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JANUARY 2019

SIMULTANEOUS SPECTROPHOTOMETRIC ESTIMATION OF ISONIAZID AND PYRIDOXINE

Anitha K*1, T. M. Kalyankar2, U. A. Khedkar2, R. B. Gholve2
1Department of Chemistry, Sri Krishnadevaraya University, Ananthapuram - 515003, Andhra Pradesh, India.

2School of Pharmacy, Swami Ramanand Teerth Marathwada University, Nanded - 431606, Maharashtra, India.

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A STUDY OF PATTERN OF REFERRALS IN LIAISON PSYCHIATRY

Dr Sally John^1*,Dr.Amrita Singam², Dr Sonia Mary Thomas³
¹Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi ,Wardha, Maharashtra Pin 442 001.
²Indira Gandhi Govt. Medical College, Department.of Pharmacology, Nagpur.
³Santhula Trust Hospital, Vadakkara, Oliyapuram P.O Kuthattukulam, Ernakulam Dt, Kerala.

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Liaison psychiatry specializes in bridging psychiatric services to other specialities. It has been actively intervening in the reduction of the communication gap between the various specialities in many health care setups. Thereby it provides them the ability to acquire adequate understanding about the intricacies involved in treating patients with physical and psychiatric co-morbidities. Efficient communication between different levels of care has a great impact on quality of health care. Objectives: To assess the source of referral, reason for referral, the psychiatric diagnosis of the patients referred and the Psychiatric treatment initiated by the referring team and the knowledge of the illness. Materials and method: The study was a cross sectional study conducted on the out patients and inpatients referred to the psychiatric department in a tertiary care hospital in central India. It was completed in the time period of 3 months from June 1st 2014 to August 15th 2014 with a sample size of 150 patients. All the referred patients were evaluated by a consultant psychiatrist and diagnosis was made according to the diagnostic guidelines of ICD-10 (International Classification of Diseases -10th Edition). Results: Out of the total number of patients who were referred 79(52.6%) patients were males and 71(47.3%) were females. The mean age of the study population was 36.01 years. A majority of the patients belonged to the age group of 21-30 years. A majority of the referrals were made from the department of medicine (n=76, 50.6%).The various reasons for psychiatric referral were analyzed and it was found that the most common reason was the presence abnormal behaviour (n=37, 24.6%). The most common psychiatric diagnosis made was substance use disorders (n=51, 34%) Conclusion: The observations of our study clearly show that there is significant gap existing in consultation liaison psychiatry as reflected in the profile and patterns referrals assessed. Early diagnosis and management of psychiatric disorders in patients presenting to the other departments with various physical illnesses definitely hasten recovery, reduce morbidity and improve quality of life. The way ahead is too long in this field and the need for improving the liaison is crucial in reducing the burden of morbidity and improving the quality of life of the patient and their carers.

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Liaison psychiatry specializes in bridging psychiatric services to other specialities. It has been actively intervening in the reduction of the communication gap between the various specialities in many health care setups. Thereby it provides them the ability to acquire adequate understanding about the intricacies involved in treating patients with physical and psychiatric co-morbidities. Efficient communication between different levels of care has a great impact on quality of health care. Objectives: To assess the source of referral, reason for referral, the psychiatric diagnosis of the patients referred and the Psychiatric treatment initiated by the referring team and the knowledge of the illness. Materials and method: The study was a cross sectional study conducted on the out patients and inpatients referred to the psychiatric department in a tertiary care hospital in central India. It was completed in the time period of 3 months from June 1st 2014 to August 15th 2014 with a sample size of 150 patients. All the referred patients were evaluated by a consultant psychiatrist and diagnosis was made according to the diagnostic guidelines of ICD-10 (International Classification of Diseases -10th Edition). Results: Out of the total number of patients who were referred 79(52.6%) patients were males and 71(47.3%) were females. The mean age of the study population was 36.01 years. A majority of the patients belonged to the age group of 21-30 years. A majority of the referrals were made from the department of medicine (n=76, 50.6%).The various reasons for psychiatric referral were analyzed and it was found that the most common reason was the presence abnormal behaviour (n=37, 24.6%). The most common psychiatric diagnosis made was substance use disorders (n=51, 34%) Conclusion: The observations of our study clearly show that there is significant gap existing in consultation liaison psychiatry as reflected in the profile and patterns referrals assessed. Early diagnosis and management of psychiatric disorders in patients presenting to the other departments with various physical illnesses definitely hasten recovery, reduce morbidity and improve quality of life. The way ahead is too long in this field and the need for improving the liaison is crucial in reducing the burden of morbidity and improving the quality of life of the patient and their carers.

FORMULATION DEVELOPMENT AND EVALUATION OF ORODISPERSIBLE TABLETS OF VALSARTAN USING SPRAY DRIED DILUENTS

MahaleNitin B^*1, Battase A.P².
¹Shri Jagdishprasad Jhabarmal Tibrewala University, Jhunjhunu, Rajasthan, India.
²GovindraoNikam College of Pharmacy, Sawarde, Tal ChiplunDistRatnagiri, (M.S), India.

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FORMULATION DEVELOPMENT AND EVALUATION OF NOVEL ORODISPERSIBLE TABLETS OF OLMESARTAN

Mahale Nitin B^*1, Battase A.P².
¹Shri Jagdishprasad Jhabarmal Tibrewala University, Jhunjhunu, Rajasthan, India.
²GovindraoNikam College of Pharmacy, Sawarde, Tal ChiplunDistRatnagiri, (M.S), India.

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ONE POT SYNTHESIS OF 1, 8- DIOXO -OCTAHYDROXANTHENES IN AQUASE PHASE USING ? - CYCLODEXTRIN AS AN EFFICIENT AND GREEN CATALYST

Shankar P Hangirgekar*, Vijay V Kumbhar,Navanand B Wadwale
School of Chemical Sciences, S.R.T.M.University, Nanded-431606, Maharashtra India.

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PHYTONUTRIENT COMPOSITION AND ANTIOXIDANT ACTIVITY OF PROCESSED FLAXSEED

Dharshini¹, Dr.S.Sumayaa², Dr.T.Thirunalasundari ³

¹Research Scholar, Department of Food Science and Nutrition, Thassim Beevi Abdul Kader College for Women, Kilakarai, Tamil Nadu, India.

²Head of the Department, Department of Biotechnology, Bharathidasan University, Tiruchirappali, Tamil Nadu, India.

