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Omalhassan Amir Abdelkarim,1 Usman Abubakar,2 Mohamed A Hussain,3 Abd Elrahman Babiker Abadi,1 Ahmed Osman Mohamed,3 Wadah Osman,4,5 Asmaa E Sherif,4,6 Sara Altayep Ebrahim,1 Asmaa Hussein Ahmed,1 Marwa Omer Ahmed,1 Ahmed Ashour4,6 1Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 2Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 3Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 4Department of Pharmacognosy, Faculty of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-KharJ, Saudi Arabia; 5Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan; 6Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura, EgyptCorrespondence: Omalhassan Amir Abdelkarim, Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, PO Box 2469, Sudan, Email dromal409@gmail.comBackground: Adequate training in infectious diseases and antibiotic resistance is crucial for pharmacy students to participate in antibiotic stewardship programs and understand microbiology careers.Aim: The study was carried out to assess the knowledge and self-reported confidence in antibiotic resistance, antibiotic therapy, and antimicrobial stewardship (AMS) among final-year undergraduate pharmacy students in Sudan.Methods: A cross-sectional study was conducted in three universities using a 57-item online questionnaire between April and May 2022.Results: A total of 109 students (response rate 36%) participated and showed average knowledge scores of 5.6± 1.7 (out of 10.0) for antibiotic resistance, 4.9± 2.0 (out of 5.0) for appropriate antibiotic therapy, and 3.1± 1.4 (out of 5.0) for AMS. No significant differences were observed among schools. Some students reported poor knowledge about antibiotic therapy and the consequences of resistance. One-third of students lacked confidence in interpreting microbiological results. Knowledge of antibiotic resistance among students’ practice area after graduation was higher (p=0.017) and those interested in ID careers (5.8 vs 4.8) (p=0.037). Male students (5.6 vs 4.5) and those interested in ID careers (4.3 vs 3.4) (p< 0.001) had higher scores of appropriate antibiotic therapy. Students attended antibiotic resistance courses (51.5 vs 45.2), and those interested in ID significantly had higher self-confidence (55.3 vs 45.8) (p=0.008).Conclusion: Pharmacy students in Sudan have substantial knowledge of AMS and antibiotic resistance with poor knowledge of antibiotic therapy. Adequate training about infectious diseases and related topics is recommended to improve pharmacy students’ understanding of microbiological findings, other competencies, and skills to incorporate in antimicrobial stewardship.Keywords: antibiotic resistance, antimicrobial stewardship, antimicrobial therapy, Sudan, pharmacy students

Omar E Hegazi,1,2 Samer O Alalalmeh,1,2 Moyad Shahwan,1,2 Ammar Abdulrahman Jairoun,3,4 Mansour M Alourfi,5,6 Ghfran Abdulrahman Bokhari,6 Abdullah Alkhattabi,6 Saeed Alsharif,7 Mohannad Abdulrahman Aljehani,8 Abdulmalik Mohammed Alsabban,9 Mohammad Almtrafi,9 Ysear Abdulaziz Zakri,9 Abdullah AlMahmoud,10 Khalid Mohammed Alghamdi,10 Ahmed M Ashour,11 Nasser M Alorfi11 1Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; 2Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates; 3Health and Safety Department, Dubai, United Arab Emirates; 4School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia; 5Internal medicine Department, King Faisal Medical City for Southern Region, Abha, Saudi Arabia; 6Department of gastroenterology, East Jeddah hospital, Jeddah, Saudi Arabia; 7Gastroenterology Department, Armed force Hospital of southern region, Khamis Mushait, Saudi Arabia; 8Division of Gastroenterology, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia; 9Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 10Gastroenterology Section, Internal Medicine Department, King Fahad Hospital, Jeddah, Saudi Arabia; 11Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Nasser M Alorfi, Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Email Nmorfi@uqu.edu.saBackground: Non-alcoholic fatty liver disease (NAFLD) is a common disease and has been increasing in recent years. To date, no FDA-approved drug specifically targets NAFLD.Methods: The terms “Non-alcoholic Fatty Liver Disease” and “NAFLD” were used in a search of ClinicalTrials.gov on August 24, 2023. Two evaluators independently examined the trials using predetermined eligibility criteria. Studies had to be interventional, NAFLD focused, in Phase IV, and completed to be eligible for this review.Results: The ClinicalTrials.gov database was searched for trials examining pharmacotherapeutics in NAFLD. The search revealed 1364 trials, with 31 meeting the inclusion criteria. Out of these, 19 were finalized for evaluation. The dominant intervention model was Parallel. The most prevalent studies were in Korea (26.3%) and China (21.1%). The most common intervention was metformin (12.1%), with others like Exenatide and Pioglitazone accounting for 9.1%.Conclusion: Therapeutics used to manage NAFLD are limited. However, various medications offer potential benefits. Further investigations are definitely warranted.Keywords: NAFLD, hepatology, clinical trials, therapeutics, metabolic disorder

