International Journal of Allied Medical Sciences and Clinical Research
International Journal of Allied Medical Sciences and Clinical Research (IJAMSCR) is a peer-reviewed, open-access international journal dedicated to the publication of high-quality research and review articles in all branches of medical, allied health sciences, and clinical research. The journal aims to provide a platform for academicians, researchers, clinicians, and healthcare professionals to disseminate knowledge that contributes to advancements in the medical and clinical fields. IJAMSCR encourages submissions in areas including but not limited to pharmacology, nursing, physiotherapy, biomedical sciences, clinical trials, diagnostics, and public health. The journal is published quarterly and welcomes original research papers, systematic reviews, meta-analyses, short communications, and case reports.
Knowledge and Awareness Among Dental Students Regarding College Students and Eating Habits
Over the past few decades, unhealthy eating behaviors have contributed to a rise in overweight and obesity among young adults. This study aimed to assess the knowledge and awareness among dental students regarding college students’ eating habits. A cross-sectional online survey was conducted among 204 dental students from Mamata Dental College, Khammam, using a 13-item self-administered questionnaire. Data were analyzed using SPSS version 29 and chi-square tests to compare awareness based on gender and year of study. Results showed that female students demonstrated higher awareness than males, while interns had the highest knowledge levels followed by second-, fourth-, third-, and first-year students. Statistically significant differences were observed for certain questions (p < 0.05). The findings suggest that although dental students possess basic knowledge of nutrition, greater emphasis on dietary education within the curriculum is needed to strengthen their ability to promote healthy eating and preventive oral healthcare.
Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0
FORMULATION AND EVALUATION OF ANTI -ACNE HERBAL CREAM
Acne vulgaris is one of the most common skin disorders affecting adolescents and adults, often resulting from bacterial infection, excess sebum production, and inflammation. The present study aims to formulate and evaluate a herbal cream incorporating natural ingredients with proven anti-acne, anti-inflammatory, and antimicrobial properties. Aloe vera, turmeric (Curcuma longa), neem (Azadirachta indica), and honey were selected as active herbal ingredients based on their traditional and scientific relevance in acne treatment. The herbal extracts were incorporated into a cream base using standard formulation techniques. The prepared formulation was evaluated for its physicochemical properties including pH, viscosity, spread ability, homogeneity, stability, and microbial load. In vitro antimicrobial activity was assessed against common acne-causing bacteria such as Propionibacterium acnes and Staphylococcus aureus. The results indicated that the cream was stable, non-irritant, and exhibited significant antimicrobial activity, particularly against P. acnes. The herbal ingredients showed synergistic effects, providing a promising alternative to synthetic anti-acne treatments with reduced side effects. This study supports the potential of herbal formulations as effective, safe, and natural remedies for acne management.
Copyright (c) 2025 Akash E, Gunaseelan V, Jayanthan R, Parvendhan M, Prabavathi T, Rassid Ahmad A https://creativecommons.org/licenses/by-nc-nd/4.0
Awareness and Practices of Medicine Waste Disposal in Rural Communities
The improper disposal of leftover and expired medications poses serious risks to both environmental and public health, especially in rural regions where awareness, infrastructure, and proper disposal facilities are limited. This study aimed to assess the knowledge, attitudes, and practices (KAP) related to pharmaceutical waste management among 200 households across selected villages within a gram panchayat. Data were collected using structured questionnaires, focus group discussions, and direct observations to gain a comprehensive understanding of household disposal behaviours. The findings revealed that only 38% of respondents recognized the environmental hazards associated with unsafe disposal of medicines, while 32% believed that discarded medicines were harmless, and 30% were unsure. Common disposal practices included throwing unused or expired medicines in household garbage (45%), burning them along with other waste (25%), and flushing them into drains or toilets (18%). Alarmingly, only 12% of householdsreturned leftover medicines to health centres or pharmacies. Statistical analysis indicated a strong correlation between higher educational levels, previous exposure to health awareness programs, and the adoption of safer disposal practices. The study highlights a significant knowledge gap and unsafe practices that could lead to environmental contamination and antimicrobial resistance. Therefore, the findings underscore the urgent need for implementing community-based educational campaigns, promoting accessible medicine take-back systems, and integrating sustainable pharmaceutical waste management strategies into rural public health initiatives to minimize potential health and ecological hazards.
Copyright (c) 2025 Pavithra office; Nataraj Palaniyappan*, Ravisankar Mathesan, Elavarasi R https://creativecommons.org/licenses/by-nc-nd/4.0
Inter-rater reliability of hand muscle strength, dexterity, function, joint mobility and sensory threshold assessments in individuals with type 2 Diabetes Mellitus in central part of Kerala, India
Background: Type 2 Diabetes Mellitus (T2DM) often leads to musculoskeletal complications affecting hand strength, dexterity, and function. Reliable assessment tools are essential for early detection and management of hand dysfunction, but inter-rater reliability in this population remains underexplored. Aim: To determine the inter-rater reliability of hand muscle strength, dexterity, function, joint mobility, and sensory threshold assessments in individuals with T2DM in central Kerala, India. Methods: Eighteen adults with T2DM were evaluated by two physiotherapists using standardized tools including hand-held dynamometer, pinch gauge, nine-hole peg test, box and block test, Indian-Cochin Hand Function Scale, goniometry, and Semmes Weinstein monofilaments. Inter-rater reliability was analyzed using intra-class correlation coefficients (ICC). Results: Inter-rater ICC values ranged from 0.71 to 0.99, indicating moderate to excellent reliability across all hand assessments. The highest reliability was observed for sensory threshold (ICC = 0.99) and hand function score (ICC = 0.95). Conclusion: The study confirms moderate to excellent inter-rater reliability of hand assessment tools in individuals with T2DM. These findings support their clinical use in physiotherapy for early detection and management of diabetic hand dysfunction.
