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Background: Persistent hyperglycemia in diabetes mellitus (DM) is considered the leading cause of morbidity and mortality associated with both microvascular and macrovascular complications, having a greater economic impact. This study aimed to assess the impact of socioeconomic status, prescribing patterns, and patient compliance in type 2 diabetes mellitus patients. Method: This study was carried out at the Department of Medicine and Diabetic Clinic of Hakeem Abdul Hameed (HAH) Centenary Hospital at Hamdard University, New Delhi, India. We conducted a prospective observational study on prescribing patterns and monitoring adverse drug reactions (ADRs) in patients with type 2 DM (T2DM) under standard care. We enrolled 150 confirmed cases, and data was obtained from pre-validated questionnaires and then coded and analyzed to observe the association between variables. Results: The glycosylated haemoglobin level in 56% of the cases was between 6.4 to 8.0, and cardiovascular complications were observed as the major comorbidities. 45.33 % of the cases were on mono drug therapy, and metformin (23. 52 %) was the drug of choice, followed by glimepiride (23.52 %). Among the dual drug therapies, sitagliptin with metformin and triple-drug therapy, glimepiride concurrent with metformin and voglibose was the most preferred drug in the treatment of T2DM. Sitagliptin was observed to be a major patient burden (46.213 USD). In only 7.33 % of the cases, we observed definite ADR in T2DM patients. Underprivileged awareness, mainly due to low literacy, was a major concern in the development of new cases of T2DM. Conclusion: We observed better patient compliance; however, a disease awareness program must be implemented. The use of oral hypoglycaemic drugs is still dominant in clinical practice and cardiovascular disorders as comorbidities emerge as a greater challenge in terms of patient outcome and cost burden.

5-Fluorouracil (5-FU) is a drug of choice for colorectal-cancer. But oral therapeutic efficacy of 5-FU is restricted due to their very little bioavailability because of poor membrane permeability and GIT-absorption. We have developed a multiple nanoemulsion (w/o/w i.e. 5-FU-MNE) in which 5-FU incorporated to improve their oral-absorption. Globule-size of opt-5-FU-MNE was 51.64 ± 2.61 nm with PDI and ZP 0.101 ± 0.001 and -5.59 ± 0.94, respectively.

Aim: Simethicone is anti-flatulence medicine that is used to relieves abdominal pain due to excessive gas in the digestive tract. The present study aimed to describe the use of simethicone in a public healthcare organization in Riyadh Region. Methodology: This is a retrospective study that includes reviewing the outpatient electronic prescriptions of simethicone in a public healthcare organization in Riyadh Region. Results: During the study period, 113 patients received simethicone. More than 56 % of them were females and the age of 22.12% of them was between 50 and 59 years. More than 26% of the patients received simethicone for 1 week and 23.90% of them received simethicone for 1 month. Most of the prescriptions were written by residents (90.27%) and more than 57% of the prescriptions were prescribed by emergency department. Conclusion: The present study showed that simethicone was prescribed frequently in a public healthcare organization in Riyadh Region. More studies are needed to explore the frequency of use and the appropriateness of prescribing simethicone and other anti-flatulence medicines.

Aim: The present study aimed to explore the outpatient prescribing pattern of sevelamer in Al Seih. Methodology: This was a retrospective study that included reviewing the electronic prescriptions that contained sevelamer among outpatients in the city of Al Saih. Results: During 2017 and 2018, 47 patients received sevelamer from the outpatient pharmacy in a public hospital in Alkharj. More than 23 % of the prescriptions were prescribed in January and about 21.28% of the prescriptions were prescribed in May. All of the prescriptions that contained sevelamer were prescribed for the duration of 1 month (100.00%), all of the sevelamer prescriptions were written by residents (100.00%) and all of the prescriptions were prescribed by nephrology department (100.00%). More than half of the patients who received sevelamer were females (60.00%). The age of about 90% of the patients who received sevelamer was more than 39 years. Conclusion: The present study showed that the prescribing of sevelamer was uncommon in Al Seih. Further studies are required to investigate the pattern and the frequency of sevelamer in the outpatients setting and in other settings.

