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VOL 17, ISSUE 2, 2025
Journal Impact : 2 year impact factor – 0.7
(As per Journal Citation Reports 2023)
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We see the magnificence of the nature through our two bare eyes, albeit due to image coherence at the retina, we normally perceive only one sight at a time. That is, monocular stimuli get merged into a single visual impression. When two distinct sceneries are given to our eyes simultaneously (dichoptic projection), we cannot see both images in coherence and can we actively focus on our preferred one. Rather than that, each eye’s visual experience rotates between the two exhibited images. Additionally, transient and unsteady blends of image pairs could be visible during transitions. Binocular rivalry is the term used to describe this occurrence of alternating visual impressions. To comprehend its basic process, numerous hypotheses have been advanced to date. Recent breakthroughs have enabled scientists to explain a plethora of fresh facts about binocular rivalry. However, their curiosity has not yet reached a suitable level. As such, this study considers the mechanism and ideas underlying it, as well as its future usefulness in the disciplines of neuroscience and research.
Cardiovascular disease is a significant cause of global mortality, creating a substantial burden on public health and economy. Research focusing on beneficial food and its active ingredients is essential to mark the health needs. Dates are abundant in polyphenols, particularly flavonoids, micronutrients and dietary fibers, that can influence cardiovascular health and potentially alleviate vascular illness. Based on this, we aimed to systematically review the cardiovascular effects of P. dactylifera. In this study, a systematic-research was performed according to the PRISMA guidelines to collect all relevant studies on “cardio-protective effect of P. dactylifera” using various databases up-to 2024. A total of 109 studies were obtained and evaluated in accordance with pre-selected criteria for inclusion/exclusion and finally 21 studies were included in this review. Evidence from in vitro, in vivo, clinical studies, histological and genetic data indicated that consuming date fruit entirely or its extracts could regulate specific indicators of cardiovascular health, especially level of lipids (triglycerides and cholesterol), markers of inflammation and oxidative stress. Emerging evidence suggest that integrating date fruit and extracts into one’s diet could be a beneficial factor of cardiovasculary healthy life.
Vitamin D, often called the “sunshine vitamin,” is essential for various physiological processes and overall health, produced in the skin through UVB exposure and obtainable from food and supplements. It regulates calcium and phosphorus, supports bone health, and prevents conditions like osteoporosis and rickets. Beyond skeletal benefits, evidence links vitamin D deficiency to chronic health issues such as metabolic syndrome, cancer, autoimmune diseases, inflammation, and mental health disorders. Research indicates that vitamin D could lessen the risk of these conditions by modulating immune function, reducing inflammation, and promoting cellular growth, while supplementation has shown promise in improving mood and alleviating depression and anxiety, particularly in deficient individuals. Additionally, vitamin D contributes to skin health, with potential benefits in treating psoriasis and preventing skin cancer. Its anti-inflammatory properties further suggest it may lower the risk of chronic diseases like cardiovascular and autoimmune disorders. Given its broad effects on health, maintaining adequate vitamin D levels is crucial for disease prevention and overall well-being, and additional research is required to gain a complete understanding of therapeutic potential in managing chronic conditions.
Obesity and overweight are the risk factors for Type 2 diabetes. Obesity is also linked to non-communicable diseases like dyslipidemia, hypertension, and cardiovascular diseases. Adipocyte precursor cells are multiplied and differentiated into mature adipocytes throughout the process of adipogenesis. Obesity is also linked to high levels of oxidative stress and dysfunctional antioxidant systems. White adipose tissue encourages the pathogenesis of insulin resistance, regulates metabolic inflammation, and stimulates the immune system through persistent low-grade inflammation, which further causes insulin resistance and type II diabetes mellitus. Adiponectin is the main peptide produced by adipocytes and its depletion is a major factor in obesity-related illnesses such type 2 diabetes, insulin resistance, and cardiovascular disease. Adiponectin’s effects are mediated by adiponectin receptors that exist in two isoforms (AdipoR1 and AdipoR2). Numerous researches have recently looked into how natural ingredients affect adipocyte development and lipid accumulation. Natural products’ potential anti-obesity actions include inducing apoptosis, stopping or delaying cell cycle development, and disruption of transcription factor cascades or intracellular signaling pathways at the initial stages of adipogenesis. Some of the phytoconstituents including curcumin, limonene, cinnamaldehyde, crocin, berberine, sulforaphane, piperonal, 6-gingerol and Ajoene are discussed for the management of obesity and hyperinsulinemia in this review.
Nanosponges (NSs) are a novel class of nanomaterials that have garnered substantial interest due to their unique properties and potential applications in drug delivery. The primary objective of this review is to provide the basics of nanosponge-based drug delivery systems, preparation techniques, and evaluation methods. It also covers associated aspects like challenges phased in industry and research in the manufacturing of NSs. NSs are tiny, mesh-like structures that can be loaded with drugs to improve solubility, stability, extended release, and bioavailability across various dosage forms. They can encapsulate a wide range of substances, including proteins, enzymes, hydrophilic and lipophilic chemicals, vaccines, and antibodies, and can be made from either inorganic or organic materials. NSs offer several advantages, such as compatibility, sterility, cost-effectiveness, extended release, better stability, reduced side effects, versatility, taste masking, and formulation enhancement. The review also elucidates different types of NS, their preparation methods, prospective applications, and evaluation processes. Overall, NSs have demonstrated considerable promise, with the potential to transform nanomedicine.
