Introduction: To prevent strokes or blood clots in patients with atrial fibrillation, apixaban has been preferred for prescription compared with vitamin K antagonists. This review summarizes the findings of previous studies related to apixaban pharmacotherapy. Methods: For potential relevance, the titles and abstracts of all records obtained from databases were screened, and 120 articles were included in this study. Results: In individuals with nonvalvular atrial fibrillation and venous thromboembolism, apixaban demonstrated efficacy in preventing atrial thromboembolic events. In elderly patients aged >80 years, those with a body weight <60 kg, and individuals with serum creatinine >1.5 mg/dl, a dose reduction is suggested. Simultaneous intake of grapefruit, pomelos, limes, marmalades, garlic, ginger, chamomile tea, green tea, turmeric, ginkgo biloba, vitamin E, fish oil, and St. John’s wort necessitates vigilance. Anaemia, gastrointestinal disorders, melena, haemorrhagic anaemia, gastrointestinal haemorrhage, haematuria, decreased haemoglobin, and intracranial haemorrhage were reported when apixaban was taken with drugs such as acenocoumarol, acetylsalicylic acid, allopurinol, amiodarone, celecoxib, citalopram, clopidogrel, and dabigatran. Discussion: Apixaban, or Eliquis, acts by direct inhibition of coagulation factor Xa (thrombokinase), which is synthesised in the liver. For reducing thromboembolic events and stroke, apixaban is recommended to be more effective than rivaroxaban, warfarin, and dabigatran, with a lower risk of bleeding and intracranial haemorrhage. Conclusion: Determining the vitamin E/cholesterol ratio in patients with nonvalvular atrial fibrillation is important. Polypharmacy with ketoconazole, diltiazem, sildenafil, tadalafil, vardenafil, cyclosporine, clarithromycin, enoxaparin, amiodarone, and naproxen requires further attention.

Traditional food in Uttarakhand, particularly from the Garhwal Himalayas, is deeply rooted in an ancient healing system where food and medicine often share common origins. Historical records indicate that the Garhwali people have never experienced deaths from food scarcity, underscoring the importance of their traditional dietary practices. A prominent ethnofood used during the monsoon season in this region is Urtica dioica (stinging nettle), a perennial herb belonging to the Urticaceae family. Rich in phytochemicals such as flavonoids, lignans, sterols, fatty acids, alkaloids, and terpenoids, U. dioica possesses a wide range of pharmacological properties. These include antidiabetic, antidiuretic, antiviral, antimicrobial, cardioprotective, anti-inflammatory, anti-arthritic, antihelmintic, anti-benign prostatic hyperplasia, anticancer, hepatoprotective, antioxidant, anti-allergic, detoxification, anti-endometriosis, and anti-aging activities. Experimental studies highlight the therapeutic potential of its components and extracts, which offer benefits through multiple molecular pathways. The documentation and continuous updating of knowledge regarding these ethnomedicinal foods are crucial for advancing research into their pharmacological potential. This could also promote local economic growth through initiatives like "Vocal for Local" in Uttarakhand's Garhwal region. This review focuses on offering a detailed examination of the medicinal properties, chemical composition, pharmacological activities, safety profile, and prospective applications of U. dioica.

Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a global health challenge, with lengthy treatment regimens, drug resistance, and systemic side effects hindering effective therapy. This study aimed to develop and evaluate hyaluronic acidcoated isoniazid-chitosan nanoparticles (HA-coated IS-CNP) as a macrophage-targeted drug delivery system to improve isoniazid bioavailability and reduce systemic exposure. Materials and Methods: Isoniazid-chitosan nanoparticles (IS-CNP) were manufactured using solvent evaporation, optimized using a design of experiments approach, and coated with hyaluronic acid. The nanoparticle formulations were evaluated for particle size, morphology, EE, and zeta potential. The in vitro release investigations of drug-containing nanoparticle formulations were conducted to analyze release kinetics, and macrophage uptake was evaluated in RAW 264.7 cells. Pharmacokinetic studies in Wistar rats were conducted to assess the oral bioavailability of HA-coated IS-CNP in comparison to uncoated nanoparticles and pure isoniazid. Results: The optimized HA-coated IS-CNP formulation displayed a particle size of approximately 512 nm, high EE, and stable zeta potential. FTIR and XRD analyses confirmed successful hyaluronic acid coating. In vitro release studies followed a Higuchi model, suggesting a diffusion-controlled mechanism with a non-Fickian release pattern. Macrophage uptake of HA-coated IS-CNP was significantly higher than uncoated nanoparticles and pure isoniazid. Pharmacokinetic studies indicated a substantial increase in AUC for HA-coated IS-CNP, indicating prolonged systemic circulation and enhanced bioavailability. Discussion: The improved macrophage uptake and extended circulation time of HA-coated IS-CNP underscore the potential of HA as a targeting ligand and stabilizing agent in nanoparticulate drug delivery systems. The diffusion-controlled release mechanism and improved pharmacokinetic profile support the efficacy of this novel formulation. Conclusion: The development of hyaluronic acid-coated isoniazid-chitosan nanoparticles represents significant progress in the field of TB therapy. By enhancing bioavailability and targeting the macrophages while reducing systemic side effects, this new drug delivery approach provides a potential for improving TB treatment.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by idiopathic inflammation primarily affecting the mucosa and submucosa of the colon. It manifests with symptoms such as bloody diarrhea, abdominal pain, weight loss, and rectal bleeding, following a relapsing and remitting pattern. UC incidence peaks at ages 15–30 and 50– 70, with an equal gender distribution. This multifactorial disease involves genetic predispositions, environmental influences, epithelial barrier dysfunction, and immunological factors. The intricate interplay between genetic predispositions and environmental triggers continues to shape our understanding of UC, offering potential pathways for targeted therapies and preventive strategies. Despite advances in conventional therapies—including amino-salicylates, corticosteroids, immunomodulators, and biologics—many patients experience treatment failure, loss of response over time, or debilitating side effects such as infections, malignancies, and systemic toxicities. These limitations underscore the urgent need for novel therapeutic approaches that are both more effective and safer. In this review, we highlight recent advances in UC management, focusing on emerging small molecules, novel clinical applications, and therapeutic agents that aim to provide patients with more targeted, durable, and tolerable treatment options.

Introduction: This review explores the role of Artificial Intelligence (AI), particularly Machine Learning (ML) and Deep Learning (DL), in enhancing molecular diagnostics and therapeutic strategies for glioma. Method: A comprehensive literature review was conducted using prominent scientific databases to assess current applications of AI, ML, and DL in glioma diagnosis and treatment. The review focused on medical imaging, pathology, gene expression analysis, and personalized medicine. Results: AI techniques, especially DL, effectively analyze complex datasets such as medical imaging and genomic profiles, improving diagnostic precision and efficiency. Integration of AI in microarray technologies facilitates the identification of glioma-associated biomarkers and supports disease classification and prognosis. Models such as artificial neural networks (ANNs) and Bayesian frameworks enhance the interpretation of gene expression data and the extraction of disease-specific signatures. Discussion: This review highlights AI’s potential in glioma care by improving imaging and genomic analysis, enabling biomarker identification, and advancing personalized treatment. It also emphasizes the importance of clinically validated and interpretable AI systems. Conclusion: AI has transformative potential in glioma care, offering improved diagnostic accuracy and enabling personalized therapeutic strategies. Continued research into AIdriven models is essential to advance precision medicine and elevate the standard of glioma healthcare

