Synthetic Drugs Research Articles

Reasons and Predictors of Treatment Change in Rheumatoid Arthritis Patients Treated with Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs: A Single-Center Retrospective Observational Study.

Rheumatoid arthritis (RA) patients receiving biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) often experience treatment changes due to inefficacy or adverse events. The purpose of this study was to clarify the incidence and reasons for change of b/tsDMARDs in a cohort of Japanese patients with RA and to identify the predictors of treatment change. This was a retrospective observational study of RA patients prescribed b/tsDMARD between April 2011 and December 2020 at the Kindai University Nara Hospital. We focused on the change of first-line b/tsDMARDs and identified the reasons for change using the electronic medical records. Logistic regression analysis was performed to identify predictors of treatment change as the objective variable and baseline characteristics as the explanatory variable. The reasons for treatment change were inefficacy in 69.6% of cases and adverse events in 29.7% of cases. Concomitant administration of higher dose prednisolone at baseline (adjusted odds ratio: [95% confidence interval]: 2.52 [1.19-5.33]) and old age (2.00 [1.03-3.87]) were associated with change in b/tsDMARD treatment due to inefficacy within 2 years of initiation. A better understanding of b/tsDMARDs persistence and elucidating the predictors of treatment change can help improve treatment outcomes for RA.

Cardiovascular Effects of a Glycosylated Flavonoids-Rich Leaf Extract from Brazilian Erythroxylum campestre: A Potential Health Bio-Input

Background: Bioactivity assessments of plant-derived products can benefit human and animal health, especially in regions with vast plant diversity. This study focused on chemical and cardiovascular analyses of Erythroxylum campestre A. St. Hil. leaf extracts. Methods: High-performance liquid chromatography, liquid chromatography coupled with mass spectrometry, and nuclear magnetic resonance spectroscopy were used to elucidate the structures of the flavonoids in E. campestre. The E. campestre methanolic fraction (ECM-ppt-M; at doses of 1, 2, 3, and 6 mg∙kg−1 or vehicle) was administered intravenously to normotensive and spontaneously hypertensive rats (SHRs), and we recorded the mean arterial pressure (MAP), heart rate (HR), renal vascular resistance (RVR), and aortic vascular resistance (AVC). Results: The ECM-ppt-M extract demonstrated significant antihypertensive activity, as evidenced by reductions in MAP, RVR, and AVR, with effects that were particularly pronounced in SHRs. Following the establishment of these cardiovascular effects, phytochemical analysis revealed the presence of glycosylated flavonoids, which are likely contributors to the observed antihypertensive properties of the extract. Conclusions: The notable reductions in MAP and vascular resistance observed with ECM-ppt-M treatment suggest its antihypertensive effect. These findings demonstrate the potential therapeutic value of this extract with regard to the treatment of hypertension. Future studies on ECM may provide a promising therapeutic alternative capable of reducing the risk of toxicity and adverse effects associated with synthetic drugs.

The Incidence, Aetiology and Clinical Course of Serious Infections Complicating Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drug Therapy in Patients with Rheumatoid Arthritis in Tropical Australia

Introduction: Patients receiving biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) for rheumatological conditions are at an increased risk of serious, potentially life-threatening, infection. However, the incidence, aetiology, and clinical course of serious infection in patients receiving b/tsDMARDs in tropical settings are incompletely defined. Methods: We retrospectively reviewed all patients with rheumatoid arthritis receiving b/tsDMARDs between October 2012 and October 2021, at Cairns Hospital in tropical Australia. The incidence, aetiology, and clinical course of serious infections (those requiring admission to hospital or parenteral antibiotics) were determined. Results: 310 patients had 1468 patient years of b/tsDMARD therapy during the study period; 74/310 (24%) had 147 serious infections translating to an overall risk of 10.0 episodes of serious infection per 100 patient years. The respiratory tract (50/147, 34%) and skin (37/147, 25%) were the most frequently affected sites. A pathogen was identified in 59/147 (40%) episodes and was most commonly Staphylococcus aureus (24/147, 16%). Only 2/147 (1%) were confirmed “tropical infections”: 1 case of Burkholderia pseudomallei and 1 case of mixed B. pseudomallei and community-acquired Acinetobacter baumannii infection. Overall, 13/147 (9%) episodes of serious infection required Intensive Care Unit admission (0.9 per 100-patient years of b/tsDMARD therapy) and 4/147 (3%) died from their infection (0.3 per 100-patient years of b/tsDMARD therapy). The burden of comorbidity and co-administration of prednisone were the strongest predictors of death or a requirement for ICU admission. Conclusions: The risk of serious infection in patients taking b/tsDMARDs in tropical Australia is higher than in temperate settings, but this is not explained by an increased incidence of traditional tropical pathogens.