Ahmed M Ashour Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Ahmed M Ashour, Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Tel +966566664464, Fax +966126066693, Email amashour@uqu.edu.saBackground: Melatonin is a hormone produced by the pineal gland primarily at night. It has been suggested that melatonin may possess various cardiovascular benefits, including the potential to lower blood pressure. For this reason, we sought to identify and provide evidence of the effectiveness of melatonin on high arterial blood pressure in clinical trials.Methods: Using the search term “melatonin and hypertension”, a search of the ClinicalTrials.gov database was performed on October 10th, 2023. I defined the exclusion and inclusion criteria to isolate appropriate clinical trials. Inclusion criteria for the search included hypertension that utilized melatonin as a treatment supplement; all non-related trials were omitted from the search. The data extractions, including study title, study type, study status, and intervention and outcome details, were compiled.Results: Of the 13 clinical trials identified, only three focused on examining the effects of melatonin. The study titles, enrollment numbers, conditions, statuses, interventions, and outcome measures have been explained in depth. Information gathered from these clinical trials will assist us in identifying the possible risks and benefits of melatonin with respect to high arterial blood pressure.Conclusion: Melatonin has been shown to be an effective treatment for lowering blood pressure. More research is required to fully establish the potential benefits and risks and highlight the mechanisms through which melatonin may influence blood pressure regulation.Keywords: melatonin, blood, clinical trials, arterial, supplement

Background: The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommends statin treatment for all adult kidney transplant recipients (KTRs), except those aged

Nasser M Alorfi, Ahmed M Ashour Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Nasser M Alorfi, Email Nmorfi@uqu.edu.saBackground: Non-alcoholic fatty liver disease (NAFLD) is a predominant health condition across the world due to its rising prevalence and association with various metabolic disorders. Intermittent fasting (IF) has attracted increasing attention as a dietary approach to addressing weight management and enhancing metabolic well-being, and its potential effects on NAFLD have been a topic of growing research interest.Aim: This review aims to critically evaluate the current evidence on IF’s impact on NAFLD, including the mechanisms underlying the observed effects in older adults (65+).Methods: A comprehensive search of Clinicaltrials.gov was conducted to identify relevant studies that investigated the effects of IF on NAFLD in older adults (65+). Data on study design, sample size, intervention details, and outcomes related to NAFLD were extracted and analyzed.Results: As of April 12th, 2023, there were 1304 clinical trials on NAFLD. Most of these were interventional studies. The investigation focused on completed studies and found that limited clinical trials were identified with limited interventional measures. Only five out of the 1304 studies on NAFLD involved IF. Basic and advanced outcome measures were examined.Conclusion: Although some studies suggest that IF may have potential benefits for NAFLD, the evidence is still limited and inconclusive.Keywords: hepatology, intermittent fasting, metabolic disease, lifestyles, clinical trials

