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Diabetes insipidus (DI) is an acquired or hereditary water imbalance disorder characterized by polydipsia and polyuria. It is a condition that involves the excretion of dilute urine in large volumes. The illness can strike at any age, with males and females have identical rates of occurrence of the disease. The two main mechanisms responsible for diabetes insipidus are either insufficient release or production of ADH (antidiuretic hormone) from the hypothalamus (central diabetes insipidus) or ADH resistance in which the kidneys are unable to respond to ADH (nephrogenic diabetes insipidus). Another form of DI is transient diabetes insipidus commonly known as gestational diabetes insipidus that occurs in the second/third trimester of pregnancy due to increased levels of placental vasopressinase that occurs progressively during pregnancy and increases metabolic clearance of vasopressin. The fourth type of DI is primary polydipsia, characterized by elevated levels of water intake that physiologically lower vasopressin and may be psychogenic, iatrogenic or dipsogenic. Signs and symptoms of DI often include water electrolyte-imbalance, excessive or severe thirst, frequent and excessive urination, fatigue, dehydration, and weight loss. Diabetes insipidus (DI) should be distinguished from primary polydipsia, and whether it is caused by a central, nephrogenic, or gestational cause. This distinction is critical since incorrect treatment can result in serious repercussions. Diagnosis of DI includes measurement of plasma sodium and osmolality, baseline copeptin, hypertonic saline stimulation and arginine stimulation test. The treatment for DI includes the use of drugs such as desmopressin, thiazide diuretics, indomethacin and amiloride.

Gastroretentive drug delivery systems (GRDDs) have emerged as an innovative and promising approach for enhancing the bioavailability and therapeutic efficacy of drugs with narrow absorption windows in the upper gastrointestinal tract (GIT). Among various GRDDs, swellable and floating systems have garnered significant attention due to their ability to prolong gastric residence time, improve drug dissolution, and facilitate sustained drug release (SDR). This comprehensive review provides a detailed exploration of the principles, mechanisms, and advancements in swellable and floating Gastroretentive systems. The key strategies, such as the use of hydrophilic polymers, gasgenerating agents, and superporous hydrogels, are discussed. These systems offer benefits in treating conditions like peptic ulcers, gastroesophageal reflux disease, and infections, where prolonged localized drug action is desirable. A critical assessment of recent preclinical and clinical studies highlights the therapeutic potential of GRDDs in optimizing drug delivery for poorly soluble drugs and drugs with short half-lives. Challenges such as variability in gastric retention, potential toxicity of excipients, and patient-specific factors are also examined. It includes the outlining future trends in GRDDs, focusing on the incorporation of nanotechnology, 3D printing, and biocompatible materials to overcome existing limitations and further enhance therapeutic outcomes. This highlight of review article is initially introduction of GRDDs and their significance, mechanism and their classification of GRDDs, intermediately describe brief on swelling and floating GRDDs system with their application, lastly it describes the recent advances in patent, clinical trials and marketed products for GRDDs swellable and floating system. [ABSTRACT FROM AUTHOR]

Hypoxia-inducible Factor 1 (HIF-1) is a transcriptional activator that intervenes in versatile reactions to hypoxia. Natural drugs, widely distributed in plants, comprise many metabolites, possessing their potential as anti-cancer agents. Studies have highlighted HIF-1 as a potential pharmacological target for cancer therapy. Secondary metabolites derived from natural products (plant-derived or marine organisms) with unique chemical structures have demonstrated HIF-1 inhibition. Ganetespib, topotecan, PX-478, aminoflavone, fluorine-19-fluoroded xyglucose, etc. have entered clinical phases of evaluation for different types of cancer. The present work describes role of HIF-1 in tumor progression, summarizes plant based inhibitors such as berberine, rohitukine, harringtonine, acronycin, nuciferine, evodiamine, matrine, etc. Some of the major categories with HIF-1 inhibitory potential are alkaloids, flavonoids, steroids, etc. The manuscript aims to benefit the discovery and development of anti-cancer therapeutics from natural compounds. [ABSTRACT FROM AUTHOR]

