Encapsulation of gingerol into nanoliposomes: Evaluation of in vitro anti-inflammatory and anti-cancer activity.

Nanoliposomes (NLs) are ideal carriers for delivering complex molecules and phytochemical products, but ginger by-products, despite their therapeutic benefits, have poor bioavailability due to their low water solubility and stability. Crude ginger extracts (CGEs) and 6-gingerol were individually encapsulated within NLs for in vitro activity assessment. In vitro evaluation of anti-proliferative and anti-inflammatory properties of encapsulated 6-gingerol and CGE was performed on healthy human periodontal ligament (PDL) fibroblasts and MDA-MB-231 breast cancer cells. Encapsulation efficiency and loading capacity of 6-gingerol reached 25.23% and 2.5%, respectively. NLs were found stable for up to 30 days at 4°C with a gradual load loss of up to 20%. In vitro cytotoxic effect of encapsulated 6-gingerol exceeded 70% in the MDA-MB-231 cell line, in a comparable manner with non-encapsulated 6-gingerol and CGE. The effect of CGE with an IC50 of 3.11 ± 0.39, 7.14 ± 0.80, and 0.82 ± 0.55 µM and encapsulated 6-gingerol on inhibiting IL-8 was evident, indicating its potential anti-inflammatory activity. Encapsulating 6-gingerol within NLs enhanced its stability and facilitated its biological activity. All compounds, including vitamin C, were equivalent at concentrations below 2 mg/mL, with a slight difference in antioxidant activity. The concentrations capable of inhibiting 50% of 2,2-diphenyl-1-picrylhydrazyl (DPPH) substrate were comparable.

The effect of omega-3 supplements on the serum levels of ACE/ACE2 ratio as a potential key in cardiovascular disease: A randomized clinical trial in participants with vitamin D deficiency.

Objective: The aim of this randomized controlled clinical trial was to determine the effect of the omega-3 fatty acid supplementations 300 mg per day for 8 weeks on the serum levels of ACE/ACE2 ratio in Jordanian participants with vitamin D deficiency (VDD). Methods: The physical and clinical characteristic of individuals in both intervention and control randomized controlled clinical trial were measured and analyzed. The comparisons between the two groups and the changes in each group before and after taking omega-3 doses were studied through independent t test and paired t test, respectively. Possible factors that have a role in the changes were determined by multivariate stepwise regression. Follow-up period lasted 10 weeks. Results: The sample consisted of 82 participants with VDD and a mean age of 37.85 ± 9.85 years. Omega-3 Supplements resulted in a significant decrease in serum ACE levels, ACE/ACE2 ratio and serum 25-hydroxy vitamin D (25OHD). While the change in serum ACE2 levels and serum triglycerides levels were insignificant. Also, a significant increase in serum LDL levels were observed. Conclusion: It is possible that taking high doses of omega-3 fatty acid supplementations have positive effects on the heart and circulatory system and could protect from COVID-19 or decrease disease severity, in connection with a decrease in the ACE/ACE 2 ratio. On the other hand, omega-3 supplement may have negative effect on cardiovascular system due to the significant increase in serum LDL levels.

Preparation, Characterization, Wound Healing, and Cytotoxicity Assay of PEGylated Nanophytosomes Loaded with 6-Gingerol.