Factors predicting treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs in psoriatic arthritis - a systematic review and meta-analysis.

The therapeutic response of patients with psoriatic arthritis (PsA) varies greatly and is often unsatisfactory. Accordingly, it is essential to individualise treatment selection to minimise long-term complications. This study aimed to identify factors that might predict treatment response to biological and targeted synthetic disease-modifying antirheumatic drugs (bDMARDs and tsDMARDs) in patients with PsA and to outline their potential application using artificial intelligence (AI). Five electronic databases were screened to identify relevant studies. A random-effects meta-analysis was performed for factors that were investigated in at least four studies. Finally, 37 studies with a total of 17,042 patients were included. The most frequently investigated predictors in these studies were sex, age, C-reactive protein (CRP), the Health Assessment Questionnaire (HAQ), BMI, and disease duration. The meta-analysis revealed that male sex (odds ratio (OR) = 2.188, 95% confidence interval (CI) = 1.912-2.503) and higher baseline CRP (1.537, 1.111-2.125) were associated with greater treatment response. Older age (0.982, 0.975-0.99), higher baseline HAQ score (0.483, 0.336-0.696), higher baseline DAPSA score (0.789, 0.663-0.938), and higher baseline tender joint count (TJC) (0.97, 0.945-0.996) were negatively correlated with the response to therapy. The other factors were not statistically significant but might be of clinical importance in the context of a complex AI test battery. Further studies are needed to validate these findings and identify novel factors that could guide personalised treatment decisions for PsA patients, in particular in developing AI applications. In accordance with the latest medical developments, decision-support tools based on supervised learning algorithms have been proposed as a clinical application of these predictors. Key messages • Given the often unsatisfactory and unpredictable therapeutic response in patients with Psoriatic Arthritis (PsA), treatment selection must be highly individualized. • A systematic literature review was conducted to identify the most reliable predictors of treatment response to biologic and targeted synthetic disease-modifying antirheumatic drugs in PsA patients. • The potential integration of these predictors into AI tools for routine clinical practice is discussed.

Increased adoption of IL-1 pathway inhibition and the steroid-sparing paradigm shift: temporal trends in recurrent pericarditis treatment from the RESONANCE patient registry