Dengue is a wide spectrum of diseases creating menace in the community. This vector-born disease alone has a significant impact on global public health and the economy. Resources need to be mobilized to tackle the situation. The present article focused on the novice concept of "Seven-Plus-One models" as an approach to dengue prevention with vector management through community participation. A multidisciplinary approach along with exemplifying effective methods of inspectorial coordination and community participation is much required. The implementation of the Seven-Plus-One model has a positive impact on reducing dengue cases, indicating acceptance and effectiveness of the concept among the public. Dengue morbidity rate can be reduced through early detection and mobilizing the community for active participation in dengue prevention and control. [ABSTRACT FROM AUTHOR]

The research involves the synthesis of a series of new pyridine analogs 5(i‐x) and their evaluation for anti‐epileptic potential using in silico and in vivo models. Synthesis of the compounds was accomplished by using the Vilsmeier‐Haack reaction principle. AutoDock 4.2 was used for their in silico screening against AMPA (‐amino‐3‐hydroxy‐5‐methylisoxazole) receptor (PDB ID:3m3f). For in vivo testing, the maximal electroshock seizure (MES) model was used. The physicochemical, pharmacokinetic, drug‐like, and drug‐score features of all synthesized compounds were assessed using the online Swiss ADME and Protein Plus software. The in silico results showed that all the synthesized compounds 5(i‐x) had 1–3 interactions and affinities ranging from −6.5 to −8.0 kJ/mol with the targeted receptor compared to the binding affinities of the standard drug phenytoin and the original ligand of the target (P99), which were −7.6 and −6.8 kJ/mol, respectively. In vivo study results showed that the compound 5‐Carbamoyl‐2‐formyl‐1‐[2‐(4‐nitrophenyl)‐2‐oxo‐ethyl]‐pyridinium gave 60% protection against epileptic seizures compared to 59% protection afforded by regular phenytoin. All of them met Lipinski's rule of five and had drug‐likeness and drug score values of 0.55 and 0.8, respectively, making them chemically and functionally like phenytoin. According to the findings of the studies, the synthesized derivatives have the potential to be employed as a stepping stone in the development of novel anti‐epileptic drugs. [ABSTRACT FROM AUTHOR]

Nowadays, Camellia sinensis (L.) O. Kuntze is used as a health drink as well as a medication worldwide. Quercetin, kaempferol, and myricetin are different flavonoids present in it. Therefore, it was decided to extract and isolate the flavonoid content of Camellia sinensis with an evaluation of their anticancer activity. In the methodology, the extraction of the dried leaves was performed with the help of the Soxhlet apparatus. The extractives were obtained with different solvents. For the isolation of desired flavonoid column chromatography was applied using solvents of different polarity. Different polarity solvents utilization helped in determining a better medium for the extraction and isolation of flavonols. The flavonol quercetin obtained from Camellia sinensis was subjected to the estimation of anticancer activity. Anticancer ability was determined on the ovarian cancer cell line by in vitro method. The results depicted that the flavonoids especially quercetin, work as a good antineoplastic agent. The outcomes revealed that naturally available anticancer agents having good potential and lesser toxicity can be obtained from easily available natural sources like green tea leaves. Thus, the work in the future may be elaborated to find new targets for quercetin. [ABSTRACT FROM AUTHOR]