Emerging Trends in Breast Cancer Research: Molecular Mechanisms, Therapeutics, and Clinical Applications
Breast cancer remains the most frequently diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. The past two decades have witnessed profound advances in understanding its molecular underpinnings, heterogeneity, and therapeutic vulnerabilities. The traditional classification of breast cancer into hormone receptor–positive, HER2-positive, and triple-negative subtypes has expanded into a continuum of molecularly defined entities based on genomic, transcriptomic, and proteomic signatures. Recent discoveries have highlighted the significance of DNA damage repair pathways, immune evasion mechanisms, cancer stem cell niches, and tumor microenvironmental influences in driving disease progression and therapeutic resistance. Parallelly, novel therapeutic strategies, including cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, antibody–drug conjugates (ADCs), immune checkpoint inhibitors, PARP inhibitors, and targeted nanomedicine, are transforming clinical outcomes. This review comprehensively explores the molecular mechanisms shaping breast cancer biology, recent advances in therapeutic modalities, and translational applications in clinical practice. Emphasis is placed on bridging preclinical discoveries with patient-centered interventions, evaluating the current limitations of standard therapies, and outlining future perspectives in precision oncology for breast cancer.
A Case Report on Addisons Disease: Clinical Presentation and Management
Background: Addison’s disease, also known as primary adrenal insufficiency, is a rare endocrine disorder characterized by inadequate production of glucocorticoids and mineralocorticoids from the adrenal cortex. It can present with nonspecific symptoms and is often associated with autoimmune or infectious etiologies, such as tuberculosis. Case Presentation: A 45-year-old male was admitted with complaints of nausea, vomiting, generalized weakness, hyperpigmentation of the buccal mucosa, and darkening of skin and nails. Laboratory investigations revealed hyponatremia, hypotension, and low serum cortisol levels. Imaging studies, including chest X-ray and CT scan, showed miliary tuberculosis and bilateral adrenal enlargement. The patient was diagnosed with Addison’s disease secondary to adrenal tuberculosis. Management included intravenous hydrocortisone, correction of electrolyte imbalance, antitubercular therapy, and supportive care. On discharge, oral hydrocortisone and fludrocortisone were prescribed, with counseling on medication adherence and lifestyle modification. Conclusion: Addison’s disease remains a potentially life-threatening but treatable condition. Early recognition of characteristic features such as hyperpigmentation and persistent hyponatremia can facilitate timely diagnosis. Integrated management involving corticosteroid replacement, treatment of underlying causes, and patient education is essential to prevent adrenal crises and improve quality of life.
Targeting Metabolic Pathways for Neurodegeneration: The Emerging Role of Anti-Diabetic and Lipid-Lowering Agents
Neurodegenerative disorders such as Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and Huntington’s disease (HD) represent a significant and growing global health burden. Despite extensive research, effective disease-modifying therapies remain elusive. Recent insights into the shared pathophysiological pathways between metabolic syndromes and neurodegeneration particularly mitochondrial dysfunction, insulin resistance, oxidative stress, and chronic inflammation have opened new therapeutic opportunities. The concept of drug repurposing, wherein existing anti-metabolic drugs like anti-diabetics and lipid-lowering agents are evaluated for neuroprotective efficacy, offers a promising translational route to accelerate therapeutic discovery. Agents such as metformin, pioglitazone, GLP-1 receptor agonists, and statins have demonstrated neurorestorative and anti-inflammatory effects in preclinical and early clinical settings. Moreover, AMP-activated protein kinase (AMPK) activation, peroxisome proliferator-activated receptor gamma (PPARγ) modulation, and enhancement of insulin signaling appear central to their neuroprotective mechanisms. This review consolidates mechanistic evidence, preclinical data, and emerging clinical trials supporting the repositioning of anti-metabolic agents for neurodegenerative disease modification, with a focus on molecular pathways, pharmacodynamic interactions, and translational challenges. It also highlights future perspectives, emphasizing combinatorial and precision medicine strategies integrating metabolomics, neuroimaging, and artificial intelligence to optimize therapeutic repurposing for neurodegenerative diseases.
Green synthesis of Moringa oleifera mediated iron oxide nano particles and its Antibacterial, Antioxidant and photo catalytic activity
The development of nanomaterials via green chemistry has gained momentum due to its minimal environmental impact and sustainability. In this research, iron oxide nanoparticles (FeO-NPs) were synthesized utilizing aqueous extracts of Moringa oleifera leaves. The phytochemicals present in the leaf extract acted as natural reducing and capping agents during synthesis. The formed nanoparticles were thoroughly characterized to determine their structural and morphological attributes. Their antibacterial efficacy, free radical scavenging ability, and photocatalytic performance were investigated. The results confirmed the nanoparticles' potential for applications in environmental remediation and biomedicine, owing to their multifunctional bioactivity.xxxxxxxxxx
The Role of Stability Studies in Ensuring Pharmaceutical Product Quality
Pharmaceutical stability studies are fundamental to maintaining the quality, safety, and therapeutic efficacy of drug products throughout their lifecycle. They provide vital evidence for determining shelf life, appropriate storage conditions, and suitable packaging systems, ensuring that products remain within acceptable quality specifications over time. The evolution of stability testing from empirical, long-term observation to scientifically guided, data-driven methodologies marks a significant advancement in pharmaceutical development. The International Council for Harmonisation (ICH) and World Health Organization (WHO) have played pivotal roles in standardizing global regulatory expectations through guidelines such as ICH Q1A–Q1F. Modern stability science integrates kinetic modeling, degradation pathway elucidation, and quality-by-design (QbD) principles to enhance product robustness and predictability. Recent technological innovations including chromatographic, spectroscopic, and thermal analytical techniques have improved the accuracy and sensitivity of stability assessments. These advanced tools enable early risk identification, optimization of formulation strategies, and sustainable, resource-efficient testing models. Furthermore, stability considerations now extend beyond conventional dosage forms to include biologics, vaccines, nanocarriers, and 3D-printed medicines, underscoring their growing complexity. This review provides an integrative overview of the scientific principles, regulatory harmonization, analytical innovations, and future perspectives driving the transformation of pharmaceutical stability testing into a proactive, predictive, and globally harmonized discipline.