Abstract Background Recurrent pericarditis (RP) is a chronic autoinflammatory disease mediated by IL-1 that requires long-term treatment. While the 2015 European Society of Cardiology Guidelines position IL-1 pathway inhibition only after corticosteroids, complications associated with long-term steroid use underscore the importance of steroid-sparing strategies. Rilonacept, an IL-1α and IL-1β cytokine trap, is the only FDA-approved treatment for RP (available since April 2021). RESONANCE, an ongoing 5-year non-interventional US registry of patients (pts) with RP, has collected real-world data from pts cared for by cardiologists with a focus on pericardial disease, with a goal of informing contemporary RP clinical management. Purpose Analysis of temporal trends in RP management from RESONANCE. Methods From a database cut-off (DCO) on 21 December 2023, patient demographics and disease characteristics are reported for 242 active RP pts (excluding RHAPSODY prior participants) at 20 US sites (median [Q1:Q3] 2.1 [1.5:2.6] years and 556 patient-years [PY] of observation). Complete medication class use data were available for 239 pts (total 546 PY). Proportional medication class use prior to initiating rilonacept was analyzed annually across the observation period. Results Mean (standard deviation) age at DCO was 50.2 (16.6) years; 58.1% were female. Median [Q1:Q3] disease duration at DCO from index pericarditis episode was 3.1 [2.2:5] years. Median [Q1:Q3] number of prior recurrences at enrollment was 3 [2:5]. Prior to rilonacept availability, NSAIDs/Colchicine/Aspirin represented the highest proportion of treatment (73% of PY); steroid use was 9% of PY, IL-1 pathway inhibition (anakinra) was 13% of PY, and conventional synthetic disease modifying antirheumatic drugs (csDMARDs) were 0.46% PY (no RP-specific treatment was 5% of PY) (Fig 1). In the years since rilonacept availability, proportional IL-1 pathway inhibition use has increased, from 13% of PY in 2020-21 to 26% of PY in 2023, driven by an increase in rilonacept use (6%, 13%, 16% of PY in 2021, 2022, and 2023, respectively). Over that same period, proportional NSAIDs/Colchicine/Aspirin use (57%-63% of PY) has been consistently 6-times more than proportional steroid use (10%-11% of PY). Among pts who initiated rilonacept (n=81), similar proportions transitioned from NSAIDs/Colchicine/Aspirin as from corticosteroids (Fig 2), a robust trend observed each year. Of those pts transitioning from corticosteroids, 1/3 had used corticosteroids for <30 days and 1/3 for >6 months. Conclusions Real-world data from the RESONANCE registry reveal a temporal shift in RP management in US centers with RP-focused cardiologists, with increased proportional IL-1 pathway inhibition use since rilonacept availability in 2021. Advancing beyond 2015 guideline recommendations, IL-1 pathway inhibition is often being used as steroid-sparing treatment, i.e., after colchicine instead of chronic corticosteroids.

Flavonoid Based Development of Synthetic Drugs: Chemistry and Biological Activities.

The toxicity associated with synthetic drugs used for treating various diseases is common. This led to a growing interest in searching and incorporating natural functional core structures such as flavonoid and their derivativesviachemical modifications to overcome the toxicity problems andenhance their biological spectrum. Natural core structures such as flavonoids are accepted due to their safety to the environment and owing to their varieties of biological activities such as anti-Alzheimer, antimicrobial, anticancer, anti-inflammatory, antidiabetics, and antiviral properties.Based on their chemical structure, flavonoids are classified into various classes such as flavone, flavanol, flavanone, isoflavone, and Anthocyanin, etc.The present review focuses onthe potential role of the flavonoid ring-containing derivatives, highlighting their ability to prevent and treat non-communicable diseases such as diabetes, Alzheimer's, and cancer. The pharmacological activities of the flavonoid's derivatives are mainly attributed to their antioxidant effects against free radicals, and reactive oxygen species as well as their ability to act as enzymes inhibitors. The reviewcovers the synthetic strategies of flavonoid derivatives, structure activity relationship (SAR), andin silicostudies to improve the efficacy of these compounds. TheSAR,molecular docking analysis will enable medicinal chemists to search further, develop potent and newer therapeutic agents.

Increasing the productivity of oil flax in the Central Non-Black Earth region

Oil fl ax is a valuable oil crop with a wide range of applications, the raw materials of which are used in the food, technical, chemical, pharmaceutical industries and feed production. In terms of metabolism energy content, fl ax seed surpasses the grain of legumes, cereals and oilseeds. Due to the combination of high energy nutritional value and a large content of useful organic elements, fl ax has a unique biological value. In terms of amino acid composition, fl ax seed is similar to soy protein, but it contains less lysine than soy. Flaxseed presscake obtained during oil production is the most valuable among other types of presscake. Adding waste from fl ax seeds to presscake and meal for young livestock is a proven and good preventive measure that allows reducing the use of expensive synthetic drugs. The purpose of the research was to study the possibility of increasing the productivity of oil fl ax in the Central Non-Black Earth region. Under the conditions of the Central part of the Non-Chernozem zone, on sod-podzolic heavy loamy soils, in multifactorial field experiments, comprehensive studies were carried out on the effect of various techniques (previous crop, use of microfertilizers, level of mineral nutrition, chemical measures of weed control) included in the cultivation technology to obtain diff erent levels of the planned yield of oil flax. It was found that for agricultural production it is possible to recommend the use of winter wheat in crop rotation as a predecessor for oil fl ax, application of mineral fertilizer at the rate of N175P20K65, calculated to obtain the planned yield of 2.5 t/ha, treatment of crops with a mixture of herbicides Hacker, VRG, 80 g/ha + Gerbitox, VRK, 0.8 l/ha, microfertilizer Micropolidoc Plus at a dose of 0.5 l/ha in the “herringbone” phase when the fl ax plants are 8–10 cm tall.

