Standardized Extract Research Articles

Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Southwestern Oromia, Ethiopia: ten-year retrospective analysis.

Treatment of rifampicin-resistant or multidrug-resistant tuberculosis (RR/MDR-TB) requires the use of second-line anti-TB drugs, which are less effective and more toxic. This study assessed treatment outcomes and factors associated with unfavorable treatment outcomes among RR/MDR-TB patients in Southwestern Oromia, Ethiopia. A multicenter retrospective study was conducted on 226 RR/MDR-TB patients (six extrapulmonary and 220 pulmonary) treated under a national TB program between 2013 and 2022 at five treatment facilities in Southwestern Oromia, Ethiopia. RR/MDR-TB patient data, such as sociodemographic, clinical, and laboratory results and treatment outcomes, were collected from the RR/MDR-TB registry using a standard data extraction form between April and June 2023. Logistic regression analysis was used to explore the associations between risk factors and unfavorable treatment outcomes. Among 220 pulmonary RR/MDR-TB patients, 181 (82.3%) achieved favorable treatment outcomes (161 cured and 20 treatment completed). However, 39 (17.7%) patients had unfavorable treatment outcomes (12 were lost to follow-up, seven experienced treatment failure, and 20 died). Of the six extrapulmonary RR/MDR-TB patients, five (83.3%) had favorable treatment outcomes, and one (16.7%) was lost to follow-up. Pulmonary RR/MDR-TB patients with HIV infection (AOR = 4.85, 95% CI: 1.90 to 12.39), history of previous TB treatment (AOR = 3.09, 95% CI: 1.21 to 7.86), and low baseline BMI (AOR = 2.86, 95% CI: 1.06 to 7.72) had increased risk of unfavorable treatment outcomes. Although the majority of RR/MDR-TB patients have favorable treatment outcomes, a significant proportion of patients still experienced unfavorable outcomes. Patients with HIV infection, history of previous TB treatment, and low baseline BMI require special attention to improve pulmonary RR/MDR-TB treatment outcomes. Future studies with larger sample sizes are required to evaluate treatment outcomes and associated factors among patients with extrapulmonary RR/MDR-TB.

Key Proteins in Rat Cerebral Cortex: Application of Cornu aspersum Extract as a Neuroprotective Agent in Alzheimer’s Type Dementia

Alzheimer’s disease (AD) is the most widespread neurodegenerative disorder. Recently, it was found that mucus extract from Cornu aspersum has beneficial effects on memory and cognitive processes in a rat scopolamine model of AD. The present study elucidated the mechanisms of action of standardized mucus snail extract (SE) enriched with a fraction above 20 kDa on Alzheimer-type dementia in rats. Using proteomic analysis on two-dimensional polyacrylamide gel electrophoresis (2D–PAGE) on rat cortex extracts, we compared protein expression in both groups: the first group was treated intraperitoneally with scopolamine (Sco, 2 mg/kg, 11 days) and the second (Sco + SE) group was treated intraperitoneally with Sco (Sco, 2 mg/kg) and protected by SE (0.5 mL/100 g bw) applied daily orally for 11 days. Brain cortex was separated and the expressions of various proteins related to memory and cognitive functions were identified. We found that the expression of Ubiquitin carboxyl-terminal hydrolase isozyme L1, Calbindin, Vacuolar ATP synthase catalytic subunit A, Tropomyosin beta chain, 14-3-3 zeta/delta, Kinesin-1 heavy chain, and Stathmin-4 significantly differs in SE-protected rats as compared to dement animals treated only by Sco, and these brain proteins might be potential therapeutic targets for Alzheimer’s-type dementia treatment.