INFLAMMATORY MARKERS OF SEPSIS IN PEDIATRICS CASES
Background: Sepsis is currently one of the important problems in medicine due to its complexity from pathophysiologic, clinical and therapeutic perspectives. The study was aimed to assess the levels of inflammatory markers and evaluate their performance in predicting severity and outcome in pediatric sepsis cases. Methods: The study included 84 cases admitted to pediatric intensive care unit with suspicion of sepsis based on International Pediatric Sepsis Consensus Criteria for sepsis (2005). Blood sample from cases were assessed for serum presepsin, procalcitonin, C-reactive protein in addition to routine investigations in sepsis including blood culture at the time of admission. Results: The study sample comprised 47 cases with sepsis and 37 cases with severe sepsis. The mean values of serum presepsin, procalcitonin and C-reactive protein in severe sepsis were significantly higher in comparison to sepsis cases with p value <0.01. The rise in serum presepsin was six fold in severe sepsis as compared to its rise in sepsis cases. However, increase in C-reactive protein was two folds in severe sepsis cases as compared to sepsis cases. The area under the curve (AUC) of serum presepsin (0.814) was highest followed by C-reactive protein (0.749) and procalcitonin (0.718) in predicting the severity. With serum presepsin value greater than 650 pg. /ml, had 80% positive predictive value and 76% negative predictive value. Serum presepsin showed higher specificity (95 % against 55% and 49%) and positive predictive value (55 % against 17% and 15%) than procalcitonin and C-reactive protein respectively, in predicting mortality. Interpretation and Conclusion: Serum presepsin was found to be better inflammatory marker of sepsis than procalcitonin and C-reactive protein in predicting both severity and mortality in these cases.
THERAPEUTIC ASPECT OF DERIVED POSITION FOR STROKE PATIENTS
Stroke remains a major cause of long-term disability, leading to impairments in motor function, muscle tone, and postural control. Positioning strategies play a vital role in stroke rehabilitation, as incorrect posture may contribute to contractures, spasticity, and pressure sores. Derived positions—specific postural modifications based on biomechanical and neurophysiological principles—are used to optimize muscle activity and facilitate recovery.
LOSARTAN INDUCED ANGIO EDEMA: A RARE CASE REPORT
Angioedema is a rapid, localized swelling of subcutaneous or submucosal tissues, which can be life-threatening when involving the airway. It is most often associated with angiotensin-converting enzyme inhibitors (ACEIs), while angiotensin receptor blocker (ARB)-induced angioedema is rare, with an incidence of approximately 0.1%. Losartan-related cases are uncommon, and onset can be delayed, occurring even after years of therapy. Methods We present the case of a 75-year-old male with a 15-year history of hypertension managed with losartan 50 mg daily and ecosprin 75/10 mg. :he patient was evaluated in the emergency department for acute-onset swelling of the tongue, neck, and face, along with throat itching. Clinical examination and laboratory investigations, including complete blood count and immuno-globulin E levels, were performed. Suspected offending drug was discontinued and replaced with an alternative anti-hypertensive. Supportive treatment was initiated. Results:Vital signs on presentation were stable. Laboratory parameters were within normal limits. Losartan was stopped and replaced with cilnidipine. The patient received intravenous hydrocortisone, chlorpheniramine, and betamethasone, along with supportive therapy. Significant improvement was observed within 24 hours, with complete resolution of symptoms over subsequent days. The patient was discharged in stable condition on oral antihistamines and an alternative antihypertensive regimen, with no recurrence noted during follow-up. Conclusion:Although uncommon, ARB-induced angioedema can occur unpredictably, even after prolonged use. Early recognition, immediate discontinuation of the offending agent, and supportive management are essential to prevent airway compromise. Clinician awareness and patient education regarding potential hypersensitivity reactions to ARBs remain crucial for early intervention and improved outcomes.
A suture granuloma is a localized inflammatory lesion that develops as a tissue reaction to residual suture material following surgery. It represents a foreign-body response and typically appears as a small, painful swelling, firm nodule, or sometimes as a sinus discharging from the surgical site. This case involves a 27-year-old woman who presented with pain, swelling, and purulent discharge over the infra umbilical scar, six months after multiple abdominal operations. Clinical assessment and ultrasonography confirmed the diagnosis of an infected suture granuloma. The condition was successfully managed through surgical removal of the granulomatous tissue and the retained sutures, followed by appropriate antibiotic treatment. Timely diagnosis and intervention are crucial to avoid further infection, complications, or recurrence.
