The study of DDIs has evolved significantly over the years, early in-vitro detections could help identify potential interactions before clinical use, enhancing drug efficacy and patient safety. This work therefore focused on finding in-vitro DDI (incompatibility) between the two commonly prescribed antibiotics Ciprofloxacin (CFX) and Metronidazole (MTZ) in neutral, acidic and basic mediums using derivative spectroscopy. The spectral measurements were performed on UV-Visible spectrophotometer at 0, 4 and 24 hours. Standard solutions (100ppm) and working solutions (3-11ppm) of both drugs were prepared in water, while mixture contained 5ppm of each drug. AGREE calculator software was used to figure out the environmental impact of the used spectrophotometric method. A zero-crossing method was employed for simultaneous quantification of CFX and MTZ in admixture. It was observed that a mixture having 5ppm CFX and MTZ showed a recovery percentage of 87.704% ± 0.001041 and 78.226% ± 0.002379 respectively in neutral medium at 4 hours, along with AGREE score of 0.8. The proposed method was greener (eco-friendly). The findings concluded that although the two drugs were compatible in acidic and basic mediums, these might be incompatible in neutral environment upon simultaneous administration.

Chronic hepatitis B (HBV) and C (HCV) remain major global health burdens due to high morbidity, treatment costs, and the emergence of antiviral resistance. Plant-derived compounds offer a potential alternative or complementary therapeutic approach. This study evaluated the antiviral effects of Azadirachta indica (neem) and Moringa oleifera (drumstick tree) leaf extracts on peripheral blood mononuclear cells (PBMCs) obtained from HBV- and HCV-infected patients. To determine and compare the phytochemical profiles of A. indica and M. oleifera leaf extracts and assess their antiviral activity through induction of apoptosis and necrosis in virus-infected PBMCs. Leaf extracts were subjected to phytochemical screening. PBMCs isolated from HBV- and HCV-infected patients were treated with each extract and analyzed by flow cytometry to quantify live, apoptotic, and necrotic cell populations. Statistical analysis was performed using one-way ANOVA with significance set at P < 0.05. Phytochemical analysis revealed that A. indica contained flavonoids, alkaloids, tannins, saponins, glycosides, and steroids, whereas M. oleifera contained flavonoids, alkaloids, and tannins but lacked glycosides and saponins. In HBV-infected PBMCs, A. indica significantly reduced live cell percentages from 24.3% to 11.35% and increased necrotic cells from 18.98% to 55.43%. In HCV samples, live cells decreased from 40.27% to 37.78%, while necrosis increased from 21.35% to 30.1%. M. oleifera demonstrated comparatively moderate effects consistent with its simpler phytochemical profile. A. indica exhibited strong antiviral potential, markedly enhancing necrotic responses in HBV- and HCV-infected PBMCs, while M. oleifera showed moderate activity. These results highlight the therapeutic promise of phytochemical-rich extracts, particularly A. indica. Further investigations-including in-vivo validation, dosage formulation, cost-effectiveness assessments, and evaluation of synergistic effects with existing antiviral therapies-are warranted to advance their development as complementary treatments for chronic viral hepatitis.

Acute fever is a frequently-seen disease in the department of paediatrics. This study aims to evaluate the antipyretic efficacy of dexibuprofen suppositories in pediatric patients with high fever. 100 children with high fever who received antipyretic treatment in our hospital from March 2022 to March 2023 were retrospectively analysed. Among them, 57 children treated with dexibuprofen suppositories were taken as the study group and 43 children treated with ibuprofen suspension were taken as the control group. The body temperatures of the two groups were analyzed and compared before medication and at 0.5, 1, 2, 4 and 6 hrs after medication. The two groups were compared in the therapeutic effects and adverse reactions. Independent sample t-tests and repeated measures analysis of variance were used for comparisons between groups and chi-square tests or Fisher's exact tests were used for categorical variables. The study group had significantly lower temperatures at 0.5, 2, 4 and 6 hrs (P < 0.0001), with similar overall efficacy (P > 0.05) and fewer adverse reactions (P = 0.0272). Multivariate logistic regression analysis determined that the disease course and admission body temperature were independent risk factors. Dexibuprofen suppository provides rapid and effective antipyresis with better safety in pediatric emergency settings.

