, Namita Arora
The objective of the present research was to formulate and evaluate anti-dandruff herbal shampoo. The herbal anti-dandruff shampoo was prepared using lanatan camara leaf extract, triethanolamine lauryl sulphate, cocodiethanolamide, EGDS, jasmine oil, sodium chloride, methyl papaben, gelatin and lemon juice. Twelve formulations were prepared. Various evaluation parameters like physical appearance, determination of pH, determination of percentage of solid content, measurement of surface tension, determination of wetting time, determination of foam ability and foam stability determination of dirt dispersion, stability study and antifungal activity were performed were performed. Results also showed that liquid anti-dandruff herbal shampoo formulations LSF3 and LSF4 possess the characteristics of an ideal shampoo and are effective against Malassezia furfur MTCC 1374 and Candida albicans MTCC 227, the fungi responsible for dandruff in humans. It was found that LSF4 was most stable and effective amongst all formulations.

DPI: 10.5281/zenodo.7612834

11. Quality of Life in Patients with Autoimmune Bullous Disease (AIBD).
S.B. Nishitha, Anuradha S, Mary Augustine
Background:  Background:  AIBD is a chronic dermatological condition of autoimmune origin, affecting skin and mucous membrane. Systemic corticosteroids are mainstay of treatment. Use of newer biologic Rituximab has been introduced in the last decade.  Comprehensive studies reporting quality of life, factors affecting it are few in India. Methods and Materials: Prospective observational study in paitents with AIBD, followed up at 1 and 3 months. Data on demographics, disease characteristics, treatment, and treatment costs were collected. QOL was assessed and data were summarized using descriptive statistics and compared using chi-squared and t-tests. Results: Of the 47 patients recruited, 66% were females, mean age (SD) of participants being 46.6 (±11.1) years. Median (IQR) duration of AIBD was 0.83 (0.46-1.50) years.  The baseline DLQI was 10 with 44.7% patients having a poor QoL (DLQI ≥11). The mean change in DLQI over 3 months was 8.67 (±2.83), which was statistically significant. Significant predictors of poor QoL was adjuvant treatment [OR 55.00, 95% C.I. (4.30-703.43) p=0.002]. Conclusion: Patients had moderate severity of disease and poor QoL at baseline. They received rational treatment and there was an improvement in the DLQI score. There was a high economic burden due to hospital and drug costs. We recommend that health insurance coverage should be increased to help these patients.

DPI: 10.5281/zenodo.7612867

12. Patterns of Drug Use and Adverse Drug Reactions in Patients with Autoimmune Bullous Disease (AIBD).
S.B. Nishitha, Anuradha S, Mary Augustine
Background:  AIBD is an autoimmune dermatological disorder affecting predominantly the skin and mucous membrane. Though newer biologic Rituximab has been introduced in the last decade, systemic corticosteroids form the mainstay of the treatment. Comprehensive studies reporting drug use pattern, adverse effcects and costs involved with treatment have been few in India. Objectives: To evaluate the pharmacotherapy its adverse effects of AIBD, and costs incurred for treatment. Methods and Materials: Prospective observational study that enrolled adults with AIBD, who were followed up at 1 and 3 months. Data on demographics, disease characteristics, treatment, and treatment costs were collected. Data were summarized using descriptive statistics and compared using chi-squared and t-tests.  Results: Of the 47 patients recruited, 66% were females, mean age (SD) of participants being 46.6 (±11.1) years. Median (IQR) duration of AIBD was 0.83 (0.46-1.50) years. Mean no. of drugs was 9.2 ± 2.80. Thirty three (70.2%) patients received topical and 47 (100%) received systemic corticosteroid therapy and 18 (38.2%) received rituximab therapy. Most commonly prescribed topical drugs were supplements (calcium) 100%, oral prednisolone 100%, anti-inflammatory agents (79%). The median treatment cost including admission was INR 26702.1 (SD 21971.2). Conclusion: Patients had moderate severity of disease and poor QoL at baseline compared to other studies. They received rational treatment and there was an improvement in the DLQI score. There was a high economic burden due to hospital and drug costs. We recommend that health insurance coverage should be increased to help these patients.