Metformin is an oral hypoglycemic agent and it is the primary medication for managing hyperglycemia. The relationship between metformin, gut microbiota and their combined effects on metabolic health and cognitive function remains inadequately explored, particularly concerning the modulation of gut microbes by metformin. Metformin recognized for its role in diabetes management, emerging evidence highlights its influence on gut microbiota and suggesting that its therapeutic effects extend beyond the gastrointestinal tract. The review delves into metformin’s capacity to modulate epigenetic pathways, including DNA methylation and histone modifications, thereby regulating gene expression related to inflammation and metabolism and modification of Key beneficial microbes, such as Akkermansia muciniphila and various Lactobacillus species, promoting systemic health through the production of SCFAs and modulation of gut-brain axis signaling. The role of gut microbiota in influencing neuroinflammation, cognitive function and metabolic health is well-explored in this review, revealing metformin’s potential to enhance cognitive performance, protect against neurodegenerative disorders and reduce neuroinflammation. This review provides critical insights into the mechanistic underpinnings of metformin’s actions, paving the way for future research on its broader applications in metabolic and cognitive health.
Cystic Fibrosis (CF) is a multisystem disorder primarily impacting the lungs, characterized by bronchial obstruction, infection and inflammation. Over 75% of CF patients are diagnosed by age 2, with most living beyond 18. The disease is linked to over 2,000 mutations in the CFTR gene. Current treatments focus on CFTR modulators like ivacaftor, lumacaftor and tezacaftor, which enhance CFTR protein function and improve lung health. However, these therapies face challenges, including limited efficacy against a wide range of CFTR mutations, high costs and concerns about long-term safety and effectiveness. Poor patient adherence and inefficacy of genetic therapies further complicate treatment. This review explores the genotypic and phenotypic expression of CFTR, evaluates current treatment strategies and analyzes the clinical outcomes of CFTR modulators in specific populations. It also examines the scope of ongoing clinical trials and considers future approaches, such as advanced gene editing technologies and personalized medicine, aiming to address the limitations of current treatments and improve disease management. These futuristic strategies hold promise in enhancing therapeutic efficacy, broadening mutation coverage and reducing the prevalence of CF through more targeted and durable interventions.
Cardiovascular Disorders (CVDs) are the leading cause of mortality and disability worldwide. Nanotechnology involving metal complexes as drug delivery systems is gaining attention for its cardioprotective potential. This review article discusses the effects of specific metal complexes implicated in CVD treatment. Complexation of these metals with some ligands and co-ligands such as VOL, Olmesartan, Metallothionein, α-Methyldopa, ADR-925, EDTA, DOX, p-cymene, and phenanthroline exhibit promising upshots in treating CVDs. This review compiles some metallic Nanoparticles (NPs) such as AgNPs, CuO, ZnO, SA-SeNPs, and Se-NPs with more specific physical, chemical, and biological characteristics along with their biological significance and their outstanding effectiveness in cardioprotection due to their smaller size. The discussion also highlights the mechanisms of metal complexes and nanoparticles and their role in ischemia-reperfusion injury, along with an emphasis on the potential toxicity of these metal complexes. These complexes demonstrated enhanced pharmacokinetics, reduced side effects, and superior cardioprotective outcomes by selectively targeting ischemic and infarcted tissues. Hence, coordinated complexes prove more effective than their free metal ions or drugs. The groundbreaking potential of metal complexes redefines the domain of cardioprotective strategies.
Background
Analytical Quality by Design (AQbD) enhances method robustness more effectively than traditional methods. Risk assessment and factor screening studies enabled to detection of analytical method parameters. The present study describes an AQbD enabled stability indicating RP-HPLC method for simultaneous determination of the phytochemical markers, Chlorogenic acid and Berberine in standard and clear stone drops, a Homeopathic marketed formulation. Currently no published methods reported based on stability indicating RP-HPLC technique for determination of these markers in any herbal formulations.
Materials and Methods
Two factors at three levels were considered using Central Composite Design for the method optimization. Statistical and graphical analyses were employed to assess the individual and combined interaction effects of critical method parameters on critical method responses.
Results
The optimized mobile phase was Methanol: 0.1% Formic acid (41.67:58.33% v/v) with 1.1 mL/min rate of flow, at 343 nm. Chlorogenic acid was eluted at 3.534 min and Berberine was eluted at 5.140 min respectively with 8 min run time. The method was validated as per ICH Q2 R1 guidelines and performed stress degradation studies; all validation parameters were within acceptable limits.
Conclusion
The established HPLC technique was useful as quality control tool for assessment of phytochemical markers in various traditional medicines and successfully applied to determine Chlorogenic acid and Berberine in Marketed Homeopathic formulation.
Background
Marjoram oil, an antimicrobial agent, has significant potential for industrial applications due to the presence of a high proportion of chemical components such as terpinene-4-ol, sabinene hydrate, thymol, and carvacrol. These components are effective against various broad-spectrum bacteria. Practically, microemulsions of oily drugs improve antibacterial effects by increasing penetration into the skin and bacteria. The topical microemulsion of marjoram oil for otitis media has not yet been explored. Therefore, the present study focuses on the development of a microemulsion of marjoram oil in the context of in vitro antibacterial studies against Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae, the microorganisms responsible for otitis media infections.