Hyperosmotic stress is often overlooked in various clinical conditions like diabetes and may lead to anemia. Erythrocytes are very sensitive cells in body circulation and are affected by very minute changes in the environment. Eryptosis (suicidal death of erythrocytes) is mainly characterized by phosphatidylserine exposure, cell shrinkage, blabbing and is triggered by hyperosmolarity, oxidative stress, energy depletion, xenobiotic exposure and activation of various kinases. This study was planned to evaluate the eryptotic effects of hyperosmolarity by stimulating p38 MAPK and enhanced ROS generation and allicin's anti-hemolytic, antioxidant, p38MAPK inhibitory and anti-eryptotic potential. Effects of allicin on erythrocytes facing hyperosmolarity were confirmed by measuring enzyme activity (SOD, GPx and CAT), ROS level, eryptotic marker (change in cell size and phosphatidylserine exposure) and underlying mechanisms of eryptosis (role of Ca2+ in eryptosis and p38 MAPK activation) were confirmed. To measure the cytotoxic effects of allicin hemolysis % was measured. To check statistical significance of data ANOVA was used. Results confirmed that allicin treatment enhances SOD, GPx and CAT activity, reduces ROS level, p38 MAPK activation and Ca2+ effects, positively affects cell size (normal range) and phosphatidylserine exposure (reduced) and reduces hemolysis % in erythrocytes facing hyperosmolarity. It is concluded from this study that hyperosmolarity is the main stimulator of eryptosis and leads to anemia in various clinical conditions, while allicin treatment helps to increase erythrocyte survival by inhibiting and attenuating various pathways and reducing eryptpotic rate. Allicin's anti-eryptotic and cytoprotective potential gives foundation for future clinical research targeting hyperosmolarity triggered anemia.

Vascular dementia (VaD) is the second most prevalent cause of dementia following Alzheimer's disease. Rubia yunnanensis, a medicinal plant recorded in the Chinese Materia Medica, has historically been utilized for managing cerebral ischaemia-related disorders. While recent attention has focused on its neuroprotective potential, the specific mechanisms underlying the effects of Rubia yunnanensis water decoction (RY-W) on VaD remain unelucidated. This study aimed to identify the active chemical components and elucidate the molecular mechanisms of RY-W in the treatment of VaD by integrating network pharmacology with experimental validation. The chemical constituents of RY-W and their potential therapeutic targets were analyzed using UPLC-MS/MS and network pharmacology techniques. To validate these findings, the cerebral protective effects of RY-W were assessed in a rat model of VaD. Cognitive function was evaluated using the Morris Water Maze (MWM) test. Pathological changes and molecular markers were analyzed via Hematoxylin and Eosin (HE) staining, Nissl staining, TUNEL fluorescence staining, Immunohistochemistry (IHC), and Western blotting. Network pharmacology analysis identified IL-6, IL-1β, ALB, TNF, and AKT1 as potential core targets for RY-W. Experimental results demonstrated that RY-W significantly alleviated cognitive deficits in VaD rats. Furthermore, RY-W exhibited anti-inflammatory properties and reduced neuronal apoptosis. These neuroprotective effects appear to be mediated through the regulation of ALB and the PI3K-Akt signaling pathway. RY-W effectively ameliorates VaD pathology by exerting anti-inflammatory and anti-apoptotic effects. These findings highlight the involvement of ALB and the PI3K-Akt signaling pathway in the therapeutic action of RY-W, supporting its potential as a treatment for vascular dementia.

