Tropical Journal of Pharmaceutical Research

Bergamot regulates oxidized low density lipoprotein induced inflammation and foam cell formation of human umbilical vein endothelial cells by regulating SIRT1/NF κB pathway

Fan Zhao — 2024-04-14

Purpose: To investigate the effects of bergamot (BGM) on the progression of atherosclerosis, and to unravel the mechanism of action.

Methods: Oxidized low-density lipoprotein (Ox-LDL)-induced HUVECs were used as an in vitro model of atherosclerosis. CCK-8, flow cytometry (FCM), and enzyme-linked Immunosorbent assay (ELISA) assays were performed to confirm the effects of BGM on the viability and inflammation of ox-LDL-induced HUVECs. Oil-red staining and immunoblot tests were conducted to determine the effects of BGM on foam cell formation and macrophage polarization. Furthermore, The mechanism of action of BGM was examined by immunoblot studies.

Results: BGM alleviated the ox-LDL-stimulated decline in HUVEC cell viability, and the ox-LDL-stimulated HUVEC inflammation, but inhibited ox-LDL-stimulated foam cell formation and macrophage polarization in vitro (p < 0.05). In addition, BGM regulated SIRT1/NF-κB pathway, thereby alleviating atherosclerosis (p < 0.05).

Conclusion: BGM regulates OX-LDL-induced inflammation and foam cell formation of HUVECs by mediating SIRT1/NF-κB pathway, and therefore can potentially serve as a drug for the treatment of atherosclerosis.

In vitro cytotoxic activity of Sansevieria trifasciata against various cancer cell lines

Sheryar Afzal — 2024-04-14

Purpose: To determine the in vitro anticancer properties of Sansevieria trifasciata extracts.

Methods: The cytotoxic activity of n-hexane, ethyl acetate and methanol leaf extracts at different concentrations was assessed against Vero, pancreatic (AsPC-1), lung (A549), esophageal squamous carcinoma (KYSE 150) and rhabdomyosarcoma (RD) cancer cell lines using MTT assay. The apoptosis-inducing potential of selected S. trifasciata leaf extract was determined using a caspase 3/7 assay kit.

Results: Ethyl acetate extract of S. trifasciata leaf showed significant anticancer activity against RD cells and methanol extract against KYSE cells (p < 0.05). Ethyl acetate and methanol extract possessed higher toxicity towards RD and KYSE 150 cell lines and exhibited relatively lower toxicity towards Vero normal cells. Ethyl acetate extract-treated RD cells and KYSE 150 cancer cells had more typical apoptotic morphologic features when compared to normal cells.

Conclusion: Sansevieria trifasciata possesses anticancer activity and provides new insights for future molecular work on investigating its utilization in cancer treatment.

Acute toxicity, antidiarrheal and antisecretory properties of methanol extract of Lavandula stoechas L aerial part in mice

Fatima Benchikh — 2024-04-14

Purpose: To determine the polyphenol content of the methanol extract (ME) of Lavandula stoechas L. aerial part and its anti-diarrheal and antisecretory activities in mice.

Method: Methanol was used to extract the plant's powder. Spectrophotometric techniques were employed to determine the extract's total phenol, flavonoid and tannin content. The effect of the extract on secretion and diarrhea at three concentrations (50, 250 and 500 mg/kg) was evaluated by castor oil method. The extract was administered to the rats orally and loperamide at a dose of 5 mg/kg served as reference drug. Acute toxicity of two single doses (2 and 5 g/kg) of the plant extract was determined using OECD method.

Results: Pretreatment of mice with ME (50, 250 and 500 mg/kg) caused a dose-dependent and significant (p ≤ 0.001) delay in onset of diarrhea. Inhibition of mass intestinal content at the highest dose reached 74.75 ± 4.45 % compared to the reference drug, loperamide (85.82 ± 4.7 %). Inhibition of defecation increased in a significant (p ≤ 0.001) and dose-dependent manner with the most remarkable inhibition at the highest dose (53.73 ± 2.98 %), which was very close to that of loperamide (59.62 ± 1.57 %).