Materials and Methods
Marjoram oil was extracted via hydrodistillation and evaluated for physicochemical properties. It was combined with a co-surfactant and surfactant, emulsified with water to create a microemulsion. A 1:1 ratio of surfactants to co-surfactant was used, with varying concentrations of Smix and oil. Formulations were developed using a triangular diagram and titration method, and evaluated for compatibility, droplet size, polydispersity index, and zeta potential. The stable formulation F7 was tested for antibacterial activity against chloramphenicol ear drops.
Results
Formulation F7 contained the highest oil quantity (44.99% w/w), with water (35.73% w/w) and Smix (19.28% w/w). Its globule size was 370.3 nm, polydispersity index 0.48, and zeta potential -25.7 mV. FTIR studies confirmed formulation compatibility. The F7 microemulsion (200 μg/mL) showed a greater zone of inhibition compared to chloramphenicol (100 μg/mL) and was effective against Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae.
Conclusion
The developed microemulsion of marjoram oil was stable and effective against the microorganisms causing otitis media.
Background
Almost 1-3% of people worldwide suffer from arthritis. It is an autoimmune disease that can harm extra-articular organs in addition to joints. Rheumatoid arthritis is commonly treated with steroidal, non-steroidal anti-inflammatory, disease-modifying, antirheumatic, and immunosuppressive medications. These medications have the potential to cause several kinds of side effects, such as gastrointestinal issues, immunodeficiency, and humoral changes. Ayurvedic and Siddha medicine have been recognised as alternative treatments for arthritis. This study aims to develop a topical poly-herbal gel (containing extracts of ginger, garlic, clove, and eucalyptus) and evaluate it, as well as determine its ability to reduce inflammation in animals. The essential oils from the herbs were extracted using the hydro distillation method.
Materials and Methods
To prepare the poly-herbal gel, PEG 400, Carbopol 934, and the appropriate amount of distilled water have been used. After the herbal extract and gelling part were properly mixed. The final formulation’s pH was adjusted using triethanolamine.
Results
Various physical tests were conducted on the produced gel like colour, appearance, pH, texture, and viscosity as well as primary skin irritation, analgesic, and anti-inflammatory tests in rats to be compared to the marketed product. The study observed that carrageenan significantly enhanced paw oedema and cellular infiltrates, whereas the test sample (a polyherbal gel including ginger, garlic, eucalyptus, and clove extract) significantly decreased paw oedema.
Conclusion
In the treatment of rheumatoid arthritis, the developed topical polyherbal gel may be a safe and effective alternative for non-steroidal anti-inflammatory medicines; however, further study is required.
Background
Pharmacognosy is a scientific and systematic study of natural products helps in identification of raw material through morphological and chemical properties. Citrus limon (L.) Burm. f. is a tree, and its fruits are used for nutritional and therapeutic values in Indian traditional system of medicine, Ayurveda, and other like African and Romanian traditional systems. Citrus limon has a wide use but its pharmacognostical, physicochemical, phytochemical profile is not published till date. Thus, to develop a preliminary pharmacognostical, physicochemical, and phytochemical profile of Citrus limon current research has been carried out.
Materials and Methods
Citrus limon fruits were collected from its natural habitat and authenticated at CSIR-National Institute of Science Communication and Policy Research (CSIR-NIScPR). Pharmacognostical, physicochemical analysis was done as per Ayurvedic Pharmacopeia of India.
Results
The macroscopic analysis suggested that fruit of Citrus limon was ovoid; the microscopic analysis revealed the presence of prismatic calcium oxalate crystals; in the physicochemical parameters loss on drying was found 11.90% and pH 2.98. The phytochemical analysis revealed presence of proteins, alkaloids and flavonoids. The fourier transform infrared spectroscopy showed presence of alcohol, alkenes, and aromatic compounds. Fingerprinting analysis of C. limon through high performance thin layer chromatography showed presence of various phytoconstituents in different concentrations through different peaks and R f values and also sample showed presence of 2.36% limonene.
Conclusion
The present study will serve as a quality control parameter of Citrus limon fruit. The study will be helpful in easy identification, authentication, and detection of adulteration in marketed samples.
Background
Serotonergic system plays an important role in the energy balance evidenced by various studies. The present study was designed to investigate the involvement of 5-HT1 receptor subtype in experimental obesity.
Materials and Methods
In the present study effects of chronic administration of eletriptan (2.5 and 10 mg kg-1 day-1, .p.o) specific 5-HT1receptor agonist for 8 weeks along with high fat diet to the obese rats which were pre-treated with high fat diet feeding for 8 weeks on the various parameters of obesity were analysed.
Results
Treatment with eletriptan (2.5 and 10 mg kg-1 day-1, .p.o) produced significant dose dependent decrease (p<0.05) in various parameters of obesity as compared to high fat diet group. Eletriptan positively modulate the parameters of obesity. The present data demonstrated that high fat diet induced obesity was prevented by 5-HT receptor agonist eletriptan.
Conclusion
Above findings give the strong evidence of involvement of 5-HT1 receptor subtype in obesity.