Effect of Protein, Carbohydrate, and Oil on Phytochemical Bioaccessibility and Bioactivities of the Ginkgo biloba L. Leaf Formulations After In Vitro Digestion

The present work evaluates the effect of casein, glucose, and olive oil on phytochemical bioaccessibility, antioxidant potential (DPPH and FRAP), antidiabetic potential (inhibition of amylase, α-glucosidase, and BSA glycation), and antihyperlipidemic potential (inhibition of lipase) of gingko standardized leaf extract in the form of tablets after in vitro digestion. Gingko extract formulations with protein, carbohydrates, and oil had high (>70%) in vitro bioaccessibility of quercetin, kaempferol, and isorhamnetin after each phases of digestion in comparison to moderate (35–70%) in vitro bioaccessibility from gingko water extract. Formulation with the highest in vitro bioaccessibility of the majority of the tested polyphenolic groups and terpene lactones after oral and intestinal phases was ginkgo with olive oil. High (>70%) antioxidant (DPPH and FRAP), antidiabetic (α-glucosidase and BSA glycation), and antihyperlipidemic potential were detected in almost all ginkgo formulations. Based on the results, we conclude that the in vitro bioaccessibility of individual compounds or groups of compounds depends on whether the tablets are taken with water or with foods (protein, carbohydrates, and oil).

Social network interventions for dietary adherence among adults with type 2 diabetes: a systematic review and meta-analysis protocol

IntroductionOptimal adherence to recommended diets is crucial to achieving long-term glycaemic control among individuals with type 2 diabetes (T2D) individuals. However, there is limited evidence on the effectiveness of interventions...

Hepatosplenic schistosomiasis, treatment outcomes and associated factors among adult patients treated at public hospitals in the Harari Region of Ethiopia: retrospective cross-sectional study.

Schistosomiasis is one of the neglected tropical diseases that pose a significant burden in developing countries, particularly in sub-Saharan Africa. Hepatosplenic schistosomiasis (HSS) is a substantial cause of morbidity and mortality. This study aimed to determine clinical patterns, outcomes and factors associated with HSS in the Harari Region of Ethiopia. An institutional-based retrospective cross-sectional study was conducted among 93 adult patients diagnosed with HSS at public hospitals in the Harari Region from December 2018 to November 2022. Data were extracted from medical records using a standardized data extraction tool. EpiData version 4.2 and SPSS version 26.0 were used for data entry and analysis. Fisher's exact test was used to identify the association between dependent and independent variables, and statistical significance was declared at p<0.05. In the current study, HSS-related mortality was recorded in 7.5% of patients. Recurrent episodes of upper gastrointestinal (GI) bleeding (p=0.04), hypotension (p=0.02), altered mental status at admission (p=0.009) and antibiotic use for the treatment of spontaneous bacterial peritonitis (p=0.04) were significant factors associated with HSS-related mortality. The study found that treatment outcomes of HSS patients were strongly associated with recurrent upper GI bleeding, hypotension, altered mental status and antibiotic use for spontaneous bacterial peritonitis treatment. The use of antibiotics for spontaneous bacterial peritonitis treatment was strongly associated with the treatment outcome of patients with HSS and was unique to our study. Adequate recording of patient data, improving chart keeping, integration of preventive and curative programs, improvement of the diagnostic tools, comprehensive treatment guidelines, early diagnosis and treatment are strongly recommended. Rigorous prospective studies that can fully reflect cause-and-effect relationships are crucial to fill fundamental evidence gaps.

Categorizing Care Delays and Their Impact on Hospital Length of Stay.

Unnecessary care delays of hospitalized patients increase the risk of hospital-related complications and drive up health care costs. While health systems focus on reducing the length of stay of hospitalized patients, not many studies looked at specific causes of the care delays that prolong length of stay. In this study, we sought to systematically identify and categorize the various care delays that contribute to prolonged length of stay on a hospital medicine service. We conducted a retrospective observational study looking at all inpatient encounters to the hospitalist service (N=6633) for the fiscal year 2021. Observation status, COVID-19 positive, and other services' discharged patients were excluded (N=2849) leaving 3784 eligible encounters. The resulting 5% stratified random sample accounted for 190 encounters accounting for a total of 1152 patient-days. Using a standardized data extraction tool, a day-by-day review of the sample encounters was performed for all care delays. These care delays were categorized into specific groups (System, Discharge, Provider, Patient/Family, or Consultant related) and subgroups based on predetermined criteria. The stratified sample was found to be comparable to the total patient population, with no statistically significant differences in key demographic and clinical metrics. About 30% of all patient-days had a care delay; 33% of these delays were attributable to system delays internal to the hospital such as waiting for imaging/procedures; 28% of delays were due to discharge barriers, driven overwhelmingly by a lack of available post-acute care beds, and about 20% of delays were attributable to the provider. Our study systematically looked at care delays that led to prolonged hospital length of stay. Most of these care delays were caused by either wait times for procedures and imaging studies or by a lack of post-acute care bed availability. Hospitals and health systems can use this approach to better determine which systemic changes are likely to be the most effective at reducing length of stay.

