13 research outputs found

    Undertreatment of Migraine in the United States – A Population Based Study

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    Migraine is a debilitating chronic disease that affects approximately 36 million of the United States population. The objective of the study is to investigate the prevalence and patient’s socio demographic characteristics associated with under treatment of migraine in the US. ambulatory care settings. A retrospective population-based study was conducted by analyzing a national database from 2010 National Ambulatory Medical Care Survey (NAMCS). The NAMCS is a national probability sample survey conducted annually by the National Center for Health Statistics. All patient visits coded with a diagnosis of migraine were included in the study. A series of weighted descriptive analyses were used to estimate the prevalence of prescription medications recommended in the American Neurology Association latest practice guidelines on migraine. A multivariate logistic regression was conducted to predict the maximum likelihood of migraine pharmacotherapy associated with patient’s socio demographic characteristics. An estimated total of 5.45 million outpatient visits related to migraines occurred in the US. Only 3.08 million visits (56.48%) received at least one migraine prescription. Abortive drugs were prescribed much more than prophylaxis drugs (68.8% vs 31.2%). The results from logistic regression identified patient’s gender (OR=0.164, 95%CI: 0.034 – 0.790), race (OR=0.123, 95%CI: 0.029 – 0.520), and ethnicity (OR=0.075, 95%CI: 0.006 – 0.927) contribute significant impacts on the migraine treatment. The study revealed that under treatment of migraine is a significant problem in the US. Future studies are recommended to explore intervention and educational strategies to ensure physicians are well-informed evidence-based practice guidelines and provide timely and appropriate treatment for people with Migraine

    Anti-Hyperglycaemic Evaluation of <i>Buddleia indica</i> Leaves Using In Vitro, In Vivo and In Silico Studies and Its Correlation with the Major Phytoconstituents

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    Buddleia indica Lam. is an ornamental evergreen shrub with few reports concerning its phytoconstituents and biological activities. Herein, the antihyperglycaemic activity of B. indica leaves methanol extract (BIT) was evaluated for the first time using in vitro and in vivo studies. Molecular modelling was performed for its major phytoconstituents that were further subjected to ADME/TOPAKT (absorption, distribution, metabolism, excretion and toxicity) prediction. BIT revealed considerable reduction in glucose concentration by 9.93% at 50 Όg/mL using 3T3-L1 adipocyte culture. It displayed substantial inhibition versus α-glucosidase and α-amylase with IC50 205.2 and 385.06 Όg/mL, respectively. In vivo antihyperglycaemic activity of BIT and the ethyl acetate fraction (BIE) was performed using streptozotocin-induced diabetes in rat model. BIT and BIE effectively ameliorate oxidative stress markers in addition to reducing serum blood glucose by 56.08 and 54.00%, respectively, and are associated with a substantial increase in serum insulin by 4.1 and 12.7%, respectively. This can be attributed to its richness with polyphenolic compounds comprising flavonoids, phenolic acids, phenyl propanoids and iridoids. Molecular docking showed that verbascoside and kaempferol displayed the highest fitting within human α-amylase (HA) and human α-glucosidase (HG) active sites, respectively. They showed reasonable pharmacokinetic, pharmacodynamic and toxicity properties, as revealed by ADME/TOPKAT study

    Modelling the Cost‐Effectiveness of Statin Therapy in Rheumatoid Arthritis: A Markov‐Cycle Evaluation from National Data Bank for Rheumatic Diseases

