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Mona Bustami,1 Khalid Z Matalka,2 Eyad Mallah,3 Luay Abu-Qatouseh,1 Wael Abu Dayyih,3 Nour Hussein,4 Nayef Abu Safieh,4 Yousef Elyyan,5 Nagham Hussein,6 Tawfiq Arafat7 1Department of Pharmacology and Biomedical Sciences, University of Petra, Amman, 11196, Jordan; 2Faculty of Health Sciences, American University of Madaba, Madaba, Jordan; 3Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, 11196, Jordan; 4School of Medicine, University of Jordan, Amman, Jordan; 5Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan; 6Istishari Hospital, Amman, Jordan; 7Jordan Center for Pharmaceutical Research, Amman, JordanCorrespondence: Mona Bustami Email mbustami@uop.edu.joObjective: The study aimed to investigate the prevalence of obesity among Jordanian women and its association with a wide range of chronic diseases.Methods: Subjects were enrolled in the present cross-sectional study based on a random drop-off technique at the Obstetrics and Gynecology clinics at Jordan University Hospital. Initially, any female 18 years of age and older was asked to enroll in the study. Relevant data were gathered using a questionnaire composed of 30 questions, and body mass index (BMI) was determined from each participant’s weight and height. The following variables were collected: socio-demographic, chronic diseases, and health status. Each variable’s frequencies were reported, and the 95% confidence interval (95% CI) for each variable was calculated. For association analysis, Chi-square analysis was performed with an odds ratio (OR) and 95% CI. Multinomial logistic regression analysis was applied to a combination of independent variables and a dependent condition with covariate factors.Results: The age-standardized prevalence of overweight/obese Jordanian women was 70.6% (95% CI 66.0– 74.8%). On the other hand, the age-standardized prevalence of only obese women was 36.4 (95% Cl 31.9– 41.2%). Furthermore, the association between age and overweight/obesity was significant (p< 0.0001). The percentage of overweight and obesity started to be significant in the 30– 39 year age group. Moreover, the OR for obesity ranged from 2.7 to 7.0 (p< 0.05– 0.01) for those women with only elementary education. Besides, high parity was significantly associated with obesity and elementary education. For chronic conditions, the percentages of hypertension, diabetes, hypertriglyceridemia, osteoporosis, and rheumatoid arthritis were significantly correlated with increased BMI in Jordanian women. With age adjustment, however, only hypertension was associated with obese level 3 with OR of 7.2 and 95% CI of 2.1– 25.1 (p< 0.01).Conclusion: There is a high prevalence of overweight/obesity among women in Jordan, which was related to high parity and low education level. This high prevalence of obesity increased the incidence of chronic diseases, such as hypertension. Therefore, community-based multiple strategies are required to combat obesity in Jordanian women.Keywords: women, obesity, hypertension, chronic diseases, parity, education, Jordan

Mona Bustami,1 Khalid Z Matalka,2 Yousef Elyyan,3 Nagham Hussein,4 Nour Hussein,5 Nayef Abu Safieh,5 Fida Thekrallah,3 Eyad Mallah,6 Luay Abu-Qatouseh,1 Tawfiq Arafat7 1Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan; 2Matalka’s Scientific Writing, Lexington, MA, USA; 3Department of Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan; 4Istishari Hospital, Amman, Jordan; 5School of Medicine, University of Jordan, Amman, Jordan; 6Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan; 7Jordan Center for Pharmaceutical Research, Amman, JordanCorrespondence: Mona Bustami Email mbustami@uop.edu.joObjective: The aim of this study was to assess factors related to the onset of premature/early natural menopause among Jordanian women.Methods: A cross-sectional study was conducted in early 2016. Subjects were enrolled based on random drop-off technique to the Obstetrics and Gynecology clinics at the Jordan University Hospital. Women 18 years of age and above were initially eligible to enroll, and women who had surgically induced menopause or specific disease were excluded from the analysis. Relevant data were collected using a questionnaire that included 30 questions. The following variables were collected: socio-demographic, body mass index, chronic conditions, diseases, reproductive characteristics, and health status. Hormone indicators of menopause were tested by measuring estrogen (E2) and follicle-stimulating hormone (FSH) levels. Age at natural menopause (ANM) was self-reported retrospectively and considered an independent variable against BMI, smoking, hormone therapy, and concomitant diseases. Association analysis and multinomial logistic regression were used to examine the associated factors of ANM with adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) were reported.Results: A total of 409 women were included in the analysis, aged between 20− 75 years. The mean ANM in our sample was 48.5± 5.0, with 2.7% of the women experienced premature menopause (ANM < 40) and 7.8% early menopause (ANM 40– 44). Within the menopause women (n=242), the percentage of women who had premature menopause was 4.5%, 13.6% with early menopause, and 21.1% with late menopause (ANM > 52). Smoking was the major risk factor for premature/early menopausal age among Jordanian women with an OR of 2.46 (95% CI: 1.08– 5.59, p< 0.05). On the other hand, women with occasional arthritis symptoms and diseases such as hypertension, diabetes, dyslipidemia, and their combination were associated with average (45– 52 years) or late menopause (> 52 years).Conclusion: Smoking is the main contributor of premature/early menopause in Jordanian women. Increased awareness and public health policy about the adverse effects of smoking on women’s reproductive health are needed.Keywords: Jordanian women, menopause age, smoking, diseases, socioeconomic variables