³Principal, Thassim Beevi Abdul Kader College for Women, Kilakarai, Tamil Nadu, India.

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Flax is a nutraceutical with many nutritional benefits. Aside from the vitamins, minerals, fiber and protein it contains some primary and secondary metabolites. Flaxseed is a good source of omega-3 fatty acids. Through its high concentration of alpha-linolenic acid, flax provides more omega-3 fatty acids than any other grain. (57% of its fatty acids are omega-3s.) As the health revolution continues to evolve, look for it to be added to more and more processed foods to attain the health smart claim. Flaxseed (FS), a whole grain used as a nutritional supplement, has gained popularity because it is a rich source of natural antioxidants. Dietary intake of polyphenols has been associated to reduce risk of chronic diseases, such as heart disease, stress induced diabetes and cancer. This is probably due to their antioxidant properties. Many phenolic compounds have been detected in Flaxseed. Hence with the objectives to analyze the phytonutrient composition, assess the non-antioxidant enzymes vitamin A, E and C and find the antioxidant activity of processed flaxseed the study was carried out. The flaxseed was subjected to various methods of food processing like roasting, pressure cooking and soaking. The processed flaxseed was further analysed the primary and secondary metabolites and their antioxidants activity. This study does not show much variation in primary and secondary metabolites between the raw and roasted seeds. The acceptance and palatability was high in the case of roasted soybean and flaxseed because of their nutrients nutty flavour, colour and texture than the unprocessed seeds. Non- antioxidant enzymes, vitamin A, vitamin E and vitamin C content was high in both soaked and roasted flaxseed. Antioxidant activity was high in roasted and soaked flaxseed. Thus the presence of these phytonutrient and antioxidant activity of processed namely roasted and soaked flaxseeds indicates that, it has a potential of being used in formulations prepared for food consumption. Flaxseed could also be a remedy for the major killer diseases like cancer, diabetes and cardiovascular diseases.

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Flax is a nutraceutical with many nutritional benefits. Aside from the vitamins, minerals, fiber and protein it contains some primary and secondary metabolites. Flaxseed is a good source of omega-3 fatty acids. Through its high concentration of alpha-linolenic acid, flax provides more omega-3 fatty acids than any other grain. (57% of its fatty acids are omega-3s.) As the health revolution continues to evolve, look for it to be added to more and more processed foods to attain the health smart claim. Flaxseed (FS), a whole grain used as a nutritional supplement, has gained popularity because it is a rich source of natural antioxidants. Dietary intake of polyphenols has been associated to reduce risk of chronic diseases, such as heart disease, stress induced diabetes and cancer. This is probably due to their antioxidant properties. Many phenolic compounds have been detected in Flaxseed. Hence with the objectives to analyze the phytonutrient composition, assess the non-antioxidant enzymes vitamin A, E and C and find the antioxidant activity of processed flaxseed the study was carried out. The flaxseed was subjected to various methods of food processing like roasting, pressure cooking and soaking. The processed flaxseed was further analysed the primary and secondary metabolites and their antioxidants activity. This study does not show much variation in primary and secondary metabolites between the raw and roasted seeds. The acceptance and palatability was high in the case of roasted soybean and flaxseed because of their nutrients nutty flavour, colour and texture than the unprocessed seeds. Non- antioxidant enzymes, vitamin A, vitamin E and vitamin C content was high in both soaked and roasted flaxseed. Antioxidant activity was high in roasted and soaked flaxseed. Thus the presence of these phytonutrient and antioxidant activity of processed namely roasted and soaked flaxseeds indicates that, it has a potential of being used in formulations prepared for food consumption. Flaxseed could also be a remedy for the major killer diseases like cancer, diabetes and cardiovascular diseases.

FORMULATION AND EVALUATION OF CHRONOMODULATED DRUG DELIVERY OF NISOLDIPINE

Raghavender Chenna¹, Y. Padmanabha Reddy²
¹Rayalaseema University, Kurnool, AP.
²Raghavendra Institute of Pharmaceutical Education and Research, Ananthapuramu, AP.

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A PROSPECTIVE STUDY ON THE MANAGEMENT OF HYPERTENSION IN PATIENTS WITH END STAGE RENAL DISEASE IN A TERTIARY CARE HOSPITAL, BANGALORE.

Remya Bhaskaran S, G. Saranya, P.Vaishnavi Reddy, Dr. Ritty Sara Cherian, Dr. B.A Vishwanath
Aditya Bangalore Institute for Pharmacy Education & Research (ABIPER).

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NOVEL COMPOUNDS OF THIO-PYRIMIDINE ANTHRANILATE AND SULFONAMIDE ANTHRANILATE DERIVATIVES WITH ANTIMICROBIAL ACTIVITY AND ITS SYNTHESIS

Nitin A. Shimpi*, Rajesh B. Dhake
D.D.N. Bhole College, North Maharashtra University, Jalgaon, India.

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FAST DISSOLVING SYSTEMS AN ALTERNATIVE APPROACH FOR ENHANCED THERAPEUTIC ACTION

R. Santosh Kumar*, T. Naga Satya Yagnesh
GITAM Institute of Pharmacy, GITAM University, Rushikonda, Visakhapatnam, A.P 530045, INDIA.

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THE STUDY ON ALCOHOLIC EXTRACT OF Tagetes erectus, Bougainvillea glabra & Caesalpinia pulcherrima - As pH Herbal Indicator

Gayatri Gautam Varma¹, Mrs. Shubhangi Kshirsagar¹, Sofiya R. Moris², Mrs. Suchita Gokhale¹, Rani Dagadu Shinde¹, Vedanti Kashiram Sawant¹
¹Ideal College of Pharmacy & Research Institute (Affiliated to UNIVERSITY OF MUMBAI).
²Shri D. D Vispute College of Pharmacy and Research Center, Panvel.

