Prevalence and pattern of usage of complementary and alternative medicine among south Indian asthma patients in a tertiary care hospital

Chalcones reloaded: an integration of network pharmacology and molecular docking for type 2 diabetes therapy

Chalcones have various biological effects, from immune boosting to anti-cancer and anti-diabetic. Structurally modified chalcones (SMC) are clinically relevant for diabetes and cardiometabolic complications. From the original research articles, a structurally proven and biologically outstanding 14 structurally modified chalcones were screened and inducted in this study. This study evaluated the effects of SMC towards diabetes via network pharmacology analysis. The network data shows compounds S2, S3, S5, S9 &S12 suit the diabetes target. Especially Compounds S5 and S9 have a higher binding affinity towards the targets of TNF, PI3K, MAPK1 and AKT1 active sites. Compound S9 [(E)-3-(4-(1H-imidazol-1-yl)phenyl)-1-(4-(2,4-difluorobenz-yloxy)phenyl)prop-2-en-1-one] have identified with stronger binding affinities towards the active sites of MAPK3 (PDB:4QTB) -10.5(Kcal/mol). To provide a more effective mechanism for demonstrating protein-ligand interaction, one of the molecular docking complex (ERK2 kinase-S5) was subjected to a molecular dynamic at 300K for 100 ns. In term of structural stability, structure compactness, residual flexibility and hydrogen bond interaction of the complex was evaluated Integrating network pharmacology, in silico virtual screening, and molecular docking analysis shows that structurally modified compounds are effective and may help identify lead compounds towards glycemic control.Communicated by Ramaswamy H. Sarma.

Isolation of 6-gingerol and semi-synthesis of 1,4-benzodiazepines derivatives: An in-situ pharmacokinetics properties, molecular docking and molecular dynamics simulation assessments

This paper outlines a methodical approach for isolating 6-gingerol (1a) from Zingiber officinale Roscoe rhizomes on a gram-scale, resulting in a product of high purity and significant yield. Further, 6-gingerol (1a) [SSG1] derivatives, including 1-(4-hydroxy-3-methoxyphenyl)decane-3,5-dione (1ab), were synthesized via a semi-synthetic pathway involving DMP-mediated fast oxidation and replication. Subsequently, a new series of 1,4-benzodiazepines (3a-c) was synthesized quantitatively using a basic technique. This synthesis necessitated the interaction of 1ab with various o-phenylenediamine (2a-c) compounds. Spectroscopic methods were employed to characterize the synthesized 1,4-benzodiazepines (3a-c)[SSG2, SSG3 & SSG4]. Despite extensive investments by pharmaceutical companies in traditional drug research and development for diseases like type 2 diabetes (T2D), successful treatments remain elusive. Medication repurposing has gained traction as a strategy to address not only diabetes but also other disorders. Leveraging existing molecular pharmacology data accelerates the development of new medications. This paper underscores the importance of repurposing traditional medicines to combat a range of communicable and non-communicable diseases, offering a promising avenue for therapeutic advancement. Additionally, molecular docking studies suggested that one derivative (SSG2) exhibited stronger binding affinity compared to the reference standards. Overall, the findings of this study highlight the potential of semi-synthetic gingerol derivatives for the development of novel therapeutic agents.

Insight on sarcopenic obesity and epicatechin as a promising treatment option

BACKGROUND AND AIM

Sarcopenic Obesity (SO) in the elderly population is a complex and multifactorial condition which refers to the loss of skeletal muscle mass, strength, and function associated with aging, while obesity involves excessive adipose tissue accumulation. The simultaneous occurrence of these two conditions presents a unique set of challenges to public health and clinical management. This narrative review aims to provide an overview of the use of epicatechin (EC) in the treatment of SO and its related complications.

METHOD

A survey of studies related to preclinical and clinical evidence of Epicatechin in sarcopenic obesity and its complications was performed in the following database Medline, Scopus, ProQuest, Embase, Web of Science, and Google scholar. Followed by structural activity relationship and pharmacokinetic profile of Epicatechin was discussed in this paper.

RESULTS

The main pharmacological effect of Epicatechin is myostatin inhibition activity which has been described by both in vitro and in vivo studies earlier. The SO is directly correlated with the alteration of Myostatin. The pre-clinical and clinical studies suggest that epicatechin can be a potential candidate in the management of SO and its related complication.

CONCLUSION

The present review describes the pharmacokinetic profile and structural activity of epicatechin respective to SO and its related complications. The goal of this review is to update the scientific community on the therapeutic potential of epicatechin in SO and age-related factors. Conduction of clinical and pre-clinical trials, also drug dosage optimization may provide with insights on the use of epicatechin in SO.