Introduction Serum sclerostin is a protein inhibitor of the wingless signaling pathway of bone formation whose role in osteoimmunology and inflammatory arthritides is still controversial. Aim The aim of the present study was to examine the relation of serum sclerostin as one member of the wingless signal protein inhibitors to arthritic and bony manifestation of psoriasis as a model of autoimmune inflammatory arthritis. Settings and design This was a cross-sectional, prospective study. Patients and methods The study included 30 psoriatic arthritis (PsA) male patients whose mean age was 43.3±8.3 years and had a disease duration of 3.8±2.6 years, and 15 age-matched and sex-matched apparently healthy controls. Serum sclerostin was measured using the enzyme-linked immunosorbent assay. Disease activity was measured using the Disease Activity Index for Psoriatic Arthritis. Ultrasonography of enthesis at Leeds enthesitis sites and dual energy X-ray absorptiometry at the lumbar spine were also carried out for all patients. Statistical analysis The independent t-test, Pearson’s correlation coefficient, and one-way analysis of variance were used for statistical analysis. Results The serum sclerostin level was significantly higher in PsA patients compared with controls, with a mean of 0.64 and 0.37 ng/ml, respectively. Serum sclerostin correlated significantly with Disease Activity Index for Psoriatic Arthritis, ultrasonography inflammatory and damage scores, and dual energy X-ray absorptiometry at the lumbar spine. Conclusion Serum sclerostin could have a significant role in the development of inflammation-associated bone damage in PsA. Further follow-up studies are recommended to confirm the role of serum sclerostin in inflammation and bone damage in PsA patients and the factors that could regulate this autoimmune pathological event.

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience's Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study's results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Advanced Pharmaceutical Technology & Research.)

Objective: Graviola is a tropical fruit with medicinal properties, used for treating various diseases such as inflammation, diabetes, and cancer. Histone deacetylase inhibitors (HDACIs), including carbamazepine (CBZ) and valproic acid (VPA), have been proven strong inhibitors against cancer cell growth. This study investigated the effect of Graviola fruit extract (GFE) on CBZ in healthy rat plasma using high-performance liquid chromatography (HPLC). In addition, the effect of GFE in combination with CBZ and VPA on two human cancer cell lines (PC3 and MCF-7) was explored., Methods: The CBZ levels were analyzed using a simple validated HPLC method. The linearity was achieved at a 0.9998 coefficient of determination over a range of 75-5000 ng/mL CBZ. The MTT assay was used to quantify the percentage of viable cells., Result: The maximum plasma concentration (Cmax) and area under the curve (AUC) for CBZ alone were 4,631 ng/mL and 49,225 ng. h/mL, respectively. However, in the presence of GFE, the values reduced significantly to 2,994 ng/mL and 26,587 ng. h/mL, while the p-value was <0.05. The 3-(4,5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay results for VPA showed a weak cytotoxicity activity on PC3 and MCF-7 cell lines., Conclusion: A simple and validated HPLC method was used to determine CBZ levels in rats' plasma. The plasma CBZ levels (Cmax) were significantly reduced in the presence of GFE, indicating the importance of drug-herb interactions. For in vitro studies, two human cancer cell lines, MCF-7 (breast cancer cells) and PC3 (prostate cancer cells), were used to screen the cytotoxicity activity of GFE, CBZ, and VPA. We observed an antagonism effect for GFE and CBZ combination in both cell lines with FIC values > 4. On the contrary, the combination of GFE and VPA showed an additive or indifferent effect.