Nano-formulations for the Management of Epilepsy: Synthetic and Herbal Drug Perspectives

Introduction: Epilepsy is a multifaceted neurological disorder impacting many individuals globally. Although the main treatment method is through medicines, many patients do not respond to existing drugs. This has spurred extensive research for new therapeutic targets and drug delivery methods. Inflammation and oxidative stress have been associated with the development and progression of epilepsy. Nanomedicine-based treatments focussing on these pathways could provide a promising way to enhance treatment results. Objective: This review aims to provide insights into enhancing antiepileptic therapy through the development of nanoformulations of synthetic and herbal drugs. Methods: A comprehensive review of existing literature was conducted to evaluate the potential of nanoformulations in improving the delivery and efficacy of antiepileptic drugs. The review covers the pathophysiological hypotheses of epilepsy, including the glutamatergic, GABAergic, oxidative stress, and neuroinflammation hypotheses, and examines the role of neurotransmitter imbalances in seizure activity. Results: Nanoformulations offer promising advantages for epilepsy treatment by enhancing drug delivery across the blood-brain barrier, reducing required dosages, and minimizing side effects. The utilization of nanoparticles can improve the bioavailability and targeting of AEDs, potentially leading to better seizure control. However, challenges such as ensuring biocompatibility and optimizing nanoparticle characteristics remain. Conclusion: While significant progress has been made in understanding epilepsy and developing treatments, the disorder continues to pose challenges. Nanoformulations represent a promising area of research that could lead to more effective and targeted therapies for epilepsy, although further studies are needed to address the associated challenges and fully realize their potential.

Difficult-to-treat Takayasu arteritis: a case-based review.

Takayasu arteritis is a rare chronic inflammatory large vessel vasculitis which affects the aorta and its large branches. The diagnosis is based on the 2022 ACR/EULAR classification criteria for Takayasu arteritis. The management of this vasculitis is challenging. Although it is corticosteroid-responsive, relapses and disease progression are common. Thus, it is possible to resort to alternative conventional synthetic disease-modifying anti-rheumatic drugs and biologics, as second-line such as tumor necrosis factor-alpha inhibitors, tocilizumab, or JAK inhibitors as second-line agents is possible. Nevertheless, in some complex cases, the vasculitis remains active despite different proposed therapeutic lines, and a multitarget approach could induce sustained remission. We report herewith a case of 33-female patient with a refractory Takayasu arteritis which remained active after three different therapeutic lines with tocilizumab, then infliximab, then Upadacitinib. Finally, we consider a successful multitarget approach with a combination of infliximab, Upadacitinib, and methotrexate.

Recent Advances on the Construction of Functionalized Indolizine and Imidazo[1,2-a]pyridine Derivatives.

Indolizines and imidazo[1,2-a]pyridines are commonly found in natural products, synthetic drugs, and bioactive molecules. These two types of derivatives possess good antibacterial, antiparasitic, anticancer activities, and so on. The functionalization of indolizines and imidazo[1,2-a]pyridines has always been a hot topic in organic chemistry research and has made significant progress. In recent years, our group has been dedicated to developing diverse synthetic methods for the preparation of such important compounds. 1) We have developed diverse C-H functionalization reactions for efficient modification of the parent indolizines and imidazo[1,2-a]pyridines. 2) A variety of cycloaddition reactions were established for the construction of indolizine and imidazo[1,2-a]pyridine derivatives from simple raw materials. 3) We have developed intriguing deconstruction-functionalization reactions of indolizines, enabling the reorganization of heterocyclic frameworks. This paper outlines our group's latest advancements in constructing structurally diverse indolizine and imidazo[1,2-a]pyridine derivatives. We hope that this work will offer valuable insights and inspiration for the ongoing research in the field of N-heterocyclic compounds.

