Network pharmacology and molecular docking: combined computational approaches to explore the antihypertensive potential of Fabaceae species

Hypertension is a major global public health issue, affecting quarter of adults worldwide. Numerous synthetic drugs are available for treating hypertension; however, they often come with a higher risk of side effects and long-term therapy. Modern formulations with active phytoconstituents are gaining popularity, addressing some of these issues. This study aims to discover novel antihypertensive compounds in Cassia fistula, Senna alexandrina, and Cassia occidentalis from family Fabaceae and understand their interaction mechanism with hypertension targeted genes, using network pharmacology and molecular docking. Total 414 compounds were identified; initial screening was conducted based on their pharmacokinetic and ADMET properties, with a particular emphasis on adherence to Lipinski's rules. 6 compounds, namely Germichrysone, Benzeneacetic acid, Flavan-3-ol, 5,7,3',4'-Tetrahydroxy-6, 8-dimethoxyflavon, Dihydrokaempferol, and Epiafzelechin, were identified as effective agents. Most of the compounds found non-toxic against various indicators with greater bioactivity score. 161 common targets were obtained against these compounds and hypertension followed by compound-target network construction and protein-protein interaction, which showed their role in diverse biological system. Top hub genes identified were TLR4, MMP9, MAPK14, AKT1, VEGFA and HSP90AA1 with their respective associates. Higher binding affinities was found with three compounds Dihydrokaempferol, Flavan-3-ol and Germichrysone, -7.1, -9.0 and -8.0 kcal/mol, respectively. The MD simulation results validate the structural flexibility of two complexes Flavan-MMP9 and Germich-TLR4 based on no. of hydrogen bonds, root mean square deviations and interaction energies. This study concluded that C. fistula (Dihydrokaempferol, Flavan-3-ol) and C. occidentalis (Germichrysone) have potential therapeutic active constituents to treat hypertension and in future novel drug formulation.

Application of green synthesized magnesium oxide nanoparticles to prolong commercial availability of Vitis vinifera L

The objective of the study was to extend shelf life of Vitis vinifera (L.) by the application of green synthesized Magnesium oxide nanoparticles. Aqueous leaf extract of Azadirachta indica A. juss. and various concentrations of 20 mM, 30 mM, and 40 mM solutions of Magnesium nitrate hexa hydrate salt, were used to synthesize nanoparticles of different size. The characterization of nanoparticles was done by SEM, XRD, and UV. The antimicrobial activity of MgO NPs was evaluated for Azospirilum brasilense and Trichoderma viride, representative of microbes responsible for V. vinifera fruits spoilage. Nanoparticles with crystal size of 28.60 nm has more pronounced effect against microbes. The Shelf life of the Vitis vinifera L. was evaluated by application of 28.60 nm MgO NPs through T1 (nanoparticles coated on packaging), T2 (nanoparticles coated directly on fruit) at 4 °C and 25 °C. T1 at 4 °C was effective to extend the shelf life of Vitis vinifera (L) for an average of 20 days.

Addressing quality medication use among migrant patients: Establishment of an organization to provide culturally competent medication care

As the global landscape continues to witness an increase in migration, the healthcare community faces an evolving challenge: the provision of quality medication care to migrant patients. Language barriers, cultural differences, and a lack of understanding of the local healthcare system can often impede the effective management of medications and access to healthcare services among migrant populations. Pharmacists, as medication experts, are dignified to make a substantial impact in bridging the gap between migrants and quality healthcare. Their expertise in medication management, accessibility, and counseling positions them as critical healthcare providers for this patient population. Pharmacies and pharmacists can serve as trusted hubs where migrants receive not only essential medications but also culturally sensitive support in navigating the healthcare system. This commentary article highlights the critical importance of culturally competent medication care for migrant patients and the central role that pharmacists can play in this endeavor. By establishing organization dedicated to this cause lead by pharmacists, we can not only address an urgent healthcare concern but also set a precedent for a healthcare system that values inclusivity, cultural competence, and equitable access to quality medication care for all, regardless of their cultural background.

Uroprotective Potential of Campesterol in Cyclophosphamide Induced Interstitial Cystitis; Molecular Docking Studies

Cyclophosphamide (CYP) is commonly used to treat cancer of the ovaries, breast, lymph, and blood system and produces interstitial cystitis (IC) via its urotoxic metabolite: i. e., acrolein. The present study was aimed to investigate the uroprotective effect of campesterol (a steroidal phytochemical) in cyclophosphamide induced IC. IC was induced by CYP (150 mg/kg, i. p.) in rats. The Enzyme linked immunosorbent assays for oxidative stress markers and Polymerase Chain Reaction (PCR) for inflammatory cytokines were carried out. The Tissue Organ Bath Technique was used for the evaluation of the spasmolytic effect of campesterol. Different pharmacological antagonists have been used to explore the mechanism of action of campesterol. Treatment with campesterol (70 mg/kg) reduced nociception (55 %), edema (67 %), hemorrhage (67 %), and protein leakage significantly (94 %). The antioxidant activity of campesterol was exhibited by a fall in MDA, NO, and an elevation in SOD, CAT, and GPX levels. Campesterol presented anti-inflammatory potential by decreasing IL-1, TNF-α, and TGF-β expression levels. Histologically, it preserved urothelium from the deleterious effect of CYP. Campesterol showed a spasmolytic effect by reducing bladder overactivity that was dependent on muscarinic receptors, voltage-gated calcium and KATP channels, and cyclo-oxygenase pathways. In silico studies confirmed the biochemical findings. The findings suggest that campesterol could be valorized as a possible therapeutic agent against cyclophosphamide-induced interstitial cystitis.

Cuminum cyminum Ameliorates Urotoxic Effects of Cyclophosphamide by Modulating Antioxidant, Inflammatory Cytokines, and Urinary Bladder Overactivity: In vivo and in Silico Investigations

Interstitial Cystitis (IC) is a chronic inflammatory disease that lacks effective treatment. The present study aimed to investigate the potential of aqueous ethanol extract of Cuminum cyminum (AEECC) on oxidative stress, inflammation and overactivity of urinary bladder induced by cyclophosphamide (CYP). Female Sprague-Dawley rats received intraperitoneal administration of cyclophosphamide (150 mg/kg, i. p. 1st , 4th , and 7th days). To investigate the urothelial damage, the bladder weight, nociception behavior, and Evans blue dye extravasation method was used. The antioxidants CAT, GPX and NO were measured. ELISA determined the IL-6 and TNF-α levels. The spasmolytic effect of AEECC was investigated on isolated bladder strips and its mechanisms were determined. The enhanced nociception behavior, bladder weight, vascular permeability, edema, hemorrhage, nitric oxide, IL-6 and TNF-α levels by CYP administration were significantly reduced by AEECC (250 and 500 mg/kg). A significant increase in serum antioxidant system such as CAT and GPx was also observed in AEECC-treated rats. The AEECC (3 mg/ml) significantly reduced urinary bladder tone in the strips pre-contracted with carbachol in both control and CYP-treated rats. This relaxation was demolished by atropine, nifedipine, glibenclamide, and indomethacin but not with propranolol. The plant extract showed the presence of antioxidant and anti-inflammatory phytochemicals. These results suggest that Cuminum cyminum offers uroprotective activity and can ameliorate CYP-induced bladder toxicity by modulating antioxidant parameters, pro-inflammatory cytokine levels and bladder smooth muscle overactivity. The in silico binding interactions of antioxidant 2I3Y and anti-inflammatory protein 1TNF with various ligands from Cuminum cyminum seeds revealed potential bioactive compounds with promising antioxidant and anti-inflammatory properties, providing valuable insights for drug development and nutraceutical research.

