Transmission of Middle East respiratory syndrome coronavirus infections among healthcare personnel in the Middle East: A systematic review

Purpose: To undertake a systematic review of the high mortality rate of Middle East respiratory syndrome coronavirus infections (MERS-CoV) among healthcare personnel in the Middle East.Methods: To conduct this systematic review various electronic databases were searched for earlier recorded studies. Prisma guidelines were used to shortlist the studies based on the inclusion and exclusion criterion. Finally, twelve studies were selected and analysed for the systematic review.Results: Twelve articles were selected after filtering 184 articles on Coronavirus. The studies chosen for this systematic review which outline the transmission information of MERS-CoV among health care personnel. A majority of studies were from Saudi Arabia, as the prevalence of Mers-CoV in Saudi Arabia is higher than in other countries in the region. Mers-CoV transmission into humans was mainly expected from infected dromedary camels.Conclusion: The results indicate that the use of infection control procedures and protocols, which include ensuring that all persons with respiratory infection symptoms adhere to respiratory hygiene, hand hygiene, and cough etiquette, would minimize the infection rate among HCPs. The required consumables for maintaining hand hygiene should be readily available to all HCPs.Keywords: Middle East respiratory syndrome coronavirus (MERS-CoV), Systematic review, healthcareassociated infections, Coronaviruses, Health care personne

Design and Evaluation of Chitosan films for Transdermal delivery of Glimepiride

Glimepiride is a third generation oral antidiabetic sulphonylurea drug frequently prescribed to patients of type 2 diabetes. However, its oral therapy is encountered with bioavailability problems due to its poor solubility leading to irreproducible clinical response, in addition to adverse effects like dizziness and gastric disturbances. As a potential for convenient, safe and effective antidiabetic therapy, the rationale of this study was to develop a transdermal delivery system for glimepiride. Chitosan polymer was utilized in developing transdermal films for glimepiride. Chitosan has film forming ability, bioadhesive and absorption enhancing properties. Aiming at optimizing the drug delivery and circumventing the skin barrier function, inclusion complexation of glimepiride with beta-cyclodextrin (β-CyD) as well as the use of several conventional penetration enhancers were monitored for augmenting the drug flux. The physical and mechanical properties of the prepared films were investigated using tensile testing, IR spectroscopy and X-ray diffractometry. Release studies revealed adequate release rates from chitosan films. Permeation studies through full thickness rat abdominal skin were conducted. High flux values were obtained from films comprising a combination of the drug with limonene and ethanol as well as from films containing glimepiride-β-CyD complex. In vivo studies on diabetic rats for selected formulae revealed a marked therapeutic efficacy sustained for about 48 hours. The above-mentioned results shed light on feasibility of utilizing chitosan as an effective, safe transdermal delivery system for glimepiride characterized by increased patient compliance and better control of the disease

Environmental Ethics of Islam

Islam is the monotheistic religion articulated by the Quran, the word of God, and by the teaching of Muhammad (PBUH). Islamic ethics is its moral principles, which defines what is good for the society. It enlightens the sacred views that man must strive to maintain the harmony of their inner and outer environments, in conformity with the world of nature. In the Quranic theology of creation God created this cosmos out -of-nothing. He created man, as a vice-gerent on this earth. He created lands seas, mountains, plants and animals, and than entrusted all this to humans to take advantage of it. So humans are now guardian of this cosmos for a limited period of time. After this life He will audit and judge the individual for using or misusing the world. The earth thus is a testing ground of the human species. In other words, the Quranic environmental ethics tells us that God has trusted humans His world. They have to prove them selves capable of this trust, by maintaining a balance, in a way to get benefits from the nature, and protect it from discards. Thus the relation of humans to its environment is a relation of “the trustee” and “the trust”. The Qur'an says, “Cheat not in maintaining the balance. Establish just measure and do not fall short in maintaining the balance.”[1] The article focuses to investigate the ethics in the Quran and teachings of the Prophet regarding the relationship of man towards the natural world. Key Point: Environment and Islam; Quranic Environmental Ethics; Islam and Nature; Islamic Ethics toward the Natural World, Islam and the Eco- System. [1] . The Qur'an 55:1-

Beryllium is a potent and unique GSK-3β inhibitor with potential to differentially regulate glycogen synthase and β-catenin

