Frequency of Hyperemesis Gravidarum and associated risk factors among pregnant women.

OBJECTIVE: To determine the frequency of hyperemesis gravidarum (HG) and associated factors among pregnant women. METHODS: The hospital-based cross-sectional study was conducted from October 2016 to March 2017 at Lady Reading Hospital (LRH), Peshawar, District Headquarter Hospital (DHQ), Mardan, and District Headquarter Hospital, Nowshera, Khyber Pakhtunkhwa, Pakistan, and comprised data of 146 pregnant women with hyperemesis gravidarum. Data was compiled using pre-designed proforma. Frequency data of HG was also collected from the two hospitals of Peshawar and Mardan presenting in 2015 and 2016. Blood samples of all patients were analysed for serum electrolytes and complete blood count. Data was analyzed using Microsoft Excel 2010.. RESULTS: Mean frequency of HG in LRH Peshawar and DHQ Mardan during 2015 and 2016 was 14.5% and 8.34% respectively. Of the 146 women, 103(70.5%) belonged to Nowshera, 24(16.4%) to Peshawar and 19(13%) to Mardan. The overall mean age was 27±4.9 years, and maximum number of patients 67(45.89%) were aged 26-30 years. Major risk factor was urinary tract infection in Nowshera 30(29%) and Mardan 5(26.3%), while no major factor was identified in Peshawar. Patients in the first trimester were 59(57.28%) in Nowshera, 19(100%) in Mardan and 19(83.3%) in Peshawar, and primigravidas were 19(18.4%), 6(25%) and 8(42%) respectively. Overall, 119(81.5%) patients had no history of abortion. CONCLUSIONS: The prevalence of hyperemesis gravidarum was high in Nowshera, Mardan and Peshawar, predominantly during the first trimester of pregnancy.

Genetic structure of Kho population from north-western Pakistan based on mtDNA control region sequences.

The Kho population speaking Khowar language reside since long ago in Chitral District of North-western Pakistan. So far, no report is available about their genetic structure and relationship with surrounding population groups. We partially sequenced the mitochondrial DNA control region from 16 unrelated Kho male and female individuals of different ages. The D-Loop region sequences of Kho were aligned and compared with the revised Cambridge Reference Sequence (rCRS). The genetic data of Kho was compared with surrounding north-western Pakistani population groups including Pathan, Kashmiri, and Hazara. Comparison with rCRS identified overall 49 different haplotypes for Kho samples. Among these 21 haplotypes were shared by more than one Kho individuals. The genetic diversity and power of discrimination observed for Kho group were 0.215 and 0.202 respectively indicating the Kho tribe as a least differentiated group among north-western Pakistani populations. The haplogroup mapping, phylogenetic and haplotype network analysis revealed the nearby maternal ancestral relationship between Kho and Kashmiri populations. The haplogroups analysis demonstrates the western Eurasian ancestral origin of Kho samples. However, the appearance of a few South Asian haplogroups with low frequency speculate the Kho tribe as an admixed population of western Eurasian and South Asian genetic components.

Population genetic structure of domain I of apical membrane antigen-1 in Plasmodium falciparum isolates from Hazara division of Pakistan.

BACKGROUND: The Plasmodium falciparum apical membrane antigen-1 (PfAMA1) is considered as an ideal vaccine candidate for malaria control due to its high level of immunogenicity and essential role in parasite survival. Among the three domains of PfAMA1 protein, hyper-variable region (HVR) of domain I is the most immunogenic. The present study was conducted to evaluate the extent of genetic diversity across HVR domain I of the pfama1 gene in P. falciparum isolates from Hazara division of Pakistan. METHODS: The HVR domain I of the pfama1 was amplified and sequenced from 20 P. falciparum positive cases from Hazara division of Pakistan. The sequences were analysed in context of global population data of P. falciparum from nine malaria endemic countries. The DNA sequence reads quality assessment, reads assembling, sequences alignment/phylogenetic and population genetic analyses were performed using Staden, Lasergene v. 7.1, MEGA7 and DnaSP v.5 software packages respectively. RESULTS: Total 14 mutations were found in Pakistani isolates with 12 parsimony informative sites. During comparison with global isolates, a novel non-synonymous mutation (Y240F) was found specifically in a single Pakistani sample with 5% frequency. The less number of mutations, haplotypes, recombination and low pairwise nucleotide differences revealed tightly linked uniform genetic structure with low genetic diversity at HVR domain I of pfama1 among P. falciparum isolates from Hazara region of Pakistan. This uniform genetic structure may be shaped across Pakistani P. falciparum isolates by bottleneck or natural selection events. CONCLUSION: The Pakistani P. falciparum isolates were found to maintain a distinct genetic pattern at HVR pfama1 with some extent of genetic relationship with geographically close Myanmar and Indian samples. However, the exact pattern of gene flow and demographic events may infer from whole genome sequence data with large sample size of P. falciparum collected from broad area of Pakistan.