Diuretic Potential of Fenchyl Acetate with Its Mechanism of Action: Toxicity Study

Hypertension has become a global threat and is one of the greatest risk factors for chronic kidney disease. Fenchyl acetate is a monoterpene that has been assessed for its various pharmacological activities in the past, but no study has evaluated its diuretic potential and the mechanism involved in the diuretic activity after prolonged administration in rats. Therefore, this study aimed to measure the safety and diuretic profile of fenchyl acetate in rats. For evaluating the acute toxicity, a single dose of 2000 mg/kg was administered as per the OECD guideline no. 425, and the rats were observed for 14 days. After 14 days, blood samples were assessed for biochemical, hematological, and oxidative stress parameters. For the acute diuretic study, fenchyl acetate was given in doses of 100, 200, and 400 mg/kg, and urine samples after 8 h were assessed for sodium, potassium, creatinine, uric acid excretion, and urinary output. A single dose of fenchyl acetate (F.A) was selected for prolonged diuretic activity, and furosemide was taken as the standard drug in a repeated dose administration for 7 days. Rats' urine was assessed for pH, sodium, potassium, creatinine, and uric acid excretion along with urinary volume excretion. Furthermore, blood was withdrawn by cardiac puncture, and selected organs like the heart, liver, kidney, and spleen were analyzed for oxidative stress biomarkers. Using pharmacological antagonists or inhibitors, the involvement of L-NAME, acetylcholine, or prostaglandin in F.A.-induced diuresis was determined. Mitochondrial respiratory chain enzyme complexes were also assessed in the kidney homogenates. The acute toxicity results showed F.A to be safe as its LD50 was greater than 2000 mg/kg and there were no signs of mortality or toxicity. The acute diuretic study showed that F.A resulted in a significant and dose-dependent increase in sodium, potassium, creatinine, and uric acid excretion along with urinary output, and these results were comparable to the standard drug furosemide. Prolonged administration with F.A (400 mg/kg) resulted in a comparable excretion of sodium, potassium, creatinine, uric acid, and urine output with furosemide (15 mg/kg). The oxidative stress parameters revealed that F.A (400 mg/kg) resulted in reducing the formation of free radicals. The results from the mechanism-based studies showed the involvement of NO in inducing diuresis. Furthermore, F.A (400 mg/kg) significantly increased the mitochondrial complexes I, II, III, IV, I + III, and II + III in the kidney homogenates, thus restoring the mitochondrial enzymes and improving the renal function. The current study suggests that F.A is safe with a significant diuretic potential with the involvement of NO in its mechanism of action.

Mechanistic Evaluation of Antiarthritic Effects of Citronellol in CFA-Induced Arthritic Rats

Rheumatoid arthritis (RA) is an autoimmune disease characterized by systemic inflammation, joint tissue damage, pain, and synovitis. It leads to deformity of joints, disability, and even premature death. Markers of inflammation are highly expressed in synovium fluid and serum of arthritic patients and play an important role in the pathophysiology of RA. These transcription factors promote the fabrication of type I interferons and inflammatory cytokines. In RA, degradation of synovial cartilage and bone results from stimulation of proinflammatory cytokines. Citronellol (Ct), a monoterpene alcohol, is found in citrus fruits and essential oils of many aromatic plants. It possesses numerous pharmacological properties such as antioxidant activity and potential antinociceptive and anti-inflammatory effects. Keeping in view the significant anti-inflammatory role of Ct, a trial of 28 days was conducted. Ct was administered orally at three different doses (25, 50, and 100) mg/kg in Freund's adjuvant-induced arthritic rats, and the results were compared with piroxicam, chosen as the standard drug. The antiarthritic activity of the compound was evaluated through measurements of arthritic scoring and plethysmometry before and after treatment. The blood biochemical and hematological parameters and histopathological analyses were performed. Additionally, qPCR was conducted to analyze the mRNA expression levels of TNF-α, IL-1β, NF-κB, MMP3, IL-6, and IL-4 in the blood. ELISA was performed to evaluate the levels of PGE2. The results demonstrated that Ct showed significant results at all doses, but the highest dose proved to be most significant in terms of decreasing arthritic scoring and paw edema, indicating the antiarthritic potential of Ct. Furthermore, the compound was found to downregulate all the proinflammatory cytokines (TNF-α, IL-1β, NF-κB, MMP3, and IL-6) and upregulate the anti-inflammatory cytokine (IL-4). The levels of PGE2 were also reduced which further supported the antiarthritic effects of Ct and validated it as a potential antiarthritic candidate.

University Pre-Professional Program: A Transitional Phase from Didactic to PBL Pedagogy

Purpose

The College of Science and Health Professions offers the University Pre-Professional Program (UPPP) to newly enrolled students. This study aimed to evaluate the effectiveness of the program in preparing students to become self-directed learners and to seek students' perceptions about student-centered teaching.

Methods

A quantitative quasi-experimental study that used a pre and post-test survey in two stages, before and after semester-4. A self-developed questionnaire was distributed online.

Results

The t-test showed students (n=701) after semester-4 had a significant increase in the understanding of Problem-Based Learning (PBL) (t (699) = -8.27, p < 0.01), PBL dynamics (t (699) = -5.12, p < 0.01), learning and dynamics of Case-Based Learning (CBL) and Self-Directed Learning (SDL) (t (699) = -6.48, p < 0.01), and facilitators' role in such curriculum (t (699) = -3.41, p < 0.01). The ANOVA showed students attending various courses perceived the program variables differently (Learning in PBL p = 0.08, PBL dynamics p < 0.01, CBL and SDL dynamics p < 0.01, role of facilitator in PBL p < 0.01). Regarding the resources used by students during the basic medical sciences courses, no significant difference was observed between the study groups (p = 0.06). However, the only significant difference observed was in their satisfaction with the question related to assessment and course (p < 0.01).