BACKGROUND: Nutrients are widely used for treating illnesses in traditional medicine. Ginger has long been used in folk medicine to treat motion sickness and other minor health disorders. Chronic non-healing wounds might elicit an inflammation response and cancerous mutation. Few clinical studies have investigated 6-gingerol's wound-healing activity due to its poor pharmacokinetic properties. However, nanotechnology can deliver 6-gingerol while possibly enhancing these properties. Our study aimed to develop a nanophytosome system loaded with 6-gingerol molecules to investigate the delivery system's influence on wound healing and anti-cancer activities. METHODS: We adopted the thin-film hydration method to synthesize nanophytosomes. We used lipids in a ratio of 70:25:5 for DOPC(dioleoyl-sn-glycero-3-phosphocholine): cholesterol: DSPE/PEG2000, respectively. We loaded the 6-gingerol molecules in a concentration of 1.67 mg/mL and achieved size reduction via the extrusion technique. We determined cytotoxicity using lung, breast, and pancreatic cancer cell lines. We performed gene expression of inflammation markers and cytokines according to international protocols. RESULTS: The synthesized nanophytosome particle sizes were 150.16 ± 1.65, the total charge was -13.36 ± 1.266, and the polydispersity index was 0.060 ± 0.050. Transmission electron microscopy determined the synthesized particles' spherical shape and uniform size. The encapsulation efficiency was 34.54% ± 0.035. Our biological tests showed that 6-gingerol nanophytosomes displayed selective antiproliferative activity, considerable downregulation of inflammatory markers and cytokines, and an enhanced wound-healing process. CONCLUSIONS: Our results confirm the anti-cancer activity of PEGylated nanophytosome 6-gingerol, with superior activity exhibited in accelerating wound healing.

Antiplatelets and Vascular Dementia: A Systematic Review.

Vascular dementia (VD) is a neurocognitive disorder whose precise definition is still up for debate. VD generally refers to dementia that is primarily caused by cerebrovascular disease or impaired cerebral blood flow. It is a subset of vascular cognitive impairment, a class of diseases that relate any cerebrovascular injury as a causal or correlating factor for cognitive decline, most commonly seen in the elderly. Patients who present with both cognitive impairment and clinical or radiologic indications of cerebrovascular pathology should have vascular risk factors, particularly hypertension, examined and treated. While these strategies may be more effective at avoiding dementia than at ameliorating it, there is a compelling case for intensive secondary stroke prevention in these patients. Repeated stroke is related to an increased chance of cognitive decline, and poststroke dementia is connected with an increased risk of death. In general, most physicians follow recommendations for secondary stroke prevention in patients with VD, which can be accomplished by the use of antithrombotic medicines such as antiplatelets (aspirin, clopidogrel, ticlopidine, cilostazol, etc.). In individuals with a high risk of atherosclerosis and those with documented symptomatic cerebrovascular illness, antiplatelets treatment lowers the risk of stroke. While this therapy strategy of prevention and rigorous risk management has a compelling justification, there is only limited and indirect data to support it. The following systematic review examines the role of antiplatelets in the management of vascular dementia in published clinical trials and studies and comments on the current evidence available to support their use and highlights the need for further study.

The effect of Medicago sativa extract and light on skin hypopigmentation disorders in C57/BL6 mice.

BACKGROUND: Vitiligo is a common depigmentation skin disease that affects the quality of life in many patients. AIMS: This study aims to investigate the effect of Medicago sativa methanol extract on the treatment of skin hypopigmentation disorders. METHODS: Antioxidant activity and phytochemical constituents of the extract were determined using DDPH assay, Folin-Ciocalteu, AlCl3, and HPLC-MS/MS analysis. Oil in water (o/w) creams were prepared to contain the methanolic extract, and applied to hydroquinone-induced depigmentation in vivo model and further challenged in combination with UVA light exposure. Skin and hair colors were visually scored and evaluated at different time intervals, and histopathological examinations of skin layers and hair follicles were performed. RESULTS: A total phenolic content of 187.70 mg/g, equivalent to gallic acid, and total flavonoid content of 21.97 mg/g, equivalent to quercetin, were recorded. Extract showed 71% antioxidant activity. Moreover, the HPLC-MS/MS detection revealed the presence of 18 compounds including P-coumaric acid and antioxidants flavonoids, of those are seven compounds not previously detected in this species. The in vivo study showed a remarkable skin and hair pigmentation effect on plant extract-treated groups, compared to the reference, placebo, and control groups. Histopathological examinations showed the growth of colored hair follicles in the dermis and epidermis layers of the extract-treated mice. CONCLUSION: The study suggests the use of M. sativa extract in enhancing the pigmentation process in hypopigmented skin and hair if combined with UVA light. Therefore, M. sativa extract can be considered a potential treatment for vitiligo.

