Pakistan journal of pharmaceutical sciences最新文献

Recurrent vomiting and sleep disturbance are typical postoperative complications of laparoscopic surgery, how to improve the postoperative gastrointestinal function of patients undergoing laparoscopic surgery is one of the key links to ensure their recovery. In this study, we looked at the effect of danshen acupressure on the postoperative recovery of patients undergoing laparoscopic surgery. For this purpose, we included 105 study subjects, all patients received information-motivation-behavioral skills (IMB) model-based care, of which 51 patients did not receive danshen treatment and were considered as a control group, another 54 patients were treated with danshen and considered as the research group. Comparison of gastrointestinal function between the two groups and nutritional status, psychological status, etc., we found that the gastrointestinal function of the research group recovered better and gastrin (GAS) and motilin (MTL) were lower than those of the control group (P<0.05). Meanwhile, the psychological status of the research group was also better than that of the control group and the level of nutritional protein was higher than that of the control group (P<0.05). Through the prognostic follow-up, we also found a better prognostic quality of life in the research group.

Knee osteoarthritis (KOA) is a chronic disease with limited clinical treatment and easy recurrence. This study analyze the effectiveness of intra-articular hyaluronic acid (HA) injection combined with oral nonsteroidal anti-inflammatory drugs (NSAID) in treating KOA, providing scientific basis for improving the therapeutic effect of this disease. 100 KOA patients admitted to our hospital from December 2021 to December 2023 were divided into control group (n=50) and study group (n=50). Both groups were treated with oral NSAID, study group were added with intra-articular HA injections. The pain scores (VAS), knee osteoarthritis indicator score (WOMAC), knee osteoarthritis outcome score (KOOS), Lysholm score, knee joint range of motion, inflammatory indicators, clinical efficacy and adverse reactions were compared among both groups. After treatment, all indicators in both groups remarkably improved (P<0.05). The KOOS score, Lysholm score, knee mobility and clinical efficacy in study group were remarkably higher than control group, and VAS score, WOMAC score and inflammatory factor level were less than control group (P<0.05). No significant discrepancies in the adverse reactions among both groups (P>0.05). The efficacy of the combined treatment is remarkable without increased adverse reactions and deserves to further popularize its use in the clinic.

The cross-sectional prospective study aimed to study the factors associated with traumatic brain injuries (TBIs) and acute management of patients presenting at emergency departments in two tertiary care hospitals in Lahore, Punjab, Pakistan, as well as compliance with international guidelines. Data was collected from 1,000 patients between February 2^nd to August 2^nd, 2022. Among TBI patients, 82.1% were male, and most TBIs resulted from road traffic accidents (62.6%). Headaches were experienced by 97.8% of patients, while 72.3% experienced vomiting. The diagnostic procedures included X-rays (98.9%) and CT scans (86.4%). The adherence to trauma guidelines at EDs showed blood pressure monitoring in 100% of patients, oxygen monitoring in 69.4% of patients, hyperosmolar therapy (59.2%) and infection prophylaxis (93.65%). Diagnostic procedures like X-ray (98.9%) lactulose (3.3%), anti-seizure prophylaxis (59.9%), steroid therapy (4%) and anesthetic and sedative administration were not in accordance with international guidelines. Intracranial pressure monitoring facility was not available in EDs. Deep vein thrombosis prophylaxis and nutrition were not provided in EDs. This study revealed that emergency management of TBI patients adhered to most of the international guidelines, with prompt diagnosis and therapeutic care provided in both tertiary care hospitals.