Ovarian fibroma/thecoma represents a group of benign sex cord-stromal tumors of the ovary. These tumors are often asymptomatic but can present with abdominal pain, distension, or a palpable mass. A [age]-year-old female presented with complaints of abdominal discomfort and distension at [hospital name]. Following clinical and radiological evaluation, she was diagnosed with ovarian fibroma/thecoma. The patient underwent surgical management with a favorable postoperative outcome.
RISKS AND OPPORTUNITIES IN DEVELOPMENT OF NEW DRUG
Drug Regulatory Affairs refers to all aspects within the pharmaceutical process on drug discovery and research which also deals with many risks and opportunities of drug development and they have subject to different degrees of regulations of different countries such as India, USA, Europe. The pharmaceutical law frame is used as guidelines on covering Quality, Safety and Efficacy of a drug as well as Health Authorities’ attitudes and requirements are employed for the correct pathway of pharmaceutical needs and have a great influence on the drug development process and had success through it. The role of Regulatory affairs professionals deals with all these aspects to get a desired result of drug development. The health authorities are framed to guide and analyse the drug which fulfils the appropriate quality and efficacy.
SELF AUDIT PROCEDURES FOR REGULATORY COMPLIANCE ISSUES
In the past decade we have seen phenomenal improvements in the New Product and Service Introduction processes (NPSI). Applications of tools and methods, and use of process and quality management approaches have enabled companies to reduce continuously their cycle time, introduce products faster, cheaper, with higher quality, and better satisfy market needs. Among the enabling technologies, audits and assessments have played a critical role in driving these improvements. In major companies, these have become a permanent fixture of the NPSI processes. This paper discusses evolution of audits and assessments, and application of these tools from products to processes. The author presents recent developments in process audits for software and hardware development, some results achieved, and future trends.
SIMILARITIES AND DIFFERENCE BETWEEN US DMF, CANADIAN DMF AND EDMF
Purpose: The submission of a DMF is not required by law or FDA regulation, it is submitted solely at the discretion of the DMF holder. The DMF contains factual and complete information on a drug product's chemistry, manufacture, stability, purity, impurity profile, packaging, and the cGMP status of any human drug product. The present work gives the Detailed idea on how to file Drug Master File in US, EUROPE, CANADA, AUSTRALIA. Approach: A Drug Master File is a submission of information to the FDA to permit the FDA to review this information in support of a third party's submission without revealing the information to the third party. In US, DMF filing was done through NDA for drugs, ANDA for generics and BLA for Biologics. In Europe, DMF filing was done through MAA via centralized procedure for eligible products and for other products via decentralized procedure was used. In CANADA, DMF filing was done through NDS for both drugs and biologic products, where as in AUSTRALIA different application processes and regulatory requirements apply depending on the type of therapeutic goods that is applied. Findings: This gives you clear vision on how to file Drug master file in US, EUROPE, CANADA and AUSTRALIA. This paper also gives you the comparison of DMF fling procedure in the above-mentioned countries so that reader can have clear idea on how to file DMF and different concerns on DMF among the above counties. Conclusion: The DMF contains factual and complete information on a drug product's chemistry, manufacture, stability, purity, impurity profile, Packaging and the cGMP status of any Drug product for humans. The content and the format for Drug Master File is used to obtain marketing Authorization. The main objective of the DMF is to support regulatory requirements of a medicinal product to prove its quality, safety and efficacy. This helps to obtain a marketing authorization grant. Now from 2016 onwards most of the regulated countries will use eCTD or their electronic format for their DMF submission.
To investigate "up-to-date" and "age-appropriate" indicators of preschool vaccination status and their implications for vaccination policy. The authors analyzed medical records data from the Baltimore Immunization Study for 525 2-year-olds born from August 1988 through March 1989 to mothers living in low-income Census tracts of the city of Baltimore.While only 54% of 24-month-old children were up-to-date for the primary series, indicators of up-to-date coverage were consistently higher, by 37 or more percentage points, than corresponding age-appropriate indicators. Almost 80% of children who failed to receive the first dose of DTP or OPV age-appropriately failed to be up-to-date by 24 months of age for the primary series.Age-appropriate immunization indicators more accurately reflect adequacy of protection for pre schoolers than up-to-date indicators at both the individual and population levels. Age-appropriate receipt of the first dose of DTP should be monitored to identify children likely to be under immunized. Age-appropriate indicators should also be incorporated as vaccination coverage estimators in population-based surveys and as quality of care indicators for managed care organizations. These changes would require accurate dates for each vaccination and support the need to develop population-based registries.
ROLE OF POST APPROVAL CLINICAL TRIALS FOR DRUG SAFETY
Following the drug-approval process, concerns remain regarding the safety of new drugs that are introduced into the marketplace. In the case of rare adverse events, the number of subjects that are treated in randomized controlled trials is invariably inadequate to determine the safety of the new pharmaceutical. Identifying safety signals for new and/or existing drugs is a major priority in the protection of public health. Unfortunately, design, analysis, and available data are often quite limited for detecting in a timely fashion any potentially harmful effects of drugs. In this review, we examine a variety of approaches for determining the possibility of adverse drug reactions. Our review includes spontaneous reports, meta-analysis of randomized controlled clinical trials, ecological studies, and analysis of medical claims data. We consider both experimental design and analytic problems as well as potential solutions. Many of these methodologies are then illustrated through application to data on the possible relationship between taking antidepressants and increased risk of suicidality.