Establishment and Validation of Fecal Secretory Immunoglobulin A Measurement for Intestinal Mucosal Health Assessment in Wild Lemurs.

The measurement of biomarkers in blood and excreta can enable immune status assessment and provide prognostic information on individual health outcomes. In this respect, the fecal measurement of secretory immunoglobulin A (sIgA), the primary mammalian antibody for mucosal defense, has recently received increased interest in a few anthropoid primates, but a fecal sIgA assay for use in strepsirrhine primates has not yet been reported. Here, we develop and analytically validate a cost-effective in-house sandwich enzyme immunoassay for the extraction and measurement of sIgA in feces of redfronted lemurs (Eulemur rufifrons). We also tested a simple method for sIgA extraction that can be used under remote field conditions and undertook experiments to assess the robustness of sIgA concentrations to variation in processing and storage conditions of fecal extracts. Our analytical validation revealed that the assay recognizes immunoreactive sIgA in redfronted lemur feces, that sIgA can be measured accurately with no potential interference from the fecal matrix, and that assay reagents and performance are highly stable over time. The field-friendly extraction procedure produced sIgA results strongly correlated with those generated by a standard laboratory extraction method. Short-term storage at room temperature resulted in a slight decline in sIgA concentrations, whereas freezing extracts at -20°C kept sIgA levels stable for at least 3 months. Longer-term storage of >5 months, however, led to a significant decline of sIgA concentrations. Multiple freeze-thaw cycles did not affect sIgA levels. This study, therefore, provides the basis for measuring fecal sIgA in lemurs and possibly other strepsirrhines. When samples are processed properly and stored frozen, and when sIgA analysis can be performed within 3 months upon sample collection, fecal sIgA measurements can become a valuable tool for monitoring aspects of immunity and health in both zoo-housed and wild-living lemurs.

Development of optimized standardized extracts of Echinodorus macrophyllus for arthritis management

Ethnopharmacological relevanceEchinodorus macrophyllus is a medicinal plant traditionally used in Brazil to treat rheumatic diseases. It is listed as a priority species for the development of herbal preparations for the Brazilian Unified Health System (SUS). Previous studies have demonstrated the anti-inflammatory and antiedematogenic properties of extracts and fractions from this species, but these preparations were neither standardized nor optimized for anti-arthritis effects. Aim of studyThis study aimed to investigate the anti-inflammatory and antiarthritic effects of various standardized extracts from the aerial parts of E. macrophyllus and to outline their mechanisms of action. The goal was to define an extract suitable for future scientific validation and clinical use. Material and methodsExtracts from the aerial parts of E. macrophyllus were prepared through percolation with 96°GL ethanol (EtOH) and hydroethanolic solutions at 90%, 70%, and 50% (v/v). They were standardized based on the contents of six chemical markers quantified by UPLC-DAD. Mice with acute or chronic antigen-induced arthritis (AIA) were treated with the extracts orally. The effects were evaluated by counting total and differential inflammatory cells, measuring cytokines by ELISA, and by histological analysis with toluidine blue staining. The mechanism of selected extracts was investigated in LPS-stimulated murine chondrocytes. ResultsAll extracts, except for the 90% EtOH extract, exhibited significant anti-inflammatory activity in acute AIA, reducing the migration of total inflammatory cells, neutrophils, and monocytes to the intra-articular cavity. In chronic AIA, both the 96°GL EtOH and 70% EtOH extracts markedly reduced the migration of total inflammatory cells, neutrophils, and monocytes to the intra-articular cavity, decreased IL-1β and CXCL1 levels in the periarticular tissue, and diminished proteoglycan loss in the articular cartilage. Both extracts reduced IL-6 release and MMP-3 expression in LPS-stimulated chondrocytes. The 70% EtOH and 50% EtOH extracts showed heightened activity and higher levels of chemical markers, notably cinnamoyl-tartaric acid derivatives. ConclusionsThe standardized 70% EtOH and 50% EtOH extracts from the aerial parts of E. macrophyllus, which contain higher levels of chemical markers, exhibit potent anti-inflammatory activity and reduce proteoglycan degradation. These extracts are potentially useful for developing herbal preparations to manage arthritic conditions and should be prioritized for further studies.