Aim: The present study aimed to describe the prescribing pattern of topical betamethasone in the outpatient setting in Alkharj. Methodology: This retrospective study that included collecting data from the electronic prescriptions in a public hospital in Alkharj in 2018. Results: During the study period from Jan to Dec 2018 only 46 patients received topical betamethasone. Most of the patients were female (63.04%). About 71.74% of the prescribed betamethasone was in ointment form and 28.26% in lotion form. Most of the prescribers were residents (97.83%). Most of the prescriptions were written by dermatology department (58.70%). Conclusion: The use of topical betamethasone was uncommon and this could be due to the availability of other topical corticosteroids and other alternatives. It is important to increase the knowledge of health care workers and the patients regarding the use of topical corticosteroids.

Aim: The present review aimed to describe the rate of different infections, the rate of bacterial resistance and antibiotics use in Al-kharj. Methodology: This was a narrative review that included searching Web of science for the keywords “infections” or “bacterial resistance” or “antibiotics use” and “Al-kharj” from 1st of January 2015 to 14th of October 2021. Results: Searching Web of science for the keywords resulted in 29 papers that was conducted during the study period and investigate the rate of different infections, the rate of bacterial resistance or the use of antibiotics in Al-kharj. So, 29 articles were included in the present review. Conclusion: Most of the studies about infections included only some types of infections and most of the conducted studies about the use of antibiotics focused only on the outpatient setting. More studies are needed to explore the rate of other infections and to describe the prescribing of antibiotics in other hospital settings.

Background: A drug-drug interaction arises when the pharmacologic effect of a medication is changed by the action of other medication causing unexpected clinical effects. Drug-drug interactions are widely known but the identification of the consequences of food and drug interactions has been growing slowly. Aim: The present study aims to describe the occurrence of drug –food and drug-drug interactions in the outpatient settings in Riyadh city. Methodology: A retrospective study was piloted in Riyadh city. The prescriptions were reviewed to identify potential drug - food and drug–drug interactions using Drug Interactions Checker. Results: About 16.16% of the prescriptions included a drug - drug interaction. The most frequent interaction was the interaction between ciprofloxacin and metronidazole (25.00%) that is a minor interaction. Regarding drug – food interactions there were 40 interactions, the majority of these interactions were moderate. The most common drug - food interactions were metronidazole with food (20.00%) that is a major interaction. Conclusion: Drug interactions with other drugs or with foods are common. These interactions could have a beneficial or a harmful effect. Physicians and pharmacists should use programs that detects the drug interactions.

The non-covalent immobilization of ?-glucuronidase enzyme obtained from Rhizopus oryzae was carried out by entrapment in natural fiber (papaya and coconut). The bioconversion capability of immobilized enzyme was analyzed based on conversion of glycyrrhizin to 18?-glycyrrhetinic acid under different conditions. The hydrolytic activity of the ?-glucuronidase enzyme was highly depended on the microbial source and matrix, in which enzyme was immobilized. R. oryzae ?-glucuronidase immobilized in papaya fibers produced the highest GA content (13.170 µg/mL) at 10 h of reaction. However R. oryzae ?-glucuronidase immobilized in coconut fibers produced the highest GA content (21.425 µg/mL) at 15 h of reaction. Online Molinspiration software was used to predict drug like molecular properties of the 18?-glycyrrhetinic acid, and software suggested that the compounds had potential of becoming the orally active molecules. Therefore, in silico studies were conducted on proposed 18?-glycyrrhetinic acid to select the best possible drug candidates based on drug properties and bioactivity score of the compounds.

Background: The inappropriate use of antibiotics leads to many adverse effects and also leads to bacterial resistance. A hospital-based program, commonly referred to as antibiotic stewardship programs, is used to improve the usage of antibiotics. This study aims to explore the increasing interest of the public in antibiotic stewardship programs by using data from Google Trends and Twitter. Methodology: A search trends feature that shows how frequently a given search term is entered into Google’s search engine (Google Trends) and a social network site (Twitter) were used. Results: The public and the health care professionals are now more interested in antibiotic use and antibiotic resistance due to the development of more severe infections that were caused by bacteria resisted to many antibiotics which lead to high morbidity and mortality rates. Conclusion: There is a high prevalence of infections caused by multi-drug resistant organism that could lead to more mortality and morbidity rates, as a result the interest in antimicrobial stewardship programs in internet is increased. So it is important to increase the knowledge of health care professionals regarding the appropriate antibiotic use and to encourage them to change their unsuitable prescribing patterns.