Polygenic anti-cancer activity of Indigofera macrophylla in prostate cancer induced animal model

BackgroundProstate cancer (Pca) is a deadly disease prevalent among men, and it accounts for about 7–8 % of mortality globally. Synthetic drugs have proved effective but have limitations and severe side effects. There is, therefore, a need to discover a less expensive, natural therapeutic agent with no side effects in treating the ailment. AimThe study aims to investigate the anti-prostate cancer activity of extracts of Indigofera macrophylla (I. macrophylla) at the physiological and molecular levels in experimental animals. MethodPolyphenol-rich extract of I. macrophylla was subjected to HPLC analysis to identify the plant's phytochemical constituent. Adult Wistar rats were orally administered 2mls of 50, 100 and 200 PPM of the cacodylic acid solution for 28 days to induce prostate cancer, while treatment was carried out by orally administering extract of I. macrophylla at doses of 50, 100 and 200 mg/kg for up to 28 days. The anti-inflammatory and apoptotic properties of the extract in experimental animals were investigated by the expression levels of various genetic biomarkers such as Bax-2, TNF-α, IL-6, COX2, IL-1β, β-Catenin, APC, Bcl2, CEA, Caspase 3 and β-Catenin using reverse transcriptase polymerase chain reaction (RT-PCR). ResultHPLC analysis shows that I. macrophylla has 21 bioactive components which are categorized into seven groups: flavonoid, terpenes, phenols, isoflavonoid, phytosterols, quinone and glycosides. Administration of the drug shows inconsistencies in the mean body weights of the experimental animals. Further investigation revealed that I. macrophylla increased TNF-α upregulation and expression, significantly downregulated IL-1β, significantly decreased IL-6 expression, ameliorated COX2 expression, downregulated β-catenin expression and significantly reduced the expression of the APC gene. These results show that the drug activity modulates the investigated inflammatory and apoptotic genes in the prostate gland of PCa-induced rats, thus demonstrating its anti-PCa potential. ConclusionThe results of this study suggest the potential of a novel treatment protocol of I. macrophylla plant extract to improve therapeutic outcomes for patients with aggressive PCa, which reportedly claims hundreds of thousands of lives yearly.

Phytochemistry of Petroselinum crispum (Mill.) Fuss, Murraya koenigii (L.) Spreng. and Cinnamomum tamala (Buch.-Ham.) T. Nees & C. H. Eberm. and in silico studies of the role of their bioactive components against cancer

Phytochemical profiling using reliable equipment and validated methods helps us know the medicinal value of the plants. Since natural compounds have fewer side effects, they can serve as replacements for synthetic drugs that are being used in the treatment of challenging chronic diseases like cancer. The present study focuses on the bioactive phytochemical profiling of Petroselinum crispum (Mill.) Fuss, Murraya koenigii (L.) Spreng., and Cinnamomum tamala (Buch.-Ham.) T. Nees & C. H. Eberm. and in silico studies to check the anticancer potential of their bioactive components. In thin-layer chromatography (TLC) plate analysis, it was found that the methanolic extracts of plants contained the maximum number of components. Gas chromatography–mass spectrometry (GC-MS) analysis of the methanolic extracts of plants showed the presence of 22 bioactive components. High-performance thin-layer chromatography (HPTLC) analysis of the extracts of these plants showed the important chromatographic peak, apigenin. In silico studies showed the binding efficacy of selected bioactive components observed in the analysis of plant extracts. Amongst them, apigenin was found to be most effective at binding to the receptors of targeted cancer cells, viz., hepatocellular carcinoma, lung, and breast cancer. After the analysis of the study, it was arrived at the conclusion that the plants, viz., P. crispum, M. koenigii, and C. tamala, possess various bioactive components, and some of these components have anticancer potential. Therefore, in vivo and in vitro studies should be essentially conducted for the development of cancer-preventive drugs.