Conclusion

The UPPP improved students' understanding of student-centered teaching and learning approaches, especially the PBL. Thus, UPPP helps students shift their learning habits from didactic to student-centered modern learning approaches. Variation among different students' groups could be attributed to their previous academic background and change in learning medium to English. This study suggests that preparatory teaching programs like UPPP are helpful for students interested in joining the bachelor's programs in countries like Saudi Arabia where English is not a native language.

Geraniol Suppresses Oxidative Stress, Inflammation, and Interstitial Collagenase to Protect against Inflammatory Arthritis

Geraniol (GER) is a plant-derived acyclic isoprenoid monoterpene that has displayed anti-inflammatory effects in numerous in vivo and in vitro models. This study was therefore designed to evaluate the antiarthritic potential of GER in complete Freund's adjuvant (CFA)-induced inflammatory arthritis (IA) model in rats. IA was induced by intraplantar injection of CFA (0.1 mL), and a week after CFA administration, rats were treated with various doses of methotrexate (MTX; 1 mg/kg) or GER (25, 50, and 100 mg/kg). Treatments were given on every alternate day, and animals were sacrificed on the 35th day. Paw volume, histopathological, hematological, radiographic, and qPCR analyses were performed to analyze the severity of the disease. GER significantly reduced paw edema after 35 days of treatment, and these results were comparable to the MTX-treated group. GER-treated animals displayed a perfect joint structure with minimal inflammation and no signs of cartilage or bone damage. Moreover, GER restored red blood cell and hemoglobin levels, normalized erythrocyte sedimentation rate, platelet, and c-reactive protein values, and also attenuated the levels of rheumatoid factor. RT-qPCR analysis demonstrated that GER decreased mRNA expression of pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta. GER also down-regulated the transcript levels of cyclooxygenase-2 (COX-2), microsomal prostaglandin E synthase-1, prostaglandin D2 synthase, and interstitial collagenase (MMP-1). Molecular docking of GER with COX-2, TNF-α, and MMP-1 also revealed that the antiarthritic effects of GER could be due to its direct interactions with these mediators. Based on our findings, it is conceivable that the antiarthritic effects of GER could be attributed to downregulation of pro-inflammatory mediators and protease like MMP-1.

Lauric acid provides neuroprotection against oxidative stress in mouse model of hyperglycaemic stroke

During ischemic stroke, higher glucose level linked worse outcomes were reported even in patients without pre-existing diabetes. Evidence suggest that such worse stroke outcomes were mainly due to production of reactive, toxic glucose metabolites that expands oxidative damage inside the brain. As a consequence of high oxidative stress, microvasculature structures and tight junctions compromised their functionally, infarct volume expands and brain edema exacerbates. In a mouse model of ischemic stroke with induced acute hyperglycaemia, Lauric acid (LA) as a natural saturated fatty acid demonstrated neuroprotection by attenuating infarct volume and brain edema. In addition, in the ipsilateral hyperglycaemic brain, the LA significantly increased the expression of tight junction representative protein (occludin) as well as anti-oxidative markers; Manganese superoxide dismutase (Mn) SOD, Extracellular superoxide dismutase (Ec-SOD) and nuclear factor-erythroid factor 2-related factor 2 (Nrf2) in the ipsilateral region against hyperglycemic ischemic stroke. LA treated animals showed a significant reduction in the production of lipid peroxidation products (4-HNE) in the microvascular structures, maintained the blood brain barrier (BBB) integrity. LA linked neuroprotective outcomes were further confirmed by behavioral tests, where functional outcomes and motor coordination were improved significantly. Furthermore, LA treatment enhanced food intake, decreased mortality rate, and net body weight loss. Conclusively, LA modulated ischemic insult exacerbated by hyperglycemia and provided neuroprotection.

Caftaric Acid Ameliorates Oxidative Stress, Inflammation, and Bladder Overactivity in Rats Having Interstitial Cystitis: An In Silico Study

Interstitial cystitis (IC) is the principal unwanted effect associated with the use of cyclophosphamide (CYP). It results in increased oxidative stress, overexpression of proinflammatory cytokines, and bladder overactivity. Patients receiving CYP treatment had severely depreciated quality of life, as the treatment available is not safe and effective. The goal of this study was to assess the protective effect of caftaric acid in CYP-induced IC. IC was induced in female Sprague Dawley by injecting CYP (150 mg/kg, i.p.). In the present study, oral administration of caftaric acid (20, 40, and 60 mg/kg) significantly decreased inflammation. Caftaric acid significantly increased SOD (93%), CAT (92%), and GSH (90%) while decreased iNOS (97%), IL-6 (90%), TGF 1-β (83%), and TNF-α (96%) compared to the diseased. DPPH assay showed the antioxidant capacity comparable to ascorbic acid. Molecular docking of caftaric acid with selected protein targets further confirmed its antioxidant and anti-inflammatory activities. The cyclophosphamide-induced bladder overactivity had been decreased possibly through the inhibition of M3 receptors, ATP-sensitive potassium channels, calcium channels, and COX enzyme by caftaric acid. Therefore, our findings demonstrate that caftaric acid has a considerable protective role against CYP-induced IC by decreasing the oxidative stress, inflammation, and bladder smooth muscle hyperexcitability. Thus, caftaric acid signifies a likely adjuvant agent in CYP-based chemotherapy treatments.

Flexible Topical Hydrogel Patch Loaded with Antimicrobial Drug for Accelerated Wound Healing

A hydrogel topical patch of neomycin was developed by using sodium alginate (SA) and hydroxyethylcellulose (HEC) as polymers. Free radical polymerization in an aqueous medium was initiated by using acrylic acid (AA) and N,N'-methylenebisacrylamide (MBA). Prepared hydrogels were characterized for pH sensitivity and sol-gel analysis. In addition, the effect of reactant contents on the developed formulation was evaluated by swelling behavior. SEM assay showed the rough structure of the hydrogel-based polymeric matrix, which directly enhances the ability to uptake fluid. FTIR spectra revealed the formation of a new polymeric network between reactant contents. TGA and DSC verified that fabricated polymeric patches were more thermodynamically stable than pure components. Gel fractions increased with increases in polymer, monomer, and cross-linker contents. The swelling study showed the pH-dependent swelling behavior of patches at pH 5.5, 6.5, and 7.4. The release pattern of the drug followed zero-order kinetics, with diffusion-controlled drug release patterns according to the Korsmeyer-Peppas (KP) model. Ex vivo studies across excised rabbit skin verified the drug retention in the skin layers. The hydrogel patch effectively healed the wounds produced on the rabbit skin, whereas the formulation showed no sign of irritation on intact skin. Therefore, neomycin hydrogel patches can be a potential candidate for controlled delivery for efficient wound healing.