The Punica granatum L. (pomegranate) fruit juice contains large amounts of polyphenols, mainly tannins such as ellagitannin, punicalagin, and punicalin, and flavonoids such as anthocyanins, flavan-3-ols, and flavonols. These constituents have high antioxidant, anti-inflammatory, anti-diabetic, anti-obesity, and anticancer activities. Because of these activities, many patients may consume pomegranate juice (PJ) with or without their doctor's knowledge. This may raise any significant medication errors or benefits because of food-drug interactions that modulate the drug's pharmacokinetics or pharmacodynamics. It has been shown that some drugs exhibited no interaction with pomegranate, such as theophylline. On the other hand, observational studies reported that PJ prolonged the pharmacodynamics of warfarin and sildenafil. Furthermore, since it has been shown that pomegranate constituents inhibit cytochrome P450 (CYP450) activities such as CYP3A4 and CYP2C9, PJ may affect intestinal and liver metabolism of CYP3A4 and CYP2C9-mediated drugs. This review summarizes the preclinical and clinical studies that investigated the impact of oral PJ administration on the pharmacokinetics of drugs that are metabolized by CYP3A4 and CYP2C9. Thus, it will serve as a future road map for researchers and policymakers in the fields of drug-herb, drug-food and drug-beverage interactions. Preclinical studies revealed that prolonged administration of PJ increased the absorption, and therefore the bioavailability, of buspirone, nitrendipine, metronidazole, saquinavir, and sildenafil via reducing the intestinal CYP3A4 and CYP2C9. On the other hand, clinical studies are limited to a single dose of PJ administration that needs to be protocoled with prolonged administration to observe a significant interaction.

Context: Diet and beverages are thought to have notable effects on drugs. Recently, this relationship has received significant consideration., Aims: To develop and validate a simple, rapid, and sensitive method for the determination of glimepiride in rat serum. This will be performed using high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS). Potential pharmacokinetic interactions between glimepiride and the soft drink, Vimto, will also be investigated in the serum of experimental rats., Materials and Methods: HPLC-MS/MS was constructed and clarithromycin was used as an internal standard., Results: The method was validated in terms of linearity, precision, accuracy, stability, and system suitability parameters. The method was found to be satisfactory and suitable for the determination of glimepiride. The precision of glimepiride was high (coefficient of variation, CV% <15%), the accuracy over all 3 days of validation was within the accepted criteria. Glimepiride peak serum concentration ( C max ) was 126.01 ng/mL and was reached within 1 h ( T max ) of administration. Mean area under curve (AUC) was 964.70 ng/mL and was reached within 24 h of administration. The Vimto soft drink significantly ( P < 0.050) reduced glimepiride peak serum concentration to 57.87 ng/mL and was reached within 2 h of administration. AUC was significantly reduced to 335.04 ng * h/mL ( P < 0.050)., Conclusion: Glimepiride pharmacokinetic parameters such as C max and AUC were significantly affected by the Vimto soft drink. Therefore, this study developed a simple, rapid, and sensitive method for validation and determination of the effects of soft drinks on drugs using the LC-MS/MS method., Competing Interests: There are no conflicts of interest.

Photoneutron production, and the dose equivalent, in the head assembly of the 15 MV Elekta Precise medical linac; operating in the faculty of Medicine at Alexandria University were estimated with the MCNP5 code. Photoneutron spectra were calculated in air and inside a water phantom to different depths as a function of the radiation field sizes. The maximum neutron fluence is 3.346×10 -9 n/cm 2 -e for a 30×30 cm 2 field size to 2-4 cm-depth in the phantom. The dose equivalent due to fast neutron increases as the field size increases, being a maximum of 0.912 ± 0.05 mSv/Gy at depth between 2 and 4 cm in the water phantom for 40×40 cm 2 field size. Photoneutron fluence and dose equivalent are larger to 100 cm from the isocenter than to 35 cm from the treatment room wall., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: A drug like Sildenafil is commonly used for the treatment of erectile dysfunction. Eruca sativa is known as a garden plant used in folk medicine to enhance the sexual desire in males. Nevertheless, the interaction of Sildenafil and Eruca sativa was not studied. In the current study, we aimed to examine the influence of Eruca sativa on Sildenafil pharmacokinetics in rats., Study Design: A crossover experiment with washout period of two weeks was conducted. To one group of animals, Eruca sativa was given as food and a drinking solution to rats for 12 hours before the day of the experiment. On the day of the experiment, the same group received 5 ml (50 mg/ml) orally and a half an hour later animals received 1 ml Sildenafil citrate (2.85 mg/kg) oral administrated to the study group. The other group of rats only received Sildenafil. Two-weeks later a cross-over design on the same animals was conducted. Blood samples were collected from optical vein on different time intervals, samples were analyzed using validated (HPLC-UV) method., Results and Conclusion: Pre-administration of Eruca sativa has increased Sildenafil Cmax from 226.72 to 345.25 ng/ml, (p<0.05). In addition, the AUC of Sildenafil has significantly increased when it was pre-administered with Eruca sativa (550.59 vs. 916.48 ng/ml*hr). Our findings suggest that co-administration of Eruca sativa with Sildenafil enhances the pharmacokinetics of Sildenafil in rats plasma.