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A pH indicator is weak acid and halo chromic chemical compound that is added in small quantity to a solution so that the pH (acidity or basicity) of the solution can be determined visually during experiment. Almost all indicators used for acid-base titrations are synthetic compounds, slightly expensive and are unavailable so attempt is made to prepare natural indicator by using different flower extracts. These flowers are very common and easily available; hence indicator obtained from them will be cheap & economical. Every indicator are exhibits a different range of colors at different pH values. This study has been done to investigate the indicator properties of alcoholic extract of flower- Tagetes erectus, Bougainvillea glabra & Caesalpinia pulcherrima. All samples Pigments were extracted & evaluated by preparing different pH strips by socking method. Their acid-base titration readings were compared with that of already existing synthetic indicators phenolphthalein and the work proved to be acceptable in introducing flower pigments as a substitute to the synthetic indicator in the acid-based indicators.A pH indicator is weak acid and halo chromic chemical compound that is added in small quantity to a solution so that the pH (acidity or basicity) of the solution can be determined visually during experiment. Almost all indicators used for acid-base titrations are synthetic compounds, slightly expensive and are unavailable so attempt is made to prepare natural indicator by using different flower extracts. These flowers are very common and easily available; hence indicator obtained from them will be cheap & economical. Every indicator are exhibits a different range of colors at different pH values. This study has been done to investigate the indicator properties of alcoholic extract of flower- Tagetes erectus, Bougainvillea glabra & Caesalpinia pulcherrima. All samples Pigments were extracted & evaluated by preparing different pH strips by socking method. Their acid-base titration readings were compared with that of already existing synthetic indicators phenolphthalein and the work proved to be acceptable in introducing flower pigments as a substitute to the synthetic indicator in the acid-based indicators.

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A pH indicator is weak acid and halo chromic chemical compound that is added in small quantity to a solution so that the pH (acidity or basicity) of the solution can be determined visually during experiment. Almost all indicators used for acid-base titrations are synthetic compounds, slightly expensive and are unavailable so attempt is made to prepare natural indicator by using different flower extracts. These flowers are very common and easily available; hence indicator obtained from them will be cheap & economical. Every indicator are exhibits a different range of colors at different pH values. This study has been done to investigate the indicator properties of alcoholic extract of flower- Tagetes erectus, Bougainvillea glabra & Caesalpinia pulcherrima. All samples Pigments were extracted & evaluated by preparing different pH strips by socking method. Their acid-base titration readings were compared with that of already existing synthetic indicators phenolphthalein and the work proved to be acceptable in introducing flower pigments as a substitute to the synthetic indicator in the acid-based indicators.A pH indicator is weak acid and halo chromic chemical compound that is added in small quantity to a solution so that the pH (acidity or basicity) of the solution can be determined visually during experiment. Almost all indicators used for acid-base titrations are synthetic compounds, slightly expensive and are unavailable so attempt is made to prepare natural indicator by using different flower extracts. These flowers are very common and easily available; hence indicator obtained from them will be cheap & economical. Every indicator are exhibits a different range of colors at different pH values. This study has been done to investigate the indicator properties of alcoholic extract of flower- Tagetes erectus, Bougainvillea glabra & Caesalpinia pulcherrima. All samples Pigments were extracted & evaluated by preparing different pH strips by socking method. Their acid-base titration readings were compared with that of already existing synthetic indicators phenolphthalein and the work proved to be acceptable in introducing flower pigments as a substitute to the synthetic indicator in the acid-based indicators.

METHOD DEVELOPMENT AND VALIDATION OF SIMULTANEOUS ESTIMATION OF AZITHROMYCIN AND DEXAMETHASONE IN EYE DROPS BY RP-HPLC

Chandrakanth.Bandapally*, Y.Vamshi, V.Girija Sastry
Department of Pharmaceutical Analysis, Aurobindo College of Pharmaceutical Sciences, Gangadevipally (M), Warangal Urban (D), Telangana State, India.

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EVALUATION OF ANTI-COMPULSIVE EFFECT OF ETHANOLIC EXTRACT OF BACOPA MONNIERI L. LEAVES IN MICE

Trupti A. Nimburkar¹, Anjali M. Wankhade^1?, Manish M. Wanjari²
¹Vidyabharati College of Pharmacy,C.K. Naidu road,Camp,Amravati -444602(Maharashtra) India.
²Central Research Institute (Ayurveda), Opposite Jayarog Hospital, Aamkho, Lashkar, Gwalior - 474 009 (Madhya Pradesh), India.

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SWEET WORMWOOD IN THE TREATMENT OF BREAST CANCER

Gopichand Bhoi*, Vishal Lad, Vijay Shastry
Gangamai College of Pharmacy, Nagaon, Dhule, Maharashtra-424005.

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Cancer is an abnormal growth of cells which tends to proliferate in an uncontrolled way and in some cases to spread. Many anticancer drugs are available in market with a lot of side-effects. So our objective is to introduced a drug sweet wormwood (Artemisia annua) that is 1,000 times better than chemotherapy. In chemotherapy, for every 5 cancer cells 1 normal cell may be destroyed but a recent study found that wormwood can kill up to 12,000 cancer cells for every 1 healthy cell it may affect. The active ingredient that makes sweet wormwood such a cancer healer is artemisinin. The special super concentrated compound of wormwood and iron can target cancer cells while leaving healthy cells alone. The compound is specially effective in combating breast cancer. Wormwood and iron together is said to act as a Trojan horse, creating a literal time bomb for cancer cells. Cancer cells are not as successful as healthy cell in disposing of free floating iron molecules. This weakness causes the presence of iron in general to create stressful environment for cancer cells. This compound works on a general property of cancer cells, their high iron content. Breast cancer cells in particular can sometimes contain up to 15 times more iron receptors than surrounding cells, which is why this iron-artemisinin duo may have an even more profound effect on breast cancer. Artemisinin reacted with iron to form free radicals which cause cell death. The artemisinin and its derivatives are toxic to the malarial parasites at nanomolar concentrations, causing specific membrane structural changes in the erythrocyte stage that kills the parasites. The WHO recommends artemisinin- based combination therapies as first line treatment for P. falciparum malaria because it reacts with the high levels of iron in the parasites to produced the free radicals which then destroy the cell walls of malarial- parasite. Act as anti malarial, anti parasitic, anti fungal, anti microbial, anti-inflammatory.

