A molecular informatics and in-vitro approach to evaluate the HMG-CoA reductase inhibitory efficacy of monoterpenes, carvacrol and geraniol

Currently, statins, the β-hydroxy-β-methyl-glutaryl-CoA reductase (HMG-R) inhibitors, are widely used to lower cholesterol, nevertheless, they have several side effects. Consequently, the present study is designed to unravel the cardioprotective role of selected natural monoterpenoids (carvacrol and geraniol) via in-vitro targeting and molecular informatics study of HMG-R. Computational molecular informatics study revealed that carvacrol and geraniol efficiently occupies the catalytic site of HMG-R with the binding affinity (ΔG) of −4.60, and −1.99 Kcal/mol, respectively, and molecular mechanical-generalized Born surface area (MM-GBSA) free binding energy was depicted as −17.05 and −29.48 Kcal/mol, respectively. Further, molecular dynamics simulation was carried out for 100 ns. Carvacrol and geraniol potentially and competitively inhibit the in-vitro HMG-R activity with an IC50 value of 78.23 ± 2.21 µM, and 72.91 ± 2.92 µM, respectively. Thus, both carvacrol and geraniol exhibited significant anti-hypercholesterolemic activity while the molecular simulation studies depicted that the GR complex showed better stability than the carvacrol complex

Impact of clinical pharmacist intervention on clinical outcomes in the critical care unit, Taif City, Saudi Arabia: a retrospective study

(1) Objectives: Clinical pharmacists are now playing a significant role in hospitals aiming to reduce medication errors, adverse drug reactions, and healthcare costs. Therefore, the main objective of this study was to assess the interventions provided by a clinical pharmacist in the intensive care unit at the King Faisal Hospital in Taif city. (2) Methods: For this single-center retrospective study, patients were included from December 2021 to May 2022. In the present study, all the interventions of clinical pharmacists made over six months were included. The Intensive care unit (ICU) ward was covered by three clinical pharmacists, and the interventions made were categorized into four groups: (1) interventions related to indications; (2) interventions regarding safety; (3) interventions regarding dosing, and (4) miscellaneous. Descriptive statistics was applied to evaluate the results in the form of frequencies and percentages. Analysis was performed using the statistical package SPSS 20.0. (3) Results: Overall, a total of 404 interventions were recommended for 165 patients during the six- month period of study. Among them, 370 interventions (91.5%) were accepted by physicians. Among all the interventions, the majority were suggested regarding ‘indication’ (45.7%), including the addition of drugs, drugs with no indications, and duplication. The acceptance rate of clinical pharmacist intervention was 98.5%. (4) Conclusions: This retrospective study shows that clinical pharmacists played a critical role in optimizing drug therapy which could subsequently help to prevent drug-related issues and lower drug costs. More research is needed to do a thorough cost-benefit analysis

IS STRESS A RISK FACTOR FOR HEMORRHOIDS IN ELDERLY PATIENTS?

Background: The incidence of hemorrhoids requiring medical attention among the elderly has been increasing. This study aimed to determine stress as a risk factor for hemorrhoids among elderly patients. Methods: A cross sectional study needs to be carried out to understand emotional stress as the risk factor for hemorrhoids. The study population is older people with conditions of hemorrhoids. The participants for this cross sectional study are older patients of age 45 to 65, with higher incidences of hemorrhoids. A total of 40 patients with hemorrhoids have been included in the study. The risk factors and the clinical symptoms related to the incidence of hemorrhoids were documented and analyzed. Results: The study included 306 participants from elderly population. Participants reported suffering from hemorrhoid since once a year (n= 105, 34.3%) and once every more than one year (n= 105, 34.3%). There were 82 participants reported that there is a tissue coming out of the rectum at the time of bowel movement (26.8%). Among these participants, 43 of them mentioned that it goes back spontaneously while 39 of them had to push it back. The most frequent symptom among study participants was bleeding (n= 95, 31%). More than half of study participants were stressful before having hemorrhoids (n= 194, 63.4%). Furthermore, 172 participants think that they are facing digestive issues more often since they are stressed (56.2%). More than one third of study participants had signs of constipation prior to stressful feeling (n= 109, 35.6%). Conclusion: The current study showed that participants were complaining from hemorrhoids since a year. Some of them reported tissue coming out from rectum. The most frequent symptom was bleeding and the most frequent symptom during stress was abdominal cramps. More than half of participants were stressed prior to the diagnosis of hemorrhoids. Larger cohort studies are encouraged to confirm the current observation