Conclusion: The methanol extract of Lavandula stoechas is high in polyphenols and significantly and dose-dependently inhibits intestinal secretion as well as diarrhea in mice. The extract is safe. This provides a plausible scientific basis for the traditional use of the plant to treat diarrhea. Studies in humans is needed to determine the compound's active ingredient(s) responsible for the anti-diarrheal effect and also to elucidate its mechanism of action.

Baphia nitida ethanol leaf extract restores haematological and biochemical status in P lasmodium berghei passaged rats

Chinelo Chinenye Nkwocha — 2024-04-14

Purpose: To investigate the effect of Baphia nitida ethanol leaf extract (BNELE) on heamatological and biochemical indices in Plasmodium berghei-infected mice.

Methods: A total of thirty (30) male mice were divided into 6 groups comprising of 5 mice each. Group 1 was normal control, group 2 positive control, group 3 standard group while groups 4 - 6 received 200, 400 and 600 mg/kg of BNELE, respectively. Phytochemical analysis and antimalaria effect of BNELE were investigated using standard methods. Biochemical and haematological parameters of Plasmodium berghei - infected mice given various BNELE dosages were measured using standard techniques.

Results: At increasing doses (200, 400, and 600 mg/kg), BNELE produced 63.16, 39.50 and 52.86 % inhibition of parasitemia in P. berghei-passaged mice, respectively, comparable to 43.75 % by 80 mg/kg artemether, a first-line anti-malarial medication. There was significant increase in red blood cell (RBC), packed cell volume (PCV), white blood cell (WBC) and hemoglobulin (HB) in mice administered varying doses of BNELE compared with those in group 2 (p < 0.05).

Conclusion: Baphia nitida ethanol leaf extract possesses antiplasmodial properties and aids the restoration of normal haematological and biochemical states in P. berghei-infected mice. However, further and more extensive in vivo studies to ascertain it full antimalarial potentials.

Investigating the underlying mechanisms of Wuling powder in the management of hyperuricemia based on network pharmacology and molecular docking

Yu Pu — 2024-04-14

Purpose: To investigate the potential targets and mechanisms of Wuling powder in the treatment of hyperuricemia.

Methods: Traditional Chinese Medicine Systems Pharmacy and Analysis Platform (TCMSP) database was used to obtain active compounds and potential targets of Wuling powder. Gene Cards database was searched for hyperuricemia-related targets. Protein interaction networks (PPI) based on intersection targets were created to investigate the relationship between components and disease. Gene ontology (GO), Kyoto gene and genome database (KEGG), and pathway enrichment analysis of intersection targets were performed on the DAVID website to investigate distributed pathways of targets, Using AutoDockTools 1.5.6 software, a molecular docking analysis of core active compounds and core targets was performed to investigate binding status.

Results : The study produced 88 active compounds and 598 action targets, including 10 core components and 4 core targets. Targets were mostly enriched in biological processes like apoptosis, protein synthesis, and energy metabolism, all of which were linked to cancer pathways, PI3K-Akt, human cytomegalovirus infection, lipid, atherosclerosis and other signaling pathways. During molecular docking of core components and core targets, favorable binding interactions were observed.

Conclusion: The therapeutic potential of Wuling powder against hyperuricemia is achieved by modulating critical biological processes like lipid metabolism, inflammatory responses, and cell apoptosis through a multi-component, multi-target, and multi-pathway approach. This study provides a foundational framework and novel insight for further in-depth investigation into the role of Wuling powder in hyperuricemia treatment.

A study on the mechanism of cordycepin in regulating autophagy and alleviating renal tubular interstitial fibrosis

Ke Sun — 2024-04-14

Purpose: To elucidate the role of cordycepin in modulating autophagy and mitigating renal tubular interstitial fibrosis in a rat model of unilateral ureteral obstruction (UUO).

Methods: Forty male Sprague-Dawley (SD) rats were assigned to four groups: control, sham, UUO and cordyceps-treated groups (10 rats per group). The UUO and cordyceps groups underwent surgery to induce unilateral ureteral obstruction. The cordyceps group received intravenous cordycepin (10 mg/kg) daily for 14 days, while the control and UUO groups received normal saline. Histopathological examination, assessment of fibrosis markers (α-SMA, collagen III) and autophagy markers (Atg5, LC3II/I) were conducted.

