Behavioral and psychological aspects of coffee consumption.

The chapter "Behavioral and Psychological Aspects of Coffee Consumption" delves into the complex interplay between coffee drinking and cognitive functions, human behavior, and health-related effects. It starts by looking at coffee's physiological impacts, such as how it affects the body's neurotransmitter systems, metabolism, cardiovascular health, liver health, mental health, and bone health. The larger framework of behavioral and psychological variables impacting patterns of coffee drinking provides further context for these effects. The chapter explores a range of behavior change interventions designed to encourage moderate coffee use. It also covers the role that technology, customized methods, and environmental alterations might play in supporting healthier choices. The statement underscores the significance of attending to the requirements of heterogeneous populations, surmounting obstacles to behavior modification, and guaranteeing the enduring viability of intervention results. The chapter also outlines new directions in neuroscience and behavioral science research, including developments in neuroimaging methods and the application of digital health technology to the delivery of interventions. Additionally, it emphasizes how coffee use affects public health and policy, arguing in favor of evidence-based guidelines and treatments that encourage sensible coffee consumption habits and enhance population health outcomes. Ultimately, the chapter offers a thorough summary of the behavioral and psychological effects of coffee drinking, highlighting the significance of multidisciplinary studies and cooperative efforts to deepen our comprehension of this intricate phenomenon.

Higher incidence of prescribing rates and utilization of broad spectrum cephalosporin in young patients: A retrospective observational study in a tertiary care hospital.

Frequent use of antibiotics has been developed resistance and the use of broad spectrum cephalosporin must be limited in children. The study evaluated the association of prescribing patterns of third generation cephalosporin with diagnosis, age, availability of cultural sensitivity report and gender. It is an observational study that was carried out in the duration of six months in a low socio-economic tertiary care hospital. The data of six hundred and eighty-five (685) patients were collected from the medical records of the tertiary hospital. The cephalosporin are the most prescribed antibiotics in children 118/217 (54.3%) followed by adults 119/403 (29.5%) and teenagers 18/65 (27.6%). Whereas, 75/217 (34.5%), 126/403 (31.2%) and 22/65 (33.8%) were prescribed cephalosporin with combination in patients respectively. The culture sensitivity was performed only in 25% of patients i.e., 173/685, Of 173 culture reports 70 and 91 cases from children and adults respectively. Blood is mostly examined specimen in children and urine in adults. Escherichia coli was highly recovered pathogen in culture sensitivity report. The study concluded broad spectrum cephalosporin antibiotics were highly prescribed in children. The culture sensitivity was performed in limited number of patients. Antibiotics stewardship programme will be implemented to reduce the prescribing of broad spectrum cephalosporin in young patients.

In-vitro bioassays of aqueous and ethanol extracts of Aseel dates.

Aseel is amongst the most vital date variety of Pakistan. Beside its nutritional value, it also got remedial uses therefore for the first time different in-vitro bioassays were performed to assess its medicinal value. Aqueous (DFAE) and ethanol (DFEE) extracts of fresh Aseel dates were used for the purpose. Microplate alamar blue assay was done for antibacterial activity, Brine shrimp lethality test for cytotoxicity and MTT assays with different cancer cell lines were used for anti-cancer activity. Antioxidant and anti-inflammatory activity were also evaluated by free radical scavenging bioassay and chemiluminescence technique. Alamar blue assay of both extracts exhibited weak antibacterial activity against E.coli, S, flexenari and S. aureus. Brine shrimp lethality revealed absence of cytotoxicity at 1000µ/mL concentration. DFEE 50 µ/mL was effective against MCF-7,MDA-MB-231, PC3, 3T3 and Hela cancer cell lines showing 17.59%, 20.90%, 37.60%, 22.35% and 36.70% inhibition whereas DFAE exhibits 20.46%, 30.86%, 15.21%, 29.70% and 16.40 % inhibition respectively. Similarly both extracts also showed varying degree of anti-oxidant and anti-inflammatory activity against standard drug. The results are suggestive of weak bioactivity of Aseel date extracts might because of reduced potency however further studies are required for better understanding of observed results and separation of active ingredients from Aseel dates.

Community onset of CTX-M extended spectrum ß-lactamases among uropathogenic E. coli and K. pneumoniae from Karachi, Pakistan.