Ahmed M Ashour Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Ahmed M Ashour, Pharmacology and Toxicology Department, Faculty of Pharmacy, Umm AlQura University, Makkah, 21442, Saudi Arabia, Tel +966566664464, Fax +966126066693, Email amashour@uqu.edu.saPurpose: Smoking is a global public health concern, with a significant negative impact on human health and healthcare spending. Vaping, or the use of electronic cigarettes (e-cigarettes), has emerged as a popular alternative to traditional nicotine replacement therapies (NRTs) for smoking cessation. While considered less harmful than combustible cigarettes, the long-term health effects of e-cigarettes (vaping) are unknown. Therefore, this study aimed to identify and provide a comprehensive overview of the performance of vaping in clinical trials.Patients and Methods: A search was conducted in the ClinicalTrials.gov database on April 14th, 2023, using the search term “smoking cessation, e-cigarettes, NRTs, and vaping”. Inclusion and exclusion criteria were defined to identify relevant clinical trials. Randomized controlled trials (RCTs) and non-randomized clinical trials that evaluated vaping as a therapeutic approach to smoking cessation were included.Results: A total of 87 clinical trials were identified, of which only seven were related to smoking cessation through vaping as a form of treatment. The primary endpoint was the effect of vaping as smoking cessation, and the secondary endpoints were patients’ abstinence rate, withdrawal symptoms, and adverse events of e-cigarettes. Most of the trials used e-cigarettes as an intervention, with some trials including a combination of e-cigarettes and other NRTs. The trials lasted from 4 weeks to 12 months. The overall results of the trials indicated that vaping was effective in helping smokers to quit. It was also associated with a lower risk of adverse events than combustible cigarettes.Conclusion: Vaping appears to be an effective method for smoking cessation, and it is associated with a lower risk of adverse events than combustible cigarettes.Keywords: vaping, e-cigarettes, nicotine, smoking cessation, smoking aid

Nasser M Alorfi,1 Ahmed M Ashour,1 Alanood S Algarni,1 Faris A Alsolami,2 Abdulrhman M Alansari,3 Mansour Tobaiqy4 1Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 2Khulais General Hospital, Ministry of Health, Makkah, Saudi Arabia; 3Alsafiah Health Care Center, Ministry of Health, Madinah, Saudi Arabia; 4Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah, Saudi ArabiaCorrespondence: Nasser M Alorfi, Umm Al-Qura University, Al Abdeyah, Mecca, 24381, Saudi Arabia, Email nmorfi@uqu.edu.saBackground: Pain is a global health issue that affects an individual’s quality of life. Its alleviation and management will enhance patients’ experience. Community pharmacists can help manage pain severity through their valuable roles in medical teams and by managing the consequences of pain.Objective: This study aimed to evaluate community pharmacists’ knowledge and attitudes toward pain and pain management in Saudi Arabia.Methods: A cross-sectional study was performed to evaluate community pharmacists’ knowledge and attitudes toward pain and pain management in Saudi Arabia. Pharmacists aged ≥ 21 years, with a degree in pharmacy were included in this study. Each respondent participated in an online survey covering cancer-oriented pain and assessment of pain; pharmacology; abuse of substances; and physical dependence. An independent t-test and One-way ANOVA, with least significant difference as a post-hoc test, were employed, in addition to the General Linear Regression Model using Main Effect as the model.Results: This study revealed that the pain-related knowledge and attitude among community pharmacists in Saudi Arabia were inadequate. Age (p = 0.003), work experience (p = 0.036), nature of work (p = 0.001), and work location (p = 0.003) were determined as significant factors affecting their overall knowledge and attitude toward pain.Conclusion: Overall, attempts to expand community pharmacists’ knowledge and foster an appropriate attitude toward pain management among them in Saudi Arabia are highly recommended. Additional academic courses, studies, and tailored neuroscience courses will improve their awareness and knowledge of pain and pain management.Keywords: pharmacist, pain, knowledge, attitude, practice