Results: The UUO group exhibited significant tubular damage and interstitial fibrosis, with elevated serum levels of pro-inflammatory and oxidative markers (p < 0.05). Cordycepin treatment attenuated these pathological changes, evidenced by reduced fibrosis, inflammation and oxidative stress. Enhanced autophagic activity was observed in the cordycepin group, suggesting a potential mechanism of its renoprotective effect.

Conclusion: Cordyceps is effective in inhibiting renal tubulointerstitial fibrosis, potentially through the activation of autophagy and reduction of inflammation and oxidative stress. Future studies should focus on unraveling the specific molecular mechanisms of cordycepin's action and assessing its applicability in CKD treatment.

Protective effect of remimazolam on neuronal cells from OGD/R induced damage: An in vitro study

Xianwen Wan — 2024-04-14

Purpose: To investigate the effect of remimazolam (Re) on oxygen glucose deprivation/reoxygenation (OGD/R) model, and to elucidate the mechanism of action.

Methods: The neuron cells were treated with OGD/R. MTT assays were performed to confirm The effect of Re on cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, while flow cytometry (FCM) assay was conducted to determine the apoptosis of OGD/R cells. Immunostaining assay and enzyme-linked immunosorbent assay (ELISA) were used to evaluate the effects of Re on mitochondria damage, while immunoblot assay was used unravel its mechanism of action.

Results: Remimazolam (Re) significantly enhanced OGD/R-induced neuronal survival (p < 0.05). In addition, it significantly inhibited OGD/R-induced neuronal apoptosis, and OGD/R-induced neuron mitochondrial damage. Furthermore, it suppressed MAPK pathway in OGD/R-induced neuron, thus protecting the neuronal cells from OGD/R-induced damage (p < 0.05).

Conclusion: Remimazolam protects neuronal cells from OGD/R-induced damage by mediating MAPK pathway. Therefore, it is a potential drug for the management of Ischemia-reperfusion injury (IRI). However, in vivo studies are required to buttress this.

RAPD PCR genotyping of Enterococcus faecium isolated from urinary tract infection and correlation between biofilm formation with antibiotic resistance and virulence genes

Roya Jafavzadeh Samani — 2024-04-14

Purpose: To examine the occurrence of virulence factors in Enterococcus faecium strains isolated from urinary tract infections (UTIs) and perform genotyping of the isolated strains using RAPD-PCR.

Method: A total of seventy-five (75) E. faecium strains isolated from UTIs underwent molecular and biochemical testing for verification. Sensitivity testing and identification of virulence factors were conducted using antimicrobial tests.

Results: Enterococcus faecium was detected in 53.57 % (75 out of 140) of urine samples in individuals suspected of having urinary tract infections. Additionally, all isolated strains demonstrated the ability to produce biofilm, with biofilm reactions observed in every E. faecium isolate. The strains exhibited either a strong (80 %), moderate (13.33 %) or weak (6.67 %) biofilm reaction. The highest antibiotic resistance in E. fascium isolates was related to penicillin and cotrimoxazole (83.33 and 80 %, respectively) while the lowest resistance was related to nitrofurantoin (26.67 %). The ebp C and ebp B were reported at 93.33 and 92 %, respectively, for E. faecium. The prevalence of ccf, cpd, cob and ebpA in E. fascium isolates was reported at 6.66, 13.33, 6.66, and 86.66 %, respectively. The RAPD-PCR analysis revealed the presence of 20 distinct molecular clusters, determined based on a similarity threshold of over 80 %.

Conclusion: This study demonstrates the spread of multidrug-resistant E. faecium strains isolated from urinary tract infections (UTI). Being a quick and cost-effective method, RAPD typing has been used to show clonal relatedness and to trace possible sources of organisms for epidemiological purposes.

Effect of competitive flow and diltiazem on postoperative hemodynamics and long term patency rate after coronary artery bypass grafting

Feng Cong — 2024-04-14

Purpose: To determine the effect of competitive flow and diltiazem on postoperative hemodynamics and long-term patency rate in patients undergoing coronary artery bypass grafting (CABG).