Urinary tract infections (UTIs) are major health issue in developing countries like Pakistan, become more complicated with extended spectrum ß-lactamase (ESBL) expression in Escherichia coli and Klebsiella pneumoniae. The ground of this present study was to evaluate the incidence of cefotaxime (CTX-M) gene in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. The clinical isolates from various specimens were collected for one-year duration from January till December 2015. After initial screening (n=352) isolates were examined for phenotypic expression of ESBLs by double disc synergy test. Furthermore, eight-four isolates were analyzed by polymerase chain reaction for identification of Cefotaxime (CTX-M), Temoneira (TEM) and Sulfhdryl variable (SHV) genes. Among eighty-four clinical isolates CTX-M was dominant and found positive in 50 isolates (59.5%) followed by TEM in 35 (41.6%) and SHV in 11 (13%). In uropathogenic E. coli and K. pneumoniae, ESBLs gene was found in 50 and 6 isolates out of 57 and 7 respectively. Among uropathogens CTX-M was most prevalent 78% (39/50) in E. coli followed by K. pneumoniae. In uropathogenic E. coli, CTX-M was found dominant in females. The study concluded that ESBL related uropathogenic E. coli were CTX-M dominant, showed community onsets of UTIs that can be preventive and controlled with modified hygienic practices.

Incidence of multidrug resistance and extended-spectrum beta-lactamase expression in community-acquired urinary tract infection among different age groups of patients.

OBJECTIVES: Urinary tract infection (UTI) is a frequent disorder and depends on age and gender. Ineffective empiric treatment of UTI is common when associated with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae. The aim of the study was to investigate the prevalence of Gram-negative uropathogens of E. coli and K. pneumoniae in different age groups along with the identification of ESBL-producing uropathogens and antimicrobial susceptibility profiles. MATERIALS AND METHODS: A total of 247 uropathogens of E. coli and K. pneumoniae were collected over a period of 1 year (January-December 2015) from various diagnostic centers of Karachi city (Pakistan). Antimicrobial susceptibility analysis was performed by disc diffusion method, and identification of ESBL was performed by double disc synergy test. Categorical data of ESBL and non-ESBL uropathogens were analyzed by Pearson's Chi-square test. RESULTS: The study of 247 patients with community-acquired UTI comprised 72% females and 28% males, illustrating an increased prevalence of UTIs among females. It was also revealed that 90% belonged to the age group of 16-30 years whereas 78% related to the age group of 46-60 years. ESBL was found positive in 33.5% (63/188) of E. coli and 15.25% (9/59) in K. pneumonia, with a significant association i.e., (p =0.007). Amikacin, fosfomycin, imipenem, and tazobactam/piperacillin were found to be the effective treatment options. A significant association was found between ESBL-producing uropathogens against ciprofloxacin, enoxacin, and amoxicillin/clavulanic acid resistance (P < 0.05). CONCLUSIONS: It was concluded that for effective treatment of UTIs, appropriate screening of ESBL and culture sensitivity must be employed instead of empiric treatment.

Phenotypic expression and prevalence of multi drug resistant extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae in Karachi, Pakistan.

The aim of the present study was to evaluate the prevalence rate of ESBL producing Gram negative isolates of E. coli, K. pneumoniae and P. mirabilis, to determine the association of various factors with ESBL production and therapeutic options for the treatment. Total 352 isolates were subjected for identification of ESBL by double disc synergy test. Antimicrobial susceptibility was performed using CLSI guidelines and statistical association between ESBL/Non ESBL producers were determined by chi square at significant level of 0.05. A total of 96 isolates were ESBL positive (27%), females were 67% whereas males were 33%. E. coli was most prevalent pathogen (82%) followed by Klebsiella pneumoniae (17%). Furthermore 75% of ESBL associated infections were urinary tract infections. 95% of ESBL producing isolates were multidrug resistant and tazobactam/piperacillin combination and imipenem are good choices with 100% and 97% susceptibility respectively. E coli (OR 2.83, 95% CI 1.585-5.072, RR 2.22, p 0.0004) and K. pneumoniae (OR 0.52, 95% CI 0.285-0.952, RR 0.609, p 0.032) were significantly associated with ESBL production. The spread of ESBL producing multidrug resistant E. coli and K. pneumoniae has increased and proper screening for ESBL identification is needed because of limited therapeutic antibiotic choices.

In vivo evaluation of antihyperlipidemic, antihyperglycemic and hepatoprotective effects of Vernonia anthelmintica seeds in diet model.