Background
This study assessed the effects of Vitamin D (Vit D) and Pioglitazone (PIO) on metabolic and histopathological parameters in STZ-NA-induced diabetic rats, focusing on lipid metabolism, liver enzymes, adipocytokines, and liver tissue structure.
Materials and Methods
Diabetes was induced using streptozotocin and nicotinamide, and rats were separated into five groups: normal control, diabetic control, and three treatment groups receiving Vit D, PIO, or a combination. Treatments were administered daily for eight weeks, and biochemical analyses included glucose, lipid profiles, liver enzymes, and adipocytokines (adiponectin and resistin). Liver tissue was examined histologically.
Results
Diabetic rats showed dyslipidaemia with elevated cholesterol, triglycerides, and LDL, and decreased HDL. Vit D, PIO, or their combination treated rats reduced cholesterol and LDL, with the combination also increasing HDL, suggesting a synergistic effect. Both Vit D and PIO treatments lowered liver enzymes, with combination therapy providing the greatest improvement. Adipocytokine analysis revealed a reduction in resistin levels, particularly with the combination therapy, while adiponectin levels remained unchanged. Histopathological analysis showed liver damage in diabetic rats, but the combination therapy preserved liver architecture with minimal degenerative changes.
Conclusion
The combination of Vit D and PIO shows promising potential for improving lipid metabolism, liver function, and adipocytokine regulation in diabetes, offering a therapeutic strategy for handling metabolic complications. More study is required to explore the essential mechanisms and optimize treatment protocols.
ABSTRACT
Background
Sickle Cell Anemia (SCA) is a hereditary blood disorder that significantly impacts the quality of life of those affected. While conventional treatments do have improved patient outcomes, they frequently fall short of managing all the symptoms and complications related to the disease. The trial was supported by established preclinical research, observational case studies and series reports on T-AYU-HM Premium. The present study is randomized, multicentric parallel-group clinical trial of the herbo-mineral formulation T-AYU-HM premium in patients with sickle cell anemia.
Materials and Methods
The study was designed as an open-label, randomized, multicentric trial involving 100 sickle cell anemia patients (HbSS). Prior to participation, informed consent was obtained from each patient or their guardian in accordance with the ICH-GCP guideline. Data collection focused on hemoglobin variants, hematological parameters and patients’ vital and clinical data, all screened based on specific inclusion and exclusion criteria. The study was conducted over a period of 180 days. The HRQOL-26 assessment tool was employed to assess the effectiveness of the treatment on patients’ quality of life.
Results
After 180 days, T-AYU-HM Premium significantly reduced sickle hemoglobin and increased fetal hemoglobin. The formulation also substantially decreased white blood cells, thereby preventing inflammation-associated complications. 93.9% consistently reported experiencing satisfactory sleep and no issues with anxiety, anger, or reduced activity. Additionally, 100% of participants reported no sudden or debilitating pain episodes and remained pain-free during the treatment period with T-AYU-HM Premium.
Conclusion
The treatment with T-AYU-HM Premium in sickle cell disease patients demonstrated its effectiveness. Over the 180-day period, no adverse responses were reported, highlighting its safety. Furthermore, the therapy contributed to significant improvements in mental health and pain-related quality of life for the participants.
Backgroud
Steroids are more commonly used in the treatment of tumor-induced edema in primary brain tumor patients receiving radiation therapy. Steroid-induced Cushing syndrome is one of the adverse effects of steroid therapy. The present study aimed to find out the incidence of steroid-induced Cushing syndrome, their treatment outcome and the influence of steroid induced Cushing syndrome on health-related quality of life in primary brain tumor patients.
Materials and Methods
A prospective observational study was conducted for the period of 4 months in the department of radiation oncology, Sri Ramachandra Institute of Higher Education and Research (DU) from April 2024 to July 2024. A total of 10 patients treated with radical/adjuvant radiation therapy were included as per inclusion and exclusion criteria. The health-related quality of life was assessed using validated Cushing-QOL questionnaire.
Results
Out of 10 patients, females were predominant (60%) over males (40%). Among 10 patients, 2 developed Cushing syndrome. Patients with steroid-induced Cushing syndrome have an impaired quality of life compared to other patients. Patients with Cushing syndrome have trouble brushing easily, irritability, mood swings and a poor quality of life.
Conclusion
In this study, the incidence of steroid-induced crushing syndrome was found to be 20%. The treatment outcome of steroid-induced Cushing syndrome was found to be improved after tapering the dose of steroids. Patients with steroid-induced Cushing syndrome experienced significant impairments in various aspects of their quality of life, including physical health, psychological well-being and social functioning.
Background
Poor medication adherence can significantly reduce treatment efficiency and impact clinical outcomes, ultimately hindering the effectiveness of patient care. Non-adherence to anti-hypertensive medication is a main cause of poor control of hypertension worldwide. The National Family Health Survey (NFHS 5) data from India revealed a significant proportion of individuals have had their blood pressure measured, with a national average of 66.7%. However, this rate has considerable regional variations, ranging from as low as 30.3% to as high as 98.5% across different districts. The southern region of India demonstrates the highest average prevalence of ever-measured blood pressure at 75.8% (Andhra Pradesh with 74.7%). The present study aims to assess the level of adherence and the reasons behind nonadherence in individuals with hypertension.