RETRACTED: Ahmad et al. Neuroprotection against Aluminum Chloride-Induced Hippocampus Damage in Albino Wistar Rats by Leucophyllum frutescens (Berl.) I.M. Johnst. Leaf Extracts: A Detailed Insight into Phytochemical Analysis and Antioxidant and Enzyme Inhibition Assays. Front. Biosci. (Landmark Ed) 2023, 28(8), 184.

The Editors-in-Chief have retracted the article titled "[Neuroprotection against Aluminum Chloride-Induced Hippocampus Damage in Albino Wistar Rats by Leucophyllum frutescens (Berl.) I.M. Johnst. Leaf Extracts: A Detailed Insight into Phytochemical Analysis and Antioxidant and Enzyme Inhibition Assays]" ([1]) due to significant concerns regarding the reliability and integrity of the data presented. After the publication of the article, several issues were brought to our attention regarding the originality and authenticity of the visual data within the manuscript. Specifically, Figure 4 of the article contains images that are identical to those in the previously published papers [2, 3]. This duplication of images raises serious questions about the validity of the results and the adherence to ethical standards of research. Despite multiple attempts to contact the authors for an explanation and an opportunity to address these concerns, no satisfactory response was provided. Given the lack of accountability and the serious nature of the academic misconduct implied, the Editor-in-Chief, after careful consideration and in accordance with the publication's ethical guidelines, has decided to retract the article.

Neuroprotection against Aluminum Chloride-Induced Hippocampus Damage in Albino Wistar Rats by Leucophyllum frutescens (Berl.) I.M. Johnst. Leaf Extracts: A Detailed Insight into Phytochemical Analysis and Antioxidant and Enzyme Inhibition Assays.

BACKGROUND: A previously unstudied medicinal plant, Leucophyllum frutescens (Berland.) I.M. Johnst. (Scrophulariaceae) was investigated to evaluate its potential in preventing and treating neurodegenerative diseases, including Alzheimer's disease. METHODS: Methanolic leaf extract (MELE) and its fractions (HELE, CHLE, and BULE) were evaluated for their polyphenolic content and antioxidant activity by five different methods, including in vitro enzyme inhibition assays, which are clinically linked to neurodegenerative diseases. The potentially active n-butanol fraction (BULE) was further evaluated for its neuroprotective effects using an albino rat animal model and phytoconstituents profiling using Liquid chromatography with tandem mass spectrometry (LC-MS/MS), and in silico molecular docking by Maestro® Schrödinger. RESULTS: The n-butanol fraction (BULE) in the hydroalcoholic leaf extract exhibited the highest total phenolic content (230.435 ± 1.575 mg gallic acid equivalent gm-1± SD). The chloroform leaf extract exhibited the highest total flavonoid content (293.343 ± 3.756 mg quercetin equivalent gm-1± SD) as well as the highest antioxidant content, which was equivalent to Trolox, with five assay methods. Similarly, the chloroform and n-butanol fractions from the hydroalcoholic leaf extract significantly inhibited human acetylcholinesterase and butyrylcholinesterase with their IC50 values of 12.14 ± 0.85 and 129.73 ± 1.14 µg∙mL-1, respectively. The in vivo study revealed that BULE exhibited a significant neuroprotective effect at doses of 200 and 400 mg/kg/day in an aluminum chloride-induced neurodegenerative albino rat model. The LC-MS/MS analysis of BULE tentatively confirmed the presence of biologically active secondary metabolites, such as theobromine, propyl gallate, quercetin-3-O-glucoside, myricetin-3-acetylrhamnoside, isoquercitrin-6'-O-malonate, diosmetin-7-O-glucuronide-3'-O-pentose, pinoresinol diglucoside, asarinin, eridictoyl, epigallocatechin, methyl gallate derivative, and eudesmin. The results from the computational molecular docking of the identified secondary metabolites revealed that diosmetin-7-O-glucuronide-3'-O-pentose had the highest binding affinity to human butyrylcholinesterase, while isoquercetin-6'-O-malonate had the highest to human acetylcholinesterase, and pinoresinol diglucoside to human salivary alpha-amylase. CONCLUSIONS: The present study concluded a need for further exploration into this medicinal plant, including the isolation of the bioactive compounds responsible for its neuroprotective effects.