Neveen S Abd El Rahim,1,2 Asmaa A Ashour1 1Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi ArabiaCorrespondence: Asmaa A Ashour, Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Nasr, Cairo, Egypt, Tel +20 1284048535, Email aasmaa@azhar.edu.egPurpose: To evaluate the impact of the platform-switched implant on marginal bone loss (MBL) and the probing pocket depth (PPD) in patients wearing mandibular overdenture.Patients and Methods: This longitudinal study included 40 completely edentulous patients aged 51– 64 years. All patients received complete dentures and were distributed into two groups randomly; 20 patients each. The first group GI received two platform switched implants; however, the 2nd group GII received two platform matched implants (3.6 × 11.5 mm) in the canine region of the mandible. The radiographic evaluations were carried out every year for six years, whereas probing pocket depth was evaluated every six months for 72 months for both groups. The data were analyzed by repeated ANOVA, Friedman’s, and Student’s t-test.Results: This study included 36 patients; 56 ± 3.6 years was the mean age; 17 females (47%) and 19 males (53%) completed the study. Statistically significant differences were observed in MBL and PPD in each of GI and GII after 6 years, p ≤ 0.05. Between GI and GII after 6 years, a statistically insignificant difference was detected in MBL or PPD, p ≥ 0.05, except in PPD at loading, 2 and 6 years, p ≤ 0.05.Conclusion: Time positively affected MBL and PPD in platform switched and matched implants retained mandibular overdentures. Platform switching influences probing pocket depth in implants retained mandibular overdentures.Keywords: dental implant, platform switching, overdenture, supporting structures, COVID-19

Suaad Hamsho,1 Isam Alannouf,1 Anas A Ashour2 1Faculty of Medicine, Damascus University, Damascus, Syria; 2Department of Internal Medicine, Hamad Medical Corporation, Doha, QatarCorrespondence: Anas A Ashour, Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar, Tel +974 55336238, Email aashour3@hamad.qaAbstract: Felty syndrome (FS) is a disorder that develops after a long history of erosive rheumatoid arthritis and presents with splenomegaly and neutropenia. In addition to joint deformities, FS causes a variety of extra-articular manifestations such as vasculitis, skin lesions, and lymphadenopathy. FS is also reported to cause non-cirrhotic portal hypertension which may result in variceal bleeding. FS is usually treated by disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate. Herein, we report a case of rapidly deteriorating FS and a severe relapsing neutropenia only a few weeks after discontinuation of methotrexate and other available DMARDs. The patient presented with a fever and a multi-drug resistant gangrenous ulcer consistent with ecthyma gangrenosum. The patient was also found to have hepatosplenomegaly and portal hypertension. The case was managed with antibiotics and symptomatic treatments only as DMARDs were either unavailable or not affordable by the patient. However, the patient’s condition did not improve. This case highlights that DMARDs are considered an essential part of preventing infections due to FS neutropenia. Patients with FS should continue DMARDs for life to avoid the relapse of their condition.Keywords: felty syndrome, rheumatoid arthritis, DMARDs, portal hypertension, case report

Neveen S Abd El Rahim,1,2 Asmaa A Ashour1 1Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Cairo, Egypt; 2Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi ArabiaCorrespondence: Asmaa A Ashour, Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Nasr City, Cairo, Egypt, Tel +201284048535, Email aasmaa@azhar.edu.egAim: To assess oral health-related quality of life (OHRQoL), marginal bone loss (MBL), and changes in soft tissue including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods.Methods: Forty completely edentulous patients with age 51– 64 years were recruited for that longitudinal cohort study. Complete dentures were performed for all participants. Two implants (3.6 × 11.5 mm) were installed in the canine areas of the mandible. OHRQoL and MBL measures were performed every 1 year for 5 years, while clinical measures were made every 6 months for 60 months. Data were examined using repeated ANOVA and Friedman test.Results: Thirty-seven patients had 74 implants; with mean age 56 ± 3.6 years; 43% females (n = 16) and 57% males (n = 21) accomplished the study. There were statistically significant differences in OHRQoL, MBL, and changes in soft tissue, including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods, p ≤ 0.05.Conclusion: Mandibular overdentures retained by 2 implants provide a positive long-term effect on OHRQoL, MBL, probing pocket depth, and implant stability.Keywords: implant-retained overdenture, quality of life, marginal bone loss, pocket depth, COVID-19