DPI: 10.5281/zenodo.7612880

13. An Overview of The Bilayer Tablet.
Amit Pareek, Mukesh Kumar Gupta
Background:  In the history of the development of the controlled release formulation, the introduction of bilayer tablets marked the beginning of a new age. This innovation, in alongside other factors, has made it possible to successfully provide medications to the body. Through the use of physical separation, such as bilayer tablets, it is possible to prevent chemical incompatibilities between API. Additionally, new pharmaceutical release patterns may be developed. This article provides an overview of the most recent developments in the technology behind bilayer tablets, with a primary emphasis on the most significant benefits offered by oral dosage forms. The bilayer tablet may be used for a variety of purposes, and its composition can either be a monolithic matrix that is partly covered or a multilayered matrix. This article provides a concise overview of the general characteristics, benefits, drawbacks, types, evaluation considerations, and manufacturing processes associated with bilayer tabs, along with the most current developments in this field of technology.

DPI: 10.5281/zenodo.7612899

14. A Comparative Study of Displaced Intra-Articular Fractures of Calcaneum Treated by Extensile Lateral Versus Sinus Tarsi Approach.
Sriram Sundararajan, Mukesh Dwivedi, Shubham Shah
Introduction: Currently, Open Reduction Internal Fixation (ORIF) through the Extensile Lateral approach is considered the most widely accepted surgical procedure for displaced intra- articular calcaneal fracture. Minimally invasive reduction and fixation techniques via Sinus Tarsi approach (STA) have been developed in attempts to avoid potential complications associated with an extensile lateral approach, The purpose of this study is to evaluate functional and clinical outcome of displaced intra- articular fractures of calcaneum (DIACF) treated by using Extensile Lateral and Sinus Tarsi approaches. Materials and Methods: This study was carried out in GMERS Medical College and General Hospital Gotri Vadodara from August 2020 to May 2022, consisting of total 42 patients of intra-articular fractures of calcaneum. This was a comparative prospective study. All the patients were operated by surgeons experienced in both the approaches. Results: Majority were male patients with mean age of 37 years and had history of fall from height as mode of injury and had unilateral calcaneum fracture. 90.5% of patients for ST approach were operated within 4 days of admission as compared to 61.9% of patients for EL approach who were operated within 4-6 days of admission. Days of hospitalization were more for EL compared to ST group with significant difference (P<0.005) Functional outcome at 24 weeks by AOFAS scoring system depends on fracture pattern and approach used for it. AOFAS score 78/100 for ST approach for Sanders type 2 and 75/100 for EL approach for Sanders type 3. EL group had more complications in the form of plate removal due to infection, skin necrosis or wound dehiscence as compared to ST group. Conclusion: Our study showed better results for Sander’s Type II Calcaneal fractures by Sinus Tarsi approach and better results for Sander’s Type III Calcaneal fractures by Extensile Lateral approach..

DPI: 10.5281/zenodo.7675662

15. A Comparative Study of Intertrochanteric Fracture Femur Treated with Proximal Femoral Nailing and Dynamic Hip Screw.
Sriram Sundararajan, Chirag V Thakkar, Subham Verma
Introduction: Although the effects of PFN and DHS in treatment of intertrochanteric fractures have been reported, and many studies have been done to compare both implants but the results and conclusions are not consistent and there is still ongoing controversy whether PFN is a better choice than DHS. Therefore, with the goals of better stable surgical construct of intertrochanteric fractures and early mobilization of patients, this study was planned with rationale to compare the intraoperative complications and functional and radiological outcome of intertrochanteric fractures in patients treated with dynamic hip screw and proximal femoral nail. Materials and Methods: This study was carried out in GMERS Medical College and General Hospital Gotri Vadodara from September 2020 to December 2021, consisting of total 50 patients of intertrochanteric factures of femur. This was a Randomized control prospective study. All the patients were operated by surgeons experienced in handling both implants. For evaluation, personal data, mode of trauma, type of fracture, type of surgery, intra operative & post operative complications, follow up examination and duration of full weight bearing were recorded. Results: Fracture reduction in stable fractures was good and comparable in both DHS (81.25%) And PFN (80%) groups but fracture reduction in unstable fractures was better in PFN group (73%). Mean duration of hospital stay was more in DHS group(7.2 days).Union occurred in all fractures in our study but there were two cases of shortening and varus malunion in unstable type in each DHS and PFN group. Mean duration of fracture union was earlier in PFN group, [15.56 weeks] comparing to DHS group [20.64weeks]. The duration of fracture union was more in unstable type compared to stable type in DHS group but it is nearly same in both type in PFN group. Mean HARRIS hip score was more in PFN group at 6 weeks after surgery. But it became nearly equal in both groups at 20 weeks period. Conclusion: PFN group had advantage of lesser blood loss, incision length, operative time and lesser hospital stay, Early weight bearing and early functional rehabilitation. DHS group had advantage of lesser intraoperative radiation exposure and lesser implant related intraoperative complication. Varus collapse and shortening in unstable fractures were  more in DHS than PFN group but statistically insignificant. In stable fractures Both PFN and DHS are equally performing implant. But in unstable fractures PFN had edge over DHS with better functional outcome.