The study provides information on the laws governing patents, the revisions made under the Hatch Waxman Act, and the application procedure for US patents. The case 01, involving an ANDA violation brought about by an unlawful venue, involves Valeant Pharmaceuticals and Mylan Laboratories. In the Hatch Waxman instances, the location of the ANDA submission is irrelevant; anybody can submit an ANDA from anywhere in the world. The court took notice of this observation, dismissed Valeant Pharmaceuticals' argument, and authorised Mylan Laboratories to submit an ANDA. Thus, the case gave us the impression that the location of an ANDA filing is irrelevant. The case 02 involving ANDA infringement between Merck Sharp & Dohme Corp. and Amneal Pharmaceuticals. The MFM patent is held by the Merck corporation, and when Amneal wishes to submit an ANDA for MFM, Merck claims that this is an act of infringement. Merck testified in court that three peak analyses were required to determine the amount of MFM present in Amneal's product. One peak analysis is also adequate to diagnose MFM, Amneal testified in court. Then the court instructed both firms to form an expert committee, conduct the study, and submit the report. The court dismissed Merck Sharp & Dohme Corp.'s argument after examining the report and concluding that one peak analysis is adequate and that Amneal's ANDA would not violate any patents.
PRINCIPLES AND GUIDELINES FOR REGULATORY AFFAIRS OF PHARMACEUTICAL PRODUCTS
The regulation of medical products has been expanding since early 20th century. Regulatory agencies are being established in an ever increasing number of countries across the globe. Those that have established are reorganizing their systems and attempting to harmonize with organizations of other countries . The pharmaceutical, biotechnology and medical devices are among the most highly regulated industries in the world. Regulatory affairs (RA) professionals are employed in pharmaceutical industry, government, academic research and clinical institutions. The Indian Pharmaceutical industry is one of the fastest growing industries in India, with a compounded annual growth rate (CAGR) of over 13 % in last 5 years and it is expected to grow at a higher rate in coming 10 years. It is valued at $ 8.0 billion approximately and ranks 4th in terms of volume and 13th in terms of value globally2 . All companies engaged in R&D worth its salt has an individual RA department to aid them in new product development. The clinical research industry, which provides opportunities for RA professionals, is also growing at an unparalleled rate. It has opened up new vistas of employment for a large number of trained professionals. The clinical trials market worldwide is worth over USD 52 billion. A study by Ernst and Young indicates that the total market value of Clinical Research activities performed in India is expected to grow to around USD 1.5-2 billion. There is expected to be a huge demand for qualified RA personnel in clinical research.
A CASE SERIES ON ANASARCA AS A CLINICAL MANIFESTATIONS OF CHRONIC KIDNEY, LIVER AND HEART DISEASES
Anasarca is a condition characterized by severe generalized swelling of the body following accumulated of fluid in the extracellular compartments, It may result from multiple etiology mainly of renal, hepatic, cardiovascular origin and nephrotic syndrome that change the proteins of the body, affect the balance of fluids or create abnormalities in the blood vessels or lymphatic system. This is a case report of anasarca with chronic kidney disease of which 60 year old male patient was admitted in hospital with chief complaints of bilateral lower limb swelling, facial puffiness and abdominal discomfort and distension since 1 month, Patient also had a whole body swelling, breathlessness, orthopnea, cough since 15 days with decreased urine output. So based on patient signs and symptoms. The physician has advised complete blood count, lipid profile test, serum protein, renal function test, liver function test, urine analysis, abdomen pelvic sonography etc, In which CBC, RFT, urine analysis, serum proteins were abnormal. Abdomen pelvic sonography shows left kidney not visualized atrophy, right grade 1 renal parenchymal disease, moderate ascites with bilateral pleural effusion, chronic liver disease and confirmed final diagnosis as anasarca with chronic kidney disease. The treatment was initiated with symptomatic treatment along with first line therapy includes diuretics, iron folic acid, sodium bicarbonates, amlodipine, antiemetic, proton pump inhibitors, vitamin supplements, antibiotics etc. Due to atrophy (failure) of one kidney, patient was advised for dialysis and patient counselling was given. Early identification and treatment of the patient is important and it will lead to better outcomes and hopefully decrease the need for prolonged hospitalization, prevention steps for anasarca by managing the conditions that can cause it and following the physician instructions carefully for changing daily habits and taking medications correctly.
A 45-year-old woman presented with heavy menstrual bleeding, lower abdominal pain, and urinary frequency for six months. Examination and ultrasound revealed a 6 × 5 cm cervical fibroid. Laboratory tests showed mild anemia with normal thyroid and urine findings. The patient was treated with iron, folic acid, NSAIDs, and a GnRH agonist for preoperative stabilization, followed by total abdominal hysterectomy. Histopathology confirmed benign leiomyoma. Cervical fibroids are rare but can cause significant pressure and bleeding symptoms. Early diagnosis and individualized management ensure good outcomes.
Idiopathic Bilateral Carpal Tunnel Syndrome in a Young Female: Early Diagnosis and Successful Surgical Outcome - A Case Report
Background: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression within the restricted carpal tunnel, producing characteristic sensory and motor deficits in the hand. While often linked to repetitive wrist strain, endocrine disorders, or inflammatory conditions, idiopathic CTS in young individuals without systemic comorbidities may be under-recognized. Timely identification of the condition is crucial to avoid irreversible nerve injury and maintain optimal hand function. Case Presentation: A 32-year-old woman presented with chronic right-hand pain, tingling, and nocturnal numbness without any history of trauma, systemic disease, or repetitive occupational activities. Physical examination demonstrated positive Tinel’s and Phalen’s signs. Nerve conduction studies revealed bilateral median nerve compression, more pronounced on the right. The patient underwent right-sided surgical decompression through an open carpal tunnel release. Postoperative recovery was uneventful, with significant improvement in sensory symptoms and hand function. She was discharged with instructions on wrist care, ergonomic modifications and follow-up electrophysiological assessment. Conclusion: Idiopathic CTS can present subtly in otherwise healthy young adults and may easily be overlooked without thorough clinical and electrophysiological evaluation. Early identification, combined with timely surgical decompression when indicated, is crucial for optimal recovery and prevention of irreversible neuropathy. Comprehensive postoperative guidance further enhances long-term functional outcomes.