Spasmolytic and Uroprotective Effects of Apigenin by Downregulation of TGF-β and iNOS Pathways and Upregulation of Antioxidant Mechanisms: In Vitro and In Silico Analysis

Apigenin is a phytochemical obtained from Chamomilla recutita. Its role in interstitial cystitis is not yet known. The present study is aimed at understanding the uroprotective and spasmolytic effects of apigenin in cyclophosphamide-induced interstitial cystitis. The uroprotective role of apigenin was analyzed by qRT-PCR, macroscopic analysis, Evans blue dye leakage, histological evaluation, and molecular docking. The spasmolytic response was measured by adding cumulative concentrations of apigenin to isolated bladder tissue pre-contracted with KCl (80 mM) and carbachol (10^-9-10^-4) on non-incubated and pre-incubated tissues with atropine, 4DAMP, methoctramine, glibenclamide, barium chloride, nifedipine, indomethacin, and propranolol. Apigenin inhibited pro-inflammatory cytokines (IL-6, TNF-α and TGF 1-β) and oxidant enzymes (iNOS) while increasing antioxidant enzymes (SOD, CAT, and GSH) in CYP-treated groups compared to the control. Apigenin restored normal tissue of the bladder by decreasing pain, edema, and hemorrhage. Molecular docking further confirmed the antioxidant and anti-inflammatory properties of apigenin. Apigenin produced relaxation against carbachol-mediated contractions, probably via blockade of M₃ receptors, K_ATP channels, L-type calcium channels, and prostaglandin inhibition. While the blockade of M₂ receptors, K_IR channels, and β-adrenergic receptors did not contribute to an apigenin-induced spasmolytic effect, apigenin presented as a possible spasmolytic and uroprotective agent with anti-inflammatory, antioxidant effects by attenuating TGF-β/iNOS-related tissue damage and bladder muscle overactivity. Thus, it is a potential agent likely to be used in treatment of interstitial cystitis.

Tumor necrosis factor-alpha, prostaglandin-E2 and interleukin-1β targeted anti-arthritic potential of fluvoxamine: drug repurposing

Fluvoxamine, a selective serotonin re uptake inhibitor, is used to treat depression. The aim of present study was to evaluate fluvoxamine in acute (egg albumin-induced inflammation) and chronic inflammatory rat models (formaldehyde and complete Freund's adjuvant (CFA)-induced arthritis). Fluvoxamine showed highly significant (p<0.001) protective effect at dose of 50 mg/kg orally with percentage suppression 21.3% as compared to disease control group in acute model. Likewise, formaldehyde-induced arthritic experiment confirmed the significant (p<0.001) anti-arthritic behavior, showed by fluvoxamine (50 mg/kg orally) throughout the study. Moreover, In CFA-induced model, the higher dose (fluvoxamine 50 mg/kg) exhibited highly significant (p<0.001) decrease in paw thickness and arthritic score with significant increase in weight of animals from 123.8± 1.934 g to 130.2± 1.655 g, significantly decreased the level of RF and CRP to level of 12.0±0.707 and 11.40±0.50 respectively and restoration of SOD, CAT (69.8±1.5, 72.0±1.4 respectively). Furthermore, the level of TNF-α, PGE2, and IL-1β (147.0±2.0, 406.8±2.5, and 93.8±1.3 respectively) in arthritic animals was reduced to significant (p<0.001) level (53.8±1.3, 205±3.6, and 42.0±1.4 respectively) after treatment with fluvoxamine. Furthermore, molecular docking of fluvoxamine against TNF-α, PGE2, and IL-1β protein targets showed good binding energies which hereby from computational studies proves our compound anti-inflammatory potential. In addition, absorption, distribution, metabolism, excretion, and toxicity (ADMET) studies reveled that fluvoxamine has very good pharmacokinetic profile with no specific hepatic toxicity and good absorption level. In addition, the skin sensitization test in vitro human cell line activation test (h-CLAT) and KeratinoSens have revealed that isolated flavone is not skin sensitive with confidence score of 59.6% and 91.6%. The current findings validated the anti-arthritic potential of fluvoxamine but it should be recommended for clinical investigation in future research.

Fenchone, a monoterpene: Toxicity and diuretic profiling in rats

Fenchone is a monoterpene present in the essential oils of various plants, including Foeniculum vulgare and Peumus boldus. Previous studies confirmed the anti-inflammatory, antioxidant, wound-healing, antidiarrheal, antifungal, antinociceptive, and bronchodilator activities of fenchone. Owing to various pharmacological activities of Fenchone, the current research was designed to evaluate its diuretic activity along with toxicity profiling. For evaluating acute toxicity, OECD guideline 425 was followed in which a single dose of 2000 mg/kg was orally administered to rats. For evaluating the diuretic potential in rats, three doses of Fenchone (100, 200, and 400 mg/kg) were assayed in comparison to furosemide (15 mg/kg) as the standard drug, followed by measurements of urinary volume, urinary electrolytes, uric acid, and urinary creatinine in saline-loaded rats for 8 h. The acute toxicity study showed a significant increase in hemoglobin (Hb), red blood cells (RBCs), alkaline phosphatase (ALP), and alkaline transaminase (ALT) along with a significant decrease in serum triglycerides, cholesterol, and uric acid levels when compared with the control group. The oxidative stress parameter, superoxide dismutase (SOD), was increased in the heart and spleen. Nitrite (NO) and glutathione were significantly increased in the kidney. The acute diuretic effect of Fenchone (400 mg/kg) significantly increased the urinary output, electrolytes (Na⁺, K⁺, and Ca⁺⁺), urinary creatinine, and urinary uric acid in a dose-dependent manner. The Na⁺/K⁺ ratio was remarkably higher in the treatment group than that of the control group. The diuretic index, saluretic index, and Lipschitz value were also calculated from electrolyte concentration and urinary volume measurements, and the values were significantly increased in rats administered with fenchone at 400 mg/kg dose. The current study concluded that fenchone is safe and has remarkable diuretic action.

Artificial Intelligence (AI) in Pharmacy: An Overview of Innovations

Artificial Intelligence (AI) emerged as an intervention for data and number-related problems. This breakthrough has led to several technological advancements in virtually all fields from engineering to architecture, education, accounting, business, health, and so on. AI has come a long way in healthcare, having played significant roles in data and information storage and management - such as patient medical histories, medicine stocks, sale records, and so on; automated machines; software and computer applications like diagnostic tools such as MRI radiation technology, CT diagnosis and many more have all been created to aid and simplify healthcare measures. Inarguably, AI has revolutionized healthcare to be more effective and efficient and the pharmacy sector is not left out. During the past few years, a considerable amount of increasing interest in the uses of AI technology has been identified for analyzing as well as interpreting some important fields of pharmacy like drug discovery, dosage form designing, polypharmacology, and hospital pharmacy. Given the growing importance of AI, we wanted to create a comprehensive report which helps every practicing pharmacist understand the biggest breakthroughs which are assisted by the deployment of this field.