Core-shell Pluronic F127/chitosan based nanoparticles for effective delivery of methotrexate in the management of rheumatoid arthritis.

This study was designed to improve oral bioavailability of the methotrexate (MTX) by sustaining its release profile and integration into core-shell polymeric nanoparticles. The self-micellization and ionotropic gelation technique was employed which resulted into spherical shaped nanoparticles (181-417 nm) with encapsulation efficiency of 80.14% to 85.54%. Furthermore, Fourier Transform Infrared Spectroscopy and Differential Scanning Calorimetry analyses were carried out to investigate physicochemical and thermal stability of the produced engineered core shell nanoparticles of the methotrexate. . Entrapment of drug in polymeric core was confirmed by X-ray diffraction analysis. In-vitro sustained release behavior of nanoparticles was observed at pH 6.8 for 48 h while low drug release was observed at pH 1.2 due to pH-responsive nature of Pluronic F127. Acute toxicity study confirmed safety and biocompatible profile of nanoparticles. MTX loaded polymeric nanoparticles ameliorated the pharmacokinetic profile (8 folds greater half-life, 6.26 folds higher AUC0-t and 3.48 folds higher mean residence time). In vivo study conducted in rat model depicted the improved therapeutic efficacy and healing of arthritis through MTX loaded polymeric nanoparticles, preferentially attributable to high accretion of MTX in the inflamed site. In conclusion, MTX loaded polymeric nanoparticles is an attractive drug delivery strategy for an effective management and treatment of rheumatoid arthritis.

Prevalence of Dyslipidemia in Ischemic Stroke Patients: A Single-Center Prospective Study From Pakistan.

Background Stroke is a debilitating condition that adds morbidity to the patient and is an economic burden to society. Several modifiable risk factors can be identified and controlled, and dyslipidemia is one such under-diagnosed and least reported risk factor in Pakistan. We aimed to conduct this study to determine the frequency of dyslipidemia in ischemic stroke patients. Methodology We conducted a prospective cross-sectional study for seven months at Shalamar Hospital, Lahore, from November 2020 to May 2021. One hundred four patients were enrolled as per inclusion and exclusion criteria. After informed consent, a blood sample was taken from the patients and sent to a laboratory to determine dyslipidemia. Demographic details, history, and co-morbidities were also noted on a performa. All the collected data were analyzed in SPSS 20.0. Results The mean age was 53.09 ± 12.51 years. Of 104 patients, 60 (57.69%) were male, and 44 (42.31%) were females, with a male-to-female ratio of 1.4:1. The mean duration of disease in our study was 5.77 ± 3.33 hours. The mean BMI was 27.54 ± 3.03 kg/m2. In our study, the frequency of dyslipidemia in ischemic stroke patients was 39.42% (41 patients).  Conclusion This study concluded that dyslipidemia in ischemic stroke patients is very high in the Pakistani population. This highlighted the need to control this modifiable risk factor in the population. Strategic measures, including pharmacological therapy and diet modification, should be adopted, and awareness about the disease burden, control, and importance should be spread.

Assessment of changes in biophysical parameters by dermocosmetic emulgel loaded with Cinnamomum tamala extract: A split-faced and placebo-controlled study.