Incidence of serious respiratory tract infections and associated characteristics in a population exposed to immunosuppressive therapies: a register-based population study

BackgroundImmunosuppressive therapies are associated with a risk of infections. Nevertheless, their incidence in this population remains unclear. This study aims to determine the incidence of serious respiratory tract infections (SRI) in a population exposed to immunosuppressive therapies.MethodsData from a representative sample of the French healthcare claims from 01/01/2014 to 12/31/2019 were analyzed. Exposure to immunosuppressive therapy was defined by the dispensation of drugs through community pharmacies or in hospitals. SRI diagnosis was based on ICD-10 codes from hospitalization records. A cohort analysis was performed to estimate standardized SRI incidence rates. A nested case-control analysis within this cohort was used to study the characteristics associated with SRI.ResultsWe identified 24,122 individuals exposed to immunosuppressive therapies, among which 1,559 developed SRI, resulting in a standardized incidence rate of 1,398 per 100,000 person-years. In this population, the risk of SRI was associated with a history of cancer (OR 2.68, 95% Confidence Intervals (CI) 2.24–3.21; p < 0.001), chronic respiratory disease (2.62, 95%CI 2.17–3.16; p < 0.001), end-stage renal failure (2.38, 95%CI 1.37–4.13; p = 0.003), neurodegenerative diseases (1.52, 95%CI 1.07–2.17; p = 0.026), diabetes (1.44, 95%CI 1.14–1.82; p < 0.001), psychiatric diseases (1.27, 95%CI 1.06–1.52; p < 0.001), and cardiovascular diseases (1.26, 95%CI 1.04–1.52; p = 0.002). Compared to corticosteroids alone, the risk of SRI was lower in individuals treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) only (0.44, 95%CI 0.25–0.78; p < 0.001).ConclusionIn the population exposed to immunosuppressive therapies, a history of chronic disease is associated with an increased risk of SRI. This risk is lower in those receiving csDMARD alone than corticosteroids alone.

Efficacy of the cardiac glycoside digoxin as an adjunct to csDMARDs in rheumatoid arthritis patients: a randomized, double-blind, placebo-controlled trial.

Inflammation and angiogenesis are two main mechanisms that act as mutual pathways in rheumatoid arthritis (RA). This work aimed to study the efficacy of digoxin as an adjunct therapy to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in active RA patients. In a randomized, double-blinded, placebo-controlled study, 60 adult patients with active RA received a placebo or digoxin (0.25mg every other day) combined with csDMARDs for 6months. The American College of Rheumatology (ACR) 20, ACR50, and ACR70 response rates and the disease activity score (DAS28) were assessed for patients. Flow cytometric analysis of Th17 cells and serum concentrations of IL-17A, IL-23, HIF-1α, and VEGF were evaluated before and after three and 6months of therapy. Following three and 6months of digoxin therapy combined with csDMARDs, significant differences were detected in laboratory and clinical parameters relative to the control group. After 6months, 83.3% of patients in the digoxin group, compared to 56.7% in the control group, achieved an ACR20 response (p = 0.024). The digoxin group had a significantly higher percentage of patients who achieved DAS28 remission after 6months (p = 0.024). Notable improvements in the Health Assessment Questionnaire Disability Index, ACR50, and ACR70 were detected in the digoxin group. Digoxin was well tolerated and exerted profound immunomodulatory and anti-inflammatory effects in RA patients, and may also exhibit anti-angiogenic properties, indicating that it might be an effective adjunct to csDMARDs in treating RA. clinicaltrials.gov, identifier NCT04834557.

The Role of Peptides in Combatting HIV Infection: Applications and Insights.

Peptide-based inhibitors represent a promising approach for the treatment of HIV-1, offering a range of potential advantages, including specificity, low toxicity, and the ability to target various stages of the viral lifecycle. This review outlines the current state of research on peptide-based anti-HIV therapies, highlighting key advancements and identifying future research directions. Over the past few years, there has been significant progress in developing synthetic peptide-based drugs that target various stages of the viral life cycle, including entry and replication. These approaches aim to create effective anti-HIV therapies. Additionally, peptides have proven valuable in the development of anti-HIV vaccines. In the quest for effective HIV vaccines, discovering potent antigens and designing suitable vaccine strategies are crucial for overcoming challenges such as low immunogenicity, safety concerns, and increased viral load. Innovative strategies for vaccine development through peptide research are, therefore, a key focus area for achieving effective HIV prevention. This review aims to explore the strategies for designing peptides with anti-HIV activity and to highlight their role in advancing both therapeutic and preventive measures against HIV.

