Objective: Decompressive hemicraniectomy with hematoma evacuation is life-saving and improves unfavorable outcomes. INTRODUCTION: Decompressive hemicraniectomy in enormous hemispheric areas of localized necrosis has been accounted for to bring down mortality and improve the ominous results. Hematoma volume is an amazing indicator of 30-day mortality in patients with intracerebral discharge (ICH). Hematoma volume adds to intracranial volume and may prompt unsafe rise of intracranial pressure. METHODS: This study was conducted at BMC/SPH, Quetta from Mar 2018 – Feb 2019. The 24 continual patients with hypertensive ICH treated with decompressive hemicraniectomy were evaluated. The information gathered included Glasgow Coma Scale (GCS) score at confirmation and before surgical procedure, ICH volume, ICH score and a clinical evaluating scale for ICH that precisely hazard stratifies patients in regards to 30-day mortality.  RESULTS: Of the 42 patients with decompressive hemicraniectomy, 20(83.3%) survived to discharge; of those 20, 12 (60%) had good functional outcome, defined as a mRS of 0 to 3. The mean age was 49.8 years. 20 patients with an ICH score of 6, 18 (90%) survived to discharge, 8 (44%) had good functional outcome. Hematoma volume was 60 cm3 or greater 8 (50%) patients of whom had good functional outcome. CONCLUSION: Decompressive hemicraniectomy with hematoma evacuation is life-saving and improves unfavorable outcomes in a select group of young patients with large right hemispherical ICH.

Glycogen synthase kinase 3 (GSK-3) is a serine/threonine protein kinase that mediates the addition of phosphate molecules onto serine and threonine amino acid residues. First discovered in 1980 as a regulatory kinase for its namesake, Glycogen synthase, GSK-3 has since been identified as a kinase for over forty different proteins in a variety of different pathways. GSK-3 has recently been the subject of much research because it has been implicated in a number of diseases, including Type II diabetes (Diabetes mellitus type 2), Alzheimer's Disease, inflammation, cancer, and bipolar disorder. A plethora of GSK-3 inhibitors has been described and most of the effects were observed in vitro and cellular studies. Present study is aimed at design of GSK-3 Inhibitors, their molecular docking studies using online molecular docking software, i.e. www. Dockingserver.com. Based upon previous studies on 1, 3, 4-oxadiazoles as GSK-3 inhibitors, 1, 3, 4-oxadiazole molecule skeleton was taken as the core skeleton & 4 different modifications were made. The compounds were docked with GSK (PDB ID: 3f88 and PDB ID: 4E7W).The results have shown appreciable molecular docking interactions with the GSK-3 protein amino acid residues. The Est. inhibition constant, Ki values for the ligands were observed in µM values. . It is observed that Ligand I has shown Est. free energy of binding -10.17 which is said to be better than the other 3 ligands & reference ligands.

Background: Aspects of drug product stability are of primary concern to dispensers in the dispensing of drugs at drug retail outlet. Therefore, this study assessed knowledge, attitude and practice of drug dispensers towards drug product stability at community pharmacies in Jimma town. Method: Cross-sectional study was conducted on total of 19 dispensers from Jimma private drug outlet (n=19) in Jimma town from January to June 2019. Data on knowledge, attitude, practice of dispensers towards drug stability, and sociodemographic characteristics of respondents were collected using a structured interviewer administered questionnaire. Data was analyzed by using SPSS Version 21.0 (Chicago, SPSS Inc.). The Chi square test was used to determine association between practice of maintaining drug stability through proper storage condition among respondents and sociodemographic characteristics of dispensers. Results: A total of 19 dispensers were included in this study, 13(68.4%) of the dispensers was males and mean age was 47±13 years. Thirteen (68.4%) were pharmacists and 5(26.3%) were pharmacy technicians (druggists). Twelve (63.2%) of drug dispensers revealed stability of drugs product as critical element in pharmaceutical regulatory system. Majority of respondents (36.8%) stated that stability of drug products were affected during storage condition. Moreover, study revealed that years of dispensing experience (p=0.007) and educational qualification (p=0.001) of dispensers were significantly associated with practice of maintaining drug stability through proper storage condition. Conclusions: Study revealed that majority of dispensers has a good knowledge and attitude towards drug stability at drug retail outlet of Jimma town. Moreover, years of dispensing experience and educational qualification of dispensers were significantly associated with practice of maintaining drug stability through proper storage condition. Compliance of drug retail outlet to regulatory standard assessment is paramount important.