Breast cancer is a common and deadly disease, so there is a constant need for research to find efficient targets and therapeutic approaches. Breast cancer can be classified on a molecular and histological base. Breast cancer can be divided into ER (estrogen receptor)‐positive and ER‐negative, HER2 (human epidermal growth factor receptor2)‐positive and HER2‐negative subtypes based on the presence of specific biomarkers. Targeting hormone receptors, such as the HER2, progesterone receptor (PR), and ER, is very significant and plays a vital role in the onset and progression of breast cancer. Endocrine treatments and HER2‐targeted drugs are examples of targeted therapies now being used against these receptors. Emerging immune‐based medicines with promising outcomes in the treatment of breast cancer include immune checkpoint inhibitors, cancer vaccines, and adoptive T‐cell therapy. It is also explored how immune cells and the tumor microenvironment affect breast cancer development and treatment response. The major biochemical pathways, signaling cascades, and DNA repair mechanisms that are involved in the development and progression of breast cancer, include the PI3K/AKT/mTOR system, the MAPK pathway, and others. These pathways are intended to be inhibited by a variety of targeted drugs, which are then delivered with the goal of restoring normal cellular function. This review aims to shed light on types of breast cancer with the summarization of different therapeutic approaches which can target different pathways for tailored medicines and better patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Antibiotic misuse is a global threat. In recent years, inadequate awareness and inappropriate adherence to antibiotic prescription have been coupled with frequent self-medication practices. Aims: The study aims to assess awareness, perception and practices followed by nurses on antibiotics use at a tertiary care hospital in North India. Materials and Methods: This online survey was completed by 232 nurses working at a tertiary care teaching hospital in North India from September to October 2020. A pre-validated questionnaire of awareness, perception and practices was used to collect information. Appropriate descriptive and inferential statistics are used to generate the results. Results: The mean age of nurses was 27.84 (±3.06) years, and 60% were male. The majority of the nurses (80.17%) had a graduate degree in nursing, with a professional experience of 6.25 (±5.30) years. More than two-third (87.5%) of nurses are familiar with the word antibiotics resistance. Surprisingly, 47.4% of nurses used antibiotics more than two times without a prescription in the current year. Interestingly, 95.26% of nurses know antibiotics are effective against bacteria and are disease specific (93.79%). Further, 96.55% of nurses said that unnecessary antibiotic use might lead to resistance, and 68.10% agreed to take antibiotics after a doctor's prescription. Conclusions: Self-medication practices were high amongst nurses. Organising more in-service education, intense orientation programmes and instruction-based training needs to intensify nurses on the appropriate use of antibiotics and to set up an antimicrobial stewardship programme at the institute. [ABSTRACT FROM AUTHOR]

Diabetes is of the metabolic disorder that has become one of the major cause leading to morbidity and death around the globe. Antidiabetic medications that are more effective and have adverse effects less frequently are currently being sought after. Much little study has been done on polyherbal compounds, irrespective of the fact that several individual herbs have been shown to have antidiabetic properties in studies or clinically. It is thought that herbal mixtures made of various plant products have synergistic anti-diabetic properties and may strengthen the intended results. Numerous polyherbal preparations have been investigated as potential therapeutics for the treatment of diabetes. A thorough assessment of the literature was conducted using many significant databases to characterize the present state of research on polyherbal substances for the treatment of diabetes. This research focused on the formulation and evaluation of polyherbal tablets containing extract from leaves of Phyllanthus amarus, Tinospora cordifolia, Momordica charantia, Vinca rosea available in the local areas of Sambalpur, Odisha, India. Invivo studies showed that the blood sugar lowering effect was found more pronounced in higher dose 500 mg/kg than lower dose 250 mg/kg. The efficacy of 500 mg/kg of the formulation was almost equal to that of standard therapy. Along with it oral glucose tolerance test showed increase in blood glucose level within a period of 30 mins from the starting of test as compared to the initial level of glucose concentration. This hyperglycemia was maintained until 60 min and then began to decrease. The polyherbal formulation proves to be an effective method of treatment of diabetes mellitus thus required to be explored further for better promising results. [ABSTRACT FROM AUTHOR]

Hyperglycemia, a common metabolic abnormality associated with diabetes mellitus, is primarily brought on by insufficient insulin synthesis at the cellular level or/and errors in insulin action. Such an endocrine condition causes major health issues and is spreading rapidly around the globe. The widespread control of diabetes with oral drug administration without producing any side effects is still regarded as a difficult undertaking, and the rising cost of traditional treatment in developing nations is another issue of concern. Traditional preparations of herbal plant extracts in the form of medications have already drawn a lot of attention in an effort to treat these problems. Locals use the crude extract of Swertia chirayita and Zizyphus mauritiana, two prominent Nepalese medicinal plants, for a variety of ailments, including type 2 diabetes. The current study's objectives were hydroalcoholic extract extraction of plant material, phytochemical analysis of Swertia chirayita and Zizyphus mauritiana, and formulation, development, and assessment of phytosomes. This study confirms the glucose tolerance activity with help of phytosomes containing the extracts of Swertia chirayita and Zizyphus mauritiana. The increase in blood glucose level can be controlled with help of phytosomes containing these extracts, along with it phytosomes showed a sustained release activity that best fitted with Korsmeyer peppas model. [ABSTRACT FROM AUTHOR]

