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Context • Arthritis is an inflammatory disease of diarthrodial joints and is associated with swollen inflamed joints, disruption of joints, and loss of integrity of articular cartilage and synovial joints. Objective • The current review intended to examine the data on the epidemiology, causes, clinical diagnosis, and prevention and control of different types of arthritis and on the use of medicinal plants in gouty arthritis. Design • The research team performed a literature review, searching relevant literature databases, including bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, and PubMed. The search terms were arthritis, diarthodial joints, use of medicinal plants in gouty arthritis, and synovial joints. Setting • The study took place in the main library of the University of Sargodha in Sargodha, Pakistan. Results • The research team identified 135 studies, and eventually 92 unique academic publications were included in the analysis. Arthritis can develop and progress in any musculoskeletal joint, and most commonly occurs in knees, hips, shoulders, and hands. Major risk factors for arthritis include age, obesity, trauma, other diseases, and smoking. Arthritis is classified into various types, including rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis, septic arthritis, and psoriatic arthritis (PsA). RA and OA are the most common types worldwide. RA is an autoimmune disease in which the body’s immune cells attack the joints. OA develops due to damage of cartilage, tissues, and joints due to age, obesity, or stress on joints. Gouty arthritis develops due to hyperuricemia; deposits of monosodium urate crystals can lead to gouty arthritis. Septic arthritis occurs due to a microbial infection in synovial joints because in synovial joints the basement membrane is absent. PsA develops due to the psoriasis— skin disease. Conclusions • The current review showed that different types of arthritis has different causes and pathogeneses. Pain in joints is a major and common symptom in all types of arthritis. Arthritis is managed pharmacologically and nonpharmacologically. Treatment is different for each class of arthritis according to its cause and symptoms. [ABSTRACT FROM AUTHOR]

The modern trend of research is highly focused on finding new bioactive molecules from medicinal plants. As a functional bicyclic monoterpene, Bornyl acetate (BA) has displayed antioxidant and anti-inflammatory properties in different types of cells and tissues. The purpose of this research was to evaluate the probable hypotensive effect of BA, an underlying mechanism(s) backboned by in-silico studies. Mean arterial pressure and heart rate were recorded via invasive blood pressure measuring technique in normotensive Sprague-Dawley rats following the administration of BA (1-80mg/kg). Docking studies were carried out with various targets involved in the pathophysiology of hypertension.RO5 and ADMET properties were also evaluated. In the current study dose-dependent reduction in systolic, diastolic and mean arterial pressure was observed. Pretreatment with atropine and captopril significantly (p<0.001) reduced the hypotensive effect produced by BA. On the other hand docking studies showed pronounced interactions with M2 mAch receptor in an agonistic way and ACE protein in an antagonistic way. BA justified all cut-off limits of RO5 and had an acceptable predicted computational toxicity profile. Results postulate that dose-dependent hypotensive effect of BA is mediated through the muscarinic pathway and ACE inhibitory activity corresponding well with findings of in-silico studies. [ABSTRACT FROM AUTHOR]

Thin-film drug delivery, also referred to as orodispersible film has emerged as an advanced alternative to the traditional tablets, capsules, and liquids. The present work investigates the improvement in solubility to have a rapid onset of action, and palatability of chlorpromazine hydrochloride (CPZ) by developing an orodispersible film (ODF) using the solvent casting method. CPZ indicated for the control of nausea and vomiting, and in the treatment of schizophrenia in adults and children, has low bioavailability (30-50%) when taken orally as a tablet due to extensive first-pass metabolism. Moreover, it is very bitter and has an unpleasant after-taste. In this study, seven placebo formulations were prepared containing different concentrations of film-forming polymers (hydroxypropyl methylcellulose E5 and polyvinyl pyrrolidone K30) and plasticizers (propylene glycol and glycerin), and the most suitable polymer-plasticizer combination was screened to obtain required physical properties. CPZ loaded film was made using an optimized polymer-plasticizer combination employing sucralose and menthol as taste-masking agents. Drug-loaded films were transparent, smooth, and disintegrated in 14.67 ± 1.53 sec. Films showed a folding endurance of > 400, tensile strength of 1.54 ± 0.11 N/mm2 and percentage elongation of 18.7% ± 0.50 suggesting good mechanical strength. More than 90% drug release was obtained within 3 min in dissolution media. FTIR analysis displayed no significant interactions between drug and polymer. The film was also found palatable with a sweet taste by human volunteers. Hence the taste-masked films of CPZ can be a potential alternative to conventional oral dosage forms and may also enhance patient compliance. [ABSTRACT FROM AUTHOR]