DPI: 10.5281/zenodo.7675666

16. Profile of Ocular Manifestations in Pemphigus Pateints.
Nagashree BN, Sai Sushma Yeturu, Prabhudeva H
Purpose: To study the ocular manifestations in pemphigus and bullous pemphigoid (BP) patients. Methods:  Cross-sectional Observational Study was conducted on patients diagnosed with all types of pemphigus attending Outpatient Department at Basaveshwara Hospital, Chitradurga from December 2021 to September 2022. Exclusion criteria being Patients  on chronic antiglaucoma medications, Pre-existing dry eye or xerophthalmic patients, Patients on long term topical steroids in eye, Patients who underwent previous ocular surgeries, Patients with previous corneal scar. Results: A total of 50 patients of pemphigus were examined. Out of 50, 12 patients had ocular involvement. Duration of disease of all patients was more than 6 months. Redness and burning sensation  was the most common symptom . The most common ocular signs, conjunctival hyperemia, and moderate dry eye. Ocular manifestations are more common with bullous pemphigoid patients than other types. Conclusions:  High occurrence of dry eye and conjuctival scarring can lead to visual morbidity. Thus ocular examination of pemphigus patients prevents long term sequelae and complications.

DPI: 10.5281/zenodo.7675682

17. A Case-Control Study to Assess the Relationship between Febrile Seizures and Iron Deficient Anaemia.
Kavya Shivaswamy, Shanthi M, Surabhi D, Kartheeka M G
Aim: The purpose of this study was to assess relationship between febrile seizures and iron deficient anemia. Methods: In this prospective hospital-based study, the Cases (n=50) were children between the ages of 1 and 5yr who experienced normal febrile convulsions (AAP clinical practise guidelines). A control group (n=50) was chosen from children who were admitted with febrile illness but no seizures and who were matched for age and sex. Results: The outcome demonstrates that 86% (n=43) children from the case group had Hb 11 gm/dl in comparison to 24% (n=12) in the control group, with a significant p-value (p<0.01).. In comparison to controls, the proportion of cases who had anemia was considerably higher (p=0.012). The outcome demonstrates that the MHL and MCV in patients were considerably lower than those in controls (p<0.04). RDW value in cases is substantially greater than in controls (p 0.04). The mean MCH levels in the two groups did not significantly differ (p > 0.04). Regarding mean MCH levels, there was no discernible difference between the two groups (p > 0.04). When compared to controls, serum iron and serum ferritin levels in patients were considerably lower (p<.01). In cases compared to controls, the TIBC value is considerably greater (p 0.01). Conclusion: According to the research, a sizable portion of children who experience febrile seizures have low serum iron levels and iron-deficiency anaemia. As a result, anaemia and low serum iron levels may act as a trigger for febrile seizures in young children.

DPI: 10.5281/zenodo.7675691

18. Study on Effects of Tobacco (Smoked and Chewed) and Areca Nut on Oral Health and Quality of Life in Indian Population Not Having Overt Oral Malignancy
Rahul Litoria, Shivali Pandey
Background: Tobacco dependence is a major public health problem that results in significant morbidity and mortality. Approximately, 5 million people are killed annually by tobacco use. In this study we wanted to assess the oral health status and quality of life among adult tobacco users (smoked and chewed) and areca nut users. Methods: This was a longitudinal case control study. Each one of the study subjects (tobacco users of more than one year duration, n = 296) & healthy subjects (non-users, n = 150) were interviewed by a questionnaire based on 5-point Likert scale.  Questionnaire consisted of 11 questions of different quality of life aspects in Hindi (vernacular), each question having 5 options.  Minimum score was 11 depicting good quality of life and highest score was 55 representing significantly poor quality of life. Result: The greater duration of usage of gutka, gutka and bidi, gutka, bidi and cigarette, bidi and cigarette, areca nut and pan masala have attained higher scores and there was a fall in percentage of individuals with lower scores when the duration of usage was increased. Minor oral cavity problems were present in the subjects who used tobacco and areca nut. Study subjects with lower scores were less when compared to healthy subjects i.e., 14.48 % study subjects were between 11 – 20 compared to 65 % of healthy subjects. This was also statistically significant with p value of < 0.001. Conclusion: The study concludes that duration of tobacco usage correlated with individual’s quality of life and as evident from this work, study subjects with duration of usage of tobacco/areca nut for > 15 years attained higher scores and the percentage of study subjects with lower scores increased for duration of < 5 years.