Introduction: Gastric ulcers are common lesions of the gastrointestinal tract. Alginate is a natural copolymer extracted from brown sea algae, while zinc oxide nanoparticles (ZnO NPs) exhibit notable anti-inflammatory, antioxidant, antimicrobial, and antibacterial activities. This study aimed to combine the therapeutic advantages of zinc oxide and alginate in nanoparticle form, leveraging their antioxidant, antibacterial, and anti-inflammatory properties for the treatment of gastric ulcers. Materials and Methods: Thirty-six rats were divided into six groups. Gastric ulcers were induced by administering 95% ethanol orally at a dose of 5 ml/kg body weight. One hour later, the ulcerated rats received the following treatments: distilled water (ulcer group), 60 mg/kg ZnO NPs (ZnO NPs–treated group), 60 mg/kg alginate (alginate-treated group), 30 mg/kg ZnO-ALGNPs (low-dose ZnO-ALGNPs–treated group), or 60 mg/kg ZnO-AL-GNPs (high-dose ZnO-ALGNPs–treated group), along with a control group. Results: Treatment with alginate, zinc oxide, and both low and high doses of ZnO-AL-GNPs significantly reduced the ulcer index, gastric juice volume, malondialdehyde, TNF-α, IL-6, DNA fragmentation, and caspase-3 expression. These treatments also significantly increased gastric juice pH, glutathione, nitric oxide, catalase, and Bcl-2 expression.. Histo-logical examination demonstrated marked improvement in gastric mucosal architecture, with the most pronounced therapeutic effects observed in the high-dose ZnO-ALGNPs group. Discussion: ZnO-ALGNPs offer a promising therapeutic strategy for gastric injury due to their potent antioxidant and anti-inflammatory activities, their ability to protect DNA, their capacity to neutralize gastric acid, and their effectiveness in promoting mucosal healing. Conclusion: ZnO-ALGNPs possess strong antiulcer properties attributed to their antioxidant and anti-inflammatory actions and their overall protective effects on gastric tissue.

Background: Atopic dermatitis (AD) is a chronic inflammatory dermatosis characterized by immune imbalance and oxidative damage. Ramelteon, a melatoninergic receptor agonist, has recently been shown to exhibit immunomodulatory and antioxidant properties, suggesting potential therapeutic benefit in inflammatory dermatoses. Objective: The present study aimed to investigate the therapeutic effect of topically applied ramelteon in the DNCB-evoked mouse version of atopic dermatitis. Methods: 40 albino mice were indiscriminately allocated into 5 categories of 8 animals: normal controls, DNCB-model, sham, tacrolimus, and ramelteon. Ramelteon 0.25% was applied one time daily for three weeks, and the standard comparison was with tacrolimus 0.1%. Results: Ramelteon dramatically suppressed DNCB-exacerbated eczematous lesions, including decreased cumulative dermatitis scores and skin levels of TNF-α, TGF-β, IL-4, IL-13, IL-17, IL-25, IL-31, IgE, and MDA but increased SOD activity. Ramelteon also improved DNCB-exacerbated abnormalities in histopathology, including acanthosis and infiltration of immune system cells. Discussion: These results suggest the possible usefulness of ramelteon in reducing atopic dermatitis through the regulation of inflammation and oxidant pathways. Although it suppressed cytokines and oxidative markers in this study, the realization of the relative potency and long-term safety is desired. The immunomodulatory characteristics imply that it could be used as an adjuvant to present modalities. Conclusion: Through immunomodulatory and antioxidative processes, topically administered ramelteon presented probable protective qualities in DNCB-triggered atopic dermatitis, recommending it may serve as an attractive alternative and advocating for additional research to validate efficiency and safety.

Introduction: The modification of potato starch (PS) by conventional methods (hydrolysis and oxidation) has been extensively studied. In this preliminary study, the effects of endogenous α-amylase and hydrogen peroxide (H2O2) from Undiluted Euphorbia honey (UEH) and Dissolved EH (DEH) on PS were studied to introduce novel PS, namely hydrolyzed PS and oxidized PS, which are named HPS and OPS, respectively. Methods: This study reports one of the first such attempts to improve the antimicrobial viability of EH combined with PS. The potential of ultraviolet–visible (UV–Vis) and Fourier-transform infrared (FTIR) spectroscopy for the detection and characterization of EH and enhancing the structural properties of HPS and OPS was investigated, along with an analysis of the in vitro antioxidant and antimicrobial potential. The antimicrobial effectiveness of the prepared biomaterial was investigated using the bacteria Pseudomonas aeruginosa and Staphylococcus aureus and a fungus, Candida. albicans. They were evaluated using the agar well diffusion assay. Results: The FTIR spectral data set revealed discrepancies with EH and PS, with bands associated with lower water content and higher carbohydrate amounts. The visual inspection of the UV–vis spectra revealed distinct chemical compositions. FT-IR data revealed the presence of high-intensity peaks at 3464 cm−1 (EH) and 3263–3583 cm−1 (EH-PS). The obtained experimental results suggested that the UEH had promising antimicrobial activity with an inhibition rate that reached 62.50%, 85%, and 86%. Discussion: Additionally, the inhibition rate indicated that the UEH had a higher inhibition rate than the DEH, with the exception of DEH12.5%, resulting in a 70% inhibition rate. Thereby, the OPS displayed excellent antimicrobial activity; their maximum antibacterial rate against Pseudomonas aeruginosa, Staphylococcus aureus, and Candida. albicans were up to 85.85 %,85.04% and 75%, respectively. On the other hand, in our previously reported work, we found that application of a mixture of PS and EH as a natural antibacterial agent shows an additive effect. conclusion: In line with these results, EH made with dual-modified PS exhibits antimicrobial properties. Overall, these preliminary results highlight the findings that underscore the impact of HPS and OPS on enhancing the antimicrobial activity of the EH, offering a novel biomaterial candidate for antimicrobial wound dressing applications Conclusion: In line with these results, EH made with dual-modified PS exhibits antimicrobial properties. Overall, these preliminary results highlight the findings that underscore the impact of HPS and OPS on enhancing the antimicrobial activity of the EH, offering a novel bio-material candidate for antimicrobial wound dressing applications.