Fabrication of pH responsive hydrogel blends of chondroitin sulfate/pluronic F-127 for the controlled release of ketorolac: its characterization and acute oral toxicity study

OBJECTIVE

Ketorolac tromethamine (KT), selected as a model drug, is used in management of moderate to severe acute pain. It has a short half-life (∼5.5 h) and requires frequent dose administration when needed for longer period of time. In our current project, we designed pH responsive hydrogel blends of chondroitin sulfate/pluronic F-127 (CS/Pl) for the controlled release of ketorolac.

METHODS

Hydrogel blends were fabricated using free radical polymerization reaction technique utilizing different ratios of chondroitin sulfate (CS) (polymer) and pluronic F-127 (polymer), acrylic acid (monomer), N,N'-methyl-bisacrylamide (MBA) (cross-linker), initiator ammonium persulfate (APS) and tween-80 (surfactant). The fabricated hydrogel blends were studied and evaluated for pH responsiveness, swelling, water absorbency, in vitro drug release, and morphological characteristics such as SEM, XRD, FTIR, and TGA/DSC. Acute toxicity study was performed on rabbits.

RESULTS

Maximum swelling and water absorbency were shown by CS/Pl blends being significantly greater at 7.4 (basic pH) than in 1.2 (acidic pH). In vitro dissolution demonstrated pH responsive controlled KT release following zero order at higher pH (7.4) medium up to 36 h. FTIR studies confirmed the structures of our blends; SEM results showed porous framework; thermal studies revealed higher stability of hydrogels than the individual polymers; and XRD confirmed the nature of our blends. Toxicity study revealed the nontoxic nature of the hydrogel blends.

CONCLUSION

The prepared CS/Pl hydrogels demonstrated stimuli-controlled release with delivery of drug for prolonged period of time and thus can minimize dosing frequency, safe drug delivery, increased patient compliance and easiness.

Evaluation of Hepatoprotective and Gastroprotective Activities of Paspalidium flavidum Leaves Extract in Experimental Animal Models

Paspalidium flavidum (watercrown grass), a medicinal plant, is traditionally used in liver ailments and stomach problems. The hepatoprotective and gastroprotective activities of the aqueous methanol extract of Paspalidium flavidum (AMEPF) were studied in experimental animal models. Paracetamol and aspirin were used to induce hepatotoxicity and gastric ulcer in rats, respectively. Biochemical hepatic parameters, gastric pH, total acidity, ulcer index, percentage protection, nitric oxide and TNF-α were measured in AMEPF-treated groups. Moreover, GC-MS analysis of AMEPF was performed. Pretreatment with AMEPF improved the blood lipid profile and restored liver function tests in paracetamol-induced hepatotoxicity. While in aspirin-induced gastric ulcer, oral administration of AMEPF significantly reduced (P<0.05) the gastric lesions, total acidity and ulcer scoring index, TNF-α with upregulation of nitric oxide when compared with the Diseased group. AMEPF exhibited anti-lipid peroxidation activity. Histopathological studies were in good agreement with the biochemical findings. GC-MS analysis revealed the presence of anti-oxidant phyto-constituents, including oleic acid and 1,2-benzenedicarboxylic acid, mono(2-ethylhexyl) in AMEPF. This study suggested that aqueous methanol extract from the leaves of P. flavidum has beneficial hepatoprotective and gastroprotective activities related to its anti-oxidant phytochemicals.

Anti-Inflammatory, analgesic and anti-pyretic activity of Fagonia bruguieri DC in rats

Traditional medicine has employed the plant Fagonia bruguieri DC. to alleviate inflammation, fever and pain. The goal of this study was to test the anti-inflammatory, analgesic and antipyretic properties of the methanol extract of whole plant of Fagonia bruguieri (F. bruguieri). The writhing test and Eddy's hot plate test were used to assess the analgesic potential of F. bruguieri at three different doses. Carrageenan-induced rat paw edema was applied to investigate anti-inflammatory activity, whereas antipyretic activity was estimated in Brewer's yeast induced pyrexia model. Flavonoids, alkaloids, saponins, tannins and glycosides were found in F. bruguieri's phytochemical analysis. F. bruguieri at 750 mg/kg reduced writhing count by 62.23 percent, while F. bruguieri enhanced latency in Eddy's hot plate test. In carrageenan-induced edema, F. bruguieri at 750 mg/kg exhibited considerable anti-inflammatory effect (41.11 percent) after 2 ^nd, 3 ^rd and 4 ^th hours of therapy. F. bruguieri was also found to show antipyretic properties. The anti-inflammatory, analgesic and antipyretic properties of F. bruguieri were confirmed in this study, which might be attributable to the presence of several phyto-constituents.

pH Sensitive Pluronic Acid/Agarose-Hydrogels as Controlled Drug Delivery Carriers: Design, Characterization and Toxicity Evaluation

The objective of this study was to fabricate and evaluate a pH sensitive cross-linked polymeric network through the free radical polymerization technique for the model drug, cyclophosphamide, used in the treatment of non-Hodgkin’s lymphoma. The Hydrogels were prepared using a polymeric blend of agarose, Pluronic acid, glutaraldehyde, and methacrylic acid. The prepared hydrogels were characterized for drug loading (%), swelling pattern, release behavior, the ingredient’s compatibility, structural evaluation, thermal integrity, and toxicity evaluation in rabbits. The new polymer formation was evident from FTIR findings. The percentage loaded into the hydrogels was in the range of 58.65–75.32%. The developed hydrogels showed significant differences in swelling dynamics and drug release behavior in simulated intestinal fluid (SIF) when compared with simulated gastric fluid (SGF). The drug release was persistent and performed in a controlled manner for up to 24 h. A toxicity study was conducted on white albino rabbits. The developed hydrogels did not show any signs of ocular, skin, or oral toxicity; therefore, these hydrogels can be regarded as safe and potential carriers for controlled drug delivery in biomedical applications.

Immunomodulatory and anti-inflammatory effects of Aerva lanata in ovalbumin induced allergic asthmatic mice

ETHNOPHARMACOLOGICAL RELEVANCE

Aerva lanata Linn. (A. lanata) is traditionally used for cough, sore throat and asthma.

AIM OF STUDY

The aim of the present study was to investigate the immunomodulatory and anti-inflammatory potentials of A. lanata in allergic asthmatic mice.

MATERIALS AND METHODS

BALB/c mice were administered with three different (methanol, n-hexane and ethyl acetate) extracts of A. lanata two weeks after immunization with ovalbumin and continued for 7 days. Inflammatory cells count was estimated in blood and broncho-alveolar lavage fluid (BALF). RT-PCR was used to find out mRNA expression levels of inflammatory mediators. GC-MS analysis was also carried out.