Anti-hyperglycemic, anti-hyperlipidemic and hepatoprotective effects of Vernonia anthelmintica seeds were evaluated in diet rat model. The study included forty eight Sprague Dawley rats of either sex with eight animals in each group. Except for control the disease control, standard and treatment groups were treated with high-fat high-sugar diet for 8 weeks. After confirmation of hyperlipidemia and hyperglycemia, the standard group received atorvastatin (2.1 mg.kg-1), treatment groups received hexane extract, ethanol extract and water decoction of Vernonia anthelmintica seeds (300mg.kg-1) for next 30 days. Disease control and control were given normal saline in volume equivalent to other groups. High-fat high-sugar diet was continued in all groups except control for 30 day period. Lipid profile, liver function tests and fasting blood sugar were analyzed in fasting blood samples. Cardiac risk parameters were calculated and results were analyzed by one way ANOVA using SPSS. All three tested extracts showed significant decrease in fasting blood glucose, LDL-C, triglycerides, VLDL-C and cardiac risk parameters as compared to disease control. However, HDL-C and cholesterol levels in treatment groups were found to be significantly increased compared to disease control. Furthermore, treatment groups showed significantly decreased AST and ALP levels compared to disease control. Hexane extract, ethanol extracts and water decoction of Vernonia anthelmintica seeds exhibited potential anti-hyperglycemic, anti-hyperlipidemic effects with favorable hepatic profile. However, further studies should be designed to strengthen these findings on mechanistic ground.

Report - Antidiabetic effects of native date fruit Aseel (Phoenix dactylifera L.) in normal and hyperglycemic rats.

Change in dietary pattern, sedentary life style and increasing stresses are contributing factors for high prevalence of diabetes mellitus. Diabetic complications often lead to cardiovascular diseases, hypertension and hyperlipidemia that are the leading cause death and disability all over the world. Apart from pharmacotherapy, use of antihyperglycemic medicinal food is a new aspect in diabetes management and prevention of its complications. Phoenix dactylifera (date palm) has been traditionally used for different diseases because of the presence of bioactive agents like anthocyanin, phenols, sterols, carotenoids, procyanidins and flavonoids however its potential as a medicinal food is still unclear. Native date fruit variety Aseel oral suspension was evaluated using 32 normoglycemic and hyperglycemic Sprague dawley rats with two doses (300 and 600mg/kg) against control, disease control and standard drug (Glibenclamide 2.5mg/kg). Outcomes of normoglycemic studies reveals insignificant glucose lowering effects however hyperglycemic studies (glucose challenge and Alloxan inducted hyperglycemia) demonstrates significant glucose lowering effect of Aseel date especially with 300mg/kg dose. Data obtained during this study reveal significant anti-hyperglycemic effects of Aseel dates in diabetes management however further preclinical and clinical studies are required to verify the same.

Evaluation of anti-inflammatory and anti-oxidant potential of seed extracts of Vernonia anthelmintica.

Seeds of Vernonia anthelmintica in the form of Ethanol seed extract of Vernonia anthelmintica (EEVA), Hexane extract of Vernonia anthelmintica (HEVA) and water decoction of Vernonia anthelmintica (WDVA) were evaluated for their in-vivo anti-Inflammatory potential in carrageenan induced rat paw model. The results were compared to anti-inflammatory activity of standard drug (ibuprofen) and untreated groups. In-vitro evaluation of antioxidant potential of EEVA and HEVA were also conducted by "DPPH scavenging assay". The results of present study depicts that HEVA and EEVA in higher dose possess a strong anti-inflammatory potential as compared to standard anti-inflammatory drugs, whereas WDVA showed milder anti-inflammatory potential. DPPH assay has revealed strong anti-oxidant potential of EEVC with the percentage Radical Scavenging activity (%RSA) of 89.709 at concentrations of 500 ul as compared to standard drugs gallic acid (23.436±0.43) and acetyl salicylic acid (111.44±0.7) at concentrations of 95.95 µM. The other extract HEVC has shown to have insignificant %RSA at the concentration of 500µl. Hence the present study revealed that selected extracts of Vernonia anthelmintica exhibited significant in-vitro antioxidant and in-vivo anti-inflammatory potential.

Cardiovascular Disease Risk Associated With the Long-term Use of Depot Medroxyprogesterone Acetate.