Background: Community pharmacists help patients in making informed decisions about their treatment and prevent the problems that could be developed from self-medication. The maintenance therapy with inhaled medications is the keystone of pharmacotherapy in many respiratory diseases such as asthma and chronic obstructive pulmonary disease. Aim: The aim of the present study was to explore the frequency of inhalers dispensing in Riyadh. Methodology: This was a cross-sectional, observational study carried out in Riyadh city to analyze the prescriptions in outpatient pharmacies. Results and Discussion: The total number of prescriptions is 198 prescriptions that include 650 different medications. Out of the 650 medications, the majority were in the form of a tablet (61.7%), followed by capsules. The present study showed that the use of inhalers was uncommon in Riyadh. Out of 650 drugs, 27 drugs were available as inhalers (4.15%). Out of 27 Inhalers, Ventolin inhalers is the most prescribed (48.14%), followed by Seretide Evohaler (29.62%) and Symbicort Turbuhaler (22.2%). Conclusion: Although there is a high prevalence of respiratory diseases, inhaler prescriptions and dispensing aren’t common. This may be due to the use of these inhalers as OTC drugs. The role of pharmacists should be to dispense the regular medications only by prescriptions and to counsel patients about the information regarding the use of inhalers.

Background: The use of herbal medicines and natural health products by the public is continuously being increased by the day. Community pharmacists are the most accessible healthcare providers, this necessitates that pharmacists should be aware of the appropriate use of herbal medicines. Objective: The objective of the present study was to assess the knowledge, attitude and practice of community pharmacists in the Al-Kharj region. Methodology: A cross-sectional study was carried out amongst pharmacists who work in different community pharmacies in Al-Kharj, Saudi Arabia. The questionnaire was prepared using surveys of previous studies and was hand-delivered to the pharmacists concerning the use of herbal medicines. Results: All of the respondents were male and more than 50% of them were in the age range between 30-39. Most of the pharmacists reported that they have sufficient information about dietary supplements and that they are interested in updating their knowledge about herbal drugs. Furthermore, more than 70% of the participants said that they take both medical and medication history from the buyers before supplying herbal medicines. Conclusion: The study shows that pharmacists have good knowledge and a positive attitude toward using herbal medicines by the public in Al-Kharj city.

Introduction: Antibiotics are medications that are used to kill a bacterium which causes different infections. The misuse of these medications has contributed to the development of bacterial resistance. In order to predict the efficacy of the antimicrobial drugs and to guide antimicrobial therapy, antibiogram should be used. Objective: This study aims to explore the Antibiotic resistance patterns in a university hospital in AL-kharj city. Methods: Data from a university hospital in Al-Kharj city were used to assess the in vitro antimicrobial susceptibility rates for different types of bacteria. We included all bacterial and fungal cultures in the last 2 years. Results: The most common bacterium was E. coli and the most common fungus pathogen was Candida albicans. There was a low resistance rate to gentamicin, imipenem, meropenem and amikacin for the studied bacteria pathogens and high resistance rate for some antibiotics such as erythromycin, tetracycline and ampicillin. Conclusion: The physicians should follow the treatment guidelines and they should know the susceptibility rate of different bacteria to prescribe antibiotics appropriately.

The aim of the present study was to investigate the effects of Cichorium intybus on lipid peroxidation activities of both enzymatic and non-enzymatic antioxidants, inflammatory mediators, myocardial enzymes and histopathology of cardiac tissues in experimental diabetic cardiomyopathy (DCM). DCM was induced by single intraperitoneal injection of streptozotocin (STZ) (40 mg/kg) combined with high energy intake in rats. Seed extract of Cichorium intybus (CIE) (250 mg/kg & 500 mg/kg) was administered orally once a day for 3 weeks. Phytochemical investigations of seed extract revealed presence of some active ingredients such as alkaloids, tannins, saponin, phenols, glycosides, steroids, terpenoids and flavonoids. Seed extract of Cichorium intybus confirmed a significant potency towards restoring the blood glucose, an elevation of the levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS), blood glutathione (GSH), TNF-α and IL-6 and a reduction in the levels of catalase (CAT) was observed following the STZ treatment. Oxidative stress was accompanied by myocardial degeneration as evidenced by histopathological examination of cardiac tissues. Administration of CIE reduced the lipid peroxides level in heart. Serum levels of AST, GSH, LDH and SOD were brought down to physiological levels by CIE in STZ induced DCM rats. CIE also markedly down-regulated serum TNF-α and IL-6 levels. Catalase that was reduced in serum was brought back to near normal level. The extensive necrotic changes of cardiac tissue by STZ was minimized to normal morphology upon CIE administration. The study demonstrates the cardioprotective effect of CIE via inhibition of oxidative stress and pro-inflammatory cytokines.

