Chemical constituents and acetylcholinesterase inhibitory activity of Beilschmiedia insignis Gamble

ABSTRACT. Secondary metabolites from natural products are potential sources of acetylcholinesterase inhibitors, which are key enzymes in the treatment of many neurodegenerative diseases. Inspired by the reported activities of alkaloids herein we report the chemical investigation on the chemical constituents from Beilschmiedia insignis and their acetylcholinesterase inhibitory activity. Isolation of the stem bark of B. insignis led to the isolation and identification of five aporphine alkaloids, namely isocorydine (1), norisocorydine (2), (+)-laurotetanine (3), (+)-N-methyllaurotetanine (4), and (+)-boldine (5), together with β-sitosterol (6), β-sitostenone (7), lupeol (8), and lupenone (9). The chemical structures of these compounds were obtained by analysis of their spectroscopic data, as well as the comparison with that of reported data. Acetylcholinesterase inhibitory activity revealed that all isolated alkaloids were found to inhibit AChE with percentage inhibition values ranged from 44.9 to 74.5%. This is the first report on phytochemicals from B. insignis.                     KEY WORDS: Lauraceae, Beilschmiedia insignis, Alkaloid, Acetylcholinesterase, Alzheimer   Bull. Chem. Soc. Ethiop. 2021, 35(3), 685-691. DOI: https://dx.doi.org/10.4314/bcse.v35i3.19

The genetic landscape of polycystic kidney disease in Ireland

Polycystic kidney diseases (PKDs) comprise the most common Mendelian forms of renal disease. It is characterised by the development of fluid-filled renal cysts, causing progressive loss of kidney function, culminating in the need for renal replacement therapy or kidney transplant. Ireland represents a valuable region for the genetic study of PKD, as family sizes are traditionally large and the population relatively homogenous. Studying a cohort of 169 patients, we describe the genetic landscape of PKD in Ireland for the first time, compare the clinical features of patients with and without a molecular diagnosis and correlate disease severity with autosomal dominant pathogenic variant type. Using a combination of molecular genetic tools, including targeted next-generation sequencing, we report diagnostic rates of 71-83% in Irish PKD patients, depending on which variant classification guidelines are used (ACMG or Mayo clinic respectively). We have catalogued a spectrum of Irish autosomal dominant PKD pathogenic variants including 36 novel variants. We illustrate how apparently unrelated individuals carrying the same autosomal dominant pathogenic variant are highly likely to have inherited that variant from a common ancestor. We highlight issues surrounding the implementation of the ACMG guidelines for variant pathogenicity interpretation in PKD, which have important implications for clinical genetics.

Preparing lifelong learners for delivering pharmaceutical care in an ever-changing world: a study of pharmacy students

BACKGROUND

Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning (LLL). Many pharmacy schools have not adopted yet specific programs targeting the development of LLL skills, though LLL is widely accepted as an essential competence. This paper examines the effectiveness and utility of a longitudinal CPD training program.

METHODS

A CPD simulation course was introduced to a cohort of fifth year students in Northern Cyprus in the 2018-2019 academic year. The program was delivered as an interactive orientation course in one semester; meanwhile, in the second semester, the students applied the CPD cycle and completed their portfolios during their final experiential practice. A mixed-methods approach was used to evaluate the outcomes of the intervention using students' preparedness for lifelong learning (SPLLL) self-administered questionnaire delivered pre-post program, focus group sessions for students to reflect on the course experience, and instructors' evaluations of portfolios.

RESULTS

Following the implementation of the course, students' assessment scores were significantly higher overall and for all scale domains, including "knowledge, skills, attitude and practice", compared to the baseline assessment. Additionally, compared to fifth year students who responded to the second SPLLL questionnaire, the intervention group students' assessment was significantly higher in knowledge, skills, and practice. The qualitative analysis reported high student satisfaction and achievement of the course objectives. Nineteen of the students scored high on their portfolios.

CONCLUSION

The CPD simulation course provided students with opportunities to practice and develop self-assessment and self-management skills that are all desirable for lifelong learning and prepared them for CPD.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module

BACKGROUND

We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific.

METHODS

During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied.

RESULTS

Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher.

CONCLUSIONS

Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.