Materials and Methods
A cross-sectional observational study was conducted using a questionnaire from October to December 2023.
Results
A Total of 217 hypertensive individuals participated. Which had a predominance of females (n=119, 54.8%) and 98 (45.2%) were males. The mean age of respondents was 60.4 years, the majority aged 61-80 years (n= 125, 57.60%). In this study, 63.5% were low adherers, 34.1% were medium adherers, and 2.3% were high adherers. The study disclosed that forgetfulness (20.73%) is among the primary reasons for non-adherence in hypertensive patients.
Conclusion
Based on this study’s results, improving people’s understanding of hypertension is necessary. Strategies such as patient education, patient counselling, and medication management programs could help the identified hurdles to adherence and reduce hypertension-related cardiac adverse outcomes.
Backgroud
Invasive Fungal Infections (IFIs) are on the rise, notably among critical care patients in the Intensive Care Unit (ICU) undergoing treatment with Broad Spectrum Antibiotics (BSAs). These antibiotics, designed to combat a wide range of bacteria, inadvertently disrupt the body's microbial balance, creating an environment favorable for opportunistic fungi, particularly Candida albicans, leading to severe infections. ICU patients, often with multiple risk factors, are at heightened risk. Aim and Objectives: This study aimed to assess the incidence of fungal infections in ICU patients treated with broad-spectrum antibiotics, highlighting the potential implications for patient outcomes and antibiotic stewardship in healthcare settings.
Materials and Methods
A cross-sectional observational study was conducted in the intensive care unit of Dhiraj General Hospital, Vadodara, Gujarat. Patients aged between 18-65 years who received broad-spectrum antibiotics for more than five days were included in the study. Patients with additional risk factors for developing fungal infections in the ICU, such as diabetes mellitus or corticosteroid therapy, were excluded. Relevant data were collected from patients' medical records using a predefined proforma. The study aimed to determine if broad-spectrum antibiotics were independently associated with the development of fungal infections in ICU patients.
Results
The study unveiled a significant incidence of fungal infections in patients on broad-spectrum antibiotics. Among the 71 patients, 9.8% (7 individuals) met criteria for fungal infection development, emphasizing the need for vigilant monitoring.
Conclusion
The use of broad-spectrum antibiotics in the ICU is strongly linked to an increased risk of fungal infections. To mitigate this risk, healthcare providers should consider dose adjustments, narrow-spectrum antibiotics and prompt fungal infection diagnosis and treatment. Diagnosing fungal infections remains challenging due to confounding factors, comorbidities and high diagnostic costs. Therefore, it's advisable to restrict broad-spectrum antibiotic use, such as third-generation cephalosporins and carbapenems, to reduce invasive fungal infection risk and antibiotic-resistant strains. Close monitoring of patients for fungal infection signs during broad-spectrum antibiotic treatment is essential.
Backgroud
Antibiogram serves as a crucial tool for providing guidance in empiric therapy. Most of the hospitals rely on Traditional Antibiograms (TA) for prescribing antibiotics. But recognizing the importance of Syndromic Antibiograms (SA) and integrating it into clinical practice enhances the effectiveness of empiric antibiotic therapy. It is crucial for the Antimicrobial Stewardship Programs (AMSPs) to extend their approach beyond the TA. Purpose: This prospective study was aimed to compare the susceptibility rates between a traditional and syndromic antibiogram for the most common organisms.
Materials and Methods
This study was conducted in a tertiary care hospital, Chennai for a period of 6 months. SA’s were developed and compared with TA to analyze the antibiotic susceptibility of the most common pathogens associated with Urinary Tract Infection (UTI), Respiratory Tract Infection (RTI) and Blood Stream Infection (BSI). The collected data were analyzed using SPSS version 23.
Results
A total of 400 bacterial isolates were examined. The three most frequently identified organisms were Escherichia coli (E. coli), streptococci and Salmonella typhi. The cumulative susceptibilities of these bacteria were compared using both TA and SA. A significant difference was found in the susceptibility rate of E. coli and streptococci species for fosfomycin, amikacin, nitrofurantoin, ampicillin and doxycycline between TA and SA.
Conclusion
Our study clearly depicted the variations in isolated microorganism’s susceptibility rate between a syndromic and traditional antibiogram. These differences may be significant, not only for selecting most effective empirical antimicrobial therapy for a patient but also helps in monitoring the resistance pattern of antibiotics to certain organisms within an institution.
Backgroud
Blood Pressure (BP) variability is a crucial yet often overlooked factor in cardiovascular health, reflecting the dynamic nature of cardiovascular regulation in response to various stimuli. Among the factors influencing BP variability, body posture is particularly significant, as it can affect hemodynamics and blood flow. Furthermore, the Body Mass Index (BMI) serves as a critical indicator of body composition and health risk. Research has indicated that BMI can influence BP, but its interaction with postural changes remains less explored. Hence, the current study aimed to assess the BP variability in different sitting postures in correlation with BMI.
Materials and Methods
A cross-sectional descriptive study was carried out with the sample of 50 participants aged between 20 to 33 years. BP was measured according to the standardized protocol with mercury sphygmomanometer including four different sitting measurements: sitting with back rest and without crossed legs, sitting without back rest and without crossed legs, sitting with crossed legs and back rest, sitting with crossed legs and without back rest. BMI was calculated by dividing weight in kilograms by height in meters squared. Paired t-test and Pearson correlation were used for statistical analysis.