In this article, we model the current and voltage across the weak link between two superconductors. This gives us a nonhomogeneous, nonlinear parametric-driven sine-Gordon equation with phase shifts. This model equation cannot be solved directly but can be approximated. For the approximations, we use two methods, and analytic perturbation method and the numerical approximation method known as the Runge–Kutta method. For the analytic method, we construct a perturbation expansion method with multiple-scale expansion. We discuss the parametric-driven in the sine-Gordon equation with phase shifts for the 0–π–0 junction. Further, we also describe the breathing modes for various order of perturbation. At the end, we compare the solutions obtained via perturbation and numerical methods of parametric-driven sine-Gordon equation with phase shifts. Finally, we concluded that the modes of the breathing decay to a constant in both cases. Also we found a good agreement between both approximate methods.

Nasser Alorfi, Ahmed Ashour Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Nasser Alorfi, Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Tel +966500644261, Email nmorfi@uqu.edu.saBackground: The Pfizer-BioNTech COVID-19 vaccine has been widely used and approved for the prevention of 2019 coronavirus disease (COVID-19) for individuals aged 16 years and older in Saudi Arabia. The emergency use authorization of this vaccine is crucial to managing the pandemic in the Kingdom. This vaccination strategy requires proper usage, knowledge, and management by pharmacists and other health professionals.Methods: This cross-sectional study was conducted using several previously validated questionnaires. Pharmacists working in different health sectors in Saudi Arabia in March–July 2021 participated via an online questionnaire. Comparative and descriptive analyses were used to analyze the data, and a P-value < 0.05 was considered significant.Results: A total of 145 pharmacists with a mean age of 35.2 years (SD ± 5.59) were included. The study sample showed adequate general knowledge of COVID-19 and its causative virus signs. Overall, the results showed good knowledge of Pfizer-BioNTech COVID-19 vaccine and its pharmacological application among pharmacists in Saudi Arabia with significant chi square values (p< 0.0001).Conclusion: Pharmacists have good knowledge and understanding of the Pfizer-BioNTech COVID-19 vaccine; interestingly, the majority expressed a high level of awareness and agreed that Pfizer-BioNTech COVID-19 vaccine is a valuable vaccine for COVID-19 management.Keywords: COVID-19, Pfizer-Biontech, vaccination, pharmacists

Mohammad Z Haider,1 Amna Al-Mannai,1 Sally Al-Sirhan,1 Ahmed Elsabagh,1 Nasser Nasser,1 Noora Al-Quraishi,1 Amr Ouda,1 Khadija Erradi,1 Anas A Ashour,2 Ishita Gupta,1,3 Jazeel Abdulmajeed,4 Hamad E Al-Romaihi,4 Devendra Bansal,4 Omran AH Musa,4 Elmoubasher Abu Baker Abd Farag,4 Mohammed HJ Al-Thani,4 Ala-Eddin Al Moustafa1,3,5 1College of Medicine, QU Health, Qatar University, Doha, Qatar; 2Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar; 3Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar; 4Ministry of Public Health, Doha, Qatar; 5Biomedical Research Centre, Qatar University, Doha, QatarCorrespondence: Ala-Eddin Al Moustafa, College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, Qatar, Tel +974 4403 7817, Fax +974 4403-3333, Email aalmoustafa@qu.edu.qaPurpose: Predisposition to acute illness from COVID-19 is suggested to correlate with cigarette smoking as it augments the risk of developing cardiovascular and respiratory illnesses, including infections. However, the effects of smoking on COVID-19 symptoms are not well described and controversial. In this study, we aim to explore the associations between smoking and COVID-19 symptoms.Subjects and Methods: A cross-sectional study using the Ministry of Public Health (MoPH), Qatar database was administered to a Qatari population with confirmed COVID-19 disease who filled in pre-defined phone-call questionnaire between 27th February 2020 and 31st December 2020. We analyzed 11,701 non-vaccinated COVID-19 individuals (2952 smokers and 8749 non-smokers) with confirmed RT-PCR test results. The association of smoking and the presence of symptoms as well as patient characteristics was calculated using Pearson’s Chi-square and Fisher’s exact tests, adjusting for potential covariates.Results: Compared with the non-smokers, symptomatic COVID-19 infection is significantly higher in smokers. In addition, we found fever as the most common symptom developed in COVID-19 patients followed by cough, headache, muscle ache, and sore throat. As compared to other symptoms, association of smoking with chills and abdominal pain was less evident (P < 0.05 and P < 0.001, respectively). However, both groups showed similar rates of developing cough.Conclusion: In conclusion, smoking is associated with COVID-19 symptoms frequency in non-vaccinated patients; nevertheless, further investigations are necessary to understand the mechanism of this association which could generate new targets for the management of COVID-19 in smoker patients.Keywords: COVID-19, smoking, frequency, Qatar, symptoms