Does an Osteoporosis-like Condition Jeopardize the Osseointegration Process around Dental Implants Placed in Animal Models? A Systematic Review.

Knowing that osteoporosis is a metabolic disease that could decrease dental implant success and survival, the purpose of this review was to gather information on the characteristics of implant osseointegration in animal models of induced osteoporosis. By pointing out the role of some factors that could improve the success rate in these situations, this study aimed to enhance the knowledge about this process that can be further translated to clinical designs. A systematic search in PubMed/Medline, Lilacs, Cochrane Library, Scopus and Web of Science was conducted to identify information between 2002 and 2023 regarding osseointegration of dental implants in animal models of induced osteoporosis. The following search strategy was utilized and adjusted to each database: (((dental implant) AND (Osseointegration)) AND (osteoporosis)) AND/OR (osteoporosis treatment). The inclusion criteria were animal studies in English, involving the placement of an osseointegrated implant in osteoporotic bone, and evaluating bone to implant contact (BIC) %. Exclusion criteria were studies in humans, in vitro studies, procedures involving any kind of bone graft and studies evaluating medication related osteonecrosis of the jaw. A standardized data extraction form was used to record data for each study, covering article title, date, authors, number of animals, purpose of study, type of analysis used by authors, follow-up, type of implant, test and control groups, intervention and conclusions. The risk of bias of the included studies was assessed using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) Risk of Bias tool.20 Results: A total of 204 articles were found for evaluation and selection. All of the 43 selected studies evaluated the bone-implant contact (BIC) %. Other parameters such as bone to implant mechanical interface, bone area (BA) and bone volume (BV) ratio were also evaluated in some of the studies. There was a tendency for compromised results of implant osseointegration in the presence of osteoporosis. Modification of the implant surface, systemic and local use of anti-resorptive drugs and other substances, showed benefits for the implant success in osteoporotic sites. Still, no consensus among studies on the superiority of systemic medications in improving the process of peri-implant bone repair, was observed. Although it is possible to improve the osseointegration of implants in osteoporotic bone, either by using systemic or local factors, the metabolic bone syndrome caused by osteoporosis can jeopardize the osseointegration of dental implants.

Ficus deltoidea standardized methanolic extract improves kidney structure and function against streptozotocin-induced diabetic nephropathy in rats

Ficus deltoidea standardized methanolic extract improves kidney structure and function against streptozotocin-induced diabetic nephropathy in rats

