Development of topical silver nano gel formulation of Bixin: Characterization, and evaluation of anticancer activity.

Objective: Skin cancer refers to the pathological condition characterized by the proliferation of atypical skin cells in an uncontrolled manner. Plant-based products such as bixin although show promising anticancer properties, but maintaining their stability in a formulation is a difficult task. The objective of the research is to formulate a silver nanoparticle gel preparation of bixin and evaluate its anticancer properties. Methods: The extract from Bixa orellana seed was prepared by hot extraction technique to isolate the active ingredient, bixin. A green synthesis approach was utilized for preparing the silver nanoparticle gel of bixin (BOAgNPs). Characterization of silver nanoparticles was done using FTIR, scanning electron microscopy, compatibility study, homogeneity testing, pH evaluation, and drug content determination. The in-vitro anticancer activity was performed using cell lines (B16F10) and in-vivo by chemical carcinogen (7,12-dimethylbenz (a) anthracene) in mice. Results: The BOAgNPs-loaded topical gel was found to be homogeneous (clear orange color) and pH-compatible (pH ≈ 6.66) with the skin. The characterization studies indicated the presence of all functional groups in the formulation. An optimized batch of bixin-nano gel showed about 60% inhibitory effects on B16F10 cell lines (in-vitro activity) when equated with a reference drug, 5-fluorouracil. The in-vivo anticancer study suggested suppression of tumorigenesis and promotion of the healing process with bixin-nano gel application on the skin. Conclusion: The results suggested the promising anticancer property of bixin when formulated in silver nanoparticle gel. The preparation of silver particles nano gel with bixin might provide an effective alternative option for treating skin cancers, provided more research complements the findings of the present study.

Association of cholesterol with hepatorenal markers and quality of life in diabetic patients before and after magnesium and potassium supplements.

Background: Magnesium and potassium are two critical minerals that have been linked to the treatment of diabetes and its consequences. A lack of magnesium has been linked to insulin resistance and diabetes, whereas potassium has been found to promote insulin sensitivity and glucose metabolism. The study aimed to determine the relationship between cholesterol, liver and kidney markers, and quality of life in diabetic patients before and after magnesium and potassium supplementation. Methods: It was a single-blind randomized controlled study at Lahore Garrison University and Lahore Medical Research Centre (LMRC). The study included 200 diabetes participants. Four groups were made based on supplements. Blood samples of all diabetes patients were obtained to assess their quality of life before and after using Mg + and K + supplements, as well as the association between cholesterol, liver, and kidney markers. Results: The participants' average age was 51.0 ± 11.08. 139 (69.5 %) of the 200 participants were female, whereas 26 (30.5 %) were male. There was no correlation between the quality of life measure and the patients' cholesterol levels before and after the magnesium and potassium supplementation. Furthermore, the kidney and liver indicators were not dependent on the diabetes individuals' cholesterol levels. Conclusions: The study concluded that none of the four groups noticed a significant effect of magnesium and potassium therapies on the patient's quality of life or cholesterol levels. However, more research is needed to determine if liver and kidney problems are linked to cholesterol levels before and after medication, as the current study found no significant correlation between the two parameters.

Neuroprotective potential of Cordia dichotoma in Parkinson's syndrome induced by haloperidol: An animal study.

Background: Parkinson's disease (PD) is one of the major neurodegenerative disorders and the prevalence is expected to increase during the next couple of decades. There is a need for safe and effective therapeutic regimen that can effectively manage this neurotoxicity. The leaves and several other parts of Cordia dichotoma are known to possess number of medicinal properties. The purpose of this study was to examine the neuroprotective role of Cordia dichotoma in an experimental model of haloperidol-induced P.D. Materials and methods: Five groups of rats were randomly assigned into different groups. Intraperitoneal haloperidol 1 mg/kg was given to the inducer group and 0.5% CMC to the normal control. The reference standard was syndopa 10 mg/kg, p.o., and the test group animals received C. dichotoma's ethanolic extract at 200 and 400 mg/kg orally for one week. Rats exposed to haloperidol were assessed for behavioral, neurochemical, and histopathological parameters. Results: C. dichotoma leaves extract dose-dependently increased behavioral activity and muscle coordination. The extract at 400 mg/kg was found to increase significantly (P < 0.001) the central square activity in open-field test, compared to haloperidol treated rats. In stepping test, both tested doses of C. dichotoma (200 mg and 400 mg/kg) were found to significantly (P < 0.001) reduce akinesia, besides these doses also decreased the catatonic responses induced by haloperidol. Further, the extraction treatment (200 mg and 400 mg/kg) significantly (P < 0.001) decreased malonaldehyde and increased antioxidant enzymes like catalase compared to the control group. Histopathological changes in the test group showed a significant reduction in haloperidol damage to normal morphology in cortical, hippocampus, substantia nigra, and pyramidal. Conclusion: The observations of the study suggest that Cordia dichotoma attenuated the haloperidol-induced neurological changes, indicating that the plant might benefit in the treatment of Parkinson's disease. The activity of Cordia dichotoma could be linked to its antioxidant property. Since, the drug is traditionally used in different parts of world; it could be a promising agent if more research establishes its safety and efficacy in other experimental models of Parkinson's Disease.