Asmaa A Ashour,1 Amal H El-Kamel,1 Doaa A Abdelmonsif,2,3 Hoda M Khalifa,4 Alyaa A Ramadan1 1Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, 21521, Egypt; 2Department of Medical Biochemistry, Faculty of Medicine, Alexandria University, Alexandria, 21131, Egypt; 3Center of Excellence for Research in Regenerative Medicine and Applications (CERRMA), Faculty of Medicine, Alexandria University, Alexandria, 21131, Egypt; 4Department of Histology, Faculty of Medicine, Alexandria University, Alexandria, 21131, EgyptCorrespondence: Amal H El-KamelDepartment of Pharmaceutics, Faculty of Pharmacy, Alexandria University, 1 Khartoum Square, Azarita, Messalla Post Office PO Box 21521, Alexandria, EgyptTel +20 10-0508-0510Fax +20 3 4873273Email amalelkamel@yahoo.comIntroduction: Liver fibrosis represents a serious global disease with no approved treatment. Tanshinone IIA (TSIIA) is a phytomedicine with documented activity in treating many hepatic disorders. TSIIA has been reported to have potent anti-inflammatory and antioxidant properties. It can also induce apoptosis for activated hepatic stellate cells, and is thereby considered as a promising herbal remedy for treating fibrotic liver. However, its poor aqueous solubility, short half-life, exposure to the first-pass effect, and low concentration reaching targeted cells constitute the major barriers hindering its effective therapeutic potential. Therefore, this work aimed at enhancing TSIIA systemic bioavailability together with achieving active targeting potential to fibrotic liver via its incorporation into novel modified lipid nanocapsules (LNCs).Methods: Blank and TSIIA-loaded LNCs modified with either hyaluronate sodium or phosphatidyl serine were successfully prepared, optimized, and characterized both in vitro and in vivo.Results: The developed LNCs showed good colloidal properties (size ≤ 100 nm and PDI ≤ 0.2), high drug-entrapment efficiency (> 97%) with sustained-release profile for 24 hours, high storage stability up to 6 months, and good in vitro serum stability. After a single intraperitoneal injection, the administered LNCs exhibited a 2.4-fold significant increase in AUC0–∞ compared with the TSIIA suspension (p≤ 0.01). Biodistribution-study results proved the liver-targeting ability of the prepared modified LNCs, with a significant ∼ 1.5-fold increase in hepatic accumulation compared with the unmodified formulation (p≤ 0.05). Moreover, the modified formulations had an improved antifibrotic effect compared with both unmodified LNCs and TSIIA suspension, as evidenced by the results of biochemical and histopathological evaluation.Conclusion: The modified TSIIA-LNCs could be regarded as promising novel targeted nanomedicines for effective management of liver fibrosis.Keywords: phytomedicine, hyaluronic acid, phosphatidyl serine, antifibrotic activity