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Cancer is an abnormal growth of cells which tends to proliferate in an uncontrolled way and in some cases to spread. Many anticancer drugs are available in market with a lot of side-effects. So our objective is to introduced a drug sweet wormwood (Artemisia annua) that is 1,000 times better than chemotherapy. In chemotherapy, for every 5 cancer cells 1 normal cell may be destroyed but a recent study found that wormwood can kill up to 12,000 cancer cells for every 1 healthy cell it may affect. The active ingredient that makes sweet wormwood such a cancer healer is artemisinin. The special super concentrated compound of wormwood and iron can target cancer cells while leaving healthy cells alone. The compound is specially effective in combating breast cancer. Wormwood and iron together is said to act as a Trojan horse, creating a literal time bomb for cancer cells. Cancer cells are not as successful as healthy cell in disposing of free floating iron molecules. This weakness causes the presence of iron in general to create stressful environment for cancer cells. This compound works on a general property of cancer cells, their high iron content. Breast cancer cells in particular can sometimes contain up to 15 times more iron receptors than surrounding cells, which is why this iron-artemisinin duo may have an even more profound effect on breast cancer. Artemisinin reacted with iron to form free radicals which cause cell death. The artemisinin and its derivatives are toxic to the malarial parasites at nanomolar concentrations, causing specific membrane structural changes in the erythrocyte stage that kills the parasites. The WHO recommends artemisinin- based combination therapies as first line treatment for P. falciparum malaria because it reacts with the high levels of iron in the parasites to produced the free radicals which then destroy the cell walls of malarial- parasite. Act as anti malarial, anti parasitic, anti fungal, anti microbial, anti-inflammatory.

EFFECT OF LOW DOSE KETAMINE HYDROCHLORIDE ON TOURNIQUET INDUCED HYPERTENSION IN LOWER LIMB SURGERIES

Dr. Srishti Meghare, Dr.Kinna Shah, Dr. Bhavana Shah
Anesthesia Department, G C R I, Ahmedabad, Gujarat.

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Aim:-There is a constant increase in hemodynamic parameters during prolonged tourniquet inflation .We had investigated the effect of low dose 0.5mg/kg bolus ketamine on hemodynamic changes during tourniquet application in lower limb orthopaedic surgeries under general Anesthesia. Method:-100 patients posted for lower limb surgeries under standard general anesthesia using tourniquet were randomly assigned to one of two groups in double blind study. The Group C (control group) received 10 ml saline IV and Group K (study group) received 0.5mg/kg diluted in 10ml 0.9% saline IV given 10 minutes before tourniquet inflation. We had recorded hemodynamic changes, EtCO2 and Et Sevoflurane at 5 minutes interval up to 20 minutes of tourniquet deflation. Inj. Fentanyl 1mcg/kg supplemented if Systolic BP or heart rate raised more than 30% of base line. Results: - Hemodynamic stability was seen statically significant in Group K (p value, < 0.05) at 40, 50 and 60 minutes. Less number of patients needed supplemental fentanyl intra operatively in Group K than in Group C (3 V/s.18 p value <0.05). Conclusion: - Low dose bolus Ketamine 0.5mg/kg prevents tourniquet induced hypertension in lower limb surgery done under general anesthesia.Aim:-There is a constant increase in hemodynamic parameters during prolonged tourniquet inflation .We had investigated the effect of low dose 0.5mg/kg bolus ketamine on hemodynamic changes during tourniquet application in lower limb orthopaedic surgeries under general Anesthesia. Method:-100 patients posted for lower limb surgeries under standard general anesthesia using tourniquet were randomly assigned to one of two groups in double blind study. The Group C (control group) received 10 ml saline IV and Group K (study group) received 0.5mg/kg diluted in 10ml 0.9% saline IV given 10 minutes before tourniquet inflation. We had recorded hemodynamic changes, EtCO2 and Et Sevoflurane at 5 minutes interval up to 20 minutes of tourniquet deflation. Inj. Fentanyl 1mcg/kg supplemented if Systolic BP or heart rate raised more than 30% of base line. Results: - Hemodynamic stability was seen statically significant in Group K (p value, < 0.05) at 40, 50 and 60 minutes. Less number of patients needed supplemental fentanyl intra operatively in Group K than in Group C (3 V/s.18 p value <0.05). Conclusion: - Low dose bolus Ketamine 0.5mg/kg prevents tourniquet induced hypertension in lower limb surgery done under general anesthesia.

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Aim:-There is a constant increase in hemodynamic parameters during prolonged tourniquet inflation .We had investigated the effect of low dose 0.5mg/kg bolus ketamine on hemodynamic changes during tourniquet application in lower limb orthopaedic surgeries under general Anesthesia. Method:-100 patients posted for lower limb surgeries under standard general anesthesia using tourniquet were randomly assigned to one of two groups in double blind study. The Group C (control group) received 10 ml saline IV and Group K (study group) received 0.5mg/kg diluted in 10ml 0.9% saline IV given 10 minutes before tourniquet inflation. We had recorded hemodynamic changes, EtCO2 and Et Sevoflurane at 5 minutes interval up to 20 minutes of tourniquet deflation. Inj. Fentanyl 1mcg/kg supplemented if Systolic BP or heart rate raised more than 30% of base line. Results: - Hemodynamic stability was seen statically significant in Group K (p value, < 0.05) at 40, 50 and 60 minutes. Less number of patients needed supplemental fentanyl intra operatively in Group K than in Group C (3 V/s.18 p value <0.05). Conclusion: - Low dose bolus Ketamine 0.5mg/kg prevents tourniquet induced hypertension in lower limb surgery done under general anesthesia.Aim:-There is a constant increase in hemodynamic parameters during prolonged tourniquet inflation .We had investigated the effect of low dose 0.5mg/kg bolus ketamine on hemodynamic changes during tourniquet application in lower limb orthopaedic surgeries under general Anesthesia. Method:-100 patients posted for lower limb surgeries under standard general anesthesia using tourniquet were randomly assigned to one of two groups in double blind study. The Group C (control group) received 10 ml saline IV and Group K (study group) received 0.5mg/kg diluted in 10ml 0.9% saline IV given 10 minutes before tourniquet inflation. We had recorded hemodynamic changes, EtCO2 and Et Sevoflurane at 5 minutes interval up to 20 minutes of tourniquet deflation. Inj. Fentanyl 1mcg/kg supplemented if Systolic BP or heart rate raised more than 30% of base line. Results: - Hemodynamic stability was seen statically significant in Group K (p value, < 0.05) at 40, 50 and 60 minutes. Less number of patients needed supplemental fentanyl intra operatively in Group K than in Group C (3 V/s.18 p value <0.05). Conclusion: - Low dose bolus Ketamine 0.5mg/kg prevents tourniquet induced hypertension in lower limb surgery done under general anesthesia.