Central pathophysiological mechanisms underlying cognitive impairment and mood disorders are complex. Traditional Chinese Medicine (TCM)-derived bioactive compounds have significant research value in this field. This study aimed to synthesize current preclinical and emerging clinical evidence on the neuroprotective and psychotropic effects of key TCM constituents, with a particular focus on their roles in modulating neuroinflammatory signalling, synaptic plasticity, oxidative balance and stress-related neuroendocrine pathways. A narrative synthesis of experimental and early clinical studies was conducted, emphasizing mechanistic investigations in rodent models and exploratory human trials. Outcomes of interest included inflammatory cytokine expression, inflammasome activation, redox homeostasis, synaptic signalling pathways, neuroendocrine regulation, behavioural performance and translational pharmaceutical considerations. Multiple TCM constituents attenuate microglial activation and inflammasome signalling, suppressing interleukin-1β, interleukin-6 and tumor necrosis factor-alpha through inhibition of nuclear factor κB and NOD-like receptor pyrin domain-containing 3 pathways. These effects restore redox homeostasis, reduce synaptic loss and improve cognitive and behavioural outcomes in animal models. Concurrently, several compounds enhance synaptic resilience by upregulating brain-derived neurotrophic factor and tropomyosin receptor kinase B signalling, activating downstream mechanistic target of rapamycin complex 1 and cyclic adenosine monophosphate response element-binding protein pathways and preserving synaptic proteins. Key agents, including ginsenosides, baicalin and curcumin, have shown translational promise, with small human trials reporting improvements in depressive symptoms, cognitive function and biomarker profiles. Additionally, TCM compounds modulate HPA axis dynamics by attenuating stress-induced corticosterone elevation, restoring glucocorticoid receptor sensitivity and rebalancing monoaminergic and glutamatergic neurotransmission. However, pharmaceutical translation remains limited by challenges related to formulation, dosage standardization and poor oral bioavailability, particularly for flavonoids and saponins. TCM-derived compounds exert multifaceted neuroprotective and psychotropic effects, while successful clinical translation requires strengthened pharmaceutical characterization, standardized dosing strategies and advanced delivery systems such as nanoformulations, phytosomes and standardized granules to enhance bioavailability, reliability and regulatory acceptance.

Despite of having broad spectrum anti-bacterial activity, benzimidazole has limited clinical applications out of low solubility and bioavailability. Benzimidazole and cubosomal delivery systems are individually well studied, their combined application remains limited, particularly for newly designed derivatives with unexplored biological activity. This study reports the synthesis and characterization of N-cyclopentyl benzimidazole-loaded cubosomes for antibacterial application through improved solubility and controlled release. The N-cyclopentyl benzimidazole was synthesized by the reaction of benzimidazole with Bromo cyclopentane and confirmed by FT-IR, 1H, and 13C NMR spectroscopy. Cubosome nanoparticles were formed by the homogenization method, using glyceryl monooleate (GMO) as a lipid and poloxamer 407 (P407) as a surfactant. Different co-surfactants like Brij 35 (B 35), Myrj 52 (M 52), Tween 20 (T 20), and polyvinyl alcohol (PVA) as stabilizer were used to optimize the formulations and characterized for size, zeta potential, polydispersity index, entrapment efficiency, in-vitro drug release, and transmission electron microscopy. Among the tested formulations, the cubosome containing 3% PVA demonstrated optimal characteristics, including a nanosize (~128 nm), high drug entrapment efficiency (94.08%), and colloidal stability. The antibacterial activity was assessed against Staphylococcus aureus and Escherichia coli. While the free drug exhibited larger zones of inhibition, the cubosome-encapsulated formulation showed sustained antibacterial effects, attributed to improved aqueous dispersion and prolonged release. These findings highlight the potential of cubosome-based delivery to enhance the solubility and therapeutic efficacy.

Optimal pharmacotherapy and maintenance of thyroid hormone homeostasis following thyroidectomy are essential for effective metabolic regulation and overall endocrine balance. Surgical techniques that preserve neural integrity play a critical role in maintaining endocrine balance and ensuring stability of thyroid hormone dosage, thereby influencing the overall success of thyroid hormone replacement therapy. This study assessed the impact of intraoperative nerve monitoring (IONM) during thyroidectomy on postoperative endocrine outcomes, with prominence on thyroid hormone stability and levothyroxine dose requirements. The study includes review of 45 patients who underwent thyroid surgery from 2018 to 2023 at a tertiary care center in Turkey. The patients were subsequently allocated into two groups: The first group underwent surgery with IONM (n = 23), whereas the second group underwent surgery without IONM (n = 22). The primary outcome was levothyroxine dose stability, defined as achievement of euthyroid status (TSH 0.4-4.0 mIU/L with normal FT4 levels) without further dose adjustment over two consecutive follow-up visits. Secondary outcomes included time to euthyroid status, number of dose adjustments, postoperative hypocalcemia, RLN injury and hospital stay duration. Postoperative thyroid function tests were assessed at 2, 6 and 12 weeks. Statistical analysis was conducted using SPSS Statistics version 26.0. Patients undergoing thyroid surgery with IONM had an average hospital stay of 1.67 days, while those who did not have IONM had an average hospital stay of 1.77 days. No statistically significant difference between the two groups regarding total time in the operating room. Patients in the IONM group demonstrated a more stable pattern of postoperative thyroid hormone levels and a lower rate of endocrine-related complications compared to the non-IONM group. This study suggests that IONM was associated with postoperative hormonal stability as well as more predictable pharmacotherapy with respect to levothyroxine use. Given the retrospective design, these findings demonstrate association rather than causation and further prospective studies are required.

