Effect of Calcium Channel Blockers on Lower Urinary Tract Symptoms: A Systematic Review

Background. Numerous medications are known to be associated with the development of lower urinary tract symptoms (LUTS). One such medication group is calcium channel blockers (CCB). Objective. To critically examine the literature regarding the involvement of CCB in manifestation of LUTS in humans. Methods. A systematic literature search was conducted on PubMed, SciELO, Scopus, and OpenGrey databases to find all potentially relevant research studies before August 2016. Results. Five studies met the inclusion criteria and were included in this review. Three out of five studies stated that CCB were involved in either precipitation or exacerbation of LUTS. As for the remaining two studies, one study found out that only the monotherapy of CCB was associated with increased prevalence of nocturia and voiding symptoms in young females, whereas the other study reported an inverse association of CCB with LUTS. The methodological quality of studies was considered high for four studies and low for one study. Conclusion. Healthcare providers should make efforts for an earlier identification of the individuals at risk of LUTS prior to the commencement of CCB therapy. Moreover, patients should be counselled to notify their healthcare provider if they notice urinary symptoms after the initiation of CCB

An Updated Review on Rheumatoid Arthritis (RA): Epidemiology, Pathophysiology, Diagnosis, and the Current Approaches for Its Treatment

Rheumatoid arthritis (RA) is a systemic self-inflicted inflammatory disease that primarily affects middle-aged women. Globally, 1% of people live with RA. This review aims to provide updated information on the different aspects of RA, including its epidemiology, pathophysiology, diagnosis, treatment, and management. A web-based literature search was conducted through various databases, including PubMed, Google Scholar, and Science Direct, to identify the most relevant studies. Epidemiological studies have suggested that the prevalence and occurrence of RA have remained inconsistent across geographical areas in different periods. Many factors such as age, gender, inheritances, and environmental exposure can contribute to the severity of the disease. The acute form of RA usually presents with pain, and if left untreated, it can result in joint deformities and influence a patient’s quality of life (QoL). RA diagnosis is usually based on the manifestation of pain with inflammation. Currently, many therapeutic strategies are available for the cure of RA. The management of