Quantification of Total Phenols and Antioxidants in Coffee Samples of Different Origins and Evaluation of the Effect of Degree of Roasting on Their Levels.

Phenolic and antioxidant compounds have received considerable attention due to their beneficial effects on human health. The aim of this study is to determine the content of total phenols and antioxidants in fifty-two coffee samples of different origins, purchased from the Jordanian local market, and investigate the effect of the degree of roasting on the levels of these compounds. The coffee samples were extracted using the hot water extraction method, while Folin−Ciocalteu (FC) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay methods were used to analyze these compounds. The results showed that the highest content of total phenol (16.55 mg/g equivalent to GAE) was found in the medium roasted coffee, and the highest content of antioxidants (1.07 mg/g equivalent to TEAC) content was found in the green coffee. Only light and medium roasted coffee showed a significant correlation (p < 0.05, R2 > 0.95) between the average of total phenolic and antioxidant content. A negative correlation between the antioxidant content and the degree of roasting (p < 0.05, R2 > 0.95) were shown, while it did not correlate with phenolic contents. Previously, a positive correlation between antioxidant and chlorogenic acids content was observed, with no correlation between the origin of coffee samples nor heavy metal content, which was previously determined for the same coffee samples. These findings suggest that the antioxidant content for coffee extracts is largely determined by its chlorogenic acid content, rather than the coffee origin or total phenolic and heavy metals content.

Current Trends in the Duration of Anticoagulant Therapy for Venous Thromboembolism: A Systematic Review.

Anticoagulation therapy is the first line and drug of choice for both the treatment and prophylaxis of venous thromboembolism (deep vein thrombosis and/or pulmonary embolism). Anticoagulation drugs, ranging from different preparations of heparin, warfarin, and newer direct oral drugs such as rivaroxaban and dabigatran, work mainly by inhibiting important factors and enzymes in the coagulation cascade by preventing fibrin formation, platelet aggregation, and clot assembly. With recurrent thrombosis and embolisms being a feared complication for many physicians treating such cases, anticoagulation is often extended beyond the initial three- to six-month acute phase after an incident of venous thromboembolism. For some groups of patients, anticoagulation needs to be offered indefinitely to decrease the risk of a recurrent thrombosis. However, this concomitantly increases obvious and dangerous adverse effects such as increased risk of hemorrhage, as the ability to clot is hindered. This tradeoff between recurrent venous thromboembolism and bleeding is what underscores the controversy of the clinical question: for how long should anticoagulation be administered for venous thromboembolism? This review analyzes the use of anticoagulants in different types of venous thromboembolism and remarks on current consensus and trends on the length of anticoagulation treatment. We are doing so while acknowledging that venous thromboembolism management is an active area of research that is rapidly evolving. A literature search was performed looking at recent studies on anticoagulant administration for the treatment of venous thromboembolism with a focus on varying durations and patient populations. Factors that affect clinical decisions of duration are also elucidated. The most clinically relevant anticoagulants were discussed and their effects on the risk of recurrent thrombosis and embolism, and the risk of bleeding in relation to other drugs were analyzed. Ultimately, this article discussed patterns of anticoagulant treatments duration and which patient groups are likely to benefit the most from certain durations, shedding light on the ambiguity in how physicians should approach administering anticoagulation therapy over time for a broad range of presentations of venous thromboembolism.

Quantification of Caffeine and Chlorogenic Acid in Green and Roasted Coffee Samples Using HPLC-DAD and Evaluation of the Effect of Degree of Roasting on Their Levels.