Glycogen Synthase Kinase-3β (GSK-3β) is an important serine/threonine kinase that phosphorylates/regulates diverse and metabolically important proteins. Some of the important substrates of GSK-3β are glycogen synthase, tau, β-catenin, cyclin D1, axin, c-jun, c-myc, Heat Shock Factor–1, BCL-3, CREB, Histone H1.5, mdm2, p21 (CIP1), pyruvate dehydrogenase and many more. De-regulation of GSK-3β has been implicated in diseases like cancer, Alzheimer’s disease, bipolar disorder and type 2 diabetes mellitus. Currently, GSK-3β is one of the most widely studied proteins and there is a great interest in developing potent and efficient GSK-3β-inhibitors for research as well as therapeutic purposes. We demonstrate that beryllium in the form of BeSO4 salt is a much more potent GSK-3β-inhibitor compared to LiCl. We observed that one of the unique properties of beryllium is its modus operandi to regulate the inhibitory Ser-9 phosphorylation of GSK-3β in a cell type specific manner. Our study for the first time validates the potential of beryllium to function as a biologically relevant GSK-3β-inhibitor. Beryllium induces a decrease in the phosphorylation of glycogen synthase in cultured NIH/3T3 cells. This decrease in phosphorylated form of glycogen synthase demonstrates the ability of beryllium to inhibit GSK-3β’s kinase activity in treated cells. One of the most important substrates in relation to GSK-3β’s inhibition is β-catenin – one of the downstream effector molecules of the Wnt signaling pathway. Our results in NIH/3T3 and A172 cells indicate that beryllium has minimal effect on Wnt signaling/ β-catenin pathway compared to other established GSK-3β-inhibitors. The minimal effect of beryllium at physiologically effective concentrations on Wnt signaling/β-catenin pathway indicates that it could be a more pathway specific inhibitor. One of the most intriguing discoveries of our study has been the lithium induced increase in the phosphorylated form of β-catenin, which is against the “accepted dogma”. Here we propose an alternative model explaining the regulation of the Wnt/β-catenin signaling pathway by lithium. Use of GSK-3β-inhibitors for therapeutic purposes presents the risk of inducing cancer in patients due to accumulation of β-catenin, an oncogene activator. The unique ability of beryllium to repress the kinase activity of GSK-3β without inducing a heavy nuclear localization of β-catenin might provide an opportunity to develop a potentially potent, efficient, pathway-specific and biologically active GSK-3β inhibitor with minimal adverse effects

Management of diabetes and arthritis –A systematic review

Purpose: Diabetes is a metabolic syndrome with reported musculoskeletal  effects. This systemic review aimed to identify a relationship between  diabetes and arthritis; disease-related risk factors, the effect of diet in disease management and the effect of anti-arthritic drugs on diabetes  treatment.Methods: This study analysed 20 articles identified and selected according to the study criteria. PRISMA guidelines were used for identification and screening of literature. Data search covered several primary databases, including Pubmed, Wiley library, Scopus, Clinical Trial Registry, etc.Results: The study findings suggest a significant correlation between  diabetes and arthritis. Obesity, impaired glucose tolerance (MS  components), vascular cell adhesion molecule 1 (VCAM-1) hypertension and dyslipidemia are the most common risk factors leading to disease progression. Omega -3-fatty acid showed no protective effect on disease condition.Conclusion: The findings indicate that anti-tumor necrosis factor (Tnf)-α, disease modifying antirheumatic drugs, and Interleukin receptors  antagonist improved the efficacy of diabetic medication and maintained blood sugar levels. However, Tnf-α reduced glucose intolerance, and therefore, its therapeutic use in conjunction with diabetic medications should be limited.Keywords: Diabetes, Arthritis, Risk factors, Diet, Pathogenesis, Disease progression, Medicatio

Assessment of hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care in Madinah, Saudi Arabia

Purpose: To evaluate hospital pharmacists’ clinical knowledge and practical skill levels for pharmaceutical care.Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists’ in three different government hospitals in Madinah, Saudi Arabia recorded their responses or assessments in their work manuals for preparing reports. Instructors encouraged interactive learning by presenting case studies, in which pharmacists had to interpret medical history and clinical assessments of various body systems. Course learning design also focused on drug use evaluation, monitoring plans, and reaching clinical evidencebased decision-making.Results: A total of two hundred and fifty-five (255) hospital pharmacists participated in the study. The study sample was comprised of 128 (50.9 %) males and 127 (49.1 %) females. A significant (p < 0.01) difference was noticed between genders (male: 47.91 ± 7.15, female: 50.31 ± 4.88) for total mean scores of clinical skills. Cronbach’s alpha reliability coefficient for case data recitation was 0.91, while clinical assessment skills coefficient was 0.89. Overall, pharmacists reported that they “agree” (4.01 ± 0.67) that they acquired the ability to use case data recitation taught in the PBL; they also reported a positive evaluation (4.48 ± 0.58) of their ability to perform clinical data assessment.Conclusion: The findings indicate that pharmacist’s self-confidence to perform clinical assessment activities is low. Lack of confidence remains a critical education issue among pharmacists in the study setting.Keywords: Clinical pharmacy, Problem-based learning, Clinical skills, Pharmacist focus group, Therapeutics, Pharmaceutical car