Leishmaniasis is a protozoal infection which presents a broad spectrum drug resistance and causing diseases ranging from asymptomatic infections to significant mortality. The enzyme, trypanothione reductase from Leishmania infantumis is essential for the parasite survival. It is an attractive target to design new less toxic drugs against Leishmaniasis as found absent in mammalian cells. The antileishmanial activity of epicoccamide derivatives was studied by in silico approaches. The crystallographic structure of trypanothione reductase was obtained from the protein data bank (ID: 2W0H) database. Binding mode of the epicoccamide inhibitors showed that they are stabilized in the active site of enzyme through hydrogen bond and hydrophobic interactions. These derivatives (A-D) showed significant binding affinities with trypanothione reductase with binding energies: -13.21, -13.44, -13.31, and -13.52 kcal/mol, respectively. The present study showed new and effective antileishmanial compounds that can get pharmaceutical importance. [ABSTRACT FROM AUTHOR]

Despite a number of traditional medicinal uses and pharmacological properties, the usefulness of Oxalis corniculata Linn. (Family: Oxalidaceae) is a question due to its high oxalate content which can form insoluble salts with physiological calcium. Therefore, the present study aimed to reduce oxalates in extracts and to investigate such extracts chemically and biologically. The extraction was carried out using different solvents and methods, and analytical studies of extracts indicated that oxalate contents decrease on drying the material. Furthermore, extraction of both fresh and dried materials using 1 % aqueous calcium chloride and ferric chloride solutions resulted in lowering oxalate contents. Methanolic extracts of stems and leaves having lower oxalates were obtained using sequential extraction, which showed good in vitro antioxidant activity - by DPPH and β-carotene linoleate models - and in vivo hepatoprotective activity in isoniazid and rifampicininduced oxidative stressed rats (P < 0.05). It was concluded that methanolic extracts of leaves and stems of Oxalis corniculata had lower oxalates and showed promising antioxidant and hepatoprotective activities. [ABSTRACT FROM AUTHOR]

5-Fluorouracil (5-FU) is a chemotherapeutic agent used to treat various types of cancers. Although widely used, it has consistently been attributed to cardiotoxicities after administration. The purpose of this study was to assess the parameters and predictors of cardiotoxicities associated with various 5-FU-based chemotherapeutic protocols in patients with GI/colorectal cancer, as well as the correlation of these cardiotoxic events with age, sex, cumulative dose, and risk factors such as obesity, hypertension, and family history of cardiac diseases.A prospective study consisting of 396 patients of both sexes was conducted in the oncology ward of Nishtar Hospital in Multan, Pakistan. Patients were grouped according to the therapeutic protocol they received (5-FU monotherapy or in combination, with different dosing regimens). Electrocardiography and serum troponin levels were used to assess 5-FU-induced cardiotoxicity. In cases where cardiotoxicity was detected, 5-FU treatment was interrupted; nitroglycerin, nitrates, and calcium channel blockers were administered; and cardiac monitoring was initiated. 5-FU was discontinued in all cases of acute myocardial infarction.Of the 396 patients, 28.5% reported different cardiotoxic symptoms after receiving various 5-FU-containing protocols. 35% had anginal pain, 13% suffered a myocardial infarction, 11% developed hypertension, and 10% presented heart failure. Patients receiving 5-FU combination therapy showed cardiotoxic events that were significantly different from those on 5-FU monotherapy. Based on the ECG results, only the QTc-d interval increased significantly (p < 0.001) after therapy. 68% of the patients had troponin levels > 2 ng/mL at the end of treatment.Pre-existing cardiac diseases, treatment duration, smoking, and obesity were found to be influential components in the development of cardiotoxicity, and patients with cancer should be closely monitored during 5-FU chemotherapy. [ABSTRACT FROM AUTHOR]

Context • A completely unique coronavirus (2019-nCoV), formally referred to as severe acute respiratory syndrome (SARS-CoV-2), appeared in China. SARS-CoV-2 is an etiological mediator of coronavirus 2 (COVID-19), characterized by pneumonic contagion in human beings. In spite of forceful suppression, this virus has spread worldwide. No specific drugs have been approved by the FDA for treating COVID-19 patients. Objective • The study intended to examine the data from studies on clinical management of COVID-19. Design • The research team performed a literature review, searching relevant literature databases. The sources of data included bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, WanFang Data, and PubMed. The search terms were treatment of the novel coronavirus, management of nCoV-19, chloroquine, and hydroxychloroquine. Setting • The study took place in the main library of the University of Sargodha in Sargodha, Pakistan. Results • The study identified 42 unique studies that had reported and confirmed over 1500 cases of nCoV-19 by April 21, 2020. The studies found that clinical management, for patients who presented with symptoms, included supportive care and control measures that comprised mechanical ventilator support and supplementary oxygen. Conclusions • There have been intensive attempts to explore drug therapy for the prophylaxis and treatment of SARS-CoV-2 infection during this COVID-19 pandemic. Several drugs have been identified which including remdesivir, two antimalarials (chloroquine and hydroxychloroquine) and immunosuppressive agents. The effects of most drug interventions are currently highly uncertain and several drugs and vaccines are under trail for the effective treatment of COVID-19 virus, until an effective treatment will discover social distancing and physical hygiene should be practiced strictly. [ABSTRACT FROM AUTHOR]

