Pakistan journal of pharmaceutical sciences最新文献

Salmonella Typhi, a human-restricted pathogen, is demonstrating multi-drug resistance (MDR) due to widespread and inappropriate antibiotic use. This study aims to molecular identify the pattern of antibiotic resistance. Blood samples from 2456 suspected patients were assessed. Molecular identification of Salmonella Typhi was performed by amplifying the fliC gene. The Disc diffusion method was used to measure the susceptibility of antibiotics. 2456 patient samples, bacterial growth and Salmonella Typhi were 152 (6.2 %) positive. PCR analysis confirmed that all 152 isolated strains were Salmonella Typhi (100%) through the amplification of the fliC gene. Salmonella Typhi isolates showed resistance to trimethoprim (58%), ampicillin (63%), ciprofloxacin (79%) and chloramphenicol (58%). Fifty-eight percent of the isolates showed multi-drug resistance, whereas 26 percent had extensive drug resistance. Antibiotic resistance gene of quinolones was isolated as 44 (36.4%), whereas 88 (57.9 %) were positive for bla_CTX-M gene were detected among cephalosporin-resistance bacteria 56 (36.8 %) resistance bla_IMP and bla_OXA-48 were detected among carbapenem-resistance bacteria. For the azithromycin resistance, more genes were detected as a percentage 03 (50 %) from isolates. It concludes that several multidrug resistance and extensive drug-resistance Salmonella Typhi were found. The majority of isolates were sensitive to meropenem, Imipenem and Azithromycin.

Acute pulmonary embolism (APE) is a fatal disease characterized by pulmonary artery obstruction, leading to endothelial dysfunction, elevated pulmonary arterial pressure, right ventricular overload, and systemic inflammation. Whether breviscapine, a flavonoid glycoside with vasoprotective, anti-inflammatory, and antioxidant activities, whether protects pulmonary vascular function in APE was investigated. Male Sprague-Dawley rats were allocated at random into sham, APE, APE + low-dose breviscapine (0.2 mg/kg/day), or APE + high-dose breviscapine (1 mg/kg/day) groups. APE was induced by intravenous infusion of polystyrene microspheres, and breviscapine was administered intraperitoneally for 48 hours. Hemodynamic parameters, including mean pulmonary arterial pressure and right ventricular hypertrophy, were assessed. Lung tissues were examined histologically and immunohistochemically for endothelial markers (CD31, ICAM-1, VCAM-1) and inflammatory cytokines (IL-6, TNF-α, IL-10, MCP-1). APE caused marked pulmonary hypertension, right ventricular hypertrophy, endothelial injury, increased pro-inflammatory cytokines, and oxidative stress (p < 0.05 for all comparisons). Treatment with breviscapine, particularly with high dose, preserved endothelial structure, reduced pro-inflammatory cytokines, increased IL-10, restored endothelial markers, and corrected pulmonary hemodynamics. These results show that breviscapine maintains pulmonary vascular function and reduces inflammatory damage in APE and thus is a potential therapeutic drug.

Vtamin A (VA) and vitamin E (VE) deficiencies are common in premature infants and may impair immune function, increasing the risk of necrotizing enterocolitis (NEC). This study examined the link between VA and VE levels and neonatal immune function and NEC in 220 premature infants from 2022 to 2024. Infants were divided into VA, VE, VA+VE supplementation groups and a control group. After one month, VA and VE levels and immune function markers (T lymphocyte subsets) were reassessed. Results showed that VA and VE levels increased significantly in supplemented groups (P<0.05). Immune function improved, with the best results in the VA+VE group (P<0.05). NEC incidence was lowest in the VA+VE group (1.82%, P=0.031). Correlation analysis revealed that higher VA and VE levels were associated with better immune function and lower NEC risk (P<0.05). The concentrations of VA and VE are closely related to neonatal immune function and the occurrence of NEC. Supplementation with VA and VE may help prevent the occurrence of NEC in newborns.