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    Objectives Rheumatoid arthritis (RA) affects approximately 1% of the world\u27s population. In the United States, an estimated 1.5 million adults live with RA. Due to the high prevalence of comorbidities among patients with RA, the economic burden of the disease has raised concerns over the past decades. Researchers have increasingly recognized that the treatment strategy should focus on both disease progression and comorbidities management. The study aimed to evaluate the potential long‐term benefits of adjunctive statin therapy in combination with one or more biologic disease‐modifying antirheumatic drugs (DMARDs), versus biologic DMARDs alone, in patients with RA using a decision analytical framework and determined the associated incremental cost‐effectiveness ratios. Methods This study was conducted to determine the cost‐effectiveness of using adjunctive statin therapy in combination with one or more biologic DMARD, versus biologic DMARDs alone, in patients with RA. The study first conducted a secondary data analysis using the National Data Bank between 2003 and 2013 to identify study subjects and parameters used for further decision analysis. Second, a Markov simulation model was developed to assess the long‐term cost‐effectiveness of adjunctive statin therapy. Key findings The findings indicate that the clinical benefits of adjunctive statin therapy in treating RA disease progression resulted in an incremental cost per QALY gain, $36 642/QALY over 10 years, compared to biologic DMARDs alone. Conclusions Given the high costs associated with the management of RA, our study successfully developed a Markov decision model to simulate real‐world treatment processes and provide a fundamental framework for further investigating cost‐effeteness of statin therapy in RA. More importantly, it provides decision‐makers with scientific evidence of clinical and economic evaluation for optimal therapeutic outcomes

    The association of vitamin D deficiency and glucose control among diabetic patients

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    Objective: To evaluate the association between the level of vitamin D and glycemic control among patients with diabetes. Research design and method: We analyzed data collected from NHANES 2003–2006. We included only non-pregnant adult diabetic persons 18 years or older. Participants who had vitamin D level less than 20 ng/ml were considered as having vitamin D deficiency. Participants were considered to have a glucose control if the HbA1c level was less than 7% [53 mmol/L]. We used student’s t test to compare the difference in HbA1c means between people with Diabetes with and without a vitamin D deficiency. We used a multivariate logistic regression model to predict the relationship between glucose control and vitamin D deficiency. We used race/ethnicity, BMI, age, gender, type of diabetic medication used, having health insurance or not, and comorbid conditions (hypertension, anemia, cholesterol, liver disease, and kidney disease) as control variables. Results: The study population included a total of 929 non-institutionalized, non-pregnant, diabetic adult persons. About 57% of patients with diabetes had a vitamin D deficiency. Blacks (non-Hispanic patients) with diabetes had the highest rate of vitamin D deficiency (79%). The unadjusted means of HbA1c were significantly different between diabetic patients with no vitamin D deficiency and those with a vitamin D deficiency (7.06% [54 mmol/L], 7.56 % [59 mmol/L], respectively, P < 0.0001). Multivariate adjustment showed a small but not significant, increase in odds (11%) of having uncontrolled diabetes in patients with a vitamin D deficiency after adjustment for other factors. Conclusion: Vitamin D deficiency is very common in patients with diabetes. We found no significant association between vitamin D level and glycemic control in patients with diabetes after adjustment for control variables. Keywords: Vitamin D deficiency, Diabetes, Glucose control, HbA1

    Silviridoside: A New Triterpene Glycoside from <i>Silene viridiflora</i> with Promising Antioxidant and Enzyme Inhibitory Potential

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    A new triterpene glycoside, silviridoside, was isolated from the aerial parts of Silene viridiflora (Caryophyllaceae) using different chromatographic techniques. The structure of silviridoside was comprehensively elucidated as 3-O-ÎČ-D-galacturonopyranosyl-quillaic acid 28-O-ÎČ-D-glucopyranosyl-(1→2)-[α-L-rhamnopyranosyl-(1→3)]-ÎČ-D-fucopyranosyl ester by one- and two-dimensional nuclear magnetic resonance (NMR) spectroscopy and high-resolution mass spectrometry (HR-MS). Silviridoside showed promising antioxidant activity in different antioxidant assays such as 2,2-diphenyl-1-picrylhydrazyl (DPPH) (2.32 mg TE/g), 2,2â€Č-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) (1.24 mg TE/g), cupric-reducing antioxidant capacity (CUPRAC) (9.59 mg TE/g), ferric-reducing antioxidant power (FRAP) (5.13 mg TE/g), phosphomolybdenum (PHD) (0.28 mmol TE/g), and metal-chelating (MCA) (6.62 mg EDTA/g) assays. It exhibited a good inhibitory potential on acetylcholinesterase (AChE) (2.52 mg GALAE/g), butyrylcholinesterase (BChE) (7.16 mg GALAE/g), α-amylase (0.19 mmol ACAE/g), α-glucosidase (1.21 mmol ACAE/g), and tyrosinase (38.83 mg KAE/g). An in silico evaluation of the pharmacodynamic, pharmacokinetic, and toxicity properties of silviridoside showed that the new compound exhibited reasonable pharmacodynamic and pharmacokinetic properties without any mutagenic effect, but slight toxicity. Thus, it could be concluded that silviridoside could act as a promising lead drug for pharmaceutical and nutraceutical developments to combat oxidative stress and various disorders, but a future optimization is necessary