DPI: 10.5281/zenodo.7869090

19. Distribution and Pattern of Head Injuries in Fatal Road Traffic Accident Victims
Raju Surwase
Background: The only public health issue where youth death and impairment are still widely accepted by society and decision-makers is road traffic accidents. It is estimated that by 2020, road traffic accidents will claim the lives of around 1.9 million people yearly, killing about 3400 people every day worldwide. Low- and middle-income nations account for about 90% of RTA fatalities worldwide, while highly motorized nations only make up a small portion of that total despite housing more than 60% of all vehicles. RTAs are a significant epidemiological and medical-legal concern. In terms of morbidity and mortality, brain injuries are the most severe injuries that can result from traffic accidents. Aim: The aim of the study is distribution and pattern of head injuries in fatal road traffic accident victims. Material and Method: The current investigation was carried out in the Department of Forensic Medicine and Toxicology and is a prospective study. For skull fractures arising from assault, railway accidents, road traffic accidents, injuries from firearms, and height falls, all autopsy cases were examined. Data and information in-depth regarding the instances were gathered. After being given the information, a post-mortem examination was carried out. Eighty fatal road traffic accident cases served as the basis for the data in the materials. At the time of autopsy, the condition of the scalp, cranial bones, meninges, intracranial hemorrhages, and brain parenchymal involvement were documented. Results: Road traffic accidents are a significant cause of morbidity and mortality. 75 individuals had scalp injuries that were reported. In 5 cases, there were no scalp injuries. 60.0% of the victims—a total of 75—had contusions. Abrasions were only seen in 57.5% of cases, followed by lacerations in 67.5% of those. The majority of the scalp injuries occurred in the frontal region (51 injuries), then in the temporal (49 injuries), parietal (36 injuries), and occipital (11 injuries), in that order. Conclusion: The number of road accidents is rising alarmingly, which is costing society’s workers and resources. The majority of them are due to human mistake, and they can be avoided by spreading awareness of road safety among everyone. It was shown that cerebral bleeding caused death in the majority of patients, either directly or indirectly.

DPI: 10.5281/zenodo.8162581

20. Pattern of Thoraco-Abdominal Injuries in Various Accidents Including Fatal Road Traffic Accidents
Raju Surwase
Background: An unintended collision between two motor vehicles, a stationary object, or a person result in a road traffic accident (RTA), which may cause injuries, fatalities, or property loss. In developing nations, the importance of road traffic accident mortality and morbidity is greater. RTA injuries are predicted to be the second most common cause of disability in the developing world and the third most common cause of disability worldwide. The frequency of brain injuries resulting from traffic accidents has reduced since the strict enforcement of the helmet law, while injuries to the thoracic and abdominal regions are still on the rise. Aim: The aim of the study is to find out the Pattern of Thoraco-Abdominal Injuries in various accidents including fatal road traffic accidents. Material and Method: The Department of Forensic Medicine and Toxicology conducted a hospital-based descriptive observational study. Among the remains brought to the mortuary for postmortem assessment, at least 80 cases of traumatic deaths met the inclusion and exclusion criteria. The current autopsy-based study sought to understand the pattern of thoracoabdominal injuries in fatal traffic accidents, the relationship between the type of vehicle and the pattern of thoracoabdominal injuries, and the examination of age- and sex-related mortality. Results: In the 80 cases, 68 of the participants were men and 12 were women, which is a clear statistic given the preponderance of men’s active participation in socioeconomic activities. 65 fatalities, or a maximum of 75 percent, were the consequence of traffic accidents, followed by 11 victims of incidents involving falls from great heights, then 2 victims of train accidents, and just 2 victims of assaults or machine injuries. Conclusion: This epidemic is getting worse every day despite the implementation of numerous strict rules pertaining to reckless and negligent driving, intoxicated driving, and the non-use of helmets and seatbelts. The worst case scenario on the roadways is the absence of first help for the injured and the indifference of bystanders toward the victims as a result of lingering issues with the police and justice.