This randomized, controlled trial evaluated the efficacy of opioid-sparing analgesic protocols in postoperative pain management for major trauma surgeries. A total of 120 patients were randomly assigned to either an opioid-sparing group or a conventional opioid-based group (n = 60 per group). Primary outcomes included pain severity, opioid use, and postoperative mobilization. The opioid-sparing group reported significantly lower pain scores at all time points (p < 0.0001) and lower sedation levels (p < 0.0001). Total opioid consumption was significantly reduced (p < 0.0001): and fewer rescue medications were required (p < 0.0001). Functional recovery was faster (p < 0.0001): patient satisfaction was higher (p < 0.0001), and length of hospital stay was shorter (p < 0.0001). At 6-month follow-up, the incidence of chronic pain was lower in the opioid-sparing group (2% vs 8%): and quality of life scores were higher (p < 0.0001). Additional multiple regression analysis determined the various predictors affecting long-term recovery results. These findings support the effectiveness of multimodal opioid-sparing strategies in enhancing recovery and reducing opioid-related complications after major trauma surgeries.

This study aimed to explore the application and effect of alanyl-glutamine (Ala-Gln) dipeptide parenteral nutrition support in liver transplantation patients. A randomized controlled trial was performed, including and analyzing 96 patients who underwent liver transplantation surgery in our hospital from March 2019 to February 2023. These 96 patients were randomly divided into an experimental group and a control group, with 48 cases in each group. The control group was supplied with branched-chain amino acids (BCAAs) as a nitrogen source, and the experimental group was supplied with BCAAs + Ala-Gln. The results indicated that the levels of prealbumin (PA), serum albumin (ALB), and transferrin (TRF) in the experimental group were higher than those in the control group (P<0.05). The duration of care at the intensive care unit (ICU) and hospitalization of the experimental group were shorter than the control group (P<0.05). The incidence of infection events of the experimental group was lower than that in the control group (P<0.05). Collectively, the use of Ala-Gln in parenteral nutrition support for liver transplantation patients can significantly improve the nutritional status of the body, shorten the length of hospitalization time and reduce the incidence of infection.

Osteoarthritis (OA) is a common chronic joint disease that seriously affects the elderly's quality of life. The goal was to analyse the comparative effectiveness of combining acupuncture and glucosamine in the treatment of pain in elderly patients with OA. 98 elderly OA patients admitted to our hospital from September 2021 to September 2024 were divided into the control group (administered with aminoglucose hydrochloride tablets, n=49) and study group (addition of acupuncture to the control group, n=49). The clinical efficacy, Traditional Chinese Medicine scores (TCMs), pain visual analogue scale (VAS) scores, Articular Rehabilitation of the Osteoarticular Mobility (AROM) scores, Joint Orthopaedic Association Treatment (JOA) scores, inflammatory indicators, quality of life scores and adverse events incidence were compared in both groups. Post-treatment, all indicators of both groups were superior to pre-treatment (P<0.05). The clinical efficacy, AROM scores, HSS scores, JOA scores and quality of life scores in study group were remarkably larger to control group, and TCMs, VAS scores and inflammatory indicators in study group were lower than control group (P<0.05). In addition, no remarkable discrepancies were found among both groups with adverse events incidence (P>0.05). The method is effective in relieving pain and improving inflammation, and has greater clinical value.

This retrospective study evaluated the effects of composite positioning and oxytocin administration on hypotension following lumbar anaesthesia in caesarean sections. Information regarding 120 patients was collected, where 60 patients were in the composite position and 60 patients in supine position. In order to avoid anaemia and post-partum uterine atony all patients, regardless of their group, were given intravenous oxytocin after the delivery of the placenta. A statistical difference was observed regarding hypotension, composite positioning reduced the occurrence of hypotension and the time taken before onset of hypotension was greater compared to subjects who did not use the method, 30% and 50% respectively (p=0.03), 6.38 and 4.67 minutes (p = 0.02) respectively. The requirements in vasopressors were reportedly slightly lower in the composite group. Patients in the composite group improved in the least postoperative pain and fatigue scores VAS pain score was 3.10 in the composite group while that of the supine group was 4.25 (p = 0.02), fatigue score was 2.75 in the composite group while that of the supine group was 3.90 (p = 0.03). The present work identifies the possible clinical advantages of composite positioning as an approach to concern hypotension and enhance the postnatal recovery process.