Chlorogenic acid and caffeine are among the important components in coffee beans, determining the taste and aroma. In addition, phenols and antioxidants content possess vital health values. The main aim of this study is to determine the levels of caffeine and chlorogenic acid in several coffee samples of different origins and degrees of roasting. The coffee samples were extracted using hot water. The levels of caffeine and chlorogenic acid were quantified using high-performance liquid chromatography (HPLC) equipped with a diode array detector, a reverse phase system, and an ODS column (C18). Total phenol and antioxidant contents were previously determined for the same samples. The results showed that the highest content of caffeine was found in the medium roasted coffee (203.63 mg/L), and the highest content of chlorogenic acid content was found in the green coffee (543.23 mg/L). The results demonstrated a negative correlation between the chlorogenic acid levels with the degree of roasting, while it showed a positive correlation between the caffeine levels with the degree of roasting till a certain point where the levels dropped in the dark roasted coffee. The origin of coffee samples did not show any effect on any of the measured variables. Antioxidant effects of coffee samples were largely determined by chlorogenic acid content.

Multi-element determination of essential and toxic metals in green and roasted coffee beans: A comparative study among different origins using ICP-MS.

The aim of this study is to compare the elemental composition among different coffee varieties consumed in Jordan. Levels of different metallic elements in coffee samples; green and roasted coffee beans from five origins; Brazil, Ethiopia, Kenya, Columbia, and India, collected from the Jordanian market were investigated. Twenty-two elements, including essential and toxic elements such as potassium (K), magnesium (Mg), calcium (Ca), iron (Fe), aluminum (Al), manganese (Mn), copper (Cu), barium (Ba), strontium (Sr), zinc (Zn), chromium (Cr), lead (Pb), nickel (Ni), vanadium (V), cobalt (Co), gallium (Ga), uranium (U), cadmium (Cd), silver (Ag), lithium (Li), indium (In), bismuth (Bi), thorium (Th), and thallium (Ti), were determined using inductively coupled plasma-mass spectrometry (ICP-MS). The detected heavy metals and their intake per 1 cup of coffee did not largely contribute to the recommended daily intake (RDI) and tolerable upper limit of daily intake (TULD) in an adult with an average body weight of 80 kg. The ICP-MS versus flame atomic absorption spectrometry (FAAS) results were linearly fitted, and the correlation coefficients (R2 > 0.95) were better than 0.95 for the three checked elements. No significant difference between the results of the two techniques was observed (p > 0.05). The ANOVA results indicated the presence of a significant difference between the levels of Cr, Co, and Zn in green and roasted coffee beans. The results of this study indicated that the coffee consumed in Jordan did not contain toxic levels of heavy elements and is safe for consumption according to health organizations.

Content of Vitamin C, Phenols and Carotenoids Extracted from Capsicum annuum with Antioxidant, Antimicrobial and Coloring Effects.

BACKGROUND AND OBJECTIVE: Capsicum annuum is considered a good source of various natural compounds. The current study aimed to assess the vitamin C and total phenolic and carotenoid contents in C. annuum using standard methods. MATERIALS AND METHODS: Microwave and Soxhlet extraction by using water and acetone were used to extract vitamin C and phenols. Saponification extraction was used to extract carotenoids. The antioxidant activities of each extract were assessed using a DPPH assay. The Minimum Inhibitory Concentration and Minimum Bactericidal Concentration (MIC and MBC) against Escherichia coli and Staphylococcus aureus were determined using the broth microdilution method. The coloring capacity for the acetone extract was evaluated and determined using glass wool fiber at different concentrations and then used in the formulation of multivitamin hard candy. RESULTS: The acetone extract showed the highest phenol and vitamin C content (1.03±0.02 and 9.7±1.3 mg mL-1, respectively), antioxidant activity (67.12±3.8 mg mL-1) and MIC and MBC of 0.96 and 1.88 mg mL-1 against E. coli and 3.75 and 7.5 mg mL-1 against S. aureus. It also showed an intense orange shade on wool fiber and on the prepared multivitamin candy at concentrations of 6 and 0.5% (w/w), respectively. Saponifications of the acetone extract yield (23.49±0.13 µg g-1) of carotenoids. CONCLUSION: The prepared acetone extract of C. annuum stands as a potential pharmaceutical additive, which can be used as coloring and preservative agents in the formulation of kids multi-vitamin candy.