Purpose: To assess the adherence of cardiologists to JNC7 and the impact of pharmacists in reducing clinical inertia by managing high blood pressure in the cardiology out-patient department of the Armed Forces Institute of Cardiology, Rawalpindi, Pakistan. Methods: This was a pre- and post-interventional prospective study in which data was abstracted from patients’ history notes or prescription of selected patients at baseline and follow-up visits by applying a reliable tool. The data were abstracted again from the same patients to evaluate the cardiologists’ adherence with the same parameters after 2,4 and 6 months. The sample size for this study was 116 patients and descriptive statistics were used for categorical variables. For the comparison of cardiologist’s adherence to JNC7, means and paired ‘t’ test were used at the level of 0.05 significance. Results: At baseline, the mean overall percentage of cardiologists’ adherence to JNC7 was 46.7 ± 18.9 %. This significantly improved to 98.8 ± 6.0 % after 2 months of the pharmacist intervening by way of discussions with cardiologists. The cardiologists’ adherence was further improved to 100 % after 4 and 6 months. Conclusion: Improvement in cardiologists’ adherence to JNC 7 guidelines and involvement of the pharmacist enhance the documentation of BP goal, lifestyle modifications and uncontrolled BP. All these helps to overcome clinical inertia that ultimately leads to better BP control and rational use of medicines. [ABSTRACT FROM AUTHOR]

Background: Warfarin (WAR) is an anticoagulant with a narrow therapeutic index and is principally metabolized by CYP3A4 and CYP2C9 enzymes. The inhibitors of these enzymes may alter the systemic exposure to WAR. Quercetin (QUE), a bioflavonoid, may modify the bioavailability of drugs used concurrently by inhibiting CYP3A4, CYP2C8, CYP2C9, CYP1A2, and Pglycoprotein (P-gp)., Objective: The current study scrutinized the influence of QUE on WAR pharmacokinetics in rats., Method: QUE was orally administered to animals for 14 consecutive days, followed by WAR as a single oral dose on the 15 th day in the pre-treatment group. The co-administration group received a single dose of QUE and WAR concomitantly. Only carboxymethylcellulose (CMC) 0.5% was administered as a vehicle to control group., Results: In the pre-treated group, WAR's C max was increased by 30.43%, AUC 0-∞ by 62.94%, and t 1/2 by 10.54%, while Cl decreased by 41.35%, relative to control. In co-administered animals, WAR's C max increased by 10.98%, AUC 0-∞ by 20.20%, and t 1/2 by 8.87%, while Cl declined by 16.40%., Conclusion: QUE alters the pharmacokinetics of WAR, warranting possibly WAR dose adjustment after confirmatory clinical investigations, specifically in patients with thrombotic disorders and a pre-treatment history of QUE or its product., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Context: Arthritis is an inflammatory disease of diarthrodial joints and is associated with swollen inflamed joints, disruption of joints, and loss of integrity of articular cartilage and synovial joints., Objective: The current review intended to examine the data on the epidemiology, causes, clinical diagnosis, and prevention and control of different types of arthritis and on the use of medicinal plants in gouty arthritis., Design: The research team performed a literature review, searching relevant literature databases, including bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, and PubMed. The search terms were arthritis, diarthodial joints, use of medicinal plants in gouty arthritis, and synovial joints., Setting: The study took place in the main library of the University of Sargodha in Sargodha, Pakistan., Results: The research team identified 135 studies, and eventually 92 unique academic publications were included in the analysis. Arthritis can develop and progress in any musculoskeletal joint, and most commonly occurs in knees, hips, shoulders, and hands. Major risk factors for arthritis include age, obesity, trauma, other diseases, and smoking. Arthritis is classified into various types, including rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis, septic arthritis, and psoriatic arthritis (PsA). RA and OA are the most common types worldwide. RA is an autoimmune disease in which the body's immune cells attack the joints. OA develops due to damage of cartilage, tissues, and joints due to age, obesity, or stress on joints. Gouty arthritis develops due to hyperuricemia; deposits of monosodium urate crystals can lead to gouty arthritis. Septic arthritis occurs due to a microbial infection in synovial joints because in synovial joints the basement membrane is absent. PsA develops due to the psoriasis-skin disease., Conclusions: The current review showed that different types of arthritis has different causes and pathogeneses. Pain in joints is a major and common symptom in all types of arthritis. Arthritis is managed pharmacologically and nonpharmacologically. Treatment is different for each class of arthritis according to its cause and symptoms.