Geo-Hydrobiology and Geoinformatics Mapping of Ethnobotany in the Gandhamardan Hills, Odisha, India

Objective: The Gandhamardan Hills (GMH)range is a group of small mountains in Peninsular India in Balangir district in Odisha state in India. There is uniqueness in geology, geography, geomorphology, climatology, Hydrology, petrology, and lithology. The lithology, soil, water, geomorphology, and traditional use of plants in Ayurveda (India) have holistic medicinal/surgery. origin. Geo-hydro-biological amalgamation through Geological Information Systems (GIS) and chemical analysis is still being explored, and the present research emphasises such studies. Methods: Data about geo-hydro-biology through grapy, geology, geomorphology, hydrology, and traditional medicinal practices are implored from literature sources, using TOPO and Q-GIS maps and ERDAS software; their analytical interpretations were reported. The chemical analysis was conducted using X-ray fluorescence spectrometric studies of the water and soil of GMH, and the exuberance of ethnobotanical species in GMH was correlated. Results Laboratory analysis, literature studies, and interaction with Ayurvedic and Kaviraj practitioners, 154 popular species databases with their pharmacological applications reported for ordinary people. Many species have multidimensional applications that can transform Ayurveda into Materia medica. Conclusion: This ethnobotanical study documented the use of plants by the local community. The natural medicinal plants are cheap for the rural communities. The information gathered can be used for further scientific investigation to develop new commercial plant-based medicines as they will be safer than synthetic drugs. SDGs 1 to 3 and 12, 13, and 15 will be satisfied if we can conserve and adequately manage the hub of medicinal plants in GMH.

Pregnancy Outcomes from a Multidisciplinary Obstetric-Medicine/Rheumatology Clinic in the United States: A Five-Year Retrospective Analysis.

At Women & Infants Hospital in Providence, Rhode Island, the Specialty Care in Pregnancy clinic combines obstetric-medicine internists with rheumatologists to care for pregnant patients with rheumatologic conditions. These clinics are scarce, with only three known similar clinics in the United States. This study aims to characterize the population cared for in this clinic, identify interventions, and analyze pregnancy outcomes for the birthing parents and newborns. A five-year retrospective chart review was performed from January 1st, 2016, through December 31st, 2021. Of 81 patients, 62% had a clinically diagnosed rheumatic disorder. Of 87 patient visits, which included preconception, prenatal, and postpartum encounters, 54% of patients were taking conventional synthetic disease modifying antirheumatic drugs, and 17% were taking biologic disease modifying antirheumatic drugs. New medications were started in 52% of patients. A total of 52% of pregnancies resulted in live births, with 2% resulting in miscarriages. Prematurity occurred in 19% of newborns, and 9% had intrauterine growth restriction. Our study illustrates the benefits of multidisciplinary care in patients with rheumatologic disorders during their prenatal and perinatal periods. The expertise from both the obstetric-medicine internists and rheumatologists was critical in making complex decisions that weighed the benefits of therapy against potential risks for the fetus. Our multidisciplinary approach resulted in doubling of the number of patients initiating disease modifying therapy and increased prophylaxis with hydroxychloroquine and/or aspirin therapy, as recommended by current guidelines. Additional multidisciplinary clinics of this type would help coordinate care among physicians who frequently treat these high-risk, unique patients and open the door for more research of this understudied population.

Factors associated with biological and targeted synthetic disease-modifying antirheumatic drug initiation for rheumatoid arthritis in underserved patient groups in England and Wales, UK: a national cohort study