This study aims to investigate the neuroprotective effects of Utilito, a novel chalcone derivative isolated from Arisaema utile in a sodium azide-induced Alzheimer's disease (AD) rat model. Anti-alzheimer activities were assessed through in silico molecular docking, simulation studies and in vivo studies. Utilito at doses of 100, 200, 300 mg/kg was administered in Wistar rats (n=6/group) for 14 days. Cognitive performance and locomotion were assessed through behavioural tests (Morris water maze, Y-maze, and open field). Biochemical assays measured the levels of oxidative stress biomarker including catalase (CAT) superoxide dismutase (SOD), reduced glutathione (GSH), and malondialdehyde (MDA). Molecular docking studies revealed a strong binding affinity of Utilito with monoamine oxidase (MAO-B), with a docking score of -41.4 kJ/mol. Conventional hydrogen bond interactions were observed between the MAO-B residues LEU171, TYR398, and TYR435 and the phenol ring of Utilito. Utilito also showed 71 ± 0.11% anti-oxidant activity in the DPPH assay. Behavioural tests utilizing animal models demonstrate the cognitive-enhancing effects of Utilito. Biochemical evaluations underscore the antioxidant properties of Utilito, offering valuable insights into their mechanisms of action at the cellular level. Utilito exhibits antioxidant activity and cognitive improvement in a rat AD model, suggesting its promise as a therapeutic candidate for AD.

Preterm births could increase the risk of neonatal conditions like cerebral palsy and neurodevelopmental delays. This trial aimed to evaluate the efficacy of magnesium sulfate and atosiban in providing neuroprotection to preterm infants. A clinical trial was conducted between 2020 and 2024, involving 102 high-risk pregnant women at multiple tertiary clinics in China. We studied the neonatal neurodevelopmental delay at 6 months and 12 months whilst also focusing on factors such as maternal side effects, gestational age, mode of delivery, and Neonatal Intensive Care Unit (NICU) admission rates. Unlike magnesium sulfate, Atosiban could reduce the fetus' breathing problems that can, in turn, lead to baby brain protection. It also has fewer maternal side effects, such as nausea and hypertension (p = 0.03). Magnesium sulfate had comparably higher risks of maternal and fetal complications, 49.02% and 68.63% respectively. This study's results suggest that while atosiban is not a commonly used intervention, it is a promising agent for fetal neuroprotection. It is also observed that considering maternal safety, it has fewer side effects. Future larger population studies should be carried out to corroborate the results for higher efficient and safer intervention for fetal neuroprotection.

This study evaluated the therapeutic effects of Citrullus colocynthis seed extract (CCSE) on PCSK9 expression in a high-fat diet (HFD)-induced insulin resistance (IR) model in Wistar rats. Fifteen phytoconstituents from CCSE were screened for drug-likeness using SwissADME and docked against PCSK9 (PDB ID: 6U26). In vivo, 30 HFD-induced-IR rats were divided into five groups: one control (saline) and four treatment groups received CCSE (100,200,300,400 mg/kg) for 28 days. Hepatic PCSK9 mRNA expression was analyzed by qRT-PCR, with relative fold changes. Data were statistically evaluated by ANOVA. In-silico analysis demonstrated all selected compounds complied with Lipinski's Rule of Five, indicated favorable oral bioavailability. Topological polar surface area (TPSA: 9.23-55.38 Å^²) and number of rotatable bonds (NRB >10) further supported their drug-like properties. Strong binding affinities were of compounds Cyclopropane carboxylic acid and 2,4-di-tert-butylphenol (-7.4 and -5.5 kcal/mol) to PCSK9. In-vivo results showed that CCSE significantly downregulated hepatic PCSK9 mRNA expression at a dose of 300mg & 400mg/kg (p < 0.05 vs. control), with the highest reduction (3.2-fold) observed at the 400 mg/kg dose. CCSE significantly downregulated hepatic PCSK9 mRNA expression and confirmed through both in-silico and In-vivo approaches. This suggests its potential as a natural therapeutic agent for managing metabolic disorders.