Results
Sitting with back rest without crossed legs showed significantly lower BP compared to other sitting postures. BP taken at the different sitting positions were positively related to each other with moderate to strong association. BMI was positively related to BP taken at sitting with crossed legs without back rest.
Conclusion
The findings of the study are expected to enhance the understanding of postural influences on cardiovascular health and contribute to more personalized recommendations for BP measurements at clinical set-up.
Backgroud
Gout is a prevalent form of inflammatory arthritis characterized by elevated uric acid levels, often influenced by dietary habits, particularly red meat consumption. Understanding public knowledge and awareness of gout and its dietary risk factors is essential for effective prevention and management strategies.
Objectives
This study aims to assess the knowledge and awareness of the general population in Saudi Arabia regarding gout disease and the health implications of high red meat consumption.
Materials and Methods
A cross-sectional survey was conducted among 818 participants across various regions of Saudi Arabia. Data were collected using a structured questionnaire covering demographics, knowledge of gout, awareness of red meat consumption risks, and information sources. Statistical analyses, including chi-square tests, were performed to identify associations between knowledge levels and sociodemographic variables.
Results
Most participants were male (63.2%), aged between 18 and 30 years (42.5%), and held a diploma (51.5%). While 81.7% had heard of gout, only 30.7% recognized red meat consumption as a contributing factor. Notably, 70% incorrectly believed that eating meat reduces the risk of gout attacks. Significant associations were found between knowledge levels and gender, marital status (p=0.01), and region (p=0.01), with males, married individuals, and those from certain regions exhibiting poorer knowledge.
Conclusion
Despite general awareness of gout, there is a substantial gap in understanding its dietary risk factors, particularly concerning red meat consumption, among the Saudi Arabian population. Targeted educational interventions are necessary to enhance public knowledge and promote dietary modifications to mitigate gout risk.
Backgroud
Medication adherence is essential for effective Type 2 Diabetes Mellitus (T2DM) management; still, non-adherence occurs in countries with low or middle incomes like India, leading to uncontrolled glycemia and comorbidities. The study objectives were to assess adherence patterns in T2DM patients, identify non-adherence factors, evaluate the effectiveness of awareness measures, and follow HbA1c changes to establish adherence-related outcomes.
Materials and Methods
The 12-month prospective observational study was conducted in the General Medicine and Endocrinology outpatient departments of a tertiary care hospital. It utilized the 8-item Morisky Medication Adherence Scale (MMAS-8) and 15-item Medication Adherence Reasons Scale (MARS-15) to measure adherence and identify non-adherence factors. The study also offered patient verbal counseling and follow-ups to assess effectiveness.
Results
The study found that glycemic control improved, with HbA1c levels dropping from 61.49% to 52.17% and medication adherence dropping from 55.9% to 23.6%. Factors contributing to poor adherence included forgetfulness 89 (20.36%), medication cost 36 (8.23%), and concerns about side effects 39 (8.92%).
Conclusion
Verbal counseling and leaflets significantly improved medication adherence and glycemic control in T2DM patients by overcoming barriers like forgetfulness, inconvenience in taking medications as prescribed, and fear of side effects, emphasizing the importance of patient-centered education strategies.
Backgroud
The practice of community pharmacies dispensing antibiotics without a prescription is widespread, and improper use of these medications is associated with the emergence of resistance. Hence, this study aimed to evaluate the dispensing practices of antimicrobials in community pharmacies of Bharatpur city, Nepal.
Materials and Methods
A cross-sectional study involving 101 community pharmacies of Bharatpur Metropolitan city was conducted for a duration of six months starting from 1st January 2022 till 30th June 2022. A simulated patient method was used to determine the antimicrobials dispensing practices using a case scenario of acute diarrhea. Using a simple random method, the community pharmacy was chosen as the study site from among the community pharmacies that were registered with the Department of Drug Administration (DDA). A trained pharmacists posing as a simulated patient gathered data, and the data was then analyzed using chi-square test to find out the association.
Results
Ninety-three percent of the 101 community pharmacies dispensed antimicrobials without prescription. Among the most frequently dispensed medications were antimicrobials (53.5%), gastrointestinal agents (44.4%) and mineral supplements (2%). Moreover, the trend of dispensing antimicrobials was significantly higher among non-pharmacy professionals (p=0.014), including Health Assistants (64%), Community Medical Assistance (55.6%) and those with orientation training (42.9%).
Conclusion
The study findings indicate that there is unquestionably irrational dispensing of antimicrobials in cases of acute diarrhea. To reduce this, it is necessary to prioritize awareness campaigns about the responsible use of antimicrobials, and to ensure that relevant policies, rules and regulations are implemented promptly.
Backgroud
Complementary and Alternative Medicine (CAM) use is prevalent among patients with Non-Communicable Diseases (NCDs). Understanding the factors driving CAM use in this population is essential for improving chronic disease management and patient care. This study aimed to assess the prevalence and factors associated with CAM use among patients with NCDs and to explore the types of CAM practices commonly utilized within this group.
Materials and Methods
The study surveyed 245 participants, gathering data on their CAM usage, types of CAM practices, conditions treated, and influential factors in their CAM choices. The study also analyzed the demographic and disease-specific preferences for CAM practices, particularly focusing on usage by condition and patient demographics.