Majd Akbik,1 Dima Naddeh,2 Anas A Ashour,3,4 Azzam Ashour1 1Al-Thumama Health Center, Primary Health Care Corporation, Doha 26555, Qatar; 2Muaither Health Center, Primary Health Care Corporation, Doha 26555, Qatar; 3College of Medicine, QU Health, Qatar University, Doha 2713, Qatar; 4Medical Education, Hamad Medical Corporation, Doha 3050, QatarCorrespondence: Anas A AshourQatar University, Doha, QatarTel +974 55336238Email aa1510042@qu.edu.qaAbstract: Immune thrombocytopenia (ITP) is an autoimmune disease that occurs following viral illnesses and may also infrequently occur after measles, mumps, and rubella (MMR) vaccination. ITP typically presents with the sudden appearance of a petechial rash, bruising, and/or bleeding in an otherwise healthy-appearing child. However, ITP following MMR vaccine does not commonly cause severely depleted platelets. We report a case of ITP after MMR vaccination in a 13-month-old baby boy, who presented with petechial rash all over his body. The child had severe thrombocytopenia but was successfully treated with a single dose of intravenous immunoglobulin without complications. The study highlights that ITP post-MMR vaccine is an easily treatable condition.Keywords: immune thrombocytopenia, MMR vaccine, thrombocytopenia, case report

Abdelkader E Ashour,1,2 Mohammad Badran,3 Ashok Kumar,4 Tajamul Hussain,5 Ibrahim A Alsarra,3 Alaa Eldeen B Yassin3,6,7 1Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 2Department of Basic Medical Sciences, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan 25200, Pahang Darul Makmur, Malaysia; 3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Vitiligo Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 5Center of Excellence in Biotechnology Research, King Saud University, Riyadh, KSA; 6Pharmaceutical Sciences Department, College of Pharmacy-3163, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 7King Abdullah International Medical Research Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi ArabiaCorrespondence: Alaa Eldeen B YassinCollege of Pharmacy-3163 King Saud bin Abdulaziz University for Health Sciences PO Box: 3660, Riyadh 11481, Saudi ArabiaTel +966509426323Fax +966114295058Email yassina@ksau-hs.edu.saPurpose: The main goal of this study is to evaluate the impact of physical incorporation of polyethylene glycol (PEG) into 5-fluorouracil (5-FU)-loaded polymeric nanoparticles (NPs).Methods: The 5-FU-loaded NPs were prepared utilizing a simple double emulsion method using polycaprolactone (PCL) and polylactic-co-glycolic acid (PLGA) with or without PEG 6000. The surface charge, particle size, and shape of NPs were evaluated by standard procedures. Both Fourier Transform Infrared Spectroscopy and X-ray diffraction spectra of the 5-FU loaded NPs were compared against the pure 5-FU. The in vitro release profile of 5-FU from the NPs was monitored by the dialysis tubing method. Cell death and apoptosis induction in response to 5-FU NP exposure were measured by MTT and Annexin–V/7-amino-actinomycin D (7-AAD) assays, respectively, in Daoy, HepG2, and HT-29 cancer cell lines.Results: The 5-FU loaded NPs were found to be spherical in shape with size ranging between 176±6.7 and 253.9±8.6 nm. The zeta potential varied between −7.13± 0.13 and −27.06±3.18 mV, and the entrapment efficiency was between 31.96% and 74.09%. The in vitro release of the drug followed a two-phase mode characterized by rapid release in the first 8 hrs followed by a period of slow release up to 72 hrs with composition-based variable extents. Cells exposed to NPs demonstrated a significant cell death which correlated with the ratio of PEG in the formulations in Daoy and HepG2 cells but not in HT-29 cells. Formulations (F1–F3) significantly induced early apoptosis in HT-29 cell lines.Conclusion: The physical PEGylation significantly enhanced the entrapment and loading efficiencies of 5-FU into NPs formulated with PLGA and PCL. It also fostered the in vitro cytotoxicity of 5-FU-loaded NPs in both Daoy and HepG2 cells. Induction of early apoptosis was confirmed for some of the formulations.Keywords: hepatocellular carcinoma HepG2, emulsification-solvent evaporation technique, colorectal carcinoma HT-29, MTT assay, apoptosis