Prolonged exposure to iron can result in severe hepatic complications such as chronic liver damage, jaundice, cirrhosis, and hepatocellular carcinoma. Current treatment options for metal-induced hepatotoxicity are limited and often associated with undesirable side effects. This study investigates the hepatoprotective and anti-inflammatory properties of three phytochemicals, albiziasaponin-A, ellagitannin and azadirachtin, against iron-induced liver toxicity. Both in silico and in vivo approaches were employed to assess their binding affinity as well as the therapeutic effects of selected phytochemicals against the target protein, cyclooxygenase-2, a marker of liver damage. Molecular docking revealed strong binding affinities of all compounds with COX-2, indicating promising anti-inflammatory potential. Hepatic injury was assessed through biomarkers including ALT, 4HNE, 8-OHdG, TNF-α, IsoP-2α, MDA, and COX-2 levels. The rat group exposed to iron overdose exhibited significantly elevated biomarker levels compared to controls, confirming hepatotoxicity. However, combination therapy with the selected phytochemicals led to a significant reduction in these biomarkers, suggesting effective hepatoprotection. These findings indicate that albiziasaponin-A, ellagitannin and azadirachtin possess potent therapeutic properties that may be beneficial in mitigating iron-induced liver damage. Further investigation is needed to establish their potential for inclusion in novel drug formulations targeting inflammatory liver diseases.

The increase of antibiotic resistance has been one of major challenges in today's healthcare. Staphylococcus aureus is responsible for approximately 60-80% of human infections. This research examines the anti-biofilm activity of key components of Binahong leaves (Anredera cordifolia), clove flower essential oil (Syzygium aromaticum) and cinnamon essential oil (Cinnamomum burmanii) against Staphylococcus aureus bacteria using in silico simulations. The compounds of plant secondary metabolites were analyzed using Liquid Chromatography High Resolution Mass Spectrometry (LC-HRMS) and Gas Chromatography-Mass Spectrometry (GC-MS) techniques to identify the main compounds. In silico studies employed the molecular docking method with BIOVIA Discovery Study Visualizer 2021 and iGEMDOCK V2.1 applications. The LC-HRMS analysis revealed that the binahong leaf ethanol extract contains vitexin, a flavonoid compound with a Cloud Best Match value of 97.4% and an Area of 657851019.181973. GC-MS analysis demonstrated that clove flower essential oil (Syzygium aromaticum) predominantly consists of eugenol, accounting for 83.89% of the oil, whereas cinnamon essential oil (Cinnamomum burmanii) contains cinnamaldehyde, constituting 72.44%. Through molecular docking analysis, it was observed that the vitexin compounds exhibited the highest potential for anti-biofilm activity. These findings provide valuable insights into the antibiofilm potential of Anredera cordifolia, Syzygium aromaticum, and Cinnamomum burmanii against Staphylococcus aureus.

This study compared the efficacy and safety of levofloxacin eye drops and pranoprofen gel in treating bacterial conjunctivitis via a prospective randomized controlled design. A total of 200 patients with bacterial conjunctivitis were included, randomly divided into two groups (100 cases each) for 14-day corresponding drug treatment. Symptom improvement, bacterial clearance and adverse reactions were observed. Results showed that on treatment days 1 and 3, the levofloxacin group had significantly lower scores in conjunctival congestion (1.9±0.4 vs 2.1±0.5; 1.5±0.3 vs 1.7±0.4) and secretions (2.1±0.5 vs 2.3±0.6; 1.7±0.4 vs 1.9±0.5) than the pranoprofen group (all P<0.05). The bacterial clearance rate of the levofloxacin group was 85% (85/100), significantly higher than the pranoprofen group's 70% (70/100) (χ_²=5.32, P<0.05). The total effective rate of the levofloxacin group was 90% (90/100), significantly higher than the pranoprofen group's 80% (80/100) (χ_²=3.92, P<0.05). For safety, the adverse reaction incidence was 15% (15/100) in the levofloxacin group and 13% (13/100) in the pranoprofen group, with no significant difference (χ_²=0.258, P=0.612). This study indicates levofloxacin eye drops have efficacy advantages and the two are comparable in safety, providing a valuable medication reference for clinical treatment of bacterial conjunctivitis.