Drug Repurposing in the Modern Era: Focus on Newly Approved and Investigational Therapeutic Applications
Drug repurposing has emerged as a pivotal strategy in modern therapeutics, offering cost-effective and accelerated pathways to identify new indications for existing drugs. In the post-genomic era, the field has shifted from serendipitous observations to data-driven, mechanism-guided repositioning, leveraging computational intelligence, multi-omics integration, and network pharmacology. Advances in artificial intelligence, machine learning, and CRISPR-based functional genomics have enabled systematic identification of drug–disease interactions, while translational approaches including adaptive clinical trials and biomarker-guided patient stratification ensure rapid validation and clinical applicability. Recent successes, such as the repurposing of remdesivir for COVID-19, ketamine/esketamine for treatment-resistant depression, and colchicine for cardiovascular inflammation, underscore the impact of these strategies. Emerging pipelines targeting oncology, neurodegenerative diseases, and regenerative medicine highlight the potential of repurposing to address unmet medical needs, including rare and orphan diseases. This review synthesizes the current landscape of drug repurposing, emphasizing novel mechanisms, AI-guided discovery, and translational outcomes, and outlines future directions for sustainable, patient-centered innovation in therapeutics.
Gastro Retentive Floating Drug Delivery System
Gastro-retentive drug delivery systems (GRDDS) have emerged as an effective strategy to the therapeutic performance of drugs that exhibit narrow absorption windows, low solubility at intestinal pH, or preferential uptake in the upper gastrointestinal tract. By prolonging residence time, these systems improve drug dissolution, absorption, and overall while reducing dosing frequency and enhancing patient compliance. Floating drug delivery (FDDS), comprising effervescent and non-effervescent mechanisms, represent one of the most widely explored GRDDS approaches due to their ability to maintain buoyancy and sustained or controlled drug release. Various formulation techniques such as solvent evaporation, emulsion solvent diffusion, spray drying, and in-situ gel formation have enabled the development of single-unit and multiple-unit floating systems, hollow microspheres, beads, and raft-forming gels. The performance of these systems is influenced by multiple factors including selection, density, gastric physiology, meal pattern, and buoyancy characteristics. Evaluation parameters such as floating lag time, total floating duration, swelling behavior profiling, in-vivo imaging, mechanical strength, and physicochemical stability are critical in determining formulation efficiency. Despite limitations associated with drug stability in media and variability in gastric conditions, advancements in polymer technology and fabrication techniques continue to expand the applicability of GRDDS. Overall, floating delivery systems offer a promising platform for improving site-specific delivery, sustaining levels, and minimizing dose-related adverse effects, thereby contributing significantly to optimization of oral drug therapy.
Formulation development and evaluation of Mini-Tablets in Enteric Capsule Drug Delivery Technology of Diclofenac sodium
Enteric capsule drug delivery technology (ECDDT) was developed to allow for fast GI tract release without coating and full enteric protection during oral route of administration Enteric capsule drug delivery technology eliminated the need for enteric coatings preparations and application process which means that development time can be shorter and program risk can be lower. Pellets that are easy to make have low porosity and all the same size and shape have smooth surface and don’t change from batch to batch can be turn into mini tablets which another to way to take medicine, the current study aimed to create a mini tablet within the Enteric capsule drug delivery technology considering the advantage of Enteric capsule drug delivery technology and mini tablets the Diclofenac sodium served as a model drug to elucidate the drug release profile and drug kinetics and stability assessment.
FORMULATION DEVELOPMENT AND EVALUATION OF ORAL DISINTEGRATING TABLETS OF RIZATRIPTAN BENZOATE
In this work Rizatriptan benzoate oral disintegrating tablets were formulated utilizing compression approach. a thorough evaluation was conducted for stability dissolution, hardness, and disintegration time characteristics of various ODT formulations, interestingly friability tests came up with results lower than1%. In accordance with USPs 3-minutesdisintegration time requirement for ODTs all tablet formulations dissolved entirely within 1 minute. In addition, the optimized formulation dissolved more than 85%of the Rizatriptan benzoate, labeled content in under 15 minutes. The FTIR examination did not reveal any changes or between the excipients and the active component interaction. The use of superdisintegrants in ODT formulations is therefore a promising approach.