Background: The dissolution method for certain drugs needs specialized conditions. Dissolution testing for felodipine extended release (ER) tablets (Plendil® 5 mg) and amlodipine-indapamide fixed dose (Natrilam®, 5/1.5 mg) ER tablets requires the use of a stationary (felodipine) basket in USP Apparatus II., Objective: The study aimed to develop simple methods for Plendil® and Natrilam® without the use of a felodipine basket., Methods: The dissolution profiles obtained from different media and paddle speeds were used to compute miscellaneous dissolution parameters and were compared to those obtained from standard (existing) methods using a felodipine basket., Results: The f1, f2, and bootstrap f2 (5th % percentile) values for Plendil® 2.47, 88.17, and 54.62, respectively, and all other dissolution factors revealed similarity between standard and the selected test method with 1% Tween 20 at 50 rpm. For Natrilam®, f1 and f2 and bootstrap f2 5.13, 72.92, and 62.67, respectively, and all other dissolution parameters showed similarity of the standard and selected test method using 0.1N HCl media having 0.38 gm/L EDTA with a sinker at 100 rpm. Release of products assumed zero-order and Weibull model, respectively., Conclusion: Test dissolution methods for Plendil® and Natrilam® tablets produced equivalent dissolution profiles compared to their respective standard methods with stationary basket USP Apparatus II., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Context: A completely unique coronavirus (2019-nCoV), formally referred to as severe acute respiratory syndrome (SARS-CoV-2), appeared in China. SARS-CoV-2 is an etiological mediator of coronavirus 2 (COVID-19), characterized by pneumonic contagion in human beings. In spite of forceful suppression, this virus has spread worldwide. No specific drugs have been approved by the FDA for treating COVID-19 patients., Objective: The study intended to examine the data from studies on clinical management of COVID-19., Design: The research team performed a literature review, searching relevant literature databases. The sources of data included bioRxiv, medRxiv, Google Scholar, Embase, PsychINFO, WanFang Data, and PubMed. The search terms were treatment of the novel coronavirus, management of nCoV-19, chloroquine, and hydroxychloroquine., Setting: The study took place in the main library of the University of Sargodha in Sargodha, Pakistan., Results: The study identified 42 unique studies that had reported and confirmed over 1500 cases of nCoV-19 by April 21, 2020. The studies found that clinical management, for patients who presented with symptoms, included supportive care and control measures that comprised mechanical ventilator support and supplementary oxygen., Conclusions: There have been intensive attempts to explore drug therapy for the prophylaxis and treatment of SARS-CoV-2 infection during this COVID-19 pandemic. Several drugs have been identified which including remdesivir, two antimalarials (chloroquine and hydroxychloroquine) and immunosuppressive agents. The effects of most drug interventions are currently highly uncertain and several drugs and vaccines are under trail for the effective treatment of COVID-19 virus, until an effective treatment will discover social distancing and physical hygiene should be practiced strictly.

Objective: To find CEA levels in smokers of different categories (hookah smokers, cigarette smokers smoking different brands of cigarettes and different number of cigarettes per day) and to correlate CEA levels with type and rate of smoking., Methods: A total of 122 cigarette smokers (115 men and 7 women) and 14 hookah smokers (all men) with age ranging from 16-80 years were studied. CEA levels were also measured in 36 non-smokers who served as controls. Enhanced chemilumiscent immunometeric technique was applied to measure CEA levels in our subjects., Results: The mean CEA levels of cigarette smokers were compared with the mean CEA levels observed in hookah smokers (7.16 +/- 10.4 ng/ml) and non-smokers (2.15 +/- 0.68 ng/ml). The mean value of CEA level observed in cigarette smokers, 9.19 +/- 14.9 ng/ml (n=122) was significantly higher than the levels in non-smokers and hookah smokers (p < 0.0067). It was also observed that CEA levels increased with the number of cigarettes smoked per day. The highest levels were observed in smokers who smoke more than 31 cigarettes per day. The smokers that use relatively cheaper brands of cigarettes had higher levels of CEA compared to those who use high quality brands., Conclusion: It was concluded that the brands of cigarettes (which were ranked on the basis of price) and the rate of smoking both play an important role in raising the CEA levels. Further the common belief that hookah also called narghile or shisha is a relatively safe mode of smoking is not completely correct; a significant proportion of hookah smokers have high levels of CEA although mean levels of hookah smokers were low compared to cigarette smokers.