DPI: 10.5281/zenodo.8162615

21. Fragment Specific Fracture Fixation in the Management of Communited Intra Articular Distal Radius Fractures: An Assessment of Functional Outcome
Santosh Veershetty Patil, GV Madan Mohan Rao, Kavyashree Sagare
Introduction: Distal radius fractures are typical high energy trauma injuries, and their treatment is impacted by parameters such as fracture stability, displacement, and patient characteristics. Fragment-specific fixation can be an effective treatment option for distal radius fractures. The purpose of this study was to assess the therapy of communited intra articular distal radius fractures using a fragment specific fracture fixation approach. Material and Methods: Thirty-one cases with communited distal radius fractures above 21 years of age were recruited. Based on Medoff fracture classification, all the fractures were treated with fragment specific fracture fixation. Postoperative follow up was conducted on the end of 3rd week, 6th week, 3rd month, 6th month and end of 12th month and then until the complete closure of fractures. The functional outcome of fracture was assessed by Gartland and Werley scoring system. Results: Majority cases had fracture union duration 8 weeks (54.84%) followed by 10 weeks (32.26%). According to Gartland and Werley score, 70.96% had score 0, 9.68% had score 2, 6.45% had core 3 and score 4. The excellent (0-2) functional outcome was observed in 90.32%, good (3-8) in 6.45% and fair (9-20) in 3.23% of cases. Conclusion: Fragment specific fracture fixation was an efficient treatment modality for Communited intraarticular distal radius fractures.

DPI: 10.5281/zenodo.168128

22. Terbinafine Vs Itraconazole Vs Fluconazole in the Management of Superficial Dermatophytosis – A Randomized Comparative Study
K. Swaroopa, V. Anil Kumar
Introduction: Superficial dermatophytic infections constitute a common dermatological illness that require necessary therapy. Oral or topical antifungal medications have proven effective in treating dermatophyte fungal infections. Oral antimycotics such as terbinafine, itraconazole, and fluconazole are useful in fighting surface mycoses. The purpose of this research was to compare the effectiveness of three pulse therapies for superficial dermatophytosis: itraconazole, terbinafine, and fluconazole. Materials and Methods: This randomized study included with 120 patients with superficial dermatophytosis divided in to three groups administered with Itraconazole pulse regimen 200 mg (Group I), Tab. Terbinafine 250 mg OD (Group T) and Tab. Fluconazole 150 mg (Group F). Post treatment follow-up was done up to 4 to 8 weeks to assess the treatment response. Results: The itching was absent in 2.5% of cases at 4th week, 70% at 8th week in group T, Erythema was absent in 20% and 7.5% at 4th week, 5% and 30% at 8th week in group I and group T respectively. Scaling was absent in 27.5%, 32.5% and 12.5% at 4th week, 10%, 12.5% and 12.5% at 8 weeks in group I, T and F respectively. The recurrence of symptoms was 22.50%, 5% and 30% in group I, group T and group F respectively. Conclusion: Pulse therapy of Tab. Terbinafine 250 mg with intermittent administration showed effective outcome and good feedback from the cases with superficial dermatophytosis. Hence, it is an effective drug to minimize the condition and reduces the diseases transmission.

DPI: 10.5281/zenodo.10608244

23. Trabeculectomy with Mitomycin and Ologen Implant and Their Post-Operative Outcomes
Santosh Kumar Sethi, Satyanarayan Mallik, Soumya Ranjan, Suroma Joysmine Marandi, Sarita Panda
Introduction: Glaucoma, a disorder characterized by increased intraocular pressure that can damage the optic nerve and lead to blindness, is treated with a surgical operation known as a trabeculectomy. Aim: The purpose of this study is to compare the success rate of trabeculectomy with mitomycin (MMC) or ologen (Olo) implant in treating primary open glaucoma (POAG) in patients in eastern India. Materials & Methods: The hospital’s ethics committee authorized the study and protected patients privacy. Participants signed informed consent forms before the trial began. It only included patients diagnosed with POAG who were receiving treatment in an outpatient clinic. Results: The study found that all Olo implants used in trabeculectomy surgery had degraded within 180 days. At the 3-month follow-up, there were significant differences in vascularity between the two groups, with the blebs in the eyes with Olo implants being more vascular and diffuse at the 6-month follow-up. The increased inflammation in the eyes with Olo implants may be responsible for the difference in vascularity. Anterior chamber reaction and hyphema were observed in a few patients in both groups, while bleb leakage and needling were performed on a few patients in each group. The study did not find any significant differences between the two groups in terms of the critical clinical outcomes examined. Conclusion: Future studies should focus on examining additional critical clinical outcomes, such as bleb morphology, and conducting large-scale, well-controlled, randomized trials to assess the efficacy of trabeculectomy surgeries using both drugs.

DPI: 10.5281/zenodo.10608285

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