BACKGROUND: Depot medroxyprogesterone acetate (DMPA) contraception is widely used all over the world; however, it may lead to a decrease in high-density lipoproteins and an increase in low-density lipoproteins (LDL) and triglycerides. These changes in lipid profile have a direct effect on cardiovascular disease risk. This study has been conducted to investigate the relationship between DMPA use and lipid profile, and the effect of worsening of lipid profile on fasting blood glucose. The objective of the present study is to ascertain the effects of DMPA on lipid profiles and Castelli indices, and to estimate the risk of cardiovascular disease in the women using progesterone-only methods for contraception. METHODS: This was a multicenter case-control study including females of reproductive age. A total of 893 women were selected according to inclusion and exclusion criteria described below with the age range of 19-49 years. Among these, 477 were females who were beginning DMPA for contraception whereas 416 were the matched controls of same age and socioeconomic status. The lipid profiles, Castelli indices and fasting blood sugar were evaluated before initiation of DMPA and thereafter at 3, 6, 9 and 12 months. Controls were also analyzed for the same parameters in the same manner as that of treated group. The results were analyzed by repeated measure analysis of variance followed by Tukey׳s post hoc test for the multiple comparisons. RESULTS: The results showed statistically significant differences in all parameters of lipid profile, namely cholesterol (180.7 ± 38.8 versus 133.03 ± 14.8mg/dL, and P = 0.000), LDL (120.04 ± 36.2 versus 94.27 ± 19.6mg/dL, and P = 0.000), very low-density lipoprotein cholesterol (24.6 ± 10.0 versus 20.99 ± 8.66mg/dL, and P = 0.000), high-density lipoprotein (39.67 ± 3.6 versus 44.13 ± 4.22mg/dL, and P = 0.000), total cholesterol (713.05 ± 110.2 versus 569.19 ± 80.4mg/dL, and P = 0.000), triglycerides (126.33 ± 48.8 versus 99.03 ± 30.6mg/dL, and P = 0.000), Castelli index I (4.61 ± 1.2 versus 3.02 ± 0.31, and P = 0.000) and Castelli index II (3.08 ± 1.07 versus 2.13 ± 0.41, and P = 0.000) between treated and control groups, respectively. Serum glucose levels were significantly higher (P ≤ 0.001) among the cases of DMPA (84.6394 ± 7.425mg/dL) compared with that in the control (77.822 ± 7.733mg/dL). CONCLUSIONS: This study clearly revealed that there is an increase in all deleterious lipid parameters and a decrease in favorable lipid measures. Hence, it can be concluded that continued use of DMPA may predispose females to the risk of cardiovascular disease in the long run.

Anti hyperlipidemic and hepatoprotective effects of native date fruit variety "Aseel" (Phoenix dactylifera).

Diet rich in saturated fats and sugars have been associated with obesity, insulin resistance, hyperlipidemia and fatty liver disease. Especially high serum lipid levels are directly connected to the progression of cardiovascular disorders, which are the leading cause of death all over the world. Date palm fruit (Phoenix dactylifera) is known for numerous health benefits however little information is available about in vivo clinical and preclinical benefits, hence antihyperlipidemic and hepatoprotective potential of native date variety Aseel has been assessed in hyperlipidemia induced albino rats. Forty adult male albino rats were divided into five groups with 8 animals in each group. One group was kept as normal control while remaining four groups were fed high fat high sugar diet for 8 weeks; from this one group was reserved as disease control while two groups as treated which received 300 and 600mg/kg of date fruit suspension. The fourth group served as positive control and received standard drug atorvastatin in the dose of 2.1mg/kg. After 14 days serum lipid profile, hepatic profile and fasting blood sugar were determined for all groups. Fasting blood sugar, cholesterol, triglycerides, LDL and VLDL along with cholesterol- HDL and LDL-HDL ratio were significantly decreased at 300 mg/kg without any increase in liver enzymes as observed in positive control group. Animals received 600 mg/kg also revealed significant decline in fasting blood sugar, triglyceride, VLDL and alkaline phosphatase. Hence present results demonstrate ameliorative role of date fruit in hyperlipidemia and fatty liver however more studies are required to gain insight into the possible mechanism of action and confirmation of these effects on human subjects.

Phytochemistry, Brine shrimp lethality and mice acute oral toxicity studies on seed extracts of Vernonia anthelmintica.

Despite the widespread use of Vernonia anthelmintica seeds in traditional medicine, the need to establish the safety of the Vernonia anthelmintica is required to ascertain the safe use of this herbal medicine. The aim of the present study is to establish the acute toxicity profile of different extracts of Vernonia anthelmintica. Hexane and ethanol extract of Vernonia Anthelmintica has been studied for its brine shrimp lethality potential. Water decoction (WDVA), Hexane (HEVA) and Ethanol (EEVA) extracts of Vernonia anthelmintica has also been evaluated for their in-vivo acute oral toxicity in mice by Lorke's method. Phytochemistry of all three extracts was also evaluated for the presence of their secondary metabolites. All three extracts showed the presence of flavonoids and terpenoids, while alkaloids, tannins and fixed oils were present in HEVA and EEVA. Furthermore EEVA also showed presence of carbohydrates and HEVA also showed the presence of cardiac glycosides. Ethanol and hexane extracts of Vernonia anthelmintica showed a positive cytotoxicity in brine shrimp lethality test at 24 hours with LC50 104.16 (224.0-48.05)µg/ml and 216.11µg/ml (378.2-128.7) respectively as compared to standard drug etoposide LC50 7.46µg/ml. The oral LD50 for EEVA, HEVA and WDVA in mice by Lorke's method was greater than 5000mg/kg. The result of brine shrimp lethality test clearly exhibited the presence of bioactive compounds with cytotoxic potential; however seems to be safe for oral use since LD50 was higher than 5000mg/kg and thus safety of acute dosing in vivo practices is justified.