Results
A high prevalence of CAM usage (72.6%) was found among participants, with diabetes mellitus and arthritis patients showing notable usage rates of 13% and 11%, respectively. Common CAM practices included herbal remedies, physician-recommended treatments, supplements, prayer, and walking. The study revealed a preference among male and higher-educated individuals for combining allopathic and herbal treatments. Friends and family were significant influences on CAM choices, affecting 65.3% of cases. Notably, many participants did not disclose their CAM use to their primary healthcare providers.
Conclusion
The findings highlight a substantial engagement with CAM among NCD patients, underscoring the need for healthcare providers to incorporate CAM considerations into chronic disease management. Enhanced communication regarding CAM can improve patient care by aligning healthcare approaches with patient preferences and needs.
Background
As recommended by World Health Organization, Traditional and Complementary Medicines should be mainstreamed to manage and prevent chronic diseases, one such deadly chronic disease is Cancer. Hence, this study was done with the objective to showcase the vital role of Siddha medicine in oncology by reporting the morbidity profile of patients attended Siddha Cancer Special OPD (SCS-OPD) of Arignar Anna Government Hospital of Indian Medicine, Chennai, Tamil Nadu, India.
Materials and Methods
This study is a retrospective cross-sectional study conducted among the cases who attended SCS-OPD from January to April of 2024. Data on socio-demographic details like age, gender, education, occupation and clinical profile were collected from the medical records already maintained in SCS-OPD. Collected data were summarized and presented as frequencies and proportions.
Results
Of 504 cases who attended the SCS-OPD during the study period, 105 cases were newly reported and the remaining were revisited cases. Among them, a greater number of cases were above 50 years of age with female preponderance. Breast cancer accounting for 21.9% of all cases, followed by mouth (9.52%), lung (9.52%) and other unspecified category (9.52%). 18.09% of patients had metastasis during their first visit. In terms of past treatment, 43.81% of patients didn’t underwent any therapies before attending SCS-OPD. 24.7% patients were seeking Palliative care.
Conclusion
This study provides valuable insights into the cancer patient population at SCS-OPD, emphasizing demographic patterns, educational and occupational backgrounds, geographic distribution, dietary habits, personal behavior, and co-morbidities. These findings suggest the need for targeted interventions, improved early detection, expanded geographic outreach, and continued exploration of Siddha treatments in comprehensive cancer care strategies.
Background
A Medication Error (ME) is a preventable adverse event in medical treatment. The main objective of the study is to classify, categorize, evaluate, monitor, and assess the severity of medication errors and report among the inpatients in tertiary care hospitals.
Materials and Methods
This prospective observational study was conducted among 100 surgical gastroenterology inpatients on medication error in tertiary hospitals. For this study, the data were collected by using patient demographic details, a reconciliation form, a medication error form, and a medication audit check review form where the medication. The outcome was expressed as mean percentages and risk. Regression analysis is used to assess the impact of different risks on the prevalence of medication error.
Results
The study was conducted among 100 inpatients. Total medication errors were included n=83. Among the most common medication errors were found prescribing errors 31 (37.30%), followed by documentation errors 28 (33.70%). Nursing errors were more than the doctor errors. Most of the errors were reported on day 28 (33.75%). Factors responsible for medication error were no usage of generic names, no documentation, and incomplete reconciliation; the risk was observed among the age group of people ?60 but not significant.
Conclusion
This study establishes the effective medication error evaluation, assessment, and reporting of medication error. These errors can be prevented by implementing a Computerized Physician Order Entry system (CPOE), and the results of this study demonstrate the role of clinical pharmacists in the identification and reporting of medication errors.
Appropriateness of Topical Corticosteroids Usage in Dermatology Patients of a Tertiary Care Hospital
Background
Topical Corticosteroids (TCs) have been a cornerstone in the management of various dermatological conditions. The dual nature of their widespread use and potential for misuse has emerged as a significant concern, particularly in resource-limited settings such as tertiary care government teaching hospitals. The aim of the study is to analyse the prescription patterns and appropriateness of TCs usage among the dermatology patients.
Materials and Methods
A prospective observational study was carried out in the out-patient dermatology department of a tertiary care government teaching hospital. Adult patients (18-60 years) who consulted the dermatology department and prescribed TCs were included in the study. Patient’s sociodemographic details, dosage form, strength, frequency and duration of TCs were documented. Depending on the strength of TCs, the potency of TCs were classified and their appropriateness was evaluated by validated questionnaire.
Results
This study evaluated 160 dermatology patients prescribed TCs in a tertiary care hospital. Male patients (58.12%) predominated, with seborrheic dermatitis (55.62%) being the most common condition followed by eczema, lichen planus, lichen simplex chronicus. Potent TCs (33.75%) were frequently prescribed. Appropriateness scores averaged 68.4%, indicating suboptimal adherence to guidelines, particularly in allergic contact dermatitis (35%). Addressing improper usage through clinical education and standardized protocols is essential.
Conclusion
This study highlights inappropriate topical corticosteroid use and suboptimal guideline adherence (68.4%) by the patients. Potent steroids were often prescribed, especially for seborrheic dermatitis. Improved prescribing practices, pharmacist involvement in dispensing, patient education and counselling are essential to ensure safe, effective, and rational use of TCs.