Introduction: Chronic obstructive pulmonary disease (COPD) exacerbations are a major contributor to long-term functional decline and healthcare burden. It is well established that patients often fail to recover baseline lung function following severe exacerbations. Re-cent trials have highlighted the role of type 2 inflammation in a subset of COPD patients and the therapeutic potential of dupilumab, a monoclonal antibody targeting IL-4/IL-13 pathways. However, its role in the post-exacerbation phase remains unexplored. Case Presentation: We report the case of a 79-year-old woman with severe COPD (GOLD stage III) and a history of two moderate exacerbations in the previous year. She was initiated on compassionate-use dupilumab after meeting eosinophilic criteria (0.33 × 10⁹/L). Baseline spirometry revealed a fixed ratio of 0.32, FEV₁ 0.49 L (30% predicted), and FVC 1.53 L (71%). Thirteen days after the first injection (March 2025), she was admitted with acute res-piratory failure and managed with non-invasive ventilation and high-dose corticosteroids in the ICU. She avoided intubation and was discharged clinically stable on home oxygen. At follow-up (April 10), spirometry showed significant improvement: FEV₁ 0.71 L (42%) and FVC 2.14 L (105%). At three months, FEV₁ remained improved (0.61 L / 36%) with a fixed ratio of 0.44. This case demonstrates an unexpected functional improvement following a se-vere exacerbation, contrary to the established lung function decline described in studies, such as WISDOM. The marked recovery in FEV₁ suggests a potential early therapeutic effect of dupilumab, possibly modulating type 2 inflammation even in the context of acute decompen-sation. The patient’s trajectory, including avoidance of mechanical ventilation and improved functional capacity, supports emerging evidence for biologic therapies in eosinophilic COPD. Conclusion: This report suggests a promising role of dupilumab in managing eosinophilic COPD beyond chronic phases, including acute exacerbations. Controlled studies are war-ranted to explore early biologic intervention and personalize COPD treatment pathways.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a major health prob-lem with a high incidence rate. Dandelion (Taraxacum peregrinum), a member of the Aster-aceae family, is widely used in traditional medicine for its therapeutic properties. This study aimed to evaluate the effect of GHASEDAK dandelion herbal capsules on liver fibrosis and function in patients with NAFLD. Methods: This was a randomized, double-blind, placebo-controlled, single-center clinical trial. 50 eligible patients (25 per group) with grade 2 or 3 NAFLD (confirmed by laboratory tests and ultrasound) were randomized to receive either 300 mg dandelion capsules (900 mg/day; 3 capsules) or a matching placebo for 12 weeks, alongside lifestyle manner. Liver fibrosis (FibroScan®) and liver enzyme levels were assessed at baseline and after the inter-vention. Data were analyzed using t-tests and chi-square tests. Results: In the dandelion group, mean liver fibrosis decreased from 6.97±1.57 to 5.87±1.36 (P< 0.0001). Alanine aminotransferase (ALT) decreased from 62.52±21.24 to 41.92±12.35, and aspartate aminotransferase (AST) from 46.68±18.01 to 28.24±8.07 (both P< 0.0001). Conclusion: Daily consumption of 900 mg of dandelion capsules, combined with lifestyle modification, significantly reduced liver fibrosis and serum liver enzyme levels in patients with NAFLD compared with the control group.