Methods: A retrospective analysis was performed on the clinical records of 98 patients who underwent CABG at Qilu Hospital of Shandong University from March 2018 to September 2020. Among them, 47 patients who underwent CABG alone were assigned to control group, while 51 patients who received additional diltiazem were assigned to study group. The severity of coronary artery stenosis (CAS) was evaluated through preoperative coronary angiography, and bridge vessel flow compared between severe stenosis and non-severe stenosis groups. Changes in hemodynamic parameters between two groups were compared before surgery, as well as 12 and 24 h after surgery.

Results: A significantly higher bridge vessel blood flow was found in severe stenosis group compared to non-severe stenosis group (p < 0.05). The CAS severity and bridge vessel blood flow revealed an inverse relationship (r = - 0.792, p < 0.001). At 12 and 24 h post-surgery, the study group exhibited significantly lower central venous pressure (CVP), heart rate (HR) and mean arterial pressure (MAP) than the control group (p < 0.05). There was no significant difference in adverse cardiovascular effects (ACEs), between the two groups after 12 months (p > 0.05). Similarly, there was no significant difference in graft patency rate, mild stenosis rate, severe stenosis rate, complete occlusion rate, and linear signs rate 12 months post-operation (p > 0.05). However, the patency rate was significantly higher in cases with severe stenosis (p < 0.05).

Conclusion: Postoperative administration of diltiazem in patients undergoing CABG improves systemic hemodynamic parameters. However, competitive blood flow may potentially decrease the long-term patency rate of bridge vessels in patients.

A clinical study on the efficacy of modified Sangsu Guiling Decoction in the treatment of pulmonary hypertension due to left sided heart disease

Zhenhua Gu — 2024-04-14

Purpose: To evaluate the efficacy/effectiveness of modified Sangsu Guiling Decoction (SSGD) formula when used in combination with standard Western medicine in the treatment of pulmonary hypertension caused by left-sided heart disease (PH-LHD).

Methods: A randomized controlled study was carried out on 60 PH-LHD patients recruited from Changzhou Traditional Chinese Medicine Hospital. The patients were randomly assigned to 2 groups, each with 30 subjects. The conventional Western medicine treatment for the control group comprised oral intake of 5 mg of andrisentan daily, 0.5 g of amoxicillin capsules every 6 to 8 h (for the patients who had infections, with daily dose not exceeding 4 g); 2.5 mg of enalapril, once daily, and 25 mg of metoprolol, twice daily. The study group received 400 mL of the modified SSGD formula in soup form, in addition to the conventional Western medicine therapy. The treatments lasted three months. In both groups, Traditional Chinese Medicine (TCM) symptom scoring, 6-minute walk test (6MWT), WHO functional classification, echocardiography, and assay of biochemical indicators were carried out, both before and after the 3-month treatment course.

Results: After 3-month treatments, there were significant improvements in the study group (p < 0.05) in terms of clinical symptom scores, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), left ventricular ejection fraction (LVEF), 6MWT distance, systolic pulmonary artery pressure (sPAP), WHO functional classification, and soluble suppression of tumorigenesis-2 (sST2) levels, relative to the control group (p < 0.05).

Conclusion: The combined use of modified SSGD formula and standard Western medicine improves the conditions of PH-LHD patients, enhances physical endurance, and reduces pulmonary systolic pressure. The combination treatment also mitigates inflammatory response, and minimizes the adverse effects caused by TCM, resulting in the enhancement of overall quality of life. Subsequent studies should involve long-term follow-up in order to determine the long-term effects of treatment.

Calcium dobesilate combined with candesartan in the treatment of proliferative diabetic retinopathy and its effect on TGF b1, VEGF and IL 19 levels in the vitreous humor

Hongying Ji — 2024-04-14

Purpose: To investigate the efficacy of a combination therapy involving calcium dobesilate and candesartan in the treatment of proliferative diabetic retinopathy and its impact on the transforming growth factor b1 (TGF-b1), vascular endothelial growth factor (VEGF) and interleukin-19 (IL-19) levels in the vitreous humor.

Methods: Between January 2020 and May 2023, 112 patients with proliferative diabetic retinopathy from Handan City Eye Hospital, China were enrolled in this study. They were divided into two groups: study group (n = 56) - orally administered 500 mg of calcium dobesilate combined with 50 mg of candesartan daily - and control group (n = 56), received calcium dobesilate only. Patients began treatment with calcium dobesilate and candesartan as soon as diabetic retinopathy was diagnosed. Treatment efficacy, changes in hemorrhage area, macular thickness and best-corrected visual acuity were assessed before and after treatment (for a duration of 60 days).