Simo decoction was used to treat patients with early liver dysfunction after liver transplantation (LT). We aimed to evaluate its effects on gastrointestinal and liver function. A total of 138 patients were divided into the control (Ctrl) group (standard care + placebo; n=69) or the experimental (Exp) group (standard care combined with Simo decoction; n=69). From postoperative day 1 to 5 (T1-T5), patients' liver and kidney function, blood glucose, blood ammonia, gastric residual volume, defecation time, enteral nutrition intake, adverse events and the co-administration of Simo decoction with tacrolimus were analyzed. Alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin and indirect bilirubin levels all showed decreasing trends, while creatinine, blood glucose and albumin remained stable. Compared with the Ctrl group, the Exp group demonstrated significantly lower blood ammonia levels during T1-T5, earlier defecation time and higher enteral nutrition intake at T4-T5. Although gastric residual volume was higher in the Exp group at T1, it was lower than the Ctrl group at T3-T5 without reaching statistical significance. Simo decoction demonstrated beneficial effects in improving gastrointestinal function and metabolic parameters following LT, facilitating toxin elimination and promoting gastrointestinal recovery, while showing no adverse effects on hepatic or renal function recovery.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Diclofenac are often employed but cause minor laboratory test abnormalities in routine examination tests, such as inflammatory markers and liver-renal function tests. They can generate pseudodisease and lead to unnecessary investigation. The present study presents a novel "interference threshold-clinical symptom correlation" model that associates lab abnormality with patient complaints or clinical symptoms after NSAID usage to differentiate drug-induced effect from actual disease in primary care. A mixed retrospective-prospective observational study was conducted in 426 patients from three major primary care centers. Retrospective laboratory data and drug exposure history were determined and clinical symptoms were prospectively monitored after withdrawal of NSAID. Logistic regression and threshold modeling established interference ranges for significant laboratory indices. Model performance was assessed by receiver operating characteristic (ROC) analysis with an area under the curve (AUC) of 0.91 (95% CI: 0.87-0.95). The model reduced unnecessary intervention by 46% in an externally validated cohort. Shortcomings include heterogeneity of NSAID type and dose, no control group and difficulty in standardizing correlation between symptom and threshold. This model, however, provides an efficient, pragmatic tool to improve interpretation of laboratory changes in association with NSAID and it enhances patient safety in primary care.

Uterine fibroids seriously affect patients' physical and mental health and clinical treatment currently faces certain challenges. This study analysed the efficacy and safety of gonadotropin-releasing hormone agonist (GnRH-a) combined with ultrasound-guided percutaneous microwave ablation (UPMA) in the treatment of uterine fibroids. In a retrospective study, 120 patients with uterine fibroids from Zhangye Second People's Hospital between March 2023 and December 2023 were divided into GA and GU groups, both groups were treated with UPMA and GnRH-a treatment was added to the GU group. Fibroid volume, fibroid shrinkage rates (FSR), symptom severity score (SSS), sex hormone levels, serum indicator levels and clinical efficacy were mainly assessed. Secondary outcomes included pain scores, uterine fibroid-relative symptom and health-related qualities of life scores (UFS-HRQL), complication profiles, recurrence rates and adverse reaction incidence. After treatment, both groups had better indicators than pre-treatment (P<0.05). The FSR, serum indicator levels, clinical efficacy and UFS-HRQL scores in the GU group were superior to the GA group and fibroids volume, SSS, sex hormone, pain scores, complication conditions, recurrence rate and adverse reaction incidences were markedly below GA group (P<0.05). This method has remarkable efficacy, can effectively reduce clinical symptoms and is worth promoting its use in clinical practice.

Propofol is widely used in anesthesia, but its role in breast cancer progression remains controversial. This study investigated the molecular mechanisms of propofol in breast cancer, focusing on IL-6 and tumor microenvironment modulation. Bioinformatics analysis identified IL-6 as a potential target of propofol. MCF-7 cells were treated with varying propofol concentrations (0-100 μg/mL), and cell viability was assessed via CCK-8 assay. Propofol at 50 μg/mL significantly reduced viability, while 25 μg/mL (a non-cytotoxic dose) was selected for further experiments. Western blot confirmed propofol down regulated IL-6 expression. Functional assays demonstrated that propofol suppressed migration, invasion, and angiogenesis in MCF-7 cells; and effects that were reversed by recombinant human IL-6 (rhIL-6). Molecular docking analysis further supported the interaction between propofol and IL-6. Additionally, IL-6 and VEGF-C were found to be co-expressed, suggesting a possible link between propofol and vascular mimicry inhibition. These findings indicate that propofol may exert anti-tumor effects in breast cancer by targeting IL-6, thereby inhibiting key oncogenic processes. This study provides new insights into the potential therapeutic benefits of propofol in breast cancer management.