Measuring changes in travel behavior pattern due to COVID-19 in a developing country: A case study of Pakistan.

Travel behavior has been affected around the world since the eruption of corona virus disease (COVID-19). Several industries including transportation industry have been hard hit by the pandemic. As the virus is transmitted through close contact with infected people, number of outdoor trips has reduced causing roads and public transport to be less crowded than before. In order to develop transport-related policies for the post COVID-19 world, it is necessary to explore how the pandemic has affected the travel behavior pattern. This study explored the influence of the COVID-19 pandemic on travel pattern and mode preferences in Pakistan using a questionnaire survey. The results showed significant shift in primary traveling purpose from work and studying to shopping during the pandemic. Number of trips performed for non-commuting purposes were also significantly different before and during the pandemic. A significant modal shift from motorbike to non-motorized modes of travel was found for distances less than 5 km. For longer distances, people shifted from public transport to private car. These findings suggest that past policies regarding different modes may be revisited in the post COVID-19 world. The statistical tests performed on the factors affecting mode choices indicated that the respondents put more priority on pandemic-related items such as infection concern, social distance, hand sanitizers' availability, and cleanliness, etc., during the pandemic. The findings of this study will certainly help in shaping up the policies for the post COVID-19 world especially in the developing countries.

A Systematic Review on the Safety and Efficacy of COVID-19 Vaccines Approved in Saudi Arabia.

Comprehensive safety and efficacy studies of COVID-19 vaccines might reduce the apprehension of the general population about the adverse reactions and duration of protection offered by them. The study aimed to conduct a systemic review on the four COVID-19 vaccines (AstraZeneca, Pfizer, Moderna, and Janssen) approved in Saudi Arabia. The study was conducted by reviewing the published articles from electronic databases such as PubMed, Embase, Cochrane Library and Web of Science using the search terms "COVID-19", "Vaccine", "Safety", "Efficacy" and "Human trials" and as per the standard guidelines for systemic review. The review analyzed eighteen articles and the data from them were evaluated to analyze the safety and efficacy of the vaccines in different groups of population such as males, females, those above 18 years and people with co-morbidities. The common local reactions observed after vaccination were pain at the site of injection (40-70%), redness (16-30%), swelling (18-39%) and tenderness (20-40%). The systemic reactions reported were fever (40-60%), chills (12-23%), fatigue (44-65%), headache (30-42%) and muscle pain (15-40%). The efficacy was observed to be above the threshold value (60%) stipulated by the WHO. However, precautions need to be followed while vaccinating special groups of population such as those that are pregnant, lactating or experiencing severe illness. Additionally, the rare and serious adverse events reported remotely after vaccination need more studies.

Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia.

COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system's preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30-39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population's predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients.

The Association of Asthma with Anxiety, Depression, and Mild Cognitive Impairment among Middle-Aged and Elderly Individuals in Saudi Arabia.

Asthma is a common chronic inflammatory condition with increasing global prevalence. There is some evidence highlighting the effect of asthma on brain functioning. In Saudi Arabia, limited studies have examined the relationship between asthma and mental health, including cognition and mood disorders in older adults in particular. In this study, we examine the association between asthma and mental health outcomes in middle-aged and elderly individuals in Riyadh, Saudi Arabia. In a cross-sectional study, 243 subjects were recruited from outpatient clinics between 2020-2021 (non-asthmatic: n = 159, asthmatic: n = 84). The Montreal Cognitive Assessment test, the Hospital Anxiety and Depression Scale, and the Asthma Control Test were used to assess cognition, anxiety and depression, and asthma control, respectively. Logistic regression analysis while controlling for covariates revealed an association between asthma and symptoms of anxiety and depression (OR = 2.40 [95% CI: 1.07-5.35]) and mild cognitive impairment (MCI) (OR = 1.80 [95% CI: 1.00-3.24]). Poorly controlled asthma increased the odds of anxiety cases (OR = 4.88 [95% CI: 1.09-17.2]). Stratifying analysis by age intervals revealed that asthma was associated with symptoms of anxiety and depression (OR = 2.5 [95% CI: 1.00-6.08]) in middle-aged patients only, while elderly asthmatics had increased odds of having MCI (OR = 7.4 [95% CI: 2.34-23.31]). These findings highlight the possible effects of asthma and its control on mental health among middle-aged and elderly individuals in Saudi Arabia.