Results: Study group had significantly higher (p < 0.05) treatment efficacy compared to control group, achieving a total effective rate of 92.86 %. It also exhibited reduced hemorrhage area and macular thickness, which were significantly lower (p < 0.05) than those in control group. Best-corrected visual acuity was significantly higher in the study group (p < 0.05) followed by improved peak systolic velocity and end-diastolic velocity after treatment (p < 0.05). Additionally, TGF-b1, VEGF and IL-19 levels in the vitreous humor were significantly lower in study group compared to control group (p < 0.05).

Conclusion: The combination of calcium dobesilate and candesartan demonstrates significant therapeutic efficacy in treating proliferative diabetic retinopathy while reducing the TGF-b1, VEGF and IL-19 levels in the vitreous humor. Large-scale studies are needed to validate these findings and delve into treatment mechanisms and long-term effects.

Effect of dapagliflozin on metabolic disorders, β islets cell function and serum protein expressions in patients with type 2 diabetes mellitus

Guifang Ji — 2024-04-14

Purpose: To investigate the effect of dapagliflozin on metabolic disorders, pancreatic islets β-cell function and serum protein expressions in patients with type 2 diabetes mellitus (T2DM).

Methods: One hundred patients with T2DM in Qinghai University Affiliated Hospital, Xining, China from June 2022 to March 2023 were selected and randomly divided into control and study groups, with 50 patients in each group. Patients in control group received basic treatment (instruction to control diet intake), while patients in study group received dapagliflozin (10 mg/day) for 6 weeks, plus basic treatment. Pre and post-treatment physical examination, blood glucose and blood lipid parameters were determined. Furthermore, hemoglobin A1c (HbA1c) level was measured with enzyme-linked immunosorbent assay (ELISA) kits while serological indices were determined using radioimmunoassay.

Results : Post-treatment levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h BG), lipid levels, and GLP 1 levels in the two groups were significantly lower than pre-treatment levels (p < 0.05), but the levels in study group were significantly lower than those in control group (p < 0.05). Moreover, HbA1c level of study group was significantly lower than that of control group (p < 0.05). After treatment, waist circumference, body mass index (BMI) and body mass of the two groups were significantly lower than pretreatment values, with study group having significantly lower values than control group (p < 0.05).

Conclusion: Dapagliflozin is effective in the treatment of patients with T2DM, as it significantly improves pancreatic islets β-cell function, blood glucose and lipid metabolism, and reduces body weight. Future studies using larger sample size and diverse study centers are recommended prior to application in clinical practice.

Application of combined erlotinib and bronchoscopic interventional therapy in the treatment of bronchial lung cancer

Ting Jiang — 2024-04-14

Purpose: To evaluate the efficacy of combined drug therapy and bronchoscopy intervention in the treatment of bronchial lung cancer.

Methods: A total of 80 patients with bronchial lung cancer admitted in The Third People's Hospital of Xindu District, Chengdu, China were enrolled and assigned in control and study groups (n = 40), and received bronchoscopy intervention alone and combined bronchoscopy intervention/erlotinib therapy, respectively, over a period of 4 weeks. Erlotinib therapy was given by oral administration of 150 mg once daily. Efficacy, levels of serum tumor marker, matrix metalloproteinase (MMP) content, and incidence of adverse reactions in the two groups of patients were evaluated.

Results: The overall response rate (ORR) in the study group was significantly higher than that of the control group (27.5 vs 55.0 %, p < 0.05). Carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and neuron-specific enolase (NSE) decreased significantly after treatment, when compared to the control group (p < 0.05). Furthermore, after treatment, matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) levels in the study group were lower than in the control group (p < 0.05). The incidence of adverse reactions was 12.5 and 17.5 % in the control and study groups, respective (p > 0.05).

Conclusion: The combination of erlotinib therapy and bronchoscopy intervention significantly improves therapeutic efficacy, as well as serum tumor marker and MMP levels in bronchial lung cancer patients. Furthermore, it is safe as it does not significantly increase the risk of adverse reactions. However, further and broader clinical trials are recommended prior to its application in clinical practice.