RELATIVE GROWTH RATE AND SURVIVAL, EFFICIENCY OF FEED UTILIZATION OF NILE TILAPIA (OREOCHROMIS NILOTICUS), AN EXPERIMENTAL STUDY BY THE ADDITION OF HERBAL EXTRACT SUPPLEMENTS AS DRUGS AND GROWTH PROMOTERS TO JUVENILE FISHES IN THE FED DIET

G.V. Pavan Kumar*, N. Mehar Nikhitha, Md. Mb.Husnara Begum, V. Chandra Sekhar, N.V.V.S.S. Lakshmi, Ch.Deena, B.Bhavani, P.Rajendra Kumar
Department of Pharmaceutical Chemistry, Koringa College of Pharmacy, Korangi, East Godavari, Andhra Pradesh, India.

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The use of herbs as drugs in disease management is gaining success, because herbal drugs are cost effective, eco-friendly and have minimal side effects. Many studies have proved that herbal additives enhanced the growth of fishes and protect them from diseases. Indeed, the herbs/herbal drugs overcome all these problems and keep the fish healthy by acting as growth promoters and treating the diseases as well. A feeding trial, involving the use of four different starter diets for the feeding of Oreochromis niloticus juveniles, was carried out in the laboratory by intensive cage farming technique. The purpose of this study was to determine the effect of adding herbal extracts in feed and observations were conducted on efficiency of feed utilization (EFU), relative growth rate (RGR), survival rate(SR) of Nile tilapia fish (Oreochromis niloticus). Fish samples in this research with an average weight of 5.34 ± 0.16 g were selected. The formulated diets consist of Fresh Cocus nucifera milk (CNMe), Ficus sycomorus (FSBe), Suaeda maritima (SMPe), Vulva Proliferans (VPAe ), and regular basal diet with all the natural ingredients. The juvenile fishes were distinctly arranged into 6 groups and fed with control, marketed feed also. Every group was fed with formulated basal feed at time intervals of 4hrs thrice a day at 08.00 am, 12.00 pm and 14.00 pm at the ration of around 14.28g/day over a period of 7 days and varied formulated herbal feed for the next 7 days until 84 days study. The results show that the addition of herbal extracts significantly (P<0.05) affected on EFU, RGR on the other hand it insignificantly (P>0.05) affected on SR of Nile tilapia. Based on results, it was concluded that growth performance and feed efficiency increased with the use of Ficus sycomorus berries extract and Suaeda maritima whole plant extract. Ficus sycomorus treatment is highly recommended as live food in the growth promotion of the Oreochromis niloticus fish. The protenaceous food from plants is easily available and most widely cultivable in freshwater fish pond environments, its bio-nutrients are readily available/utilizable by the fish and the procurement is highly economical. This technology uses herbal ingredients in formulation thus contributing towards good quality in fish meal and culturing.

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The use of herbs as drugs in disease management is gaining success, because herbal drugs are cost effective, eco-friendly and have minimal side effects. Many studies have proved that herbal additives enhanced the growth of fishes and protect them from diseases. Indeed, the herbs/herbal drugs overcome all these problems and keep the fish healthy by acting as growth promoters and treating the diseases as well. A feeding trial, involving the use of four different starter diets for the feeding of Oreochromis niloticus juveniles, was carried out in the laboratory by intensive cage farming technique. The purpose of this study was to determine the effect of adding herbal extracts in feed and observations were conducted on efficiency of feed utilization (EFU), relative growth rate (RGR), survival rate(SR) of Nile tilapia fish (Oreochromis niloticus). Fish samples in this research with an average weight of 5.34 ± 0.16 g were selected. The formulated diets consist of Fresh Cocus nucifera milk (CNMe), Ficus sycomorus (FSBe), Suaeda maritima (SMPe), Vulva Proliferans (VPAe ), and regular basal diet with all the natural ingredients. The juvenile fishes were distinctly arranged into 6 groups and fed with control, marketed feed also. Every group was fed with formulated basal feed at time intervals of 4hrs thrice a day at 08.00 am, 12.00 pm and 14.00 pm at the ration of around 14.28g/day over a period of 7 days and varied formulated herbal feed for the next 7 days until 84 days study. The results show that the addition of herbal extracts significantly (P<0.05) affected on EFU, RGR on the other hand it insignificantly (P>0.05) affected on SR of Nile tilapia. Based on results, it was concluded that growth performance and feed efficiency increased with the use of Ficus sycomorus berries extract and Suaeda maritima whole plant extract. Ficus sycomorus treatment is highly recommended as live food in the growth promotion of the Oreochromis niloticus fish. The protenaceous food from plants is easily available and most widely cultivable in freshwater fish pond environments, its bio-nutrients are readily available/utilizable by the fish and the procurement is highly economical. This technology uses herbal ingredients in formulation thus contributing towards good quality in fish meal and culturing.

THE NOVEL USE OF PENTABROMOBENZYL COLUMN FOR SIMULTANEOUS DETERMINATION OF THREE ANTIVIRAL DRUGS, SOFOSBUVIR WITH DACLATASVIR OR LEDIPASVIR IN THEIR TABLET DOSAGE FORM AND SPIKED HUMAN PLASMA

Maha Abd-Elrahman. Sultan¹, Maha Mahmoud Abou El-Alamin¹, Sherif F Hammad², Alastair W. Wark³, Marwa Mohamed Azab^*1.
¹Analytical Chemistry Department, Faculty of Pharmacy, Helwan University, 11795, Cairo, Egypt
²Pharmaceutical Chemistry Department, Faculty of Pharmacy, Helwan University, 11795, Cairo, Egypt
³Center for Molecular Nanometrology, WESTChem, Dept. of Pure & Applied Chemistry, Technology, Innovation Centre, University of Strathclyde, Glasgow, G1 1RD, UK..

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EFFECT OF SOLVENTS ON SPECTROPHOTOMETRIC ESTIMATION OF RIZATRIPTAN BENZOATE

Dr.VamseeKrishna. G^*, Dr.Y.A. Chowdary, S.N.S. Sriram, P. Lavanya, G. Varsha Sri, Sk.Sujauddin
Dept. Of Pharmaceutical Analysis, NRI College of Pharmacy, Pothavarappadu, Agiripalli, Andhra Pradesh, India.