BACKGROUND: Phenolic and flavonoid compounds found in plants alleviate the photo-damaging skin conditions by playing a major role in skin rejuvenation. AIMS: The aim of the study was to explore the cosmeceutical effects of Cinnamomum tamala extract. OBJECTIVE: Recent research was aimed to quantify phenols and flavonoids in the natural extract of C tamala leaves, to develop its phyto-cosmetic emulgel and to assess effects of emulgel on healthy human skin. METHOD: Phenols and flavonoids in C tamala (CT) extract were quantified by using ELISA assay. Emulgel formulation loaded with 4% C tamala (CT emulgel) was developed, and its cosmetic effects were evaluated on the cheeks of 13 healthy female test volunteers by comparing with placebo (base). Facial parameters including melanin, erythema, sebum, and visible facial pores (size and area) were studied by using Mexameter® , Sebumeter® , and VisioFace® at regular interval for 90 days. RESULTS: Total phenolic content and total flavonoids content of C tamala leaves extract were found to be 73.08 ± 0.0078 mg GAE/g and 52.63 ± 0.0060 mg QE/g CT extract respectively. As compared to placebo (base), CT emulgel was found to be significantly (P ≤ .05) effective in minimizing skin photo-damaging effects by reducing the levels of melanin, erythema, and sebum and size and count of both fine and large facial pores. CONCLUSION: Cinnamomum tamala leaves extract, being a rich source of phenols and flavonoids minimized the photo-damaging effects by reducing skin melanin, erythema, and excess sebum; improving the skin imperfections by reducing facial pore count and area as assessed by advanced imaging and bioengineering techniques.

Consumers' expectations and experiences with chain community pharmacies in Lahore, Pakistan: a qualitative exploratory study.

Background The model of community pharmacy practice is changing remarkably not only in the West but also in developing countries, which has led retail pharmacies to transform into chain community pharmacies. However, very little is known about consumers' expectations and experiences with chain community pharmacies in developing countries. Objective This study aims to assess the expectations and experiences of consumers with services provided by chain community pharmacies in Lahore, Pakistan. Setting Four random chain community pharmacies. Methods A qualitative study design was employed and face-to-face, audio-recorded, interviews were conducted with 12 consumers attending 4 randomly selected chain community pharmacies. All interviews were transcribed verbatim and the interview data were analysed thematically using NVivo® software. Main outcome measure Consumers' expectations and experiences with chain community pharmacies. Results The results contributed to a deeper understanding of the consumers' expectations and experiences with the services provided by chain community pharmacies. Six themes emerged from interview data including; access to pharmacists, quality use of medicines, range of distinct services, staff's behaviour, inventory management, and scope of services. The consumers reported that pharmacists working in chain community pharmacies were building trusting relationships and encouraging them to take an active role in healthcare. Pharmacists working there were providing them medication information and counselling services, which they normally do not expect from traditional pharmacies. Consumers mentioned that they had access to pharmacists and quality services, but the inventory of pharmacies was limited. Conclusions This exploratory study provides preliminary evidence that some of the consumers' expectations and experiences were aligned. However, some deficiencies were highlighted by the consumers that need to be addressed by relevant stakeholders. Further research is needed to assess the expectations and experiences of pharmacists working in the chain community pharmacy sector.

Photodamage and Photoprotection: An In vivo Approach Using Noninvasive Probes.

Solar radiations trigger the physiological alteration in skin which progress toward photoaging. Sunscreens are known to be effective against the photodamaging effects of sunlight. The purpose of this study was to evaluate the extent to which aging signs caused by real-life sunlight exposure could be avoided by comparing various parameters between sun-exposed and sun-protected skin using noninvasive probes. Female volunteers (n = 11) after getting their consent were provided with marketed sunscreen product to apply onto their skin for 6 months. Measurements were scheduled every 15 days from the baseline reading for 6 months. Cutometer, Mexameter and Corneometer were used for evaluation of facial skin parameters. Clinical evaluations showed the effects of sunlight exposure on different skin parameters by comparing sun-protected and unprotected skin, where Gross elasticity (R2), Net elasticity (R5), Viscoelasticity (R6) and Biological elasticity (R7) showed insignificant results, while Hydration, Melanin and Erythema showed significant results. Sun-exposed skin presented 0.72%, 0.66%, 0.77%, 1.39%, 1.99%, 2.01% and 3.15% changes in R2, R5, R6 and R7, melanin, erythema and hydration, respectively, which were potentially prevented by sunscreen application. Premature aging is inhibited by following photoprotective regimen on routine basis, emphasizing the potential benefit of sunscreen against early aging signs.