Practice of traditional medicine varies greatly from country to country, and the variation is seriously influenced by refugees. Refugees are facing significant barriers in accessing healthcare services. This study assessed knowledge, attitude and practice of south Sudanese refugees in Ethiopia towards traditional medicine.  A community based cross-sectional study design was conducted on total of 151 randomly selected household from south Sudanese refugees in Addis Ababa, Ethiopia. Structured interviewer administered questionnaire was used to collect data. Chi square test was used to determine association between variables. From the total of 151 participants, 84 (55.6%) were males. About 141 (96.7%) of the respondents know traditional medicine, and 120 (79.5%) of the respondents think as there were diseases which were not cured by modern medicine. Thus, 102 (67.5%) of respondents encourage others to use traditional medicine. Gender (p=0.020), duration of stay (p=0.008), marital status (p=0.000), family size (p=0.041), occupational status (p=0.000), and educational status (p=0.000) were significantly associated with practice of traditional medicine among refugees which lost their home. In conclusion, majority of respondents know traditional medicine especially, herbal type and use it because of their belief that herbals are natural thus encourage others practices. Moreover, practice of traditional medicine was significantly associated gender, duration of stay, marital status, family size, occupational status and educational status. Further study on standardization of herbal medicine is paramount to ensure its safety.

Background: Anti-tubercular drug-induced liver injury (ATDILI) is a major safety concern for the treatment of tuberculosis (TB). The impact of chronic hepatitis B infection (CHBI) and chronic hepatitis C infection (CHCI) on the risk of ATDILI is still controversial. In this study, we aimed to assess systematically the influence of CHBI, CHCI on the susceptibility to ATDILI patients. Aims and objectives: To study of the Chronic Hepatitis B infection and Chronic Hepatitis C infection as a risk factor in anti-tubercular drug-induced liver injury: A Prospective observational study. Materials and method: Prospectively, we identified 24 cases of ATDILI among 172 patients diagnosed with confirmed pulmonary tuberculosis between July 2018 to December 2018.  None of the patients with established risk factor as ATDILI as recognized by ATS guidelines was included in our study population. Regular clinical and liver function test monitoring was done at the commencement of ATT. Results: Among these, 02 (8.3%) patients had hepatitis B virus (HBV) and 02 (8.3%) patients had hepatitis C virus (HCV), out of 24 ATDILI patients. Among the ATDILI cases, 03 patients had grade-1 DILI, 06 patients had grade-2 DILI, and 14 patients had grade-3 DILI, and 01 patients had grade-4 of the DILI cases fulfilled the ATS/BTS criteria for TB DILI. There were no human immunodeficiency virus (HIV) co-infected patients. Among the total 24 patients are developed the ATT induce hepatotoxicity. Among the total 24 patients anti tubercular drug induce hepatotoxicity cases, female patients 14 (8.13%) account for the highest number of risks ATDILI. Conclusion: This study suggests that CHBI, CHCI may increase the risk of ATDILI in the standard combination therapy for active TB. In patients of pulmonary tuberculosis drug induced hepatitis is common. However viral marker should be considered to rule out hepatitis B and hepatitis C. Close follow-up and regular liver test monitoring, viral marker is mandatory to treat TB in chronic hepatitis B and C carriers. DILI is a common problem among patients on ATT in our population. Early detection not only reduces the risk of developing Hepatic Failure but also prevents mortality rate.