COMPARATIVE In-Vitro ANTIDIABETIC EVALUATION OF ETHANOLIC AND CHLOROFORM ALBIZIA AMARA LEAF EXTRACTS
Background:Diabetes is a major global health concern, impacting more than 540 million persons globally. Type 2 diabetes mellitus is the most common variety, and it is mostly associated with poor eating habits, sedentary lifestyles, and rising obesity rates, particularly in developing nations. The rising prevalence of this metabolic condition raises serious health concerns and highlights the urgent need for safer and more effective antidiabetic medications. In recent years, plants used in traditional medicine have received interest as possible sources of new antidiabetic chemicals. Albizia amara, a plant often used in herbal medicine, has been shown to contain a number of bioactive components that may contribute to its therapeutic effects. Aim:The present research sought to assess and compare the antidiabetic effects of ethanolic and chloroform leaf extracts of Albizia amara. The study also looked at how solvent polarity affected phytochemical extraction and biological activity. Method:The phytochemical content of both extracts was investigated using qualitative tests to identify important bioactive chemicals such as flavonoids, alkaloids, tannins, glycosides, and saponins. The antidiabetic potential of the extracts was then investigated using a typical experimental diabetes model, with voglibose serving as the reference medication. Blood glucose levels were measured to determine the effectiveness of each extract in managing hyperglycemia. Result:Phytochemical screening revealed the presence of many bioactive chemicals in both extracts, indicating potential therapeutic value. The ethanolic extract reduced blood glucose levels more than the chloroform extract, implying that higher-polarity solvents may improve the extraction of active components responsible for antidiabetic actions. Conclusion:The data show that Albiziaamara has strong antidiabetic potential, which supports its traditional use in diabetes management. The greater efficacy of the ethanolic extract emphasizes the significance of solvent choice in phytochemical extraction. Further research into chemical isolation, characterization, and mechanistic investigations is needed to fully understand Albiziaamara'smedicinal potential and involvement in diabetes treatment.
Prescribing Practices and Public Awareness of Oral Antibiotics: A Community Based Study
This cross sectional study examined the public knowledge and awareness about oral antibiotics and prescribing practices of oral antibiotics by the healthcare provider. This study is a community based cross-sectional study where a survey conducted on community populations in Bangalore for a period of six month. Where we used a pre-verified questionnaire form to assess the public knowledge, awareness about oral antibiotics and the prescribing practices of antibiotics by the healthcare providers. This survey has been conducted on a population with 422 participants where 401 general public and 21 healthcare providers included. The majority of participants (376) almost 93.8% of the total participants responded that they have taken oral antibiotics. 76.1% (305) participants from the total study population have been states that they knows about the antibiotics, and 296 participants almost 73.8% of the total study population states that they aware about the usage of antibiotics. The participants those who states that they know about the antibiotics, among them 79 (25.9%) individuals states that the uses of antibiotics should stop once you feel better, even some of the doses are left according to prescription, whereas 160(52.5%) participants disagreed with this statement. Through this study we can conclude that the Knowledge about the oral antibiotics uses among the population is found to be less which is required for the better quality of life. The incidences of self medication of antibiotics are more in rural area whereas in urban area majority of people takes consultations of prescriber before taking oral antibiotics.
Improving Compliance with Patient Identification Protocols: A Quality and Patient Safety Improvement Study
Background: Patient misidentification is one of the most common and preventable causes of medication errors, diagnostic delays, and procedural mistakes. Baseline audits revealed a low compliance rate of 64–70% in using two patient identifiers before interventions and 20 misidentification incidents within three months, indicating a significant threat to patient safety. Objectives: To increase compliance with patient identification protocols to 100% by reinforcing proper identification practices and reducing misidentification incidents to zero within the project period. Methods: A pre–post interventional study was conducted from April to June 2025 in the Nursing Quality and ICU areas. Interventions included re-orientation training, workflow simplification, visual reminders, and weekly audit-feedback cycles. Compliance data were collected monthly using standardized audit tools. Results: Compliance improved steadily from 70% at baseline to 75% in April, 82% in May, and 88% in June. Staff engagement increased, night-shift compliance improved, and audit fatigue reduced after introducing peer-led feedback and visual prompts. Conclusion: Structured training, visual cues, and consistent audit-feedback mechanisms significantly improved adherence to patient identification protocols. Sustained monitoring is essential to achieve the final target of 100% compliance.
Enhancing Pain Management Strategies During Labor: A Quality Improvement Initiative
Background: Pain during labor is one of the most intense forms of physical discomfort experienced by women, yet pain management practices often vary due to inconsistent staff training, limited use of non-pharmacological methods, and delays in documentation. Initial audits identified gaps in pain assessment, documentation, and intervention use, contributing to reduced maternal satisfaction and increased anxiety. Objectives: To improve compliance with pain assessment and timely documentation to ≥90%, ensure 100% staff training on pain relief methods, increase non-pharmacological pain relief usage, and enhance patient satisfaction with labor pain management. Methods: A pre–post interventional study was conducted from May to July 2025 in the Obstetrics & Gynecology Ward at WDGH. Interventions included staff training, standardized pain management protocols, integration of checklists, availability of non-pharmacological tools, and continuous audit-feedback cycles. Data were collected monthly using structured observation tools, documentation audits, and patient satisfaction surveys. Results: Pain score documentation improved from 58% to 91%, non-pharmacological pain relief usage increased from 30% to 76%, and patient satisfaction rose from 55% to 88%. Staff compliance with pain management protocols increased from 50% to 89%. Conclusion: Structured training, standardized protocols, and enhanced monitoring significantly improved clinical practices, patient satisfaction, and overall quality of pain management during labor. Sustaining these improvements requires ongoing training, audits, and leadership engagement.
Standardizing Pain Assessment Documentation in Non-Verbal ICU Patients: A Quality Improvement Study
Background: Pain is recognized as the fifth vital sign and must be assessed routinely, including in non-verbal ICU patients unable to self-report due to intubation, sedation, or neurological conditions. Baseline audits at WDGH revealed inconsistent documentation practices, lack of standard assessment tools, and delayed reassessment following analgesia administration. Such gaps place patients at risk of unrecognized and unmanaged pain, jeopardizing both safety and care quality. Objectives: To standardize the use of validated behavioral pain assessment tools (CPOT/BPS) and achieve ≥95% compliance in pain documentation among non-verbal ICU patients within three months. Methods: A quasi-experimental pre–post intervention study was conducted in the ICU from July–September 2025. Interventions included staff training, introduction of standardized checklists, bedside visual aids, revision of hourly rounding forms, and continuous audits with feedback. Data were collected using structured audit tools, and compliance trends were analyzed descriptively. Results: Pain documentation compliance improved significantly from 70% (June baseline) to 98% (September post-implementation). Nurse competency scores increased from 60% to 100%, and timely reassessment after analgesia improved from 65% to 96%. All indicators exceeded project targets. Conclusion: Standardizing behavioral pain assessments through CPOT/BPS, combined with staff training and ongoing monitoring, resulted in substantial and sustained improvement in documentation compliance. Integration of structured checklists and visual aids supported workflow efficiency and enhanced patient comfort outcomes.