RESULTS

Among three extracts of A. lanata, ethyl acetate extract ameliorated (p < 0.001) count of inflammatory cells both blood and BALF remarkably. This study indicated that ethyl acetate extract of A. lanata lowered (p < 0.001) the level of inflammatory modulator TNF-α and IgE antibodies. A. lanata reduced (p < 0.001) interleukin 4, 5, 13 and enhanced (p < 0.001) expression levels of AQP1 and AQP5 in asthmatic mice. GC-MS analysis of ethyl acetate fraction indicated the presence of various anti-oxidant phyto-constituents. The groups treated with A. lanata improved inflammatory, goblet cells hyperplasia scoring and alveolar thickening.

CONCLUSIONS

The anti-asthmatic effect of A. lanata might be contributed by the suppression of edema, pro-inflammatory cytokines and IgE antibodies, and elevation of aquaporin expression levels, suggesting future study and clinical trials to propose it as a candidate to treat allergic asthma. The anti-oxidant phytochemicals present in A. lanata might be responsible for such potential.

Boswellic Acids, Pentacyclic Triterpenes, Attenuate Oxidative Stress, and Bladder Tissue Damage in Cyclophosphamide-Induced Cystitis

Boswellic acids, derived from the Boswellia serrata plant, have been demonstrated to have anti-inflammatory properties in experimental animal models. The present study was aimed to evaluate the uro-protective effect of boswellic acids in rats with cyclophosphamide-induced cystitis. Interstitial cystitis was induced by cyclophosphamide (CYP). In order to analyze the reduction of the urothelial damage, the bladder weight, the nociception response, and the Evans blue dye extravasation from the bladder were evaluated. To investigate the involvement of lipid peroxidation and enzymatic antioxidants CAT, SOD, and GPX and MPO and NO were evaluated. IL-6 and TNF-α were measured by the ELISA immunoassay technique. The results showed that pretreatment with boswellic acids significantly reduced urothelial damage which was accompanied by a decrease in the activity of MDA, CPO, and NO levels and prevention of the depletion of CAT, SOD, and GPX. The levels of IL-6 and TNF-α were dramatically reduced by boswellic acids. Histopathological findings revealed a considerable reduction in cellular infiltration, edema, epithelial denudation, and bleeding. Our findings showed that boswellic acids, by their antioxidant and anti-inflammatory properties, negate the detrimental effects of cyclophosphamide on the bladder, suggesting boswellic acids as promising therapeutic alternatives for cystitis.

A Portrait of the Pharmacy Profession Globally: Pharmacist Universal Professional Identity and Establishment of Global Pharmacy Council

⮚ Professional identity is an important component of practice change.⮚ Research on professional identity in pharmacy is limited, and this needs to change if we are to truly move practice in the 21st century.⮚ A unified professional identity is crucial for society to see pharmacists as healthcare providers.

Anti-asthmatic effect of Juglans regia Linn. in mice

Plants are considered as an essential source to treat different diseases. In traditional system of medicine, Juglans regia (J. regia) has been used in curing sinusitis and cough. The aim of the present study was to evaluate the anti-asthmatic activity of J. regia in ovalbumin-induced allergic asthmatic BALB/c mice. The mice were sensitized intraperitoneally and subsequently challenged with ovalbumin (intranasal) to induce allergic asthma. Mice were treated with methanolic, n-hexane and ethyl acetate extracts of J. regia and methylprednisolone for 7 consecutive days, along with intranasal challenge. The total and differential leukocyte counts in blood, bronchoalveolar lavage fluid (balf) and lung wet/dry ratio were determined. GC-MS analysis was also performed. The results showed that ethyl acetate extract of J. regia significantly reduced inflammatory cells count in both blood and balf more significantly. Lung wet/dry weight ratio was reduced in asthmatic mice treated with the different extracts of J. regia. Serum IgE antibodies level was also significantly decreased in extracts treated groups. GC-MS analysis of all three extracts of J. regia showed the presence of various phytochemicals responsible for its anti-inflammatory and anti-asthmatic activity. The results of the present study validated the traditional use of J. regia in respiratory disorders like asthma and sinusitis.

Cardioprotective effect of boswellic acids against doxorubicin induced myocardial infarction in rats

The aim of the present study was to evaluate the cardioprotective activity of boswellic acids in doxorubicin (DOX) induced cardiotoxicity. DOX (2.5mg/kg) was used intraperitoneally in rats to induce cardiotoxicity in six divided doses every alternate day over a period of two weeks. Dexrazoxane (10:1) was used as a standard drug. Boswellic acids (250, 500 and 750 mg/kg) were orally administered to rats for 14 days. After 14 days, rats were sacrificed, and blood was withdrawn through cardiac puncture. The blood lipid profile and cardiac biomarkers including LDH, CK-MB, CPK, SGOT and troponin T were measured. The heart of rats was isolated for histopathological studies. Graphpad Prism was used for statistical analysis. There was a significant increase in the level of cardiac enzymes and complete lipid profile parameters in diseased group as compared to control group. Pre-treatment with boswellic acids decreased level of all the measured parameters and decreased the severity of myocardial damage as supported by histopathological studies. It was concluded that boswellic acids possess cardioprotective potential by lowering cardiac biomarkers and blood lipid profile. Thus, boswellic acids might act as cardioprotective agent against doxorubicin induced cardiotoxicity.

Anti-oxidant and hepatoprotective effects of Lactuca serriola and its phytochemical screening by HPLC and FTIR analysis

Lactucaserriola (L. serriola), commonly known asprickly lettuce, is an annual and biennial herb. The plant is traditionally used as sedative, hypnotic, cough suppressant, expectorant, purgative, diuretic, vasorelaxant, demulcent, antiseptic and antispasmodic. Aim of present study was to evaluate protective effect of L. serriola in paracetamol-induced hepatotoxicity. Silymarin was used as a standard drug. Hepatoprotective effect of extract was determined by liver biochemical markers, anti-oxidant enzymes and blood lipid profile. Methanolic extract was found to be the most potent in in-vitro antioxidant assays and used for further studies. Treatment with paracetamol increased the level of hepatic biomarkers, blood lipid profile and decreased anti-oxidant enzyme levels. Pre-treatment with Lactuca serriola caused restoration of hepatic biomarkers, blood lipid profile and antioxidant enzymes. FTIR represented that L. serriola contains hydroxyl (-OH), carboxylic acid (C=O) and alkene (C=C) groups. HPLC analysis showed presence of polyphenolic compounds in the methanolic extract of L. serriola. It is concluded that the methanolic extract of Lactuca serriola possesses hepatoprotective potential that might be linked to the presence of polyphenolic compounds and their anti-oxidant activities.