Microwave synthesis is the major breakthrough in the synthetic organic chemistry where as the conventional heating is the inefficient and time consuming. Microwave synthesis is the new lead which is being used as the source of heating in the organic synthesis reaction. The present article will give an idea about microwave assisted synthesis.

2-substituted derivatives of indane-1,3-diones  have shown many activities. Chalcones possess a number of biological and pharmacological activities such as antibacterial, antifungal, antimalarial, anti-inflammatory, anticancer, anti-tubercular, and antioxidant activities etc. The synthesis of chalcone compounds incorporating with heterocycles became great importance in medicinal chemistry. Literature survey revealed that Chalcones and Pyrimidine derivatives  possess a broad spectrum of biological activities like antimicrobial, anti-inflammatory, antimalarial, antitubercular, anticancer, antidepressant and antamoebic etc.Hence an attempt is made to synthesize some new chalcones from 2- acetyl-indane- 1,3- dione with various substituted aromatic/ heteroaromatic aldehydes by the Claisen – Schmidt condensation. The resulted chalcones have been converted into their 2-amino pyrimidine derivatives by reaction with guanidine hydrochloride. The resulted compounds were identified by physical and spectral methods and were also screened for their antibacterial and antifungal activities based on the reported literature.  2-substituted derivatives of indane-1,3-diones  have shown many activities. Chalcones possess a number of biological and pharmacological activities such as antibacterial, antifungal, antimalarial, anti-inflammatory, anticancer, anti-tubercular, and antioxidant activities etc. The synthesis of chalcone compounds incorporating with heterocycles became great importance in medicinal chemistry. Literature survey revealed that Chalcones and Pyrimidine derivatives  possess a broad spectrum of biological activities like antimicrobial, anti-inflammatory, antimalarial, antitubercular, anticancer, antidepressant and antamoebic etc.Hence an attempt is made to synthesize some new chalcones from 2- acetyl-indane- 1,3- dione with various substituted aromatic/ heteroaromatic aldehydes by the Claisen – Schmidt condensation. The resulted chalcones have been converted into their 2-amino pyrimidine derivatives by reaction with guanidine hydrochloride. The resulted compounds were identified by physical and spectral methods and were also screened for their antibacterial and antifungal activities based on the reported literature. 

Sphaeranthus indicus Linn. (SI) (Asteraceae) is widely used in Ayurvedic system of medicine to treat vitiated conditions of epilepsy, mental illness, hemicrania, jaundice, hepatopathy, diabetes, leprosy, fever, pectoralgia, cough, gastropathy, hernia, hemorrhoids, helminthiasis, dyspepsia and skin diseases. There are reports providing scientific evidences for hypotensive, anxiolytic, neuroleptic, hypolipidemic, immunomodulatory, anti-inflammatory, bronchodialatory, antihyperglycemic, hepatoprotective, anti-malarial, antioxidant, anti-microbial activities of this plant. A wide range of phytochemical constituents have been isolated from this plant including sesquiterpene lactones, eudesmenolides, flavanoids and essential oil. This comprehensive review explores the reported accountable investigations on the morphological studies, phytochemical studies, ethnobotanical uses and pharmacological activities of Sphaeranthus indicus. Therefore it is very significant to give the frontline position to this plant in the list of the most potent Indian traditional plant.

Cellulose derivatives are most commonly used to modify the release of drugs in tablet and capsule formulations for the purpose of tablet binding, thickening, film formation, water retention, adhesion, and as suspending and emulsifying agents. Annual cellulose synthesis by plants is close to 10¹² tons. Plants contain approximately 33% cellulose whereas wood contains around 50 % and cotton contains 90%. This fact was the starting point of our research into understanding, designing, synthesising and finding new alternative applications for this well-known but underused biomaterial.