Quantifying health-care inequality is essential to addressing the imbalance in outcomes attributable to age, sex, race or ethnicity, and multimorbidity. In this study, we analysed differences in the initiation of biological or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis within the universal health-care system of England and Wales, UK. An observational cohort study was conducted using the National Early Inflammatory Arthritis Audit (NEIAA) dataset. We included all patients with rheumatoid arthritis who were enrolled in NEIAA between May 8, 2018, and April 30, 2022, and who had 12-month follow-up data available. Modified Poisson regression was used to explore factors associated with the initiation of biological and targeted synthetic DMARDs within 12 months of initial rheumatology assessment. The factors evaluated included age, sex, ethnicity, socioeconomic status (index of multiple deprivation), smoking status, and relevant comorbidities (lung disease, cardiovascular disease, cancer, and depression). NEIAA is supported by people with lived experience of rheumatoid arthritis, who contributed to study design and the interpretation of findings. 6098 patients in NEIAA had new diagnoses of rheumatoid arthritis and available follow-up data. The mean age was 59·2 years (SD 14·9); 3912 (64·2%) patients were women and 2186 (35·8%) were men. 6047 (99·2%) patients had available ethnicity data, of whom 5215 (86·2%) were White, 152 (2·5%) were Black, 478 (7·9%) were Asian, and 202 (3·3%) were of mixed or other ethnicities. 508 (8·3%) of 6098 patients initiated biological and targeted synthetic DMARDs within 12 months. Patients younger than 40 years were more likely to be initiated on biological and targeted synthetic DMARDs than individuals older than 65 years (multivariable-adjusted risk ratio 2·41 [95% CI 1·83-3·19]; p<0·0001). Asian individuals were less likely to be initiated on biological and targeted synthetic DMARDs than White individuals (0·52 [0·36-0·76]; p=0·0007), which persisted after adjustment for socioeconomic status, comorbidities, baseline disease severity, and the initial response to conventional synthetic DMARDs. These differences were evident for Asian women but not Asian men. Black individuals were more likely to be initiated on biological and targeted synthetic DMARDs than White individuals (1·54 [1·10-2·16]; p=0·012), which became non-significant after adjusting for baseline disease severity and autoantibody status. The initiation of biological and targeted synthetic DMARDs for patients with newly diagnosed rheumatoid arthritis varies markedly by ethnicity and age in the universal health-care system of England and Wales. This study demonstrates the importance of providing tailored information and ensuring equitable access to high-quality care for underserved patient groups. The one-size-fits-all approach must be reconsidered if health disparities are to be mitigated effectively. Sandoz UK.

A pharmacological investigation for therapeutic potential of Callistemon citrinus as an anthelmintic agent (Bottle-Brush Plant)

The growing resistance of parasitic helminths to standard anthelmintic medications has sparked increased interest in exploring alternative treatments, particularly those derived from herbal sources. This research focuses on the anthelmintic properties of selected herbal plants, assessing their ability to inhibit and eliminate parasitic worms. Standard extraction techniques were employed to prepare various plant extracts, which were then tested using both in vitro and in vivo assays to determine their effectiveness. The findings revealed that several plant extracts showed significant anthelmintic effects, comparable to those of conventional medications. Phytochemical analysis identified a high concentration of alkaloids, tannins, saponins, and flavonoids, which are thought to be the primary contributors to the observed activity. These results indicate that these herbal plants may serve as promising natural anthelmintic agents, providing a sustainable and environmentally friendly alternative to synthetic drugs. Further research is necessary to isolate and identify the specific bioactive compounds, clarify their mechanisms of action, and assess their safety and efficacy in clinical applications. This study highlights the potential of herbal medicine in developing novel anthelmintic treatments and encourages the integration of traditional knowledge with modern scientific research.

Socialization, cultivation, and utilization of empty land for family medicinal plants

The prevalence of illness complaints among the Indonesian population is 228.15 percent, with 65.01 percent opting for self-treatment using synthetic drugs, while 38.30 percent prefer traditional medicine. The use of traditional medicines in communities, including in Katimbang Village, remains significantly lower compared to synthetic alternatives. A comprehensive strategy is needed to enhance public knowledge and understanding of how to obtain and utilize traditional medicine from medicinal plants found around the home. This socialization and cultivation activity was conducted at Integrated Service Post (Posyandu) RW 04, Katimbang Village, involving 21 community members. The event included a socialization session on family medicinal plants, pre- and post-tests, QA discussions, and the planting of 50 medicinal plant seeds, with participation from students and local residents. Statistical tests revealed the success of this intervention in improving participants' understanding of medicinal plants, with an average pre-test score of 8.4762 increasing to 8.6190 in the post-test. More than 50 percent of participants scored ≥80 in the post-test. The success of this outreach and planting activity provides a strong foundation for further increasing public awareness of the use of medicinal plants as complementary treatments for various illnesses.