Impact of Maladaptive Daydreaming on Grade Point Average (GPA) and the Association Between Maladaptive Daydreaming and Generalized Anxiety Disorder (GAD)

This study demonstrates the prevalence of the maladaptive daydreaming (MD) and generalized anxiety disorder (GAD) among Saudi medical students. It also illustrates the association of MD with both GAD and the students' grade point average (GPA). MD was assessed by using the 14-item Maladaptive Daydreaming Scale (MDS), and GAD was assessed by using both the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire and the Penn State Worry Questionnaire (PSWQ). Our data estimate the prevalence of MD among the students to be 70%, GAD prevalence to be 80%, and 55% when using both GAD-7 and PSWQ, respectively. A statistically significant decline in the GPA was apparent among maladaptive daydreamers (MDers). A statistically significant rise in the scores of GAD-7 and PSWQ among MDers compared to non-MDers was found. To sum up, our findings demonstrate a high number of MDers and GAD sufferers among our subjects, and it appears that MD is associated with both GAD and GPA.

Hepatoprotective effect of Ziziphus oxyphylla Edgew in paracetamol-induced hepatotoxic rat model

Ziziphus oxyphylla Edgew (Z. oxyphylla) is a small shrub to a medium sized tree. The aim of the present study was to evaluate the hepatoprotective activity of Z. oxyphylla in paracetamol-induced hepatotoxic rat model. Silymarin was used as a standard drug. Methanol extract was found to be the most potent in in-vitro antioxidant studies. The methanol extract of Z. oxyphylla was administered to experimental animals. The hepatoprotective effect of extract was evaluated by measuring liver biochemical markers, anti-oxidant enzymes and blood lipid profile. Treatment with the paracetamol increased the level of hepatic biomarkers, blood lipid profile and decreased anti-oxidant enzymes. Pre-treatment with Z. oxyphylla caused restoration of hepatic biomarkers, blood lipid profile and antioxidant enzymes levels. It is concluded that the methanol extract of Z. oxyphylla possesses hepatoprotective activity that might be due to quercetin and kaempferol glycosides present in the plant extract. Further studies are required to elucidate the exact mechanism of action of these isolated flavonoid glycosides.

Medicinal Plants Used To Treat Overactive Bladder

BACKGROUND AND OBJECTIVE

Overactive bladder (OAB) is a medical condition characterized by an increase frequency and urgency, with or without urge incontinence. 80% of the world's population presently uses herbal medicine for some aspect of primary health care according to a survey conducted by World Health Organization. The objective of present review was to present an updated, comprehensive and categorized information about medicinal plants used or with potential for the treatment of overactive bladder.

METHODS

All relevant literature databases were searched up. The sources of data included Google Scholar, Science Direct, Web of Science and PubMed. The search terms were plant, herb, herbal therapy, phytotherapy, overactive bladder, cystitis and urinary incontinence.

RESULTS

Studies on a number of medicinal plants revealed that phytochemials extracted from different plant's part showed protective effect against increased contractile activity of urinary bladder and increased urination frequency, the characteristic manifestations of OAB. Medicinal plant extracts also reduced urinary oxidative stress markers,inflammation and agonist induced bladder contractile response.

CONCLUSION

A variety of medicinal plants promise their use in overactive bladder diseases. In addition to the standardization of these medicinal plants, screening plants as anti-overactive bladder agents may help to find new sources of therapy for overactive bladder.

Approaches used for teaching anatomy and physiology in the university pre-professional program at King Saud bin Abdulaziz University for Health Sciences

Many medical schools offer pre-professional programs to undergraduate students. The main purpose of the university pre-professional program (UPPP) is to equip students with the necessary knowledge and skills required to successfully cope with the academic demands of further education provided by professional colleges. The aim of this commentary article is to describe the role of UPPP at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in preparing students to continue studies at the College of Medicine (COM) and other health-related colleges. The anatomy and physiology course is presented as a representative model. An outline of the UPPP in the context of the curriculum, teaching strategies, learning facilities, and assessment is presented. The pre-professional program at KSAU-HS prepares school graduates to become self-learners and enable them to learn effectively in the clinical context in a problem-based learning curriculum at COM.

Evaluation of Gastro-protective Activity of Myristica fragrans on Ethanol-induced Ulcer in Albino Rats

Myristica fragrans seeds are traditionally used to treat dyspepsia, vomiting and abdominal pain. The purpose of this study was to investigate the protective effect of Myristica fragrans in ethanol induced gastric ulcer. Study was carried out on rats, divided into four groups; negative control, positive control, standard drug control, and Myristica fragrans extract treated rats. The pH, ulcer index, acidity values and histopathological examination of stomach were evaluated. Myristica fragrans significantly (P<0.05) reduced gastric lesions by 41.68% in ethanol induced ulcer model at 200 mg/kg when compared to sucralfate (60.41%). However, histopathological findings appeared similar in Myristica fragrans extract treated and standard drug control groups, where stomachs were found with mild erosion of superficial epithelium and few infiltrated inflammatory cells. pH of gastric contents of rats from extract treated was increased (4.25 ± 0.25) as compared to positive control group (2.25 ± 0.25). Ulcer index of extract treated rats was improved (41.74%). Moreover, total acidity of extract treated group (60.0 ± 0.47) was decreased as compared to control group (74.50 ± 1.04). It is concluded that Myristica fragrans showed significant protecting activity in ethanol induced ulcer. Isolation and purification of phytochemicals responsible for gastroprotective activity becomes necessary.

Statins role in preventing contrast-induced acute kidney injury: a scoping review

BACKGROUND

Acute renal failure secondary to contrast-induced acute kidney injury (CI-AKI) is one of the most commonly encountered problems in hospitalised patients. The CI-AKI may lead to the development of persistent renal disease, causing significant morbidity and mortality in high-risk patients. Statins are increasingly recognised as effective in preventing CI-AKI. In this review, we reviewed the literature on statin use for prophylaxis of CI-AKI, its potential benefits, and adverse effects. The aim of the present review was to reveal gaps and discrepancies in the available literature, and to identify areas for future research.

METHODS

We searched PubMed for articles published up to 2018, using keywords including: "Statins AND contrast-induced kidney injury", "3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors AND contras-induced kidney injury", and "HMG-CoA reductase inhibitors AND contrast induced nephropathy".

RESULTS

Various trials and reviews have yielded promising results in terms of statin efficacy. However, conflicting results and a lack of homogeneity in the protocols of these trials have limited the applicability of statin-based therapy in clinical practice. Despite the reported beneficial therapeutic effects of short-term high-dosage statin use in preventing CI-AKI, statin therapy is not yet the standard prophylactic regimen due to widespread heterogeneity in the clinical trials.

CONCLUSION

Statin therapy can be used as an adjunct to usual prophylactic measures such as adequate hydration and use of low-volume contrast media. Large well-designed trials on the effects of short-term high-dose statin use in preventing CI-AKI should be conducted, to eliminate any form of discrepancy among results, and to clarify any potential adverse effects.