Plants have been used since antiquity to treat and prevent diseases. Plantain (Plantago lanceolata L.) is traditionally used for the treatment of the common cold and associated symptoms such as cough. This study was designed to evaluate the oral toxicity of plantain leaf extract-containing syrup. In preparation of the toxicological examination and to ensure the quality of the herbal preparation, analytical methods were developed and validated, and stability testing was performed. Physicochemical and microbial quality, thin layer chromatography patterns and high performance liquid chromatography fingerprints complied with the specifications during the entire period of stability testing. The marker substance, acteoside, remained within the stability-defining limits of 90%-110% for quantitative determinations. No hint of toxicity emerged from 14-day repeat dose toxicity testing in rats. The animals were given doses of 3, 6, or 12 mL of syrup per kg body weight by gavage twice daily. All animals showed normal appearance and behavior. Body and organ weights at the end of the study were similar to those in the control group. Overall, P. lanceolata syrup was found to be stable and non-toxic under the test conditions.

Enalapril is an angiotensin-converting enzyme inhibitor used for treatment of hypertension and chronic heart disease. Enalaprilat is its active metabolite responsible for the activity. This study aimed to develop and validate a method for enalapril and enalaprilat analysis and to determine the bioequivalence of two tablet formulae of enalapril. LC-MS/MS bioanalytical method was developed and validated and then applied to evaluate the bioavailability of two enalapril formulae. Antihyperglycemic sitagliptin was used as internal standard (IS). The method was accurate for the within- and between-days analysis, and precise CV% was <5%, being linear over the calibration range 1.0-200.0 ng/ml. Stability was >85% and the LOD was 0.907 and 0.910 ng/ml for enalapril and enalaprilat, respectively, and LLOQ was 1 ng/ml. The pharmacokinetic parameters C max , t max , AUC 0-72 , and AUC 0- ∞ values of enalapril and enalaprilat of the two formulae were calculated and nonsignificant differences were found. A linearity, specific, accurate, and precise method was developed and applied for the analysis of enalapril and enalaprilat in human plasma after oral administration of two formulae of enalapril 20 mg tablets in healthy volunteers. Depending on the statistical analysis it was concluded that the two enalapril formulae were bioequivalent.

This study was conducted to assess the in vivo and ex vivo immunomodulatory effect of the ethanol leaves extract of Moringa peregrina in Balb/c mice. For this study, five groups of 5 Balb/c mice were given a single acute subtoxic oral dose of the ethanolic extract at 1.13, 11.30, 23.40 and 113.4 mg/kg and the immunomodulatory effect was assessed on the 6 th day following the ingestion. In the (non-functional) assessment, the effect of the extract on the body weight, relative lymphoid organ weight, splenic cellularity and peripheral blood hematologic parameters were evaluated. While in the immunomodulation assessment (functional), we investigated the effect of the extract on the proliferative capacity of splenic lymphocytes and peripheral T and B lymphocytes using mitogen blastogenesis, mixed allogeneic MLR and IgM-Plaque forming cells assays. The ingestion of M. peregrina extract caused a significant increase in the body weight, weight and number of cells of spleen and lymph nodes of the treated mice. Furthermore, the count of RBCs, WBCs, platelets, hemoglobin concentration and PCV % were increased by the extract treatment in a dose-dependent manner. M. peregrina enhanced the proliferative responses of splenic lymphocytes for both T cell and B-cell mitogens. Likewise, the mixed lymphocyte reaction MLR assay has revealed a T-cell dependent proliferation enhancement in the extract treated mice. Moreover, the oral administration of M. peregrina leaves extracts significantly increased PFCs/10 6 splenocytes in a dose-dependent manner. In conclusion, subtoxic acute doses of M. peregrina extract demonstrated significant potential as an immunomodulatory agent even at the lowest dose of 1.13 mg/kg., Competing Interests: The authors declare no conflict of interest.