Aim. To study the features of lipid peroxidation of biological membranes and accumulation of toxic metabolites in the body of patients with psoriasis, depending on the presence of concomitant chronic viral hepatitis C.Materials and methods. In the survey, participated 56 patients with a vulgar form of psoriasis who received in-patient treatment at the Nalchik skin clinic in 2016–2017, divided into 2 groups, depending on the presence of concomitant chronic viral hepatitis C. In patients, the content of malonic dialdehyde in blood was determined as an indicator of the state of the prooxidant system, ceruloplasmin and erythrocyte catalase, as indicators of antioxidant protection, and also for the evaluation of the Intoxication Syndrome; the level of substances of low and medium molecular mass and oligopeptides in the biological environments of the organism in different periods of the disease.Results. It was found that the presence of concomitant chronic viral hepatitis C in patients with psoriasis was characterized by a more pronounced increase in the concentration of lipid peroxidation products than in the group of patients with hepatitis without psoriasis, accompanied by a decrease in the activity of antioxidant enzymes in the blood plasma and an increase in the activity of catalase in erythrocytes. Simultaneously, the presence of chronic hepatitis C led to a significantly higher content in the body fluids of patients with low and medium molecular weight substances and oligopeptides.

The fate of phosphorus (P) in the eco-system is strongly affected by the interaction of phosphates with soil components and especially reactive soil mineral surfaces. As a consequence, P immobilization occurs which eventually leads to P inefficiency and thus unavailability to plants with strong implications on the global food system. A molecular level understanding of the mechanisms of the P binding to soil mineral surfaces could be a key for the development of novel strategies for more efficient P application. Much experimental work has been done to understand P binding to several reactive and abundant minerals especially goethite (α-FeOOH). Complementary, atomistic modeling of the P-mineral molecular systems using molecular dynamics (MD) simulations is emerging as a new tool in environmental science, which provides more detailed information regarding the mechanisms, nature, and strength of these binding processes. The present study characterizes the binding of the most abundant organic phosphates in forest soils, inositol hexaphosphate (IHP), and glycerolphosphate (GP), to the 100 diaspore (α-AlOOH) surface plane. Here, different molecular models have been introduced to simulate typical situations for the P-binding at the diaspore/water interface. For all models, quantum mechanics/molecular mechanics (QM/MM) based MD simulations have been performed to explore the diaspore–IHP/GP–water interactions. The results provide evidence for the formation of monodentate (M) and bidentate (B) motifs for GP and M and as well as two monodentate (2M) motifs for IHP with the surface. The calculated interaction energies suggest that GP and IHP prefer to form the B and 2M motif, respectively. Moreover, IHP exhibited stronger binding than GP with diaspore and water. Further, the role of water in controlling binding strengths via promoting of specific binding motifs, formation of H-bonds, adsorption and dissociation at the surface, as well as proton transfer processes is demonstrated. Finally, the P-binding at the 100 diaspore surface plane is weaker than that at the 010 plane, studied previously (Ganta et al., 2019), highlighting the influential role of the coordination number of Al atoms at the top surface of diaspore.

The thermal decomposition behavior of the Fe(II), Co(II), Ni(II) and Zn(II) complexes of polydithiooxamide has been investigated by thermogravimetric analysis (TGA) at a heating rate of 20°C min -1 under nitrogen. The Coats-Redfern integral method is used to evaluate the kinetic param- eters for the successive steps in the decomposition sequence observed in the TGA curves. The process- es of thermal decomposition taking place in the four complexes are studied comparatively as the TGA curves indicate the difference in the thermal decomposition behavior of these complexes. The thermal stabilities of these complexes are discussed in terms of repulsion among electron pairs in the valence shell of the central ion and electronegativity effects.