Aim/Background: Across the world disease of cancer is one of the factors of death and to identify the emerging role of thiosemicarbazide analogs for the cancer disease it was decided to design, and synthesize novel thiosemicarbazide derivatives (5a-i) with in-vitro anticancer activity evaluation. Materials and Methods: Substituted benzoic acid, thionyl chloride, hydrazine hydrate, and ammonium thiocyanate were used to create a new series of thiosemicarbazide derivatives (5a-i). The final derivatives were characterized using 13C and 1H NMR, FTIR, and mass spectroscopy. The compounds were then analyzed for anticancer action with the in-vitro MTT assay method as well as by measuring the percentage of tumor growth on the B16F10 melanoma cell line, a clone of B16 cells. Results: Compounds 5a, 5b, and 5e outperformed and were comparable to the reference drug, doxorubicin. All three compounds have an electron-withdrawing group substitution and have shown remarkable anticancer effects. When compared to other substituted derivatives, the drug-likeness score evaluated by Swiss ADME online software confirmed the same fact that thiosemicarbazides with electronwithdrawing groups substitution like halogens, and nitro groups at different positions could work as excellent and promising anticancer agents. Conclusion: The study and the result of the study revealed that thiosemicarbazide moiety represents an important core and could be used as a template for further development of analogs having promising anti-cancer effects. [ABSTRACT FROM AUTHOR]

Nuclear magnetic resonance spectroscopy has largely given way for most important routine analysis of natural, synthetic drug candidate and related molecules. The quality control and simultaneous quantitation of different residual solvents, analytes and impurities have led analysts to further exploit nuclear magnetic resonance as a viable quantitative technique. Hence, this review focuses on the use and feasibility of this technique for quantitative method validation of drug and related compounds. Validated quantitative nuclear magnetic resonance methods were simple, robust, accurate and selective for evaluating different natural and synthetic samples using various commercially accessible compounds as internal standards. In this review numerous examples are cited giving proof of advancement in nuclear magnetic resonance technology and also for precise evaluation of molecular structures of substances in solids and liquid. Studied examples of different concurrent validation methods in the review shows that the results obtained is precise with less standard deviation when compared with other chromatography techniques. Concluding the entire review, various methodologies used for quantification and validations were reflected that proved to be a specific, selective and alternative means of method validation and it can be summarized that nuclear magnetic resonance is as reliable as the chromatography-based technique for quantitative analysis providing accuracy. [ABSTRACT FROM AUTHOR]

The Punicaceae family member Pomegranate is a well-known fruit with a long history in Iran and the Middle East. Pomegranates contain a large number of constituents that possess an impressive role in the management of health. Due to its extensive pharmacological properties, Pomegranate (Punica granatum) has been dubbed a "wonder fruit" over the last decade. Due to its antibacterial and anti-inflammatory properties, it has high nutritional value as well as numerous health benefits. Because of the presence of bioflavonoids, it can inhibit the production of free radicals and is also reported to inhibit lipoxygenases and thus recommended as an ingredient of various pharmaceuticals and cosmetics. The fruit of the pomegranate has been recommended as a pharmaceutical and food ingredient in the treatment of HIV/AIDS. Worldwide, the use and medicinal properties of pomegranate have attracted the attention of a large number of researchers. Significant efforts and progress have been made in determining the pharmacological mechanisms and constituents involved in the reported biological effect. This review paper has summarized information about the therapeutic and pharmacological applications of different phytoconstituents of pomegranate. [ABSTRACT FROM AUTHOR]