Knowledge, Attitude and Practice of Self-medication among Pharmacy Students in North Cyprus

Aim: The aim of our study is to assess the attitude, knowledge and practice of self-medication among fifth year Pharmacy Students at Near East University in Northern Cyprus. Study Design: A cross sectional study. Place and Duration of Study: The study was conducted in faculty of pharmacy in Near East University in Northern Cyprus on 28 of December 2018. Methodology: A 7- part self administered questionnaire was used among fifth year pharmacy students who were available during the study time. Results: A total of 77 questionnaires were distributed to be filled by respondents, all of them were filled completely and collected. 88% of the participants in our study were in the prevalent age group of 22-26 years and most of these students were from Turkey (58.3%). 25.7% of students visited a physician when they had a disease, however 25% of them didn’t comply with physician’s prescription. Headache (16.8%) and common cold (14.0%) were the most frequently reported illness for which self-medication was taken. Analgesic medicines (37.4%), followed by vitamins (29.7%) and antibiotic (13.5%), were used commonly as self-medication. Nearly all of students 95.9% knew the meaning of OTC and prescription only drugs. About 30.7% of students medicated themselves because it isn’t a serious disease. The main source of information about self-medication for students was  the advice from pharmacist (29.7%). 26.8% of students  agreed that pharmacists are good source of information for minor medical problems, 18.2% agreed that self-medication is acceptable for pharmacy students however 4.1% accepted that self-medication is not acceptable at all and it would be harmful. Conclusion: The practice of self-medication is prevalent amongst fifth year pharmacy students even with adequate knowledge and awareness about the consequences. Proactive pharmacist may contribute in management of minor illness and rationalized self-medication.

Applying Beers Criteria for Elderly Patients to Assess Rational Drug Use at a University Hospital in Northern Cyprus

Background:

Several regulations for potentially inappropriate medications (PIMs) have been published specifically for elderly patients to rationalize drug use in such vulnerable communities.

Objectives:

To determine the proportion and characteristics of PIMs in patients receiving one or more drugs according to Beers Criteria 2015.

Materials and Methods:

A cross-sectional prospective analysis of 451 inpatients admitted between September 25 and October 25, 2016, was conducted in Near East University Hospital, Northern Cyprus. Data were extracted from the patient medical records using special forms.

Results:

A total of 119 elderly patients were identified (26.4%) and evaluated, of which 107 were eligible and 12 were excluded. Of the 1039 prescribed medicines, 16.9% were PIMs during hospitalization, whereas 12% were at discharge. The most prevalent PIM group during hospitalization was identified as the “medications to be avoided in older adults” (48.8%), whereas it also formed 52% of medications prescribed at discharge. PIMs of the class “drugs used with caution” formed 19.4% of prescribed medicine during hospitalization and 18.4% on discharge. The prevalence of polypharmacy was 79.4%, mainly identified as unpreventable polypharmacy of elders.

Conclusion:

A significantly higher prevalence of PIMs was observed in hospitalized patients than those discharged, with high prevalence of polypharmacy. These results necessitate a nationwide assessment, and responsible bodies who adopt strategies should act to reduce or overcome the aforementioned high prevalence in Northern Cyprus.

Improved ankle and knee control with a dual-channel functional electrical stimulation system in chronic hemiplegia. A case report

The aim of tis report is to describe the effects of a dual-channel functional electrical stimulation (FES) system applied daily as an orthotic device to the dorsiflexors and hamstrings muscles in a subject with chronic hemiparesis. Prior to the application of FES, the patient's gait was characterized by a footdrop and knee hyperextension during stance. measurements of gait performance were collected before FES application, after a conditioning period of six weeks, and following ten months of daily use. Outcomes included lower limb kinematics and temporal gait measures. The kinematic assessments indicated significant benefits for gait with the dorsiflexors and hamstrings FES, as compared to no stimulation and peroneal FES alone. In addition ot improved ankle control, knee hyperextension was reduced during stance, and the self-selected comfortable gait velocity increased following ten months of daily use. The results of this report suggest that dual-channel FES for the dorsiflexors and hamstrings muscles may affect ankle and knee control beyond that witch can be attributed to peroneal stimulation alone. The positive effects observed in this case study point to the potential of dual-channel FES as a viable treatment options in the rehabilitation of patients with similar impairments.

Evaluation of antioxidant and nitric oxide inhibitory activities of selected Malaysian medicinal plants

Methanol extracts of seven Malaysian medicinal plants were screened for antioxidant and nitric oxide inhibitory activities. Antioxidant activity was measured by using FTC, TBA and DPPH free radical scavenging methods and Griess assay was used for the measurement of nitric oxide inhibition in lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma)-treated RAW 264.7 cells. All the extracts showed strong antioxidant activity comparable to or higher than that of alpha-tocopherol, BHT and quercetin in FTC and TBA methods. The extracts from Leea indica and Spermacoce articularis showed strong DPPH free radical scavenging activity comparable with quercetin, BHT and Vit C. Spermacoce exilis showed only moderate activity but other species were weak as compared to the standards. In the Griess assay Lasianthus oblongus, Chasalia chartacea, Hedyotis verticillata, Spermacoce articularis and Leea indica showed strong inhibitory activity on nitric oxide production in LPS and IFN-gamma-induced RAW 264.7 cells. Extracts from Psychotria rostrata and Spermacoce exilis also inhibited NO production but this was due to their cytotoxic effects upon cells during culture.