Despite the availability and advancement of diagnostic and treatments with demonstrated benefits in minimizing cardiovascular morbidity and mortality, hypertension control rates remain suboptimal. Therefore, this research aimed to determine the prevalence of uncontrolled BP in rheumatoid arthritis (RA) patients and understand all potential risk factors for uncontrolled BP. We conducted a cross-sectional study on RA patients in 2 rheumatology clinics in 2 public hospitals in Riyadh. Patients’ information such as demographics, comorbidities, drug use, and other clinical data were captured through a review of medical records and supplemented by patient interviews. Multivariate logistic regression was utilized for the analysis to identify the significant factors of uncontrolled BP (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg). In total, 834 subjects with RA and concomitant BP were involved in this cross-sectional study. The prevalence of uncontrolled BP was found to be 31.65% among all the study population. Multivariate analysis showed that males, subjects above 60 years of age, and smokers had a distinctly higher occurrence of uncontrolled BP. Among the patients with comorbid conditions, those with obesity, hyperlipidemia, diabetes, anemia, cancer, and reflex or gastroesophageal reflux disease also showed a significantly higher risk of uncontrolled BP (P

To find changes in hematologic parameters in patients who are COVID-19-positive with respect to high resolution computed tomography (HRCT) chest scan so that the exact picture of the disease course can be identified and an adequate treatment protocol can be planned to combat the COVID-19 pandemic.Patients' health-related data including age, gender, symptomatology, associated co-morbidities, laboratory test results and HRCT results were collected.The radiologic findings showed ground glass opacities (GGOs) was the most common manifestation. Analysis of HRCTs of patients with COVID-19 showed that lesions were mainly confined to the right and left lower lobes, suggesting that the COVID-19 virus is mainly harbored in the basal areas of the lungs.Radiologic and laboratory investigations can greatly help in early detection of COVID-19, thus allowing for timely interventions.

Researchers are continuously searching for various sources that could provide new promising molecules for therapeutic purposes. Nature, is one source that abundantly provides a basis for the exploration of these beneficial molecules. A class of compounds that has attracted the attention of biomedical and pharmaceutical scientists are polyphenols. Polyphenols are specifically preferred for their unique medicinal and therapeutic properties. They are generally categorised as secondary metabolites, and are predominantly employed for their antioxidant, anti-inflammatory, anticancer, cardioprotective, and antibacterial properties. Various forms of polyphenolic compounds are present in nature, and based on chemical structure and origin; they are categorized into different classes and subclasses. Although polyphenols have abundant medicinal properties but their use is greatly limited mainly due to low aqueous solubility and they are prone to environmental degradation, upon exposure to heat, moisture, and atmospheric stress. Polymeric and lipid nanoparticles are increasingly used for the encapsulation of polyphenols as they prove to be an exceptional source for drug delivery, which not only enhances their aqueous solubility and bioavailability but also protects them from various types of environmental degradation. In this chapter, the classification of polyphenols is discussed briefly along with their encapsulation in different nanoparticulate systems.

Purpose Evidence to date suggests that having chronic conditions increases the probability of severe illness from severe coronavirus disease 2019 (COVID-19). Thus, it is essential to identify the features of those patients. The purpose of this research was to identify the clinical characteristics and outcomes of COVID-19 patients with chronic conditions. Patients and Methods A retrospective cross-sectional single-center study was conducted using electronic medical records of hospitalized COVID-19 patients between March 1, 2020, and May 20, 2020. Patients’ basic information, laboratory test, clinical data, medications, and outcome data have been extracted and compared among three groups: patients without chronic conditions, patients with one chronic condition, and patients with two or more chronic conditions. Chi-square, Fisher’s exact test, Student’s t-test, and the Mann–Whitney U-test were used. Results The study population was 458 patients, with an average age of 38.8 years (standard deviation (SD) 12.8). There were 398 (86.9%) males in the study population, most of them with one chronic condition. There were 14 (14.3%) smokers, and the majority of them were among patients with two or more chronic conditions. Longer hospital stay and time in the intensive care unit (ICU), a higher probability of ICU admission, and the need for mechanical ventilation were identified among patients with two or more chronic conditions. Dyspnea, an increased level of platelet counts, and a reduction in hemoglobin levels were discovered among patients with two or more chronic conditions. Conclusion Patients with more chronic conditions were at higher risk of yielding poor clinical outcomes. Prevention and treatment of infections in these patients merit more attention.