ANTIDEPRESSANT-LIKE ACTIVITY OF AQUEOUS EXTRACT OF ROSA DAMASCENA IN MICE

Objective: Plant-based drugs have the potential to be very effective substitutes for prescription antidepressants. Rosa damascena has therapeutic potential as an analgesic, anticonvulsant, antitussive, bronchodilatory, antibacterial, anti-diabetic, anti-inflammatory, antioxidant, and laxative. Given this context, the goal of the current study was to assess Rosa damascena's potential antidepressant effects. Methods: Maceration was used to create an aqueous extract of Rosa damascena. The Tail Suspension Test (TST) on BALB/c mice and the Forced-Swimming test (FST) on C57BL/6 mice were used to quantify the antidepressant activity. Mice were divided into three groups: control (saline), standard (citalopram and desipramine), and Rosa damascena aqueous extract (n = 6 per group). Intraperitoneally (1 ml/100 g) injections of drugs were administered. Analysis of variance was used to examine the data, and then LSD post-hoc tests were performed. The data are expressed as mean±SEM. Results: Antidepressant-positive controls, citalopram and desipramine, significantly decreased the time of immobility in the FST and TST as compared to the vehicle control group (p&lt;0.001). In FST, the immobility durations were significantly reduced by the Rosa damascena aqueous extract at a dose of 40 mg/kg compared to lesser doses of the same extract (10 and 20 mg/kg) (p&lt;0.001). Similarly, the 40 mg/kg dose of Rosa damascena aqueous extract significantly reduced the length of immobility in TST (p&lt;0.001). Conclusion: The present findings demonstrate Rosa damascena's antidepressant-like effects in mice. Further research is necessary to determine the underlying mechanism by which Rosa damascena generates effects akin to those of an antidepressant in light of this observation.

Unveiling the influences of P fertilization on bioactive compounds and antioxidant activity in grains of four sorghum cultivars.

Phosphorus is a critical nutrient in agriculture, influencing plant growth and nutritional quality. This study, uniquely designed to investigate the effects of phosphorus (P) fertilization levels, sorghum cultivars, and growing locations on phytochemical content and antioxidant activity in sorghum grains, employed four sorghum cultivars (Hakeka, P954063, Tabat, and Tetron) grown under three P levels (0P, 1P, 2P) in two locations (Gezira and White Nile) in Sudan. In this study, four sorghum cultivars were grown in two distinct locations in Sudan, employing a split-plot design with three (P) fertilization levels. P was applied as triple super phosphate directly with the seeds, and additional fertilization included urea applied in two split doses. At physiological maturity, representative sorghum panicles were harvested, processed, and analyzed for bioactive compounds and antioxidant activities using standard extraction and quantification techniques such as Folin-Ciocalteu for phenolics and colorimetric flavonoid assays. Antioxidant activities were assessed through various assays, including DPPH and FRAP. Statistical analyses were performed using a three-way ANOVA to examine the effects of cultivar, P level, and location on the measured parameters, supplemented by multivariate analysis to further elucidate the interactions between these factors. Significant interactions (p<0.001) were observed among cultivars, P levels, and locations for total phenolic content (TPC), total flavonoid content (TFC), carotenoids, tannins, and various antioxidant activity measures (DPPH, FRAP, ABTS, TRP, H2O2). P fertilization significantly increased all measured phytochemicals and antioxidant activities compared to non-treated cultivars, except for H2O2, which decreased with P application. Among cultivars, Hakeka consistently exhibited the highest TFC, carotenoid content, and antioxidant activities (DPPH, FRAP, TRP, ABTS), particularly at the 2P level. P954063 showed the highest TPC and tannin concentrations. Tetron generally had the lowest phytochemical and antioxidant levels. White Nile showed higher TPC, carotenoids, DPPH, FRAP, TRP, and ABTS levels, while Gezira had higher TFC, tannins, and H2O2 concentrations. The impact of phosphorus fertilization often varies between locations. Strong positive correlations were found between TPC and all antioxidant assays (r = 0.68-0.90) and total carotenoids and antioxidant activities (r = 0.73-0.93). This study recommended cultivating the Tabat variety with 2P doses in Gezira. In addition, the Hakeka cultivar showed the highest increases in total flavonoid content, carotenoids, and antioxidant activities, particularly under the highest P level (2P). The findings highlight that P plays a critical role in enhancing sorghum's nutritional and health-promoting qualities, which are essential for leveraging this staple crop for food and nutrition security strategies in semi-arid regions.