    Development and Evaluation of Cellulose Derivative and Pectin Based Swellable pH Responsive Hydrogel Network for Controlled Delivery of Cytarabine

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    In the present study, pH-sensitive, biodegradable, and biocompatible Na-CMC/pectin poly(methacrylic acid) hydrogels were synthesized using an aqueous free radical polymerization technique and encapsulated by cytarabine (anti-cancer drug). The aim of the project was to sustain the plasma profile of cytarabine through oral administration. Sodium carboxymethyl cellulose (Na-CMC) and pectin were cross-linked chemically with methacrylic acid (MAA) as a monomer, using methylene bisacrylamide (MBA) as cross-linker and ammonium per sulfate (APS) as an initiator. Prepared hydrogel formulations were characterized for their texture, morphology, cytarabine loading efficiency, compositional and structural properties, thermal nature, stability, swelling response, drug release profile (pH 1.2 and pH 7.4), and in-vivo pharmacokinetic evaluation. Cytarabine-loaded hydrogels were also evaluated for their safety profile by carrying out toxicity studies in rabbits. Results demonstrated efficient encapsulation of cytarabine into the prepared network with loading ranging from 48.5–82.3%. The highest swelling ratio of 39.38 and maximum drug release of 83.29–85.27% were observed at pH 7.4, highlighting the pH responsiveness of the grafted system. Furthermore, cytarabine maximum release was noticed over 24 h, ensuring a sustained release response for all formulations. Histopathological studies and hemolytic profiles confirmed that the prepared hydrogel system was safe, biocompatible, and non-irritant, showing no symptoms of any toxicities and degeneration in organs. Moreover, pharmacokinetic estimation of the cytarabine-loaded hydrogel showed a remarkable increase in the plasma half-life from 4.44 h to 9.24 h and AUC from 22.06 ÎŒg/mL.h to 56.94 ÎŒg/mL.h. This study revealed that the prepared hydrogel carrier system has excellent abilities in delivering the therapeutic moieties in a controlled manner

    Production of a New Cyclic Depsipeptide by the Culture Broth of Staphylococcus sp. Isolated from Corallina officinalis L.

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    A new cyclic depsipeptide (1) has been isolated from culture broth of Staphylococcus sp. (No. P-100826-4-6) derived from Corallina officinalis L., together with the known compounds indol-3-carboxylic acid (2), 1,5-dideoxy-3-C-methyl arabinitol (3), thymine (4), uracil (5), cyclo (L-pro-L-omet) (6) and macrolactin B (7). The structure of (1) was established to be cyclo (2α, 3-diaminopropoinc acid-L-Asn-3-ÎČ-hydroxy-5-methyl-tetradecanoic acid-L-Leu1-L-Asp-L-Val-L-Leu2-L-Leu3) by extensive spectroscopic techniques including1 H NMR,13 C NMR,1 H-1 H COSY, HMBC, HSQC, NOESY, and HRFABMS. The antimicrobial activities of compounds 1?7 were evaluated. Compounds 1?5, and 7 showed moderate antimicrobial activity while compound 6 exhibited a potent antimicrobial and antifungal activities

    Production of a New Cyclic Depsipeptide by the Culture Broth of Staphylococcus sp. Isolated from Corallina officinalis L.