Effect of continuous blood purification combined with reduced glutathione on endotoxin, inflammatory mediators and severity of liver injury in patients with septic shock

Run Liu — 2024-04-14

Purpose: To investigate the impact of continuous blood purification in conjunction with reduced glutathione on endotoxin levels, inflammatory mediators and the severity of liver injury in septic shock patients.

Methods: A cohort of 100 septic shock patients admitted at The Second Affiliated Hospital of Hainan Medical University, China between May 2020 and May 2023 were enrolled in this study. They were randomly divided into study and control groups, each comprising 50 patients. Both groups received standard interventions. In addition, control group underwent continuous blood purification, while study group received reduced glutathione therapy for two weeks. Acute physiology score + age point + chronic health point (APACHE II) and sequential organ failure assessment (SOFA) scores, intensive care unit (ICU) and mechanical ventilation duration, oxygenation levels, 28-day mortality, organ injury, serum endotoxin levels, inflammatory markers, as well as serum aspartate aminotransferase (AST) and glutamate aminotransferase (ALT) levels were determined before and after treatment. Adverse events during treatment were documented.

Results: Both groups exhibited a significant decrease in APACHE II and SOFA scores, with greater decreases observed in study group (p < 0.05). The study group had shorter ICU stays and mechanical ventilation durations. The groups had no significant differences in 28-day mortality or organ injury (p > 0.05). Study group demonstrated significantly lower levels of endotoxin, tumor necrosis factor (TNF-α), procalcitoninogen (PCT), ALT and AST in comparison to control group (p < 0.05). Adverse reactions were similar between the two groups (p > 0.05).

Conclusion: Combining continuous blood purification with reduced glutathione therapy reduces endotoxin and inflammatory mediator levels, mitigates liver injury and supports patient recovery in septic shock, with a favorable safety profile. Future studies to accommodate the diverse profiles of septic shock patients from multiple centers will be needed to validate the outcomes of this study.

Effect of the combined use of docetaxel, cisplatin and apatinib mesylate on serum tumor markers and prognosis in advanced ovarian cancer patients

Miao Shen — 2024-04-14

Purpose: To examine the impact of combining docetaxel and cisplatin injections with apatinib mesylate tablets on serum tumor markers and prognosis of advanced ovarian cancer patients.

Methods: A total of 121 advanced ovarian cancer patients admitted to Jiande First People's Hospital, Jiande, China between June 2014 and December 2022 were enrolled in this study. Of these, 59 patients treated solely with docetaxel and cisplatin injections comprised control group while 62 patients who received apatinib mesylate tablets in conjunction with docetaxel and cisplatin injections formed the study group. Serum tumor marker levels, serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) levels in peripheral venous blood were evaluated. Furthermore, improvements in ascites, efficacy, incidence of adverse reactions, Karnofsky Performance Status (KPS) scores and quality of life (QoL) scores were recorded. The Kaplan-Meier method was implemented for survival analysis.

Results: After chemotherapy, serum tumor markers (CEA, CA199, CA125, CA153), VEGF and MMP-2 significantly decreased from pre-chemotherapy levels. The study group showed greater reduction than control group (p < 0.05), and also exhibited superior abdominal effusion treatment efficacy and overall effectiveness (p < 0.05). Adverse reactions were rarer in the study group (p < 0.05). The study group's KPS and QoL scores after chemotherapy exceeded those of the control group, with regard to baseline improvement (p < 0.05). Additionally, the study group had a higher 3-year survival rate (p < 0.05).

Conclusion: Although docetaxel and cisplatin injections exhibit significant efficacy in managing advanced ovarian cancer, the adjunctive use of apatinib mesylate tablets augments the efficacy and offers superior safety as well, rendering the combination a potential strategy for improved management of advanced ovarian cancer.

Prevention of stress related mucosal damage using intravenous omeprazole

Tiefeng Sun — 2024-04-14

Purpose: To evaluate the effect of using intravenous injection of omeprazole to prevent stress-related mucosal damage (SRMD) in critically ill patients.