Therapeutic use of Guggulsterone in COVID-19 induced obesity (COVIBESITY) and significant role in immunomodulatory effect

COVID-19 has emerged as a major cause of health crisis around the world. Psychosocial, Behavioral and metabolic changes especially weight gain, among variety of population was produced in this pandemic, through variety of mechanisms. Hyperlipidemia is one of the major issues that result in serious cardiovascular complications. Governmental strategies to minimize the spread of COVID-19 through closures, lockdowns, and alterations in social interaction have complicated weight management efforts. And immunity being the need of the hour has to be improved to prevent the infection. Guggulsterone (GS) isomers are major bioactive compounds present in Commiphora mukul and Commiphora wighti. Guggulsterone shows anti-hyperlipidemic, anti-oxidant, anti-inflammatory, immunomodulatory and appetite regulating activity due to its peculiar characteristics. On the basis of clinical evidence, Guggulsterone seems to possess good cholesterol lowering, appetite regulating as well as immunomodulatory activity which can be beneficial during the pandemic of COVID-19.

Patterns and predictors of complementary and alternative medicine use in people presenting with the non-communicable disease in an urban health facility, North India

Background: The rising burden of non-communicable diseases (NCDs) is a threat to India. Increasingly, individuals interested in improving their health and making healthy lifestyle changes are turning to complementary and alternative medicine (CAM) as a health-care option.

Design and Methods: The objective of this study was to determine the prevalence, pattern, and predictor of alternative medicine use among NCDs patients undergoing allopathic treatment in an urban health centre. The study design was a hospital-based crosssectional study, which was done in a government hospital, Srinagar, Pauri District, Uttarakhand, India among adult males and females aged above 20 years. The patients having NCDs were systematically sampled.

Result: Among 233 studied patients 57.1% were males. The mean age of the patients was 55.8 years (SD 13.5). Of the total studied patients 46.8% were diagnosed with DM, and 43.8% of HTN. Nearly one-fifth of the patients were known to have a CVD or COPD. A total of 49.8% of the studied NCD patients reported use of both allopathic and alternative medicine treatment and nearly 3.4% of the studied NCD patients in the last one year to seek exclusive alternative medicine treatment. The overall use of exclusive alternative medicine was low that is 3.7%, 1.0%, and 5% in diabetes, hypertension, and chronic lung disease patients, respectively. The most common form of alternative medicine used by studied patients was medicinal herbs/biological-based medicine (MB) (62.9%). Among MB commonly used were a bitter gourd, aloe vera, and others. 29.8% of the patients used Indian/Ayurveda medicine in total.

Conclusions: The use of exclusive alternative medicine is low in adult patients with NCD. However, medical pluralism is prevalent. A better understanding of practices especially that focuses on alternative medicine needs a qualitative study, which was beyond the scope of this study.

Assessment of Herb-drug Interactions Based on the Pharmacokinetic Changes of Probe Drug, Midazolam

BACKGROUND

In healthy volunteers, the probe drug method is widely practised to assess the pharmacokinetic mediated herb-drug interactions (HDI). We analyzed the clinical evidence of CYP3 A4 probe drug, Midazolam.

METHODS

Literatures, where Midazolam was used as a probe drug for prediction of herb-drug interaction, were surveyed through an online database such as google scholar, Scopus, Cochrane, PubMed and clinicaltrials.gov.

RESULTS

Midazolam was considered a sensitive probe for CYP3A4 substrates due to its bioavailability. We observed that not all the herbs are causing drug interaction. However, significant changes of the Midazolam pharmacokinetics were found after high-dose and long-term intake of some herbs and food supplements, suggesting the induction and/or inhibition of CYP activities.

CONCLUSION

Probe drug technique is one of the easiest ways for predicting CYP enzyme-mediated herb-drug interactions. Midazolam shows a good response in clinical studies because of short halflife and low harmfulness compared with other probe drugs.

A Short Exploration of Selected Sensitive CYP3A4 Substrates (Probe Drug)

BACKGROUND

CYP450 enzymes in the liver have a significant role in the metabolism of xenobiotics. Probe drug strategy is broadly used to evaluate the pharmacodynamic and pharmacokinetic drug/ herb-drug interactions/ food-drug interactions. Probe drugs reveal the exact pathway of drug metabolism in the liver by their targeted tractability property. The CYP3A4 isoenzyme metabolizes the majority of the drugs (65%).

METHODS

The characteristics of targeted probe drugs were observed from the admetSAR (version2) online database.

RESULTS

Midazolam is widely used as a probe drug because of its peculiar character. Midazolam affirms the accurate and consistent prediction of pharmacokinetic mediated drug interactions even in nanogram concentrations with or without a potent CYP3A inhibitor. Remarkably, midazolam is used as a CYP3A4 substrate in the majority of in vivo studies.

CONCLUSION

It is concluded that midazolam shows a good response in all clinical studies because of its lesser half-life and bioavailability when compared with other probe drugs.