Attitudes towards depression among non-psychiatric physicians in four tertiary centres in Riyadh

Depression is a common mental illness that has a profound impact on an estimated number of 300 million people worldwide. Depression is stigmatised in communities and even physicians, especially, non-psychiatric physicians, which affects depressed patients’ care. This study aims to investigate non-psychiatric physicians’ attitudes towards depression in Riyadh, Saudi Arabia. The study surveyed 380 participants using Revised Depression Attitude Questionnaire. Non-psychiatric physicians in Riyadh are optimistic and have a positive perspective towards depression. Yet, the majority preferred dealing with physical rather than mental illness. Understanding the attitudes of medical practitioners is important to shape service delivery and assess training needs.

Perceptions of mental illness etiology and treatment in Saudi Arabian healthcare students: A cross-sectional study

OBJECTIVES

Cultural beliefs often affect people's attitude toward mental illness and their help-seeking behavior. Belief in superstitious causes of mental illness can lead to seeking help from non-medical practitioners, which might hinder treatment. This study aimed to explore the perception of mental illness and help-seeking behavior among healthcare students.

METHODS

A cross-sectional study carried out on a sample of 400 randomly selected undergraduate health professional students in Riyadh. Data collection involved two self-administered questionnaires: the causes and treatment routes for a female vignette with psychosis and the General Health Questionnaire-28.

RESULTS

The mean age of participants was 20.9 years, and 68.2% were male. Although participants reported a lack of personal history of mental illness (81.9%), female participants were more likely to disclose psychological distress as measured by General Health Questionnaire-28 (67.6%). Mental illness (47.2%) was chosen as the main reason for the problem depicted by the female vignette. General Health Questionnaire-28 scores for "caseness" did not affect perception about psychosis versus non-caseness. Factor analysis produced four dimensions for causes of psychosis: "social," "psychobiological," "superstitious," and "socially undesirable"; and two treatment routes: "clinical" versus "social interventions." Male participants leaned toward social factors for the cause of psychosis and were more likely to endorse social interventions for treatment.

CONCLUSION

Healthcare students in Riyadh remained supportive of a biomedical approach toward the causation and treatment of mental illness. The use of religious practices as an adjunct was apparent. Students, especially females, were prone to experience more psychological distress.

Calcium sensitization mechanisms in detrusor smooth muscles

The contraction of detrusor smooth muscles depends on the increase in intracellular calcium. The influx of calcium from the plasma membrane calcium channels and calcium release from the sarcoplasmic reticulum give rise to intracellular calcium. Under the pathophysiological conditions, the increased sensitivity of regulatory and contractile proteins to calcium also plays an important role in maintaining the spontaneous detrusor smooth muscle activity. Many proteins have been identified to play a role in calcium sensitization. Both the protein kinase C (PKC) and Rho-kinase (ROCK) signaling pathways are responsible for the induction of calcium sensitization in the detrusor smooth muscles. The balance between the myosin light chain kinase (MLCK) and myosin light chain phosphatase (MLCP) regulates the intracellular calcium-contractile force relationship. The inhibition of MLCP by PKC-mediated phosphatase inhibitor (CPI-17) and myosin phosphatase target subunit (MYPT-1) phosphorylation by both the PKC and ROCK are responsible for calcium sensitization in the detrusor smooth muscles. However, the ROCK pathway predominantly participates in the calcium sensitization induction under pathophysiological situations. Many kinases are well known nowadays to play a role in calcium sensitization. This review aims to enlighten the current understanding of the regulatory mechanisms of calcium sensitization with special reference to the PKC and ROCK pathways in the detrusor smooth muscles. It will also aid in the development of new pharmacological strategies to prevent and treat bladder diseases.

Prevention of beta-thalassemia in a large Pakistani family through cascade testing

BACKGROUND

We report cascade testing of a large Pakistani family for beta-thalassemia alleles. The family was still practicing consanguineous marriages and was at risk of having more affected births.

OBJECTIVE

The objective of this study was to show that identification of disease carriers in families with index cases in order to create awareness about disease and provide genetic counseling would result in reduction of the frequency of beta-thalassemia in Pakistan.

METHODS

In this large family with an index case, 27 available living members were tested for beta-thalassemia. Carriers of the disease were detected by measuring hemoglobin indices, and amplification refractory mutation system polymerase chain reaction was used for mutation analysis. Genetic counseling was provided to members of this family.

RESULTS

There were already 3 marriages between the carrier members and 1 between a carrier and noncarrier in this large family; 12 (44.4%) members were found to carry the mutant gene, representing a very high carrier rate compared to the 5.4% carrier frequency of beta-thalassemia in the general population of Pakistan. The family was counseled for prevention of affected births. The initially reluctant family gradually became cooperative and seriously attended the genetic counseling sessions.

CONCLUSION

Cascade testing is more practical than general population screening in a country with limited health facilities where consanguineous marriages are practiced. This report emphasizes the need of extensive testing within families with index cases to identify the carriers of beta-thalassemia in order to reduce disease occurrence through awareness and genetic counseling.

Prostatic infarction/infection in acute urinary retention secondary to benign prostatic hyperplasia

PURPOSE

We assess the role of acute prostatic infarction and prostatic inflammation in causing acute urinary retention in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

A prospective controlled clinicopathological study was undertaken comparing 35 patients who presented with acute urinary retention secondary to BPH with another 35 patients with symptomatic BPH. All 70 patients were treated with transurethral resection. The prostatic chips in each group were examined by 1 histopathologist, who was unaware of the clinical presentation of the patient, for changes of infarction, acute and chronic inflammation, and predominant histological pattern.

RESULTS

There was a higher incidence of glandular pattern in the retention group compared to a stromal pattern in the control group, which was statistically significantly different (p < 0.001). A 5-fold higher incidence of prostatic carcinoma was noted in the acute retention group, which was also statistically significant (p < 0.05).

CONCLUSIONS

Prostatic infarction and inflammation had no role in the etiology of acute urinary retention due to BPH.

Prostatic infarction/infection in acute urinary retention secondary to benign prostatic hyperplasia

PURPOSE

We assess the role of acute prostatic infarction and prostatic inflammation in causing acute urinary retention in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

A prospective controlled clinicopathological study was undertaken comparing 35 patients who presented with acute urinary retention secondary to BPH with another 35 patients with symptomatic BPH. All 70 patients were treated with transurethral resection. The prostatic chips in each group were examined by 1 histopathologist, who was unaware of the clinical presentation of the patient, for changes of infarction, acute and chronic inflammation, and predominant histological pattern.

RESULTS

There was a higher incidence of glandular pattern in the retention group compared to a stromal pattern in the control group, which was statistically significantly different (p < 0.001). A 5-fold higher incidence of prostatic carcinoma was noted in the acute retention group, which was also statistically significant (p < 0.05).

CONCLUSIONS

Prostatic infarction and inflammation had no role in the etiology of acute urinary retention due to BPH.