Methods: 80 critically ill patients from the Eighth People's Hospital of Qingdao, Qingdao, China were recruited and randomly divided into control and study groups comprising 40 patients each. Control group received conventional symptomatic treatment comprising nutritional support, acid-base balance regulation, electrolyte level monitoring and correction, maintenance of fluid and electrolyte equilibrium, respiratory function management, and anti-infection measures. Study group received intravenous injection of omeprazole (20 mg/day) and conventional symptomatic treatment for 3 months. Treatment effect, gastric pH, and gastroscopic observation of the two groups of patients were recorded.

Results: The study group demonstrated significantly higher treatment efficacy (97.5 %) compared to control group (80 %, p < 0.05). Pre-treatment gastric pH did not differ significantly between the groups (p > 0.05). After treatment, the study group exhibited significantly higher pH levels (p < 0.05). Normal endoscopic findings increased to 85 % in the study group compared to 20 % in control group (p < 0.05).

Conclusion: Intravenous omeprazole significantly prevents SRMD in critically ill patients, improves gastric pH regulation and reduces abnormal endoscopic findings. Larger-scale, multicenter, and long-term studies are needed to validate the findings of this study.

Effects of path based oral care combined with compound chlorhexidine gargle on oral hygiene, comfort and intubation related complications in ICU patients undergoing tracheal intubation

Ying Wang — 2024-04-14

Purpose: To assess the effect of path-based oral care combined with compound chlorhexidine gargle on oral hygiene, comfort and intubation-related complications in patients in intensive care unit (ICU) undergoing tracheal intubation.

Methods: One hundred and fifty intensive care unit patients receiving tracheal intubation at Shanghai East Hospital ICU, Shanghai, China were split into study group (routine chlorhexidine gargle 0.2 % with additional path-based oral care) and control group (routine chlorhexidine gargle 0.2 %). This approach was evaluated for its impact on intubation-related complications. Oral health and care effects were assessed before and after a 14-day nursing period. Comparisons were made between the groups for oral cleanliness, mucosa state and odontopathy, Beck and VAS scores, oral odor, inflammation proportions, and post-nursing complications.

Results: Before nursing, there was no significant difference in oral health status and oral care between the two groups (p > 0.05). However, after nursing, scores of oral health status and indices increased and decreased in both groups, respectively. The scores for oral health status in the study group were significantly higher than those in control group, while the scores of the oral study indices were significantly lower than those in control group (p < 0.05). After nursing, however, the proportions of patients with oral odor and oral inflammation and the incidence of intubation-related complications in the study group were lower than those in the control group (p < 0.05).

Conclusion: Path-based oral care combined with compound chlorhexidine gargle improves oral care effect and comfort, and reduces the incidence of intubation-related complications in ICU patients undergoing tracheal intubation. This study will need to be conducted in a larger population in the future to validate these findings.

Neodymium yttrium aluminum garnet (Nd: YAG) laser vitreolysis versus oral iodized lecithin tablets for the management of symptomatic vitreous opacities

Mochi Yang — 2024-04-14

Purpose: To evaluate the comparative therapeutic effectiveness and safety of neodymium-yttrium aluminum garnet (Nd: YAG) laser vitreolysis and oral iodized lecithin tablets in treating symptomatic vitreous opacities caused by posterior vitreous detachment.

Methods: 111 patients admitted to the General Hospital of Ningxia Medical University China were enrolled and randomly assigned to study and control groups. The study group comprised 56 patients (58 eyes) undergoing YAG laser treatment while control group comprised 55 patients (60 eyes) taking oral iodized lecithin tablets. Visual acuity, contrast sensitivity, intraocular pressure (IOP), macular central fovea thickness, retinal nerve fiber layer thickness, efficacy rates, and vitreous opacity scores were assessed in both groups before and after treatment, with follow-up at intervals.

Results: No significant changes were seen in best-corrected visual acuity (BCVA) and intraocular pressure (IOP) within or between groups after treatment. Contrast sensitivity in the study group improved significantly (p < 0.05), while control group showed no improvement. The study group also exhibited significantly higher post-treatment contrast sensitivity compared to control group (p < 0.05). Furthermore, laser group displayed a significantly higher effectiveness in subjective scores (p < 0.01), while objective vitreous opacity scores differed significantly before and after treatment in both groups (p < 0.01), with intergroup differences also significant (p < 0.01). Furthermore, the study group reported better subjective outcomes and objective vitreous opacity scores after treatment (p < 0.01). There were no significant adverse reactions in either group.

Conclusion: The findings show that Nd: YAG laser vitreolysis demonstrates superior efficacy compared to oral iodized lecithin tablets for treating symptomatic vitreous opacities, with no significant adverse effects. Future studies should employ a larger sample size with long-follow-up periods

Efficacy and safety of Tian-teng decoction in treating hypertensive emergency

Pengying Yin — 2024-04-14

Purpose: To investigate the efficacy and safety of the traditional Chinese herbal formula (Tian-Teng Decoction) for the treatment of patients with hypertensive emergency.

Methods: 120 patients with hypertensive emergency who were treated in Hebei Provincial Hospital of Traditional Chinese Medicine between July 2021 and December 2022 were equally and randomly divided into study and control groups. Patients in the study group received orally Tian-Teng decoction (300 mL divided into two portions administered morning and evening for 2 weeks), while control group received only conventional treatment (sublingual captopril at 12.5 mg twice daily for 2 weeks). Symptoms improvement, changes in blood pressure, onset time, laboratory indicators, clinical manifestations, and adverse reactions were recorded.

Results: The study group exhibited significant decrease in blood pressure 30 min after medication (p < 0.05). Systolic and diastolic blood pressures were significantly lower in the study group compared to control group at 1, 2, and 3 h after medication. Nitric oxide (NO) was significantly higher, while angiotensin II (Ang Ⅱ), insulin-like growth factor-1 (IGF-1), angiotensin-converting enzyme (ACE), traditional Chinese medicine syndrome scores, and the incidence of adverse reactions were significantly lower in study group compared to control group (p < 0.05).

Conclusion: Tian-Teng Decoction demonstrates good efficacy and safety in the treatment of hypertensive emergency. Future studies that incorporate a larger sample size and prolonged observation period to validate the findings of this study are recommended.

Safety and tolerability of moxifloxacin in pediatric population: A systematic review of evidence based practice

Mohammed Kanan Alshammari — 2024-04-14

Purpose: To evaluate the adverse events (AEs) associated with moxifloxacin (MFX) use in children below the age of 18 years.

Methods: This review was performed in conformity with the preferred items for systematic reviews and meta-analysis (PRISMA) guidelines using different databases. Articles meeting the inclusion criteria were screened and the studies were selected for the qualitative synthesis.

Results: A total of 21 studies were included in the systematic review. Among these, 7 retrospective cohort studies, 6 case reports, 3 prospective cohort studies, 2 randomized clinical trials (RCT) and the remainder utilized other methodologies. The variability in studies allowed for an assessment of the safety and tolerability of both short-term and long-term MFX administration in pediatric patients.

Conclusion: Although MFX use is associated with AEs, the majority were mild and resolved on their own. The reason for QTc prolongation and elevated liver enzymes remain a question for clinicians in prescribing MFX in pediatric patients.

Challenges in chemotherapy induced nausea and vomiting (CINV) management: A systematic review

Nurul Suhaida Badarudin — 2024-04-14

Purpose: To systematically evaluate evidence regarding the barriers and challenges associated with chemotherapy-induced nausea and vomiting (CINV).

Methods: The databases Pubmed, Ovid, Scopus, Cochrane Library, Wiley Online, and Web of Science were searched using the following keywords: challenges, prevention, CINV, chemotherapy and their corresponding alternative keywords. This review included all studies involving adult cancer patients receiving chemotherapy exclusively, the caretaker, and healthcare professionals handling cancer patients, without geographical restriction. The articles used were in English language and were original primary studies. The data extraction form was developed based on PRISMA guide. The Joanna Briggs Institute (JBI) Critical Appraisal tool was used to assess the quality of the studies.

Results: From 1,170 related articles retrieved, 38 were included in this review of which 9 articles were from European countries while 7 were from the United States of America. All articles met the criterion of the JBI critical appraisal. The reviews indicated that the barriers and challenges reported in the management of CINV would include failure to adhere to the antiemetic guideline, misconception about CINV and its prevention, and nausea and delayed CINV.

Conclusion: Interventions such as enhancing nausea and delayed vomiting control, raising awareness of antiemetic guidelines among healthcare professionals, and dispelling misconceptions need to be planned and implemented to overcome the barriers and challenges and improve the quality of CINV management.