The present research was carried out to study the effect of 2β-hydroxybetulinic acid 3β-oleiate (HBAO), a novel compound isolated from the seeds of Euryale ferox salisb. on glycemic control, antioxidant status and histopathological morphological alterations in the liver, pancreas, kidney and heart in streptozotocin induced type-2 diabetes in rats. HBAO was isolated from the seeds of Euryale ferox salisb. according to Lee. Isolation of the active principle HBAO was performed for the first time. To date there are no reports on the isolation and evaluation of 2β-hydroxybetulinic acid 3β-oleiate (HBAO) from Euryale ferox salisb. Assessment of different biochemical parameters like the effect of HBAO on glycemic control, plasma insulin, glycosylated hemoglobin, hepatic glucose-6-phosphate dehydrogenase, glucose-6-phosphatase and fructose-1-6-biphosphatase, hepatic hexokinase, lipid profile, antioxidant marker and histopathology of pancreas, liver and kidney examination was done at the end of the experimentation, i.e. on day 45. HBAO exhibited remarkable improvement in glycemic control, lipid levels, plasma insulin, glycogenic liver enzymes and antioxidant activity in diabetic rats, along with progressive enhancement of distortive histopathological morphology of liver, pancreas and kidney. The results strongly suggest that HBAO could be a potential therapeutic agent in diabetes.

Aim of the study The role of pterostilbene against induced neurobehavioral alterations in global cerebral ischemia-reperfusion and oxidative damage was studied. Materials and methods Male SD rats (180–200 g) were exposed for 30 min to bilateral carotid artery occlusion accompanied by 60 min reperfusion to cause cerebral injury. Pretreatment with pterostilbene (200 and 400 mg/kg, orally) was given to the animals for ten days followed by ischemia-reperfusion injury. Various behavioral tests (locomotor activity, neurological score, transfer latency, hanging wire test) were studied. The brain tissues of animals were used for both the biochemical parameters (lipid peroxidation, reduced glutathione, superoxide dismutase, catalase activity) and histopathological study. Result The pterostilbene as given orally significantly improved neurobehavioral alterations compared to control ischemia-reperfusion. Treatment with pterostilbene (200, and 400 mg/kg, orally) also significantly attenuated oxidative damage as indicated by reduced lipid peroxidation, nitrite concentration, restored reduced glutathione, and catalase activity as compared to control (ischemia-reperfusion) animals. Overall, pterostilbene treated animals showed non significant histological alteration as compared to ischemia-reperfusion control. Conclusion This work suggests the beneficial effect of pterostilbene and its therapeutic potential against reperfusion-induced ischemia and associated behavioral changes in rats due to the stabilization of DNA damage with significant free radical scavenging properties., Pterostilbene, global cerebral ischemia, neurobehavioral alterations.

The selection of suitable functional excipients with low toxicity index and having P-glycoprotein inhibitory characteristics represents a major innovative step in designing a promising formulation for oral chemotherapy. This study was aimed at investigating the chemosensitizing effect of selected pharmaceutical excipients to improve the in vivo pharmacokinetic performance of VP-16. The pharmaceutical excipients having P-glycoprotein inhibitory activity were screened by shake flask method for their VP-16 solubilization capacity. The cumulative amount of VP-16 was determined with or without the selected pharmaceutical excipients at three different concentrations (0.1 % w/v, 0.5 % w/v and 1 % w/v) by an everted gut sac technique. Moreover, pharmacokinetic studies were also performed to determine the oral bioavailability assessment of VP-16 in albino male Wistar rats. The absorptive transport from mucosal-to-serosal (M → S) and secretory transport from serosal-to-mucosal (S → M) for VP-16 solution over 90 min were found to be (3.58 ± 0.32) × 10−6 and (14.63 ± 3.11) × 10−6 cm/s, respectively, with a net efflux of 4.08. Addition of verapamil (200 µM), a P-glycoprotein inhibitor, elevated the transport from M → S [Papp from (3.58 ± 0.32) to (9.66 ± 1.55) × 10–6 cm/s, p < 0.05] and lowered the S → M [Papp from (14.63 ± 3.11) to (13.35 ± 2.01) × 10–6 cm/s, p < 0.01], with a net efflux of 1.38. The relative bioavailability of VP-16 following oral administration (4.5 mg/kg) in rats was increased significantly (p