ECO-FRIENDLY WATER PURIFICATION USING TRADITIONAL METHODS
Water purification using locally available natural resources offers an eco-friendly, sustainable, and cost-effective solution to improve drinking water quality. Traditional methods employing seeds and medicinal plants have been widely recognized for their effectiveness in coagulation, antimicrobial action, and removal of impurities. Moringa seeds contain water-soluble proteins that act as natural coagulants, effectively reducing turbidity and suspended particles. Similarly, Strychnos potatorum (Nirmali seeds) possess active compounds that clarify water and enhance sedimentation. Tulasi (Ocimum sanctum), known for its antimicrobial and antioxidant properties, helps in reducing microbial load, while neem (Azadirachta indica) exhibits strong antibacterial and antifungal activity, making water safer for consumption. The combined use of these natural agents not only minimizes chemical dependency but also ensures accessibility in rural and resource-limited areas. Thus, water purification through moringa, Nirmali seeds, Tulasi, and neem represents a promising, eco-friendly approach to address safe drinking water challenges.
PERCEPTION AND UNDERSTANDING OF MERANAW MARRIED WOMEN ON VIOLENCE AGAINST WOMEN: AN EXPLORATORY QUALITATIVE STUDY
Background: Violence against women (VAW) remains a persistent issue shaped by intersecting social, cultural, and religious factors. Among the Meranaw, perceptions of VAW are deeply influenced by Islamic values, patriarchal traditions, and the cultural construct of maratabat (honor), which collectively inform how women recognize and respond to abuse. Methods: An exploratory–descriptive qualitative design was used involving twenty-two (22) Meranaw married women from Marawi City. Data were collected through semi-structured interviews conducted between August and September 2025 and analyzed thematically using Braun and Clarke’s framework. Ethical approval was secured from the Mindanao State University Research Ethics Committee (REC Code: 2025-019). Results: Three major themes emerged: (1) Broad and Contextualized Understandings of VAW) participants perceived violence not only as physical harm but also as emotional, verbal, and economic abuse situated within marital and social expectations; (2) Religion and Culture as Lenses of Meaning) Islamic principles were interpreted through patriarchal norms, often promoting endurance and silence to preserve family honor; and (3) Awareness of Abuse Typologies) while women recognized multiple forms of abuse, many normalized psychological and economic control as part of marital duty. Conclusion: VAW among Meranaw women is rooted in intertwined religious, cultural, and socio-economic structures. Addressing it requires culturally attuned, faith-sensitive interventions that promote women’s empowerment and reinterpret faith in support of equality and justice.
The Precision of Electrocautey: A Medical Marvel: A Kap Study on Undergraduate Students” Among Health Care Students in Khammam City
Electrocautery is a widely used surgical modality valued for its precision, efficacy in tissue dissection, and ability to achieve rapid hemostasis. Despite its routine application across medical and surgical disciplines, undergraduate medical students often have limited exposure to its principles, safety measures, and practical implications. Understanding their knowledge, attitudes, and practices regarding electrocautery is essential for improving early surgical education and promoting safe clinical practice. AIM: To assess the knowledge, attitude, and practice levels of undergraduate medical students toward the use, benefits, and safety considerations of electrocautery in Khammam city OBJECTIVES: To assess the use of Electrocautery in health care students based on age. To assess the perception of under graduate dental student on Electrocautery based on year of study. METHOD: A cross-sectional survey was conducted among 201 dental students, comprising 64 males (31.8%) and 134 females (68.2%), including. The survey included 15 questions exploring the use of Electrocautery among health care students were analyzed based on gender, age and year of study using chi-square tests to identify statistically significant differences.
Knowledge and Attitude Regarding Breast Cancer Among Female Attendants of Patients with Cancer in a Cancer Hospital, Guwahati, Assam
Breast cancer is a major health concern for women globally, with high rates of late-stage diagnoses contributing to increased mortality. A descriptive research design was employed, involving 74 female attendants selected through purposive sampling technique. Data collection tool included sociodemographic proforma, self-structured questionnaire for knowledge, and 5-Point Modified Likert scale for attitude. Majority of the participants were: aged 20-30 years (36.5%), with educational qualification up to higher secondary and graduate and above (29.7%), homemaker (52.7%), married (66.2%), had Rs≤10,000/- family income per month (35.1%), from rural area (59.5%), and did not have family history of breast cancer (74.3 %). Most had heard about breast cancer (74.3%), mainly from social media (29.1%). Knowledge assessment revealed that 50%, 35.1% and 14.9% had moderate, inadequate and adequate knowledge respectively with a mean score of 7.14(SD=3.25). Regarding attitude, 56.8% had neutral, while 43.2% had favourable attitude. Significant associations were noted between occupational status and knowledge, as well as between occupational status, family income, and those who heard about breast cancer with attitude. There is a need for educational campaigns to enhance women's knowledge and attitude towards breast cancer.