All black: a microplastic extraction combined with colour-based analysis allows identification and characterisation of tire wear particles (TWP) in soils

While tire wear particles (TWP) have been estimated to represent more than 90% of the total microplastic (MP) emitted in European countries and may have environmental health effects, only few data about TWP concentrations and characteristics are available today. The lack of data stems from the fact that no standardized, cost efficient or accessible extraction and identification method is available yet. We present a method allowing the extraction of TWP from soil, performing analysis with a conventional optical microscope and a machine learning approach to identify TWP in soil based on their colour. The lowest size of TWP which could be measured reliably with an acceptable recovery using our experimental set-up was 35 µm. Further improvements would be possible given more advanced technical infrastructure (higher optical magnification and image quality). Our method showed a mean recovery of 85% in the 35–2000 µm particle size range and no blank contamination. We tested for possible interference from charcoal (as another black soil component with similar properties) in the soils and found a reduction of the interference from charcoal by 92% during extraction. We applied our method to a highway adjacent soil at 1 m, 2 m, 5 m, and 10 m and detected TWP in all samples with a tendency to higher concentrations at 1 m and 2 m from the road compared to 10 m from the road. The observed TWP concentrations were in the same order of magnitude as what was previously reported in literature in highway adjacent soils. These results demonstrate the potential of the method to provide quantitative data on the occurrence and characteristics of TWP in the environment. The method can be easily implemented in many labs, and help to address our knowledge gap regarding TWP concentrations in soils.

Beneficial effect of Caesalpinia pulcherrima linn., on diabetic neuropathy, cognitive dysfunction and cardiac complications in streptozotocin-induced diabetic rats

Pharmacological relevanceCaesalpinia pulcherrima L. is used in Indian Traditional Medicinal system to treat Diabetes. AimThis study was carried out to evaluate the standardized alcoholic extract of Caesalpinia pulcherrima seed (CPS) in Streptozotocin (STZ)-induced diabetic neuropathic and cardiac complications in rodents. Materials and methodsHPLC finger printing profile of CPS was performed to identify the bioactive molecules. Two doses of CPS (100 & 200 mg/kg b.w.) was orally administered daily once for six weeks to streptozotocin (50 mg/kg, i.v.)-induced diabetic rats. Every week intervals hot & cold immersion tests were carried to know the effect of CPS on peripheral neuropathy. In addition, blood glucose, body weight, food and water intake were also monitored. At the end of the study, sciatic nerve conduction velocity, diabetic cardiomyopathy and diabetic cognitive parameters were evaluated. Furthermore, histopathological studies of sciatic nerve and aortic strip were also carried out. ResultsHPLC finger print experiment showed the presence of gallic acid and protocatechuic acid. Administration of CPS for six weeks significantly prevented the development of diabetic peripheral neuropathy (DPN), cardiomyopathy and cognitive dysfunction in diabetic rats. The CPS treated rats displayed prominent (P < 0.001) improvement in motor coordination, muscle grip, locomotor activity and memory in diabetic rats. CPS treatment restored elevated systolic, diastolic, mean arterial blood pressure (MABP), and heart rate to near normal in diabetic condition. These observed beneficial effects were well correlated and justified with histopathological studies. In addition, CPS treatment also exhibited significant (P < 0.001) reduction of loss in body weight, and reduce the water and feed intake throughout the study. ConclusionTaken together, the present study provided a good insight in the therapeutic efficacy of Caesalpinia pulcherrima seed extract in dealing with diabetic complications. The study also scientifically justifies the ethnomedicinal/traditional claims of the title plant.

Use and impact of clinical pathways across various healthcare settings: A protocol for an umbrella review of global evidence.

The proposed umbrella review aims to assess the use and impact of clinical pathways on professional practice, patient outcomes, length of hospital stay, hospital costs, patient satisfaction, and hospital staff satisfaction through a synthesis of existing systematic reviews and meta-analyses. Following PRIOR guidelines, a systematic search will be conducted in MEDLINE, Epistemonikos, and the Cochrane Library to identify relevant systematic reviews and meta-analyses, from inception till March 2024. Two reviewers will independently screen titles and abstracts, with a third resolving any disagreements. Full-text articles considered potentially relevant will be assessed for eligibility by the same process. The data extraction form will cover information about the review methods, characteristics of the included primary studies, the types of interventions evaluated, and the reported outcomes. This standardized data extraction form will be piloted by the review team on five to ten articles to ensure all relevant information is recorded. The quality of included systematic reviews and meta-analyses will be evaluated using AMSTAR 2. PROSPERO registration number is CRD42024529371. The study will present a narrative synthesis of the findings, addressing the clinical and methodological heterogeneity and assessing the impact of clinical pathways on various healthcare outcomes. This umbrella review will provide evidence-based insights into the effectiveness, challenges, and best practices of clinical pathways, guiding healthcare decision-making and identifying areas for future research. Results will be disseminated widely to inform policy and improve healthcare service delivery. No patient or public contribution, as this paper is a protocol of an umbrella review.

