Mechanistic Insights into the Ameliorative Effect of Cichoriin on Diabetic Rats-Assisted with an In Silico Approach.

Type 2 diabetes mellitus is considered to be a substantial socioeconomic burden worldwide on both patients and governments. Coumarins are biomolecules with a diversity of biological activities. The current investigation aimed to explore the ameliorative effects of cichoriin, which is a type of coumarin, on high-fat diet/streptozotocin (HFD/STZ)-induced diabetic rats. METHODS: Rats were allocated into five groups. Group I was considered as the control group, while the other groups were HFD/STZ-induced diabetic rats. Group II was assigned as the diabetic control. Groups III and IV were treated with cichoriin (50 or 100 mg/kg, respectively). Group V received glibenclamide (5 mg/kg) (as a positive control). The blood glucose (BG), serum insulin, triglycerides (TG), total cholesterol (TC), total antioxidant capacity (TAC), catalase, hepatic superoxide dismutase (SOD) and content of malondialdehyde (MDA) were assessed. Histopathological and immunohistochemistry analysis of pancreatic tissue were performed. mRNA and protein expressions of GLUT4, AMPK, and PI3K were estimated. RESULTS: Cichoriin treatment ameliorated HFD/STZ-induced diabetic conditions and mitigated the histopathological characteristics of the pancreas, as well as increasing pancreatic insulin expression. This decreased the levels of BG, TG, TC, and MDA and improved the TAC, catalase and SOD contents. Cichoriin demonstrated upregulation of mRNA and protein expressions of GLUT4, AMPK, and PI3K. The in silico binding of cichoriin with GLUT4, AMPK, and PI3K supported the possible current activities. CONCLUSION: Collectively, this work highlighted the potential role of cichoriin in mitigating HFD/STZ-induced diabetic conditions and showed it to be a valuable product.

Pharmacists' warfarin therapy knowledge and counseling practices in the Eastern Province, Saudi Arabia: A cross-sectional study.

CONTEXT: For several decades, warfarin has been considered the mainstay anticoagulant for patients who require long-term prevention or treatment of thromboembolic disorders in outpatient settings. Hospital and community pharmacists--with adequate knowledge level and counseling skills--can play a significant role in improving warfarin therapy. AIMS: The aim of this study was to assess the hospital and community pharmacists' warfarin therapy knowledge and counseling practices in the eastern province of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted for 2 months. A self-administered questionnaire was designed focusing on warfarin mechanism of action, indications, safety profile, management of toxicity, monitoring, drug/food interactions, and patient education. The questionnaire was distributed among a random sample of hospital and community pharmacists in the Eastern Province of Saudi Arabia. RESULTS: One hundred and fifty-three pharmacists participated in the study; ninety-seven of them were hospital-based (63.4%), whereas the remaining were community pharmacists. Participant's mean years' of experience was 5.67. In terms of the percentage of right answers, hospital pharmacists showed significantly better warfarin therapy knowledge than community pharmacists (P = 0.026). The percentages of right answers were 31.3% for drug/food interactions, 49.9% for safety profile/management of toxicity, 53.3% for patient education, and 58.2% for monitoring warfarin safety/efficacy. Neither the participants' educational level nor their duration of experience had a significant correlation with the percentage of right answers (P = 0.22 and 0.61). CONCLUSION: Inadequate knowledge and inappropriate practices were encountered among study participants, especially community pharmacists. Therefore, specialized training of pharmacists about warfarin therapy management is essential to optimize therapeutic outcomes and prevent complications.