The whole world is in the grip of the coronavirus disease (COVID-19) outbreak. This pandemic brought visible changes in the life of humans around the globe. Likewise, the medical health sector is forced to use digital technology to continue to provide medical health services by preventing themselves. COVID-19 pandemic highlighted the significance of digitalization in every sphere of life. By focusing on virtual care at a large scale, health care delivery becomes possible and convenient even for remote places. The use of artificial intelligence concepts in this pandemic, like robots replaced human movements and function automatically to guide the patients in the reception area and found helpful to prevent and manage the crowd in a few countries. Similarly, the use of e-earning platform has emerged as a digital solution to impart medical education to medical students in this corona outbreak. [ABSTRACT FROM AUTHOR]

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease which on progression causes cirrhosis; various studies also suggested that several diseases can co-exist in patients. In existing depiction of disease PBC, apart from entire use of ursodeoxycholic acid (UDCA), several patients need to step forward to liver-transplantation or death due to resistance or non-responder with UDCA monotherapy. To overcome this non-respondent treatment, novel bile acid semi-synthetic analogs have been identified which shows their potency against for farnesoid X receptor and transmembrane G protein-coupled receptor-5 which are identified as target for many developing analogs which have desirable pharmacokinetic profiles. A range of studies suggests that adding semisynthetic analogs in therapeutic regime improves liver biochemistries in patients with suboptimal response to UDCA. Thus, the aspire of this review is to abridge and compare therapeutic value and current markets affirm of various bile acids semi-synthetic analogs which certainly are having promising effects in PBC monotherapy or in pooled treatment with UDCA for PBC. [ABSTRACT FROM AUTHOR]

Introduction: Evaluation is vital in teaching-learning process. The present study aims to assess the perception and level of satisfaction on subjective versus objective based summative evaluation among medical and nursing students. Materials and Methods: The present study is a cross-sectional descriptive study and is conducted on 300 Medical and Nursing students studying at AIIMS Rishikesh. Participants were selected by using Nonprobability convenience sampling technique. The data was collected on perception and level of satisfaction on subjective versus objective based summative evaluation using selfadministered Likert scale. Results: The present study findings showed that majority (95%) of the participants perceived multiple choice questions (MCQ) gives better opportunity to prepare them for competitive exams and 77% of participants perceived that essay based summative evaluation improves writing skills. Further, 97.3% participants were satisfied with MCQ based summative evaluation. Almost 90% recommended MCQ based exams to assess academic performance, whereas only 17% participants recommended subjective exams. Conclusion: The present research study showed that students have both positive and negative perception towards objective and subjective based summative evaluation. [ABSTRACT FROM AUTHOR]

Background: Success in endodontic treatment depends on the prevention and control of root canal infection which is achieved by adequate cleaning, shaping, and filling. The present study was conducted to assess flow rate of different root canal sealers such as sealapex, Adseal, MTA fillapex and AH plus. Materials & Methods: This invitro study was conducted in which different root canal sealers such as sealapex, Adseal, MTA fillapex and AH plus divided into 4 groups. Flow rate of sealers was calculated. Results: The mean flow rate in group I was 19.2, in group II was 22.5, in group III was 21.9 and in group IV was 20.4. The difference was significant (P< 0.05). Conclusion: Authors found that maximum flow was achieved with Adseal whereas minimum with Sealapex. [ABSTRACT FROM AUTHOR]