Elucidation of the Possible Molecular Mechanism for the Anti-Apoptotic Effect of Terpene-Rich Extract of Amomum subulatum and Coriandrum sativum against Rodent Model of Cardiotoxicity

Background: Spices, including Amomum subulatum and Coriander sativum, are not only popular for improving food flavour but are also accepted worldwide for their health benefits in various disorders. Objective: This study aimed to elucidate the possible mechanism for the anti-apoptotic effect of terpene-rich extract of Amomum subulatum and Coriandrum sativum against the rodent model of cardiotoxicity. Methods: Effects of standardized terpenoids-rich aqueous methanolic extract of two commonly used spices, viz. Amomum subulatum Roxb. and Coriandrum sativum Linn., were investigated on doxorubicin-induced apoptotic changes and cardiotoxicity in Wistar rats with the aim of in-vestigating the mechanism. Prior to the in vivo experiment, the extracts were subjected to quan-titative estimation of possible bioactive markers of the terpenes by employing a newly devel-oped, optimized, and validated GC-MS method along with TLC profiling. Results: Cardiotoxicity was evident from elevated creatinine kinase (CK-MB), lactate dehydro-genase (LDH), and malondialdehyde (MDA) levels in the toxic control group after treatment with doxorubicin (2.5mg/kg i.p. given twice a week for three weeks). Caspase-3, Tumor necrosis factor-α (TNF-α), and Interleukin-6 (IL-6) were also induced in animals treated with doxorubi-cin. Treatment with Amomum subulatum and Coriandrum sativum at the doses of 100 and 200mg/kg exhibited significant (P&lt;0.001) reversal of CK-MB, LDH, MDA, Caspase-3, TNF-α, and IL-6 levels. This protective effect was further supported by the results of DNA gel electro-phoresis and histopathological observations. Conclusion: This study supports the cardioprotective role of selected spices against doxorubicin-induced cardiotoxicity through the anti-apoptotic mechanism.

Effectiveness of Video-Observed Therapy in Tuberculosis Management: A Systematic Review.

This systematic review aimed to assess the association between video-observed therapy (VOT) and treatment adherence among TB patients and the benefits and limitations of this treatment modality. The systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow guideline. Multiple databases including Cochrane, Lilacs, PubMed, Scopus, Lancet, Google Scholar, Science Direct, Directory of Open Access Journal (DOAJ), and BMC were employed to identify relevant articles published between 2012 and 2024. All data were extracted using a standardized data extraction form and both narrative and quantitative approaches were used to present the review outcomes and available evidence. Twenty-nine articles were included in the final analysis, with most using a prospective cohort (n = 10) research design. Treatment adherence rates were relatively higher in TB patients managed using VOT relative to those subjected to direct-observed therapies (DOTs). Likewise, using the VOT approach in most interventional studies lacking a control group depicted higher treatment adherence rates post-intervention. Although asynchronous VOT was used in most studies compared to the synchronous approach, the treatment adherence level was not significantly different between the two methods of VOT delivery. The predominant benefits of VOT include time-saving, cost-effectiveness, flexibility, and fewer self-reported side effects, whereas the main limitation was the privacy of patients' data and information. Video-directly observed therapy (VDOT) is a promising approach for TB treatment with the capacity to improve adherence to medication regimes and reduce the cost of treatment, stigmatization, and burden on healthcare providers.

Teaching and learning clinical reasoning skill in undergraduate medical students: A scoping review.