Renal interstitial fibrosis (RIF) is a core pathological process in the progression of chronic kidney disease (CKD), but effective therapeutic drugs are currently lacking. Panax notoginseng saponins (PNS) exhibit potential anti-inflammatory and anti-fibrotic effects, yet their mechanism of action in RIF remains unclear. This study aims to investigate the ameliorative effects of Panax notoginseng saponins (PNS) on renal interstitial fibrosis in a rat model of chronic kidney disease (CKD) and to elucidate whether these effects are mediated through the regulation of the TLR4/NF-κB signaling pathway. A rat model of CKD was established, with experimental groups including a healthy control group, a model group, PNS treated group, TAK 242 group, LPS group and combination groups (PNS+TAK 242 and PNS+LPS). Renal pathology and fibrosis were evaluated by HE and Masson staining, while the expression of fibrosis markers and TLR4/NF κB pathway molecules was analyzed via RT qPCR and Western blot. (1) Compared with the model group, PNS treatment significantly alleviated renal tissue damage and reduced the fibrotic area, while also downregulating the gene and protein expression of fibrosis markers, TLR4 and Rel (which encodes NF-κB p65); (2) he TLR4 inhibitor TAK-242 exhibited anti-fibrotic effects similar to those of PNS and the combination of PNS and TAK-242 yielded the most pronounced therapeutic outcomes. PNS significantly alleviates renal interstitial fibrosis in the CKD model rats and its mechanism is associated with the inhibition of the TLR4/NF-κB signaling pathway, thereby downregulating the expression of downstream pro fibrotic factors.

Piperaquine (PQ) is an anti-malarial bisquinoline BCS Class-II drug having low aqueous solubility and oral bioavailability, which affects its therapeutic effectiveness. Pharmaceutical Nanotechnology has proved its potential to overcome the challenges associated with poorly water-soluble drugs. The fabrication of Piperaquine nanoparticles (PQ-NPs) through the antisolvent technique with subsequent characterization to improve the dissolution and bioavailability was the primary objective. PQ-NPs were prepared using anti-solvent precipitation Method. The polymers hydroxypropyl methylcellulose (HPMC) of 0.25%, polyvinylpyrrolidone (PVP-K30) of 0.25 %, and sodium lauryl sulfate (SLS) of 0.5 % were used as stabilizers. The Particle size, PDI, zetapotential, DSC, XRD, SEM, In-vitro dissolution, and in vivo study were performed for characterization of PQ-NPs. The produced optimized PQ-NPs had a particle size of 184 nm, PDI of 0.248 and zeta potential of -31.4 mV. The NPs had a lower melting point and crystalline content, as shown by differential scanning calorimetry (DSC) and XRD. The SEM analysis confirmed the smaller particle size with a larger surface area. PQ-NPs showed a significantly faster release profile than raw drug, achieving 79.56% drug release in 5 minutes versus 27.31% (p < 0.05). Pharmacokinetic studies in mice revealed that Cmax,Tmax and AUC were significantly enhanced for PQ-NPs (Cmax: 2.753 µg/ml vs. 1.233 µg/ml; Tmax: 1.0 ± 0.3 hr vs 1.5 ± 0.3 hr, AUC: 1.119 µg.hr/ml vs. 0.954 µg.hr/ml. The findings indicate that PQ-NP were successfully fabricated, having substantial improvements in solubility, dissolution rate, and bioavailability, making them a promising approach for enhancing the therapeutic performance.