A skin disease, like acne, is very common and normally happens to everyone at least once in their lifetime. The structure of the stratum corneum is often compared with a brick wall, with corneocytes surrounded by the mortar of the intercellular lipid lamellae. One of the best options for successful drug delivery to the affected area of skin is the use of ethosomes which can be transported through the skin through channel-like structures. Tretinoin is a widely used retinoid for the topical treatment of acne, photo-aged skin, psoriasis and skin cancer which makes it a good candidate for topical formulation. Yet side effects, like redness, swelling, peeling, blistering and, erythema, in addition to its high lipophilicity make this challenging. Drug loaded ethosomes had been prepared using phospholipid and ethanol, were optimized and characterized for entrapment efficiency, vesicular size, shape, In-vitro skin permeation, skin retention, drug-membrane component interaction and stability. The ethosomal formulation having 0.5 %w/v of phospholipid and 20 %v/v of ethanol (F2) showing the greatest entrapment efficiency (80.25±0.23) with small particle size (205.40±2.31nm) was selected for further skin permeation studies. The skin permeation and skin retention studies were performed on ethosomal formulation, liposomal formulation (0.5 %w/v of phospholipid without alcohol), hydroethanolic drug solution and phosphate buffer saline (pH7.4) drug solution. Among them, ethosomal formulation showed higher cumulative percentage of drug permeation (93.36±0.45%) and 8 hours than the other formulations. Scanning electron microscopy confirmed the three dimensional nature of ethosomes. Dynamic light scattering technique proved that the ethosomes has smaller vesicular size than the liposomes prepared without alcohol. FT-IR studies revealed no interaction between the drug and membrane components. The ethosomal vesicles were incorporated in carbopol gel base and its anti-acne was compared with the marketed gel. Our results suggest that the ethosomes are an efficient carrier for dermal and transdermal delivery of tretinoin. [ABSTRACT FROM AUTHOR]

Novel drug delivery system is a novel approach to drug delivery that addresses the limitations of the traditional drug delivery systems. If the novel drug delivery technology is applied in herbal medicine, it may help in increasing the efficacy and reducing the side effects of various herbal compounds and herbs. The problem associated with the use of herbal preparation is of their poor bioavailability. The vesicle system composed of phospholipids can increase the therapeutic value, reduce toxicity and can increase the bioavailability of the phytomedicines. The phospholipid-based vesicle system, mainly phytosomes, has been applied recently to many popular herbal extracts including Ginkgo biloba, grape seed, hawthorn, milk thistle, green tea and ginseng. Phytosomes are complexes prepared by mixing polyphenolic phytoconstituent and phosphophatidylcholine in molar ratio. It is a patented technology that involves chemical interaction between phosphohlipid and water soluble herbal compounds, suitable as drug delivery systems for topical and oral administration. Plant extracts can bind easily to phosphatidylcholine due to presence of terpenoids and flavonoids. As novel drug delivery system they are found to be more superior to liposomes as they exhibit better pharmacokinetic and pharmacodynamics profiles than both liposomes and free plant extract. Phytosomal delivery of extracts of Ginseng, Silybin, Gingko etc have been profitably used. With the help of Phytosomes preparations, the amount of herbal extracts administered in body through several routes are required in fewer amounts and between more duration as well in phyosomal forms drugs can be administered in uniform dosage form for better therapeutic activity and less side effect. [ABSTRACT FROM AUTHOR]

Polyherbal formulation has been used all around the earth due to its medicinal and therapeutic application. It has also recognized as polyherbal therapy or herb-herb combination. The active phytochemical constituents of individual plants are inadequate to attain the desirable therapeutic effects. When polyherbal formulations combining the multiple herbs in a meticulous ratio, it will give an enhanced therapeutic effect and decrease the toxicity. The active constituents used from individual plant are inadequate to provide attractive pharmacological action. There are evidences that crude plant extracts often have greater potency rather than isolated constituents. In traditional medicine whole plants or mixtures of plants are used rather than isolated compounds. Due to synergism, polyherbalism confers some benefits which are not accessible in single herbal formulations. Polyherbal formulations express high effectiveness in numerous diseases with safe high dose. Based on the nature of the interaction, there are 2 mechanisms on how synergism acts (i.e., pharmacodynamics and pharmacokinetic). In words of pharmacokinetic synergism, the capacity of herb to ease the absorption, distribution, metabolism and elimination of the other herbs is focused. Pharmacodynamics synergism on the other hand, studies the synergistic effect when active constituents with similar therapeutic activity are targeted by diverse mechanism of action we have taken four plants ie. Phyllanthus amarus, Tinospora cordifolia, Momordica charantia, and Vinca rosea. Hence it is assumed that similar findings will be obtained from present study. [ABSTRACT FROM AUTHOR]