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Rizatriptan Benzoate is a selective 5-Hydroxy Tryptamine 1B/1D receptor agonist, which is used in the treatment of migraine headache. Three simple, sensitive, selective, accurate, precise, economical, robust, rapid and reproducible ultraviolet (UV) spectrophotometric methods have been developed and validated for quantitative estimation of Rizatriptan benzoate in bulk and tablet dosage form. The solutions of Rizatriptan were prepared using water and solvent blends containing acetonitrile: H2O (1:1), water: methanol (1:1) and studied their influence on estimation of Rizatriptan benzoate. The three different solutions of drug were scanned in the UV region of 200nm-400nm. Rizatriptan benzoate showed maximum absorbance at 224nm in all three different solvents, and obeyed Beer-Lamberts law in the concentration range of 2-12?g/ml. The linear regression equations were calculated to be Y=0.913x+0.0065 for acetonitrile: water (1:1) (R2 =0.9994), Y=0.0896x+0.0101 for methanol: water (1:1) (R2 =0.9994) and Y=0.0858x+0.0134 for water (R2 =0.9992). The analytical parameter such as linearity, A(1%/1cm), limit of detection (LOD), limit of quantification(LOQ), intermediate precision, molar absorption coefficient and sandells sensitivity were calculated. The validation parameters were treated statistically with one-way analysis of variance(ANOVA) and significant differences were noted. The study clearly revealed that the solvents influence the determination of Rizatriptan benzoate, the method described was rapid and easy. So it can be used for routine quality control analysis of Rizatriptan benzoate in pharmaceutical preparations.Rizatriptan Benzoate is a selective 5-Hydroxy Tryptamine 1B/1D receptor agonist, which is used in the treatment of migraine headache. Three simple, sensitive, selective, accurate, precise, economical, robust, rapid and reproducible ultraviolet (UV) spectrophotometric methods have been developed and validated for quantitative estimation of Rizatriptan benzoate in bulk and tablet dosage form. The solutions of Rizatriptan were prepared using water and solvent blends containing acetonitrile: H2O (1:1), water: methanol (1:1) and studied their influence on estimation of Rizatriptan benzoate. The three different solutions of drug were scanned in the UV region of 200nm-400nm. Rizatriptan benzoate showed maximum absorbance at 224nm in all three different solvents, and obeyed Beer-Lamberts law in the concentration range of 2-12?g/ml. The linear regression equations were calculated to be Y=0.913x+0.0065 for acetonitrile: water (1:1) (R2 =0.9994), Y=0.0896x+0.0101 for methanol: water (1:1) (R2 =0.9994) and Y=0.0858x+0.0134 for water (R2 =0.9992). The analytical parameter such as linearity, A(1%/1cm), limit of detection (LOD), limit of quantification(LOQ), intermediate precision, molar absorption coefficient and sandells sensitivity were calculated. The validation parameters were treated statistically with one-way analysis of variance(ANOVA) and significant differences were noted. The study clearly revealed that the solvents influence the determination of Rizatriptan benzoate, the method described was rapid and easy. So it can be used for routine quality control analysis of Rizatriptan benzoate in pharmaceutical preparations.

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Rizatriptan Benzoate is a selective 5-Hydroxy Tryptamine 1B/1D receptor agonist, which is used in the treatment of migraine headache. Three simple, sensitive, selective, accurate, precise, economical, robust, rapid and reproducible ultraviolet (UV) spectrophotometric methods have been developed and validated for quantitative estimation of Rizatriptan benzoate in bulk and tablet dosage form. The solutions of Rizatriptan were prepared using water and solvent blends containing acetonitrile: H2O (1:1), water: methanol (1:1) and studied their influence on estimation of Rizatriptan benzoate. The three different solutions of drug were scanned in the UV region of 200nm-400nm. Rizatriptan benzoate showed maximum absorbance at 224nm in all three different solvents, and obeyed Beer-Lamberts law in the concentration range of 2-12?g/ml. The linear regression equations were calculated to be Y=0.913x+0.0065 for acetonitrile: water (1:1) (R2 =0.9994), Y=0.0896x+0.0101 for methanol: water (1:1) (R2 =0.9994) and Y=0.0858x+0.0134 for water (R2 =0.9992). The analytical parameter such as linearity, A(1%/1cm), limit of detection (LOD), limit of quantification(LOQ), intermediate precision, molar absorption coefficient and sandells sensitivity were calculated. The validation parameters were treated statistically with one-way analysis of variance(ANOVA) and significant differences were noted. The study clearly revealed that the solvents influence the determination of Rizatriptan benzoate, the method described was rapid and easy. So it can be used for routine quality control analysis of Rizatriptan benzoate in pharmaceutical preparations.Rizatriptan Benzoate is a selective 5-Hydroxy Tryptamine 1B/1D receptor agonist, which is used in the treatment of migraine headache. Three simple, sensitive, selective, accurate, precise, economical, robust, rapid and reproducible ultraviolet (UV) spectrophotometric methods have been developed and validated for quantitative estimation of Rizatriptan benzoate in bulk and tablet dosage form. The solutions of Rizatriptan were prepared using water and solvent blends containing acetonitrile: H2O (1:1), water: methanol (1:1) and studied their influence on estimation of Rizatriptan benzoate. The three different solutions of drug were scanned in the UV region of 200nm-400nm. Rizatriptan benzoate showed maximum absorbance at 224nm in all three different solvents, and obeyed Beer-Lamberts law in the concentration range of 2-12?g/ml. The linear regression equations were calculated to be Y=0.913x+0.0065 for acetonitrile: water (1:1) (R2 =0.9994), Y=0.0896x+0.0101 for methanol: water (1:1) (R2 =0.9994) and Y=0.0858x+0.0134 for water (R2 =0.9992). The analytical parameter such as linearity, A(1%/1cm), limit of detection (LOD), limit of quantification(LOQ), intermediate precision, molar absorption coefficient and sandells sensitivity were calculated. The validation parameters were treated statistically with one-way analysis of variance(ANOVA) and significant differences were noted. The study clearly revealed that the solvents influence the determination of Rizatriptan benzoate, the method described was rapid and easy. So it can be used for routine quality control analysis of Rizatriptan benzoate in pharmaceutical preparations.

DESIGN AND CHARACTERIZATION OF TRANSDERMAL ETHOSOMAL GEL OF PAROXETINE BY COLD METHOD

V.Viswanath*, S.Lavanya, A.Tejaswini
Department of Pharmaceutics, P.R.R,M College of Pharmacy, Kadapa – 516 003.