Urinary schistosomiasis in schoolchildren on Zanzibar Island (Unguja), Tanzania: a parasitological survey supplemented with questionnaires

The distribution of urinary schistosomiasis in schoolchildren on Zanzibar Island (Unguja) was surveyed in May 2001 to test a potential correlation with the distribution of snail species of the Bulinus africanus group and to record contemporary baseline epidemiological data. Quasi-random samples of 40 schoolchildren of mixed sexes were selected from each of 10 schools. Schistosoma haematobium infections were detected upon the basis of micro-haematuria with subsequent confirmation by microscopy examination for schistosome eggs. At the time of urine collection, each child was interviewed with a suite of 12 questions prepared as a standardized questionnaire. Total prevalence of urinary schistosomiasis (known locally as kichocho) was 12% although schistosome infections were absent in 5 schools. Schools located west of 39 degrees 19'E and north of 6 degrees 10'S harboured nearly all of the infections; the highest prevalence (55%) was found at Kinyasini where many B. globosus habitats occur nearby. The general level of understanding of kichocho was low (24%) and individual self-diagnosis was poor (sensitivity, 8.5%; specificity, 85%). Grouped freshwater-contact patterns of schoolchildren differed significantly between schools and correlated well with prevalence of infections within schools. Across the island the area of active transmission of S. haematobium to humans appears confined within the distribution of B. globosus. There was no epidemiological evidence to suggest any involvement of B. nasutus in local transmission, confirming previous laboratory findings. In areas where B. globosus occurs, targeted snail control should be considered, to reduce schistosome transmission.

New insights into the transmission biology of urinary schistosomiasis in Zanzibar

A better understanding of the transmission biology of urinary schistosomiasis in Zanzibar, Tanzania was only possible after the development of molecular DNA markers for identification of Bulinus africanus group snails, the potential intermediate hosts of Schistosoma haematobium. Hitherto, identification of natural populations of B. globosus and B. nasutus was problematic and the intermediate host status and distribution of either species remained speculative. By recourse to molecular markers, snail distribution maps could be drawn, revealing an allopatric distribution and, more importantly, leading to the discovery that B. nasutus played no role in transmission. Indeed, in Unguja the area of active transmission of S. haematobium to humans is confined within the distribution of B. globosus. This strong relationship may prove useful for predicting the distribution of urinary schistosomiasis within Zanzibar and, if snail schistosome compatibilities persist, in other areas nearby, e.g. coastal Tanzania and Kenya. The transmission biology of urinary schistosomiasis in Zanzibar is reviewed, the paper reports on ongoing malacological studies in Zanzibar and Kenya and finally closes by posing the question whether medical malacology forms an essential component associated with mass-scale chemotherapy control programmes.

Adaptation of the Photosynthetic Apparatus in Maize Leaves as a Result of Nitrogen Limitation : Relationships between Electron Transport and Carbon Assimilation

In maize (Zea mays L., cv Contessa), nitrogen (NO(3) (-)) limitation resulted in a reduction in shoot growth and photosynthetic capacity and in an increase in the leaf zeaxanthin contents. Nitrogen deficiency had only a small effect on the quantum yield of CO(2) assimilation but a large effect on the light-saturated rate of photosynthesis. Linear relationships persisted between the quantum yield of CO(2) assimilation and that of photosystem II photochemistry in all circumstances. At high irradiances, large differences in photochemical quenching and nonphotochemical quenching of Chl a fluorescence as well as the ratio of variable to maximal fluorescence (Fv/Fm) were apparent between nitrogen-deficient plants and nitrogen-replete controls, whereas at low irradiances these parameters were comparable in all plants. Light intensity-dependent increases in nonphotochemical quenching were greatest in nitrogen-deficient plants as were the decreases in Fv/Fm ratio. In nitrogen-deficient plants, photochemical quenching decreased with increasing irradiance but remained higher than in controls at high irradiances. Thermal dissipative processes were enhanced as a result of nitrogen deficiency (nonphotochemical quenching was elevated and Fv/Fm was lowered) allowing PSII to remain relatively oxidised even when carbon metabolism was limited via nitrogen limitation.