Objectives: Food or drinks may significantly alter the pharmacokinetics and pharmacodynamics of drugs which may lead to adverse events. A drug such as metformin is widely used to regulate plasma glucose level and pomegranate and licorice have been identified to help in type-2 diabetes management. However, the interactions of the latter on metformin pharmacokinetics were not studied. Therefore, we aimed here to study the impact of pomegranate and licorice on metformin pharmacokinetics in rats., Methods: Juices were given to rats for two days and half an hour before metformin (20 mg/kg) oral administration. Blood samples, then, were collected at different time intervals, processed and analyzed using validated reliable HPLC method. Plasma profile and pharmacokinetic parameters were calculated for each group., Results and Conclusion: Pre-administration of pomegranate significantly reduced metformin maximum plasma concentration from 1410 to 1031 ng/ml. On the other hand, pre-administration of licorice significantly delayed metformin reaching its maximum plasma concentration. In conclusion, pre-administration of pomegranate may potentially reduce efficacy of metformin while licorice might delay metformin action. Thus, both juices should be cautiously administrated with metformin, the mainstay drug for type-2 diabetes mellitus management.

Vitamin D is necessary for maintaining and regulating calcium levels; thus, insufficiency of vitamin D increases the risk of many chronic diseases. This study aimed to examine vitamin D levels among Jordanian and Iraqi volunteers and find the relation between vitamin D level and lipid profile patients. Vitamin D levels were evaluated using enzyme-linked immunosorbent assay. For young healthy group subjects, vitamin D levels were 20.60 ± 5.94 ng/mL for Jordanian and 27.59 ± 7.74 ng/mL for Iraqi. Vitamin D concentrations for young males and females were 25.82 ± 8.33 ng/mL and 21.95 ± 6.39 ng/mL, respectively. Females wearing hijab were 20.87 ± 6.45 ng/mL, while uncovered females were 23.55 ± 6.04 ng/mL. For >40 years Iraqi subjects, vitamin D level for healthy was 29.78 ± 9.49 ng/mL and 23.88 ± 7.93 ng/mL for hyperlipidemic subjects. Vitamin D levels for overweight and obese healthy groups were significantly higher (P < 0.050) than those for the hyperlipidemic patients groups. Vitamin D levels for males were significantly higher than females and were significantly higher for healthy than those hyperlipidemic Iraqi patients. These findings showed that vitamin D levels are affected by age, nationality, gender, and health statues and highlight the importance of vitamin D supplementation for groups with low levels particularly old, hijab wearing females, and hyperlipidemic groups.

In the title compound, C10H16N2O9S3, the pyrimidine ring of the 1,3-dimethyl barbituric acid moiety has an envelope conformation with the C atom carrying the methyl-sulfonyl and bis-(methyl-sulfon-yl)methyl substituents as the flap. The dihedral angle between mean plane of the pyrimidine ring and the S/C/S plane is 72.4 (3)°. In the crystal, mol-ecules are linked via C-H⋯O hydrogen bonds, forming a three-dimensional structure.

The title compound, C18H28N2S2·CHCl3, crystallizes as a zwitterion. The C-S bonds are almost equivalent, with lengths of 1.666 (3) and 1.657 (3) Å. The S-C-S bond angle is expanded to 129.54 (16)° and the N-C-N angle is reduced to the tetra-hedal value of 108.8 (2)°. In the crystal, adjacent mol-ecules are linked via C-H⋯S hydrogen bonds, forming chains along [100]. The chloro-form solvent mol-ecule, which is disordered over two positions [occupancy ratio = 0.51 (2):0.49 (2)], is linked to the chain by bifurcated C-H⋯(S,S) hydrogen bonds.

In the title compound, C3H8O4S2, the two central S-C(H2) bond lengths are almost identical [1.781 (2) and 1.789 (2) Å]. In the crystal, each mol-ecule utilizes CH2 and CH3 bonds to form weak C-H⋯O hydrogen bonds to six other mol-ecules, thus linking mol-ecules into a three-dimensional network.

The title structure, (C(11)H(20)BrN(2))[Ag(CN)(2))], is built up from an approximately C(2v)-symmetric imidazolium cation and a nearly linear dicyanidoargentate anion [N-Ag-N = 176.6 (9)° and Ag-C-N = 178.8 (9) and 177.2 (11)°]. These two constituents are linked by a remarkably short inter-action between the Br atom of the imidazolium cation [C-Br = 1.85 (3) Å] and one N atom of the cyanidoargentate anion [Br⋯N = 2.96 (2) Å], which is much less than the sum of the van der Waals radii (3.40 Å). The crystal studied was twinned by merohedry.

In the title salt, C(11)H(21)N(2) (+)·C(6)H(5)O(3)S(-), which has two cation-anion pairs in the asymmetric unit, the two imidazolium cations are linked to two separate acceptor O atoms of one of the benzene-sulfonate anions through aromatic C-H⋯O hydrogen bonds, while the second anion is unassociated.