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The present investigative work is carried out to formulate and optimize the Paroxetine ethosomal gel using cold method. As a part of the investigation, we used three square design using design expert® 11.0 version software for optimization of individual concentrations of lecithin and ethanol and are considered as the independent variables. Whereas, drug content, entrapment efficacy, and vesicular size are considered as dependent variables which gets altered due to independent variable concentrations. The study was carried out using 14 formulations containing the variable concentrations of lecithin and ethanol. Further, the in-vitro studies of the formulations reveal that F3 having lecithin: ethanol ratio as 100:5 and exhibiting the drug content of 95.285% and entrapment efficacy of 95.354% is considered as optimized. In continuation to the above, F3 exhibits first order release (R2 = 0.951) mechanism with non- Fickian diffusion. The ANOVA studies and polynomial equations in terms of coded equations were generated for the obtained results which reveal the effect of lecithin on the dependent variables and strengthen the statistical data. On the whole, it can be concluded that F3 is optimized and can serve as an effective carrier for transdermal drug delivery of Paroxetine in generating the required therapeutic effect.The present investigative work is carried out to formulate and optimize the Paroxetine ethosomal gel using cold method. As a part of the investigation, we used three square design using design expert® 11.0 version software for optimization of individual concentrations of lecithin and ethanol and are considered as the independent variables. Whereas, drug content, entrapment efficacy, and vesicular size are considered as dependent variables which gets altered due to independent variable concentrations. The study was carried out using 14 formulations containing the variable concentrations of lecithin and ethanol. Further, the in-vitro studies of the formulations reveal that F3 having lecithin: ethanol ratio as 100:5 and exhibiting the drug content of 95.285% and entrapment efficacy of 95.354% is considered as optimized. In continuation to the above, F3 exhibits first order release (R2 = 0.951) mechanism with non- Fickian diffusion. The ANOVA studies and polynomial equations in terms of coded equations were generated for the obtained results which reveal the effect of lecithin on the dependent variables and strengthen the statistical data. On the whole, it can be concluded that F3 is optimized and can serve as an effective carrier for transdermal drug delivery of Paroxetine in generating the required therapeutic effect.

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The present investigative work is carried out to formulate and optimize the Paroxetine ethosomal gel using cold method. As a part of the investigation, we used three square design using design expert® 11.0 version software for optimization of individual concentrations of lecithin and ethanol and are considered as the independent variables. Whereas, drug content, entrapment efficacy, and vesicular size are considered as dependent variables which gets altered due to independent variable concentrations. The study was carried out using 14 formulations containing the variable concentrations of lecithin and ethanol. Further, the in-vitro studies of the formulations reveal that F3 having lecithin: ethanol ratio as 100:5 and exhibiting the drug content of 95.285% and entrapment efficacy of 95.354% is considered as optimized. In continuation to the above, F3 exhibits first order release (R2 = 0.951) mechanism with non- Fickian diffusion. The ANOVA studies and polynomial equations in terms of coded equations were generated for the obtained results which reveal the effect of lecithin on the dependent variables and strengthen the statistical data. On the whole, it can be concluded that F3 is optimized and can serve as an effective carrier for transdermal drug delivery of Paroxetine in generating the required therapeutic effect.The present investigative work is carried out to formulate and optimize the Paroxetine ethosomal gel using cold method. As a part of the investigation, we used three square design using design expert® 11.0 version software for optimization of individual concentrations of lecithin and ethanol and are considered as the independent variables. Whereas, drug content, entrapment efficacy, and vesicular size are considered as dependent variables which gets altered due to independent variable concentrations. The study was carried out using 14 formulations containing the variable concentrations of lecithin and ethanol. Further, the in-vitro studies of the formulations reveal that F3 having lecithin: ethanol ratio as 100:5 and exhibiting the drug content of 95.285% and entrapment efficacy of 95.354% is considered as optimized. In continuation to the above, F3 exhibits first order release (R2 = 0.951) mechanism with non- Fickian diffusion. The ANOVA studies and polynomial equations in terms of coded equations were generated for the obtained results which reveal the effect of lecithin on the dependent variables and strengthen the statistical data. On the whole, it can be concluded that F3 is optimized and can serve as an effective carrier for transdermal drug delivery of Paroxetine in generating the required therapeutic effect.

VISIBLE SPECTROPHOTOMETRIC METHOD FOR DETERMINATION OF ELETRIPTAN HYDROBROMIDE IN PHARMACEUTICAL FORMULATION USING MARQUIS REAGENT

Sailusha Ratnam K, Hemant Kumar T*, Srinivasa Rao Y, Vara Prasada Rao K
Department of Pharmaceutical Analysis and Quality Assurance, Vignan Institute of Pharmaceutical Technology, Duvvada, Visakhapatnam.

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METHOD DEVELOPMENT AND METHOD VALIDATION FOR THE ESTIMATION OF DOFETILIDE IN BULK AND PHARMACEUTICAL DOSAGE PREPARATIONS BY RP-HPLC

Ramesh Adepu*, Dr. A. Ashok Kumar
Department of Pharmaceutical Sciences, Mewar University, Chittorgarh, Rajasthan, India.

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REVIEW ON VAGINAL DRUG DELIVERY SYSTEM

Manikanta Kumar. Y.S.S
GITAM Institute of Pharmacy, GITAM (Deemed to be University), Rushikonda, Visakhapatnam-530045, Andhra Pradesh.

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EFFECT OF LOW DOSE KETAMINE HYDROCHLORIDE ON TOURNIQUET INDUCED HYPERTENSION IN LOWER LIMB SURGERIES

Dr. Srishti Meghare, Dr.Kinna Shah, Dr. Bhavana Shah
Anesthesia Department, G C R I, Ahmedabad, Gujarat.

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DEVELOPMENT AND EVALUATION OF NANOEMULSION FOR IMPROVED ORAL DELIVERY OF LURASIDONE HYDROCHLORIDE.

B. Kusum^*1, R. Shyamsunder²
¹Department of Pharmacy, University college of Technology, Osmania University, Telangana, INDIA.
²Head and Principal, University college of Technology, Osmania University, Telangana, INDIA.

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ANTIBIOTIC BEAD POUCHES IN OPEN FRACTURES: ELUTION OF ANTIBIOTICS FROM PMMA BEAD POUCHES IN OPEN FRACTURES

Dr S Amarnath M.S*, K Bindu Madhuri, L Tejaswi, A Chetanya Brahma, Dr Shaik Faizan Ali
Amar Orthopedic Hospital, Department of Pharmacy Practice, Hindu college of Pharmacy, Guntur.