Efficacy of Penicillium limosum Strain AK-7 Derived Bioactive Metabolites on Antimicrobial, Antioxidant, and Anticancer Activity against Human Ovarian Teratocarcinoma (PA-1) Cell Line.

Natural metabolites from beneficial fungi were recognized for their potential to inhibit multidrug-resistant human and plant fungal pathogens. The present study describes the isolation, metabolite profiling, antibacterial, and antifungal, antioxidant, and anticancer activities of soil fungi. Among the 17 isolates, the AK-7 isolate was selected based on the primary screening. Further, the identification of isolate AK-7 was performed by 18S rRNA sequencing and identified as Penicillium limosum (with 99.90% similarity). Additionally, the ethyl acetate extract of the Penicillium limosum strain AK-7 (AK-7 extract) was characterized by Fourier Transform Infrared Spectroscopy (FTIR) and a Gas Chromatography-Mass Spectroscopy (GC-MS) analysis, and the results showed different functional groups and bioactive metabolites. Consequently, a secondary screening of antibacterial activity by the agar well diffusion method showed significant antibacterial activity against Gram-negative and Gram-positive bacterial pathogens. The AK-7 extract exhibited notable antifungal activity by a food poisoning method and showed maximum inhibition of 77.84 ± 1.62%, 56.42 ± 1.27%, and 37.96 ± 1.84% against Cercospora canescens, Fusarium sambucinum and Sclerotium rolfsii phytopathogens. Consequently, the AK-7 extract showed significant antioxidant activity against DPPH and ABTS•+ free radicals with IC50 values of 59.084 µg/mL and 73.36 µg/mL. Further, the anticancer activity of the AK-7 extract against the human ovarian teratocarcinoma (PA-1) cell line was tested by MTT and Annexin V flow cytometry. The results showed a dose-dependent reduction in cell viability and exhibited apoptosis with an IC50 value of 82.04 µg/mL. The study highlights the potential of the Penicillium limosum strain AK-7 as a source of active metabolites and natural antibacterial, antifungal, antioxidant, and anticancer agent, and it could be an excellent alternative for pharmaceutical and agricultural sectors.

Self-Medication Related Knowledge, Attitudes, and Practices among Residents of Riyadh, Saudi Arabia: A Community-Based Cross-Sectional Study.

Rational and responsible self-medication (SM) is an essential core element for better health outcomes. It is influenced mainly by the level and adequacy of knowledge, attitude, and appropriateness of practice (KAP) towards SM. The present study explored the level and adequacy of KAP among residents of Riyadh city, Saudi Arabia. A convenient snowball sampling method was utilized to recruit the study participants. Data were analyzed using SPSS version 27. Six hundred and eleven participants completed the questionnaire. Residents with good knowledge, positive attitude, and proper practice were 43.7%, 33.1%, and 90.0%, respectively. The level of KAP was significantly influenced by the participant's occupation, age, gender, nationality, marital status, presence of chronic disease, and COVID-19 infection status. The mean knowledge, attitude, and practice scores observed were 5.11 (SD = 1.27), 22.28 (SD = 2.6) and 5.20 (SD = 1.29), respectively. Pearson correlation and scattered plot matrix analysis revealed a significant positive weak correlation among KAP, indicating that residents with good knowledge possess better attitude (r = 0.142, p < 0.001) and follow the proper practice (r = 0.256, p < 0.001) towards SM. Multivariate linear regression revealed a significant (p < 0.001) negative (ß = -0.059) influence of occupation, family members working in the health sector (p = 0.046, ß= -0.426), Body Mass Index (p = 0.019, ß = -0.049), and physical activity (p = 0.018, ß = -0.292) on the overall KAP score. Understanding the residents' level of KAP towards SM would enable the health care system to identify the gap and develop a mechanism to educate the people and make them knowledgeable about SM and self-care.

Biological Characterization of Cleome felina L.f. Extracts for Phytochemical, Antimicrobial, and Hepatoprotective Activities in Wister Albino Rats.