Fungal infections are most commonly occurring nowadays. Out of all fungal infections, cutaneous fungal infections are the most widespread. Currently available conventional dosage forms although they are able to treat these infections, they come with some drawbacks such as poor skin permeation of drugs and high dosing frequency which leads to reduction in effectiveness against these fungal infections. Present review highlights on different types of superficial fungal infections, their causative agent, drawbacks in conventional dosage forms. It also briefs different classes of antifungal drugs, their mechanism of action with some examples of each class. It emphasizes on different novel techniques of antifungal drugs, their advantages and disadvantages. Details of each novel technique with reference to fungal infection is focussed. This review concludes various different techniques to overcome the drawbacks and to increase the effectiveness of antifungal drugs using various novel strategies.

The gold colloid is a solution of colloidal nanoparticles in gold in its liquid state. These particles are usually red in color. Due to their versatile properties in the field of optics, electronics, and molecular recognition, they are subjected to immense research. They are a preferred choice in technologies like electron microscopy, electronics, nanotechnology, material sciences, and health care. In many different types of colloidal gold synthesis, the combination of gold nanoparticles with certain ligands can increase its potent and usage in different fields. They are capable of delivering useful drugs in difficult areas like the brain, retina, tumors, and intracellular organelles. However, their efficiency highly depends on their size and shape. They are also under study as carriers for serious drugs like Paclitaxel. Gold nanoparticles are also used in drugs used for the treatment of cancer. However, if consumed in unprescribed amounts have proved to be toxic to the body. Different sizes of gold particles have shown buildup in parts of the brain, stomach, pancreas, kidneys, liver and blood. Gold nanorods have shown properties for being used as photothermal agent’s in vivo applications. Gold nanoparticles are modified into nanorods, nanoshells, nanocages, etc. Gold nanoparticles are also used in on-site detection of harmful gases like H₂S.The gold colloid is a solution of colloidal nanoparticles in gold in its liquid state. These particles are usually red in color. Due to their versatile properties in the field of optics, electronics, and molecular recognition, they are subjected to immense research. They are a preferred choice in technologies like electron microscopy, electronics, nanotechnology, material sciences, and health care. In many different types of colloidal gold synthesis, the combination of gold nanoparticles with certain ligands can increase its potent and usage in different fields. They are capable of delivering useful drugs in difficult areas like the brain, retina, tumors, and intracellular organelles. However, their efficiency highly depends on their size and shape. They are also under study as carriers for serious drugs like Paclitaxel. Gold nanoparticles are also used in drugs used for the treatment of cancer. However, if consumed in unprescribed amounts have proved to be toxic to the body. Different sizes of gold particles have shown buildup in parts of the brain, stomach, pancreas, kidneys, liver and blood. Gold nanorods have shown properties for being used as photothermal agent’s in vivo applications. Gold nanoparticles are modified into nanorods, nanoshells, nanocages, etc. Gold nanoparticles are also used in on-site detection of harmful gases like H₂S.

An antimicrobial is an agent that kills or inhibits the growth of microorganisms and  use of antimicrobial agents need to be evaluated since misuse of antimicrobials may lead to increased adverse effects, resistance to antimicrobials, making illnesses more serious, and increasing expenses of health services. Objective: Drug utilization evaluation of antimicrobials are essential as it highlights the importance of assessing optimal drug use and provide a strong basis for therapeutic decision making. The aim of this study was to assess the Drug Utilization Evaluation of postoperative antimicrobials used in surgery department in a tertiary care hospital in India.  Methods: This prospective observational study was carried out with 181 patients who had undergone various surgeries in the General Surgery department of Muthoot Healthcare Kozhencherry, for a period of 6 months to assess the antimicrobials used post-operatively Key findings: In this study it was found that majority of the surgeries were performed in males and the age group of 61-80 years. Most of the subjects had performed incision and drainage followed by hernioplasty. Conclusion: Postoperative antimicrobials prescribed were antibiotics (Cefoperazone –Sulbactum (55.2%) followed by Ceftriaxone) and antiprotozoal agent (Metronidazole).

BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are of significant concern worldwide owing to their high prevalence and substantial clinical and economic burden. Adherence to inhaler may be evaluated by the speci?c inhaler adherence questionnaire, the Test of Adherence to Inhalers (TAI). OBJECTIVE: To assess the adherence profiles to inhaled therapies in COPD patients. SETTING: A 500 bedded tertiary care hospital in South India. METHOD: A prospective observational study was carried out in a tertiary care hospital in South India with a sample size of 150. MAIN OUTCOME MEASURE: To evaluate the adherence to inhalers in COPD patients and thereby taking measures to improve their adherence. RESULT: Among the study population 66% were males. The majority of patients (41.33%) were in the age group of 61-70 years. The present study shows that COPD was prevalent more in males than females. The elderly patients were at high risk of developing COPD. The non-adherence to inhalers were was associated with busy schedule, financial constraints and mood changes. CONCLUSION: Several factors may predict the incorrect use of inhalers or adherence in COPD outpatient, including the number of devices and the daily dosing frequency. Ideally, patient education, simplicity of the device operation, the use of just one device for multiple medications and the best adaptation of the patient to the inhaler should guide the physician in prescribing the device.BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are of significant concern worldwide owing to their high prevalence and substantial clinical and economic burden. Adherence to inhaler may be evaluated by the speci?c inhaler adherence questionnaire, the Test of Adherence to Inhalers (TAI). OBJECTIVE: To assess the adherence profiles to inhaled therapies in COPD patients. SETTING: A 500 bedded tertiary care hospital in South India. METHOD: A prospective observational study was carried out in a tertiary care hospital in South India with a sample size of 150. MAIN OUTCOME MEASURE: To evaluate the adherence to inhalers in COPD patients and thereby taking measures to improve their adherence. RESULT: Among the study population 66% were males. The majority of patients (41.33%) were in the age group of 61-70 years. The present study shows that COPD was prevalent more in males than females. The elderly patients were at high risk of developing COPD. The non-adherence to inhalers were was associated with busy schedule, financial constraints and mood changes. CONCLUSION: Several factors may predict the incorrect use of inhalers or adherence in COPD outpatient, including the number of devices and the daily dosing frequency. Ideally, patient education, simplicity of the device operation, the use of just one device for multiple medications and the best adaptation of the patient to the inhaler should guide the physician in prescribing the device.

We perform pre-formulation evaluation of Oxiconazole nitrate in this study to develop new formulation of ethosomal gel for antifungal activity. Pre-formulation is a group of studies focused on a new drug candidate's physicochemical properties, which could influence drug efficacy and the production of a dosage form. The program has shown that valuable information can be collected before selecting a compound as a candidate for a type of solid-dosage. The analysis of pre-formulation is to improve the elegant dosage form by determining the kinetic rate profile, compatible with the other ingredients, and to determine the new drug's physicochemical parameter. The pre-formulation also provides information about the organoleptic property, solubility, melting point and drug-related partition coefficient, drug stability, partition coefficient among these properties. All the findings and results showed that the nitrate of Oxiconazole serves as a suitable candidate for a topical drug delivery system that may boost bioavailability.

Novel Drug Delivery System refers to the approaches, formulation technologies and systems for transporting a pharmaceutical compound in the body as needed for safety achievement for its desired therapeutic effect. NDDS can be the major advancement for solving the problem related to the release of drugs at a specific site with a specific rate. This article covers the basic information regarding the Novel Drug Delivery System on Lincosamide antibiotics a model drug as Clindamycin. Clindamycin is a derivative of lincosamide which stood the test of time in the treatment of anaerobic infection. It mainly acts by inhibiting protein synthesis by acting on the 50s ribosomal subunit of bacteria. This review describes the recent development of NDDS on lincosamide antibiotic with clindamycin which has been formulated using a particulate vesicle system such as drug carriers for small and large molecules like liposomes, niosomes, solid lipid nanoparticles, microemulsions, etc. These are mainly designed to target the site-specific region to achieve the therapeutic effect by reducing the side effect or the toxic effect. Clindamycin is used with different techniques to give a better formulation for various types of bacterial infection which can be cured by the use of lincosamide antibiotics.