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MANAGEMENT PROCESSES DURING DRUG DEVELOPMENT: A SPECIAL REPORT ON RESEARCH & DEVELOPMENT IN CROS AND PHARMACEUTICAL COMPANIES

Amol B. Garde*, Dipali Jagtap, Ashish S. Pagariya
Sinhgad Institute of Pharmaceutical Sciences, Lonavala, Maharashtra.

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PREVALENCE OF SECONDARY HYPERPARATHYROIDISM IN CHRONIC KIDNEY PATIENTS

Srichurnam Sreekar, Akhil Sunkari, Vedasamhitha Ramavarapu
Malla Reddy Institute of Pharmaceutical Sciences, Jawaharlal Nehru Technological University, Hyderabad, Telangana, India.

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Secondary hyperaparathyoidism occurs mainly due to chronic kidney disease which aggravates from stage 1-5, which is due to imbalance between calcium and phosphorous homeostasis. Secondary hyperparathyroidism is the serious issue to be considered because of its complications including cardiovascular disease soft tissue and vascular calcification calcific uremic arteriolopathy (CUA). Our study was to find the prevalence of secondary hyperparathyroidism that would help to find out the epidemiological spread of the disease that would help in improving the treatment effectiveness for the safety of the subjects. our study includes 60 subjects who are undergoing dialysis from 12 to 48 months of duration we found high prevalence of secondary hyperparathyroidism with 66.6 % patients with IPTH levels over 300pg/ml, 83% of the patients were found to be hypocalcaemia and 75% of the patients were found to be having abnormal phosphorous levels with majority having high phosphorous levels so based on our study prevalence of secondary hyperparathyroidism was high which would results in serious complications like bone dystrophy which left untreated would result to death. The final result of our study include majority of the patient have secondary hyperparathyroidism which would results in further complications like bone dystrophy and cardiovascular abnormality left untreated would result in further menacing complications which left untreated would may lead to death of the patientsSecondary hyperaparathyoidism occurs mainly due to chronic kidney disease which aggravates from stage 1-5, which is due to imbalance between calcium and phosphorous homeostasis. Secondary hyperparathyroidism is the serious issue to be considered because of its complications including cardiovascular disease soft tissue and vascular calcification calcific uremic arteriolopathy (CUA). Our study was to find the prevalence of secondary hyperparathyroidism that would help to find out the epidemiological spread of the disease that would help in improving the treatment effectiveness for the safety of the subjects. our study includes 60 subjects who are undergoing dialysis from 12 to 48 months of duration we found high prevalence of secondary hyperparathyroidism with 66.6 % patients with IPTH levels over 300pg/ml, 83% of the patients were found to be hypocalcaemia and 75% of the patients were found to be having abnormal phosphorous levels with majority having high phosphorous levels so based on our study prevalence of secondary hyperparathyroidism was high which would results in serious complications like bone dystrophy which left untreated would result to death. The final result of our study include majority of the patient have secondary hyperparathyroidism which would results in further complications like bone dystrophy and cardiovascular abnormality left untreated would result in further menacing complications which left untreated would may lead to death of the patients.

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Secondary hyperaparathyoidism occurs mainly due to chronic kidney disease which aggravates from stage 1-5, which is due to imbalance between calcium and phosphorous homeostasis. Secondary hyperparathyroidism is the serious issue to be considered because of its complications including cardiovascular disease soft tissue and vascular calcification calcific uremic arteriolopathy (CUA). Our study was to find the prevalence of secondary hyperparathyroidism that would help to find out the epidemiological spread of the disease that would help in improving the treatment effectiveness for the safety of the subjects. our study includes 60 subjects who are undergoing dialysis from 12 to 48 months of duration we found high prevalence of secondary hyperparathyroidism with 66.6 % patients with IPTH levels over 300pg/ml, 83% of the patients were found to be hypocalcaemia and 75% of the patients were found to be having abnormal phosphorous levels with majority having high phosphorous levels so based on our study prevalence of secondary hyperparathyroidism was high which would results in serious complications like bone dystrophy which left untreated would result to death. The final result of our study include majority of the patient have secondary hyperparathyroidism which would results in further complications like bone dystrophy and cardiovascular abnormality left untreated would result in further menacing complications which left untreated would may lead to death of the patientsSecondary hyperaparathyoidism occurs mainly due to chronic kidney disease which aggravates from stage 1-5, which is due to imbalance between calcium and phosphorous homeostasis. Secondary hyperparathyroidism is the serious issue to be considered because of its complications including cardiovascular disease soft tissue and vascular calcification calcific uremic arteriolopathy (CUA). Our study was to find the prevalence of secondary hyperparathyroidism that would help to find out the epidemiological spread of the disease that would help in improving the treatment effectiveness for the safety of the subjects. our study includes 60 subjects who are undergoing dialysis from 12 to 48 months of duration we found high prevalence of secondary hyperparathyroidism with 66.6 % patients with IPTH levels over 300pg/ml, 83% of the patients were found to be hypocalcaemia and 75% of the patients were found to be having abnormal phosphorous levels with majority having high phosphorous levels so based on our study prevalence of secondary hyperparathyroidism was high which would results in serious complications like bone dystrophy which left untreated would result to death. The final result of our study include majority of the patient have secondary hyperparathyroidism which would results in further complications like bone dystrophy and cardiovascular abnormality left untreated would result in further menacing complications which left untreated would may lead to death of the patients.

STUDY OF SOYA (GLYCINE MAX L. MERR.) ON MENOPAUSAL SYNDROME, AN EXTRA-PHARMACOPIEAL DRUG.

Dr. Shibani Dash^*1, Dr. Siba Prasad Rout2
¹Department of Stri Roga and Prasuti Tantra, All India Institute of Ayurveda, New Delhi, India.
²Department of Dravyaguna, KATS Ayurveda Collage.

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PCSK9 INHIBITORS: TO SOLVE OUT MANY CVS PROBLEMS

Arlin George*, Naveen S, Abdul Haseeb, Sunitha Mukuntha, Dr.Vineeth Chandy
T John College of Pharmacy.

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INCIDENCE OF POST DURAL PUNCTURE HEADACHE AMONG THE PATIENTS OF AGE 30 TO 70 YEARS UNDERGOING ORTHOPEDIC SURGERY UNDER SPINAL ANESTHESIA AT KHYBER TEACHING HOSPITAL, PESHAWAR, PAKISTAN

Asad khan*, Mati ullah, Hamaad
Institute of Paramedical Sciences (IPMS) a Constituent Institute of Khyber Medical university Peshawar, Pakistan.

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