Retrospective assessment of acute poisoning incidents by nonpharmaceutical agents in Jordan: Data from Pharmacy One™ Poison Call Center, 2014 to 2018-Part I.

The Pharmacy One™ Poising Call Center (P1 PCC), located in Amman, Jordan, was created to address deficiencies identified by the pharmacy service, including in the management of poisoning cases. The aims of this study were to analyze the patterns of poisoning cases reported to the P1 PCC and to describe the role of the P1 PCC pharmacist in ensuring preparedness and managing the response to poisoning cases. In addition, the information from these interventions was used to survey human poisoning in Jordan. This is a retrospective descriptive study of acute poisoning incidents in the Jordanian population, as recorded by the P1 PCC during the period 2014-2018. Inquiries received by the P1 PCC were recorded on a predesigned form. The year, patient demographics, toxic agent involved, and circumstances of the poisoning event were all fully documented utilizing Oracle and Excel spreadsheets. A total of 1992 poisoning incidents were reported to the P1PCC, predominately (68.59%) via 911 phone calls. Reports were predominantly from males (1.67:1). Children were the second most common age group after adolescents (22.62% and 42.49%, respectively). The most frequent causative nonpharmaceutical agents were household products (17%) in preschool children and animal bites (20%) in adolescents. Most of the poisoning incidents (74.63%) occurred at home. Unintentional poisoning (54.12%), with mild medical outcomes (61.45%), accounted for most of the poisoning incidents caused by exposure to household products. These data may represent the most recent picture of poisoning incidents in Jordan. Emergency medical services were provided by experienced pharmacy practitioners at the P1 PCC, to respond to emergency needs in the community in a professional manner. Therefore, the need for unnecessary hospitalization and the cost of ambulance dispatch were minimized, which are highly valuable outcomes.

Retrospective assessment of acute poisoning incidents by pharmaceutical agents in Jordan: Data from Pharmacy One™ Poison Call Center, 2014 to 2018-Part II.

Poison control centers provide surveillance data that can be used to estimate the magnitude of poisoning cases and the level of public awareness and to evaluate control measures. The aim of this study is to describe the drug-related poisoning queries received by the Pharmacy One™ Poisoning Call Center (P1 PCC) in Jordan. This is a retrospective descriptive study of the acute drug-related poisoning incidents in the Jordanian population recorded by the P1 PCC during the 2014-2018 period. The inquiries received were recorded on a predesigned form. The demographic data, including the age and the sex of the patient, the route of and reason for exposure and the drug therapeutic groups, in addition to medical outcomes, were extracted utilizing computerized Oracle and Excel spreadsheets. During the period of evaluation, 900 drug-related poisoning incidents were reported to the P1 PCC. The majority of calls (48.5%) were received via 911, followed by the public (48.56%) and healthcare professionals (27.1%). More than half of the poisoning incidents were recorded among males (52.5%). Adults were the most affected group (40.5%), followed by children (34.0%). Unintentional exposure was the most common cause of poisoning (58.6%), followed by suicide attempts (25.3%). Nonsteroidal anti-inflammatory drugs and paracetamol caused the majority of the reported cases. Poisoning incidents were mainly classified as mild to moderate (56.1%), while only 16.6% were severe. The P1 PCC has demonstrated an important and vital role in improving patient safety and providing education on rational drug use. Reflections on these data can be used to increase public awareness in promoting the rational use of medications among Jordanian citizens.