The present study aims to explore the phytochemical constitution and biological activities of Cleome felina L.f. (Cleomaceae). C. felina (leaves, stem, and root) extracts (acetone, methanol, and water) were qualitatively assessed for phytochemical presence. Methanolic leaves extract revealed more positive phyto-compounds among all the extracts; further, methanolic leaves extract was evaluated for FTIR, EDX, GCMS, antimicrobial assay, acute toxicity, and paracetamol-induced hepatoprotective activity in Wister albino rats. FTIR and EDX analysis unveiled important functional groups and elements in the leaves. GCMS analysis of methanolic leaves extract exposed 12 active phyto-compounds: major constituents detected were 1-Butanol, 3-methyl-, formate-48.79%; 1-Decanol, 2-ethyl-13.40%; 1,6-Anhydro-ß-d-talopyranose-12.49%; Ethene, 1,2-bis(methylthio)-7.22%; Decane-4.02%; 3-Methylene-7, 11-dimethyl-1-dodecene-3.085%; Amlexanox-2.50%; 1,2,3,4-Cyclopentanetetrol, (1α,2ß,3ß,4α)-2.07%; L-Cysteine S-sulfate-1.84%; n-Hexadecanoic acid-1.70%; and Flucarbazone-1.55%. The antimicrobial assay showed a moderate zone of inhibition against S. aureus, B. cereus, E. coli, P. aeruginosa, C. albicans, and C. glabrata at 100 µL/mL concentration. Additionally, acute toxicity revealed no behavioral sign of the toxic effect. The significant results were obtained for methanolic leaves extract (low-50 and high-100 mg/kg b.wt. dose) for hepatoprotective activity, where it dramatically reduced serum blood biochemical markers (AST, ALT, ALP, Total bilirubin, and cholesterol) and exhibited elevated hepatic antioxidant enzymes (SOD, CAT, and GSH) concentration with lipid peroxidation retardation. To conclude, C. felina methanolic leaves extract ameliorated important phytochemical compounds and showed significant antimicrobial and hepatoprotective efficacy; therefore, utilization of C. felina leaves suggested in pharmacological applications, and in numerous cosmetics, herbicides, and food industries, would be a great scope for future hepatoprotective drug designing.

Ophthalmological Aspects of von-Hippel-Lindau Syndrome.

Background: von Hippel-Lindau (VHL) syndrome is a multisystem neoplastic disorder involving eyes, central nervous system, kidneys, spine, and other tissues. A retinal capillary hemangioma (RCH) is the earliest manifestation of the VHL disease in most cases.Areas covered:This paper aims to provide an up-to-date review of the current literature about von Hippel-Lindau syndrome. Molecular background, systemic and ocular features of the diseases as well as the utility of newer imaging modalities in diagnosis and monitoring of ocular VHL disease have been described. Besides, we have discussed newer treatment modalities and therapeutic targets.Conclusion: Modern imaging technologies like optical coherence tomography and optical coherence tomography angiography are tools of the trade, in making an appropriate diagnosis and monitoring disease activity and response to treatment. Peripheral RCH may be treated using laser photocoagulation in tumors up to 3000 µm. Vascular endothelial growth factor suppression can help in reducing tumor activity and stabilize the tumor size; however, it does not regress the RCH.

Evaluating the health risks of potentially toxic elements through wheat consumption in multi-industrial metropolis of Faisalabad, Pakistan.

Potentially toxic elements (PTEs) pollution is the fastest growing concern around the entire globe especially in developing countries. Rapid industrialization and urbanization are the dominant sources of anthropogenic soil-food chain contamination with PTEs. The intent of current study was to investigate the interactive levels of Cu, Fe, Mn, Ni, Pb, and Zn in soil and their accumulation in wheat (Triticum aestivum L.) samples collected from 96 sites including industrial, urban, and peri-urban areas of a leading multi-industrialized center (Faisalabad) of Pakistan. According to results obtained from present study, non-carcinogenic (HQ) and life-time carcinogenic risks (CR) of the PTEs to the local inhabitants were estimated following the risk assessment modals proposed by the US-EPA. With respect to estimated HQ for chronic non-carcinogenic risk of Mn, Ni, and Pb, higher potential hazards were observed as compared to Cu, Fe, and Zn. Meanwhile, the carcinogenic risk of Ni marginally exceeded the limit described by US-EPA for adults. Overall, the health risks of PTEs with the consumption of wheat were lower than the limits described by US-EPA except for Ni. However, continuous consumption of this PTEs contaminated food may result the potential buildup of poisonousness and various disorders in humans. Therefore, long-term monitoring and gastrointestinal bio-accessibility studies are requisite for the safety of humans under such conditions.