Background
Glimepiride along with Linagliptin have been commonly utilized in combination for treatment of type 2 diabetes mellitus. For routine analysis and quality control, it is essential to develop a straightforward, precise, as well as accurate Ultraviolet spectroscopic approach for their simultaneous quantification in synthetic mixture.
Materials and Methods
Glimepiride and Linagliptin were developed using the Ultraviolet Spectroscopic Method at 228 and 296 nm, respectively. The absorbance correction method revealed linearity with a correlation coefficient of 0.9983 in 2-10 μg/mL concentration ranges for Glimepiride as well as 5-25 μg/mL for Linagliptin. Validation parameters, that includes accuracy, linearity, robustness, precision, specificity, along with limit of detection/quantitation, had been evaluated in accordance with International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use recommendations.
Results
The developed approach showed excellent linearity for both drugs over selected concentration range. Accuracy and precision were within acceptable limits, confirming the reliability of the method. Specificity studies demonstrated no interference from impurities or excipients. The method was robust and reproducible, with detection and quantitation limits adequate for routine analysis.
Conclusion
The simultaneous measurement of Glimepiride, as well as Linagliptin in their synthetic mixture, had been achieved through successful development as well as validation of a straightforward, accurate, and precise Ultraviolet spectroscopic approach. The procedure is appropriate for routine quality control and pharmaceutical analysis since it complies with International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Q2 (R2) guidelines.
Background
This study aimed to analyze the demographic distribution, acne characteristics, treatment patterns, and quality of life impact of acne vulgaris.
Materials and Methods:
A cross-sectional study was conducted at a tertiary care hospital, it involved 70 patients with clinically diagnosed acne.
Results
The study found a slightly higher prevalence of acne in females aged 19-45 years. Common lesions were located on the cheeks and forehead, with open comedones being most frequent. Icepick scars were more common in males. The study showed that acne severity increased with age, with younger individuals often experiencing moderate to severe forms. A variety of treatments, including topical and oral medications, were prescribed, with an average of over four medications per prescription. The Dermatology Life Quality Index (DLQI) results showed varying impacts on quality of life, highlighting the need for gender-specific treatment strategies. The study emphasizes the importance of understanding acne’s demographic and clinical variations for better management.
Conclusion:
This study reveals notable age and gender variations in the distribution and severity of acne vulgaris.
Background
Kidney stones form due to the crystallization of minerals and salts in the urinary tract. Despite advancements in understanding their pathophysiology, treatment options remain expensive and often lead to recurrence. Herbal therapies have gained attention as alternative treatments. This study evaluates the anti-urolithiatic activity of methanolic extracts of Nelumbo nucifera, Anogeissus latifolia, Leucas aspera, and their polyherbal formulation (PHF) in a urolithic rat model.
Materials and Methods
A 28-day study used a CaOx-induced rat model (70 mg/ kg) to induce urolithiasis. Rats received N. nucifera, A. latifolia, and L. aspera extracts (250/500 mg/kg), Cystone (750 mg/kg), or PHF (375 mg/kg). Urine, serum, and kidney analyses, including LDH, GSH, LPO, and histopathology, were performed (p <0.001).
Results
Methanolic extracts significantly reduced elevated biochemical markers (creatinine, calcium, phosphorus, uric acid, and alkaline phosphatase), restored urinary pH, and increased urine volume. PHF exhibited the highest efficacy, outperforming individual extracts. Antioxidant activity was enhanced, reducing kidney stone formation. N. nucifera showed the most potent activity among single extracts.
Conclusion
The phytoconstituents, particularly saponins, played a key role in reducing calcium oxalate crystal formation and recurrence. This study highlights polyherbal formulations as cost-effective and efficient alternatives for managing kidney stones.
Background
Depression is a condition that affects mental health defined by persistent feelings of sadness and reduced interest in daily activities. Myocardial Infarction (MI) and stroke significantly contribute to global mortality and disability rates. Compared to other antidepressant medications, sertraline demonstrates a lower risk of overdose-related mortality, a reduced potential for dependence, and typically better tolerated by patients. The study focused on evaluating the efficacy of sertraline in managing newly diagnosed depression among patients who have suffered a stroke or MI.
Materials and Methods
A prospective cohort study includes participants assigned to two groups: Group A (post-MI depression) and Group B (post-stroke depression). We evaluated the severity of depression using HAM-D scores from baseline to Week 24, along with clinical parameters such as lipid profiles, HbA1c, blood pressure, and coagulation factors. We also measured medication adherence using MARS and assessed Health-Related Quality of Life (HRQoL) using RAND-36.
Results
This research comprised 129 participants, with 62 assigned to group A and 67 to group B. Statistical analysis indicated that sertraline resulted in symptom reduction of depression across both groups, with group B (Post-stroke patients) demonstrating a clinical enhancement in the HAM-D score at week 24. Post-stroke patients showed a more favorable response in TC, HDL, LDL, and TG levels compared to MI patients; Nevertheless, this variation did not achieve significance (p >0.05).
Conclusion
Sertraline effectively reduced depressive symptoms in both groups, with post-stroke patients demonstrating overall improvements in HAM-D scores, lipid profile, medication adherence, and HRQoL.