Clinical reasoning involves the application of knowledge and skills to collect and integrate information, typically to arrive at a diagnosis, implement appropriate interventions, solve clinical problems, and improve the quality of health care and patient outcomes. It is a vital competency that medical students must acquire, as it is considered the heart of medicine. This scoping review aimed to identify and summarize the existing literature on learning and teaching strategies for improving clinical reasoning skill in undergraduate medical education. We conducted electronic searches in Scopus, PubMed/Medline (NLM), Web of Science (WOS), and ERIC to retrieve articles published between January 1, 2010, and March 23, 2024. We also performed hand searches by scanning the reference lists of included studies and similar reviews and searching three key journals. After removing duplicates, two reviewers independently extracted data from primary articles using a standard data extraction form. The authors used Arksey and O'Malley's framework. Among the 46581 retrieved records, 54 full-text articles were included in the present review. We categorized the educational strategies based on their aspects, focus, and purpose. Included studies used various educational strategies for improving clinical reasoning skill in undergraduate medical education by serial cue or whole clinical cases that presented as process-oriented or knowledge-oriented. This scoping review investigated various dimensions of educational intervention for improving clinical reasoning skill in undergraduate medical education. There is a need for more precision studies with larger sample sizes, designing studies according to randomized controlled trials standards, determining MCID, or performing meta-analyses to acquire robust and conclusive results.

Systematic Review of Ex Vivo and In Vivo Pharmacokinetic Studies of Drugs Commonly Used During Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment for critically ill patients in cardiac or respiratory failure refractory to conventional treatment. Patients on an ECMO circuit (pump, oxygenator, tubing) require numerous medications including sedatives, analgesics, cardioactive medications, and anticonvulsants. Currently, there are few dosing guidelines to optimize pharmacotherapy in this situation. A systematic review was conducted to describe pharmacokinetics (PK) of medications commonly used during ECMO. MEDLINE, Embase, Cochrane, BIOSIS, PubMed, and Web of Science databases were searched. All articles presenting ex vivo, animal, and human data on the PK of the subject medications in the ECMO circuit were included. Three authors independently examined citation titles and abstracts. Four authors extracted relevant details from included studies into standardized data extraction forms. Methodological quality was assessed using the ClinPK guidelines and the Joanna Briggs Institute Checklist. Forty-four studies examining 30 medications were included, 26 ex vivo studies (mostly adult circuits) and 18 observational studies (mainly neonatal patients). Pharmacokinetics varied depending on the medication’s characteristics, study type, and population. Study quality was variable, limiting the possibility of deriving hard dosing guidelines from this available literature. Further population PK studies are needed to adequately determine dosing guidelines in adults and children requiring ECMO.

Nanoparticulate Herbal Formulation for the Management of Fungal Infection

Abstract: Fungal infections have been more common during the past few years as a result of an increase in the population of immunocompromised people, including those with cancer, HIV/AIDS, and organ transplant recipients. It has been reported that fungal infection is brought on by different pathogens. The main focus of this review is the use of nanosized plant components to stop fungal infections for the pharmaceutical industry and research projects. According to research about 40 million people have fungal infections. Echinocandins, griseofulvin, azoles, allylamines, and flucytosine are only a few antifungal medications used in clinical settings to treat fungal infections. Skin infections caused by fungi are among the most prevalent dermatological issues of today. Fungal infections at the skin's surface or under the skin's surface may harm the skin, keratinous tissues, and mucous membranes. Therefore, there is a high need for producing an antifungal agent that may act selectively on new targets while having minor side effects and can belong to a variety of structural classes. Natural goods offer limitless prospects for innovative medicine development due to their typically unrivaled chemical variety, whether in the form of pure phyto-compounds or standardized plant extracts. Plants have been an excellent source of medicine since the beginning of time. When compared to synthetically produced medications, phytochemicals from various plant species have been versicolor as a more potent source of therapy. Novel cell targets and antifungal chemicals, as well as new methods for the delivery of drugs based on nanotechnology, are all currently being studied.