Prevalence and Factors Influencing Use of Herbal Medicines During Pregnancy in Hail, Saudi Arabia: A cross-sectional study

Objectives: The increasing prevalence of herbal medicine use is a global public health concern. Critically, many women continue to use herbal medicines during pregnancy despite potential maternofetal risks. The current study aimed to determine the prevalence of and factors associated with herbal medicine use during pregnancy in Saudi Arabia. Methods: This cross-sectional study was conducted between February and May 2017. An Arabic-language 33-item survey assessing herbal medicine use was designed and distributed to 879 random women attending outpatient clinics at governmental and private hospitals in Hail, Saudi Arabia. Only women who were pregnant or had been pregnant in the previous 10 years were included. Results: The mean age of the participants was 29.5 years, with 49% under 30 years old. Overall, 33% of the respondents claimed to have used herbal medicines during pregnancy. The most common reasons for doing so were to improve lactation (73%), improve the course of the pregnancy (56%) and facilitate labour (49%). Women who worked full-time and those with high school diplomas or above were significantly more likely to use herbal medicines during pregnancy (P <0.001 each). Conclusion: To the best of the authors’ knowledge, this is the first study to determine the prevalence and associated factors of herbal medicine use during pregnancy in Hail. The results showed a high prevalence of herbal medicine use among pregnant women in the region. Healthcare providers should therefore ensure that patients disclose the use of herbal medicines during pregnancy to avoid treatment complications or adverse herb-drug interactions.Keywords: Herbal Medicine; Plant Preparations; Pregnancy; Complementary Therapies; Health Behaviors; Prevalence; Herb-Drug Interactions; Saudi Arabia

Metformin: A stroke of luck

http://www.ejgm.co.uk/Metformin-A-stroke-of-luck,108679,0,2.htmlMetformin is an oral glucose-lowering drug that has been widely used for more than half a century. Both the American Diabetes Association and the European Association for the study of Diabetes recommend metformin as the first line therapy for the treatment of type II diabetes mellitus. Metformin has considerably evolved from being an antidiabetic into a drug with a wider potential of therapeutic uses such as anticancer, antiaging, treatment of gestational hypertension, preeclampsia and weight loss. In addition to the in-label use of metformin as an anti-hyperglycemic medication, it is widely prescribed as an off label therapy for young women with Poly Cystic Ovary Syndrome for the treatment of symptoms associated with the disorder. This article is a brief summary that lists and briefly discusses current and potential non-hyperglycemic uses and effects of metformin

Public knowledge, attitude and practice toward diabetes mellitus in Hail region, Saudi Arabia

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643049/Background: There is a rapid increase in the number of people with type II diabetes worldwide with many preventable cases. Diabetes control or prevention is partially influenced by the individual’s knowledge, attitude and practice toward the disease. Objective: The aim of this study was to determine the general public knowledge, attitude and practice toward diabetes in the region of Hail, which is located northern of the Saudi capital. Methodology: This is a cross-sectional study conducted during the period of March 2018 until September 2018. We randomly selected participants over the age of 18 years at different locations. Results: A total of 738 participants (428 females and 310 males) with and an age range of 18–61 years and mean age of 35±12 were surveyed. The majority of the participants, regardless of education levels, residence and employment status showed high knowledge of diabetes (82%) and knew that physical activity can positively affect/prevent diabetes. Participant's age was found to have a significant association with participant's knowledge of diabetes with the ≥35 year old group knew the different types of diabetes (p<0.001) and knew that high carbohydrate consumption can increase the risk of diabetes (p<0.001), but only the younger group <18 year old's identified diabetes as a genetic disorder (p<0.001). Conclusion: The high knowledge of the disease and its risk factors were not truly mirrored in the participant’s attitude and practice toward the disease. Therefore, it is quite essential for the local health authorities to implement awareness programs to improve public attitude and practice toward diabetes

Highly Educated Mother’s Perception of Childhood Vaccination Hesitancy in Kazakhstan: A Thematic Analysis

Background: Vaccine hesitancy among parents directly affects the child’s vaccination status sincethey are the legal decision-makers regarding vaccinating their children. The study aimed to describethe perceptions of highly educated Kazakhstani mothers about childhood vaccination hesitancy.Methods: The study utilized a thematic analysis to explore the mothers’ perceptions. A sample of95 participants comprehensively answered the free-text questions in an online questionnaire fromJanuary to February 2023. The analysis of the free-text responses followed a semantic thematicanalysis approach. The data were coded manually.Results: From the in-depth analysis of the data, 285 initial codes were extracted. The combination ofsimilar meanings and concept codes led to 14 sub-themes and finally yielded four significant themes:misconceptions about childhood vaccination, fear of the effect of vaccine on children, distrust of thehealthcare system, and social learning factors.Conclusion: The perceptions of Kazakh mothers about childhood vaccination hesitancy may leadto behaviors of delaying and refusing some or all childhood vaccines. Therefore, motivational andeducational strategies can be used by healthcare providers to instill trust in parents about childhoodvaccines and their safety and effectiveness

Antiviral activity of gliotoxin, gentian violet and brilliant green against Nipah and Hendra virus in vitro

Background: Using a recently described monolayer assay amenable to high throughput screening format for the identification of potential Nipah virus and Hendra virus antivirals, we have partially screened a low molecular weight compound library (8,000 compounds) directly against live virus infection and identified twenty eight promising lead molecules. Initial single blind screens were conducted with 10 M compound in triplicate with a minimum efficacy of 90% required for lead selection. Lead compounds were then further characterised to determine the median efficacy (IC), cytotoxicity (CC) and the in vitro therapeutic index in live virus and pseudotype assay formats. Results: While a number of leads were identified, the current work describes three commercially available compounds: brilliant green, gentian violet and gliotoxin, identified as having potent antiviral activity against Nipah and Hendra virus. Similar efficacy was observed against pseudotyped Nipah and Hendra virus, vesicular stomatitis virus and human parainfluenza virus type 3 while only gliotoxin inhibited an influenza A virus suggesting a non-specific, broad spectrum activity for this compound. Conclusion: All three of these compounds have been used previously for various aspects of anti-bacterial and anti-fungal therapy and the current results suggest that while unsuitable for internal administration, they may be amenable to topical antiviral applications, or as disinfectants and provide excellent positive controls for future studies

Defining and unpacking the core concepts of pharmacology : A global initiative

The authors acknowledge the contribution of the expert group members who contributed their expertise to the study and Professor Martin Kingsbury for his invaluable guidance on concept mapping.Peer reviewe

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

DEVELOPMENT OF ANTIVIRAL AGENTS FOR THE TREATMENT OF HENDRA AND NIPAH VIRUS INFECTIONS.

Hendra virus (HeV) and Nipah virus (NiV) are emerging pathogens that resulted in previously unrecognised fatal diseases in humans and animals. They belong to a newly formed genus, Henipavirus, in the Paramyxovirdae family; a diverse group of large, enveloped, negative sense RNA viruses that include a number of important human and animal pathogens. HeV first emerged in Australia in 1994, where it fatally infected a horse trainer and a large number of horses with fatal consequences. The initial NiV outbreak occurred in peninsular Malaysia 1998, where it induced severe morbidity and mortality in animals and humans that resulted in the death of more than 100 humans and the culling of more than 1 million pigs. Both HeV and NiV have continued to reemerge causing major disease outbreaks in Australia and Asia, respectively. To date, there is no therapeutic available to either treat or prevent these lethal viral infections, necessitating their classification as biological safety level 4 (BSL4) pathogens and their inclusion as NIAID category C priority pathogens. The high risk of further outbreaks and wider spread of the diseases introduced a high demand for therapeutic entities against the highly pathogenic infections induced by HeV and NiV. The aim of this PhD project was to develop appropriate drug screening methodology to enable the identification of potential antiviral agents for the treatment of henipavirus infections. The main hypothesis of this thesis was that the screening of a large number of compounds against live henipaviruses would result in the identification of potential antiviral agents for the treatment of these deadly infections. To initiate the study, a cell monolayer based assay for rapid quantitation of HeV and NiV infection was developed. Rather than implementing antiviral screening methods using surrogate technologies, a novel high throughput screening (HTS) methodology was developed and deployed to assess the antiviral potential of novel compounds directly against live viruses in a BSL4 laboratory. The newly developed method is the first HTS method reported for use in a BSL4 environment. The results indicated that this approach can significantly reduce lead development time and can also reduce the possibility of false positives. The suitability and sensitivity of the proposed method was further validated and compared using different cell lines. The HTS methodology was used in single blind design to evaluate the antiviral competency of more than 8,000 novel compounds against live HeV and NiV viruses. This screening campaign resulted in the identification of a number of potential antiviral hits capable of inhibiting viral replication in vitro. Almost 300 novel compounds showed more than 50% inhibition of viral replication, 28 compounds showed more than 90% inhibition, of which nine compounds exhibited less than 10% crude cellular toxicity. Some of the 28 novel compounds that displayed more than 90% inhibition of viral replication are commercially available and were described as potential anti- henipavirus antiviral drugs for non systemic usage. Three of the nine hit compounds were selected to participate in the lead optimisation stage, which represents an early key phase of the drug development process. As an alternative strategy for drug development, the newly developed HTS methodology was used to screen several existing therapeutic drugs against live henipaviruses. The selection of the existing therapeutics was based on an earlier determination that disruption of intracellular calcium release resulted in potent antiviral efficacy during the novel drug screening campaign. The screening of the existing therapeutic compounds resulted in the identification of several potential antiviral agents against henipaviruses. These compounds have defined mechanism of actions for which they are licensed for; however, their specific antiviral mechanisms against HeV and NiV are still unknown. The successful establishment of the first HTS drug screening methodology suitable for BSL4 laboratory usage presents a feasible and rapid strategy for identification of potential drugs for the treatment of henipaviruses and possibly other BSL4 pathogens. This thesis presents for the first time, novel potential antiviral compounds as well as existing off-licence therapeutics capable of treating these deadly infections. It also describes a prospective anti-henipavirus antiviral target that may permit the discovery of antiviral drugs that could significantly contribute to the management of these lethal zoonotic pathogens

CLINICAL EVIDENCES ON THE ANTIVIRAL PROPERTIES OF MACROLIDE ANTIBIOTICS IN THE COVID-19 ERA AND BEYOND

Macrolides are a large group of antibiotics characterised by the presence of a macro-lactone ring of variable size. The prototype of macrolide antibiotics, erythromycin was first produced by Streptomyces and associated species more than half a century ago; other related drugs were developed. These drugs have been shown to have several pharmacological properties: in addition to their antibiotic activity, they possess some anti-inflammatory properties and have been also considered against non-bacterial infections. In this review, we analysed the available clinical evidences regarding the potential anti-viral activity of macrolides, by focusing on erythromycin, clarithromycin and azithromycin. Overall, there is no significant evidences so far that macrolides might have a direct benefit on most of viral infections considered in this review (RSV, Influenza, coronaviruses, Ebola and Zika viruses). However, their clinical benefit cannot be ruled out without further and focused clinical studies. Macrolides may improve the clinical course of viral respiratory infections somehow, at least through indirect mechanisms relying on some and variable anti-inflammatory and/or immunomodulatory effects, in addition to their well-known antibacterial activity

Anticancer activity of metformin: a systematic review of the literature

https://www.ncbi.nlm.nih.gov/pubmed/31534778BACKGROUND: The anticancer activity of metformin has been confirmed against several cancer types in vitro and in vivo. However, the underlying mechanisms of metformin in the treatment of cancer are not fully understood. This systematic review aims to discuss the possible anticancer mechanism of action of metformin. METHOD: A search through different databases was conducted, including Medline and EMBASE. RESULTS: A total of 96 articles were identified of which 56 were removed for duplication and 24 were excluded after reviewing the title and abstract. A total of 12 research articles were included that describe different antiproliferative mechanisms that may contribute to the antineoplastic effects of metformin. CONCLUSION: This analysis discussed the potential anticancer activity of metformin and highlighted the importance of AMPK as a potential target for anticancer therapy