    Get PDF
    A new cyclic depsipeptide (1) has been isolated from culture broth of Staphylococcus sp. (No. P-100826-4-6) derived from Corallina officinalis L., together with the known compounds indol-3-carboxylic acid (2), 1,5-dideoxy-3-C-methyl arabinitol (3), thymine (4), uracil (5), cyclo (L-pro-L-omet) (6) and macrolactin B (7). The structure of (1) was established to be cyclo (2α, 3-diaminopropoinc acid-L-Asn-3-ÎČ-hydroxy-5-methyl-tetradecanoic acid-L-Leu1-L-Asp-L-Val-L-Leu2-L-Leu3) by extensive spectroscopic techniques including1 H NMR,13 C NMR,1 H-1 H COSY, HMBC, HSQC, NOESY, and HRFABMS. The antimicrobial activities of compounds 1–7 were evaluated. Compounds 1–5, and 7 showed moderate antimicrobial activity while compound 6 exhibited a potent antimicrobial and antifungal activities

    Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors

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    Naturally, thiophenes represent a small family of natural metabolites featured by one to five thiophene rings. Numerous plant species belonging to the family Asteraceae commonly produce thiophenes. These metabolites possessed remarkable bioactivities, including antimicrobial, antiviral, anti-inflammatory, larvicidal, antioxidant, insecticidal, cytotoxic, and nematicidal properties. The current review provides an update over the past seven years for the reported natural thiophene derivatives, including their sources, biosynthesis, spectral data, and bioactivities since the last review published in 2015. Additionally, with the help of the SuperPred webserver, an AI (artificial intelligence) tool, the potential drug target for the compounds was predicted. In silico studies were conducted for Cathepsin D with thiophene derivatives, including ADMET (drug absorption/distribution/metabolism/excretion/and toxicity) properties prediction, molecular docking for the binding interaction, and molecular dynamics to evaluate the ligand–target interaction stability under simulated physiological conditions

    Evaluation of Possible Antioxidant, Anti-Hyperglycaemic, Anti-Alzheimer and Anti-Inflammatory Effects of <i>Teucrium polium</i> Aerial Parts (Lamiaceae)

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    Teucrium polium L. is commonly used in folk medicine to treat hypertension and diabetes and to heal wounds. The present work aimed to evaluate the different biological activities of T. polium hydroalcoholic extract, its total phenol and flavonoid content, and its mineral elements. Results showed that T. polium extract showed significant antioxidant potential in 2-diphenyl-1-picrylhydrazyl (DPPH) assay with IC50 equal to 8.68 ÎŒg/mL but with moderate activity in galvinoxyl assay with IC50 of 21.82 ÎŒg/mL and mild activity in the ÎČ-carotene assay. It also showed a pronounced anti-hyperglycemic activity using α-amylase inhibitory assay (IC50 = 111.68 ”g/mL) and exceeds that of acarbose. T. polium showed excellent activity against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) with IC50 values of 28.69 and 4.93 ÎŒg/mL, respectively, postulating its promising anti-Alzheimer potential. The plant extract exhibited a strong anti-inflammatory effect with Bovine Serum Albumin (BSA) denaturation inhibitory potential estimated by 97.53% at 2 mg/mL, which was further confirmed by the in vivo carrageen-induced edema model. The extract revealed its richness in flavonoids and phenols, evidenced by its polyphenols content (36.35 ± 0.294 ÎŒg GAE/mg) and flavonoids (24.30 ± 0.44 ÎŒg QE/mg). It is rich in minerals necessary for human health, such as calcium, potassium, iron, sodium, magnesium, manganese and zinc. Molecular docking performed for previously identified compounds on human α-amylase, 5-lipoxygenase (5-LOX) and acetylcholine esterase confirmed the results. Thus, it can be concluded that T. polium can be a good candidate for alleviating many health-debilitating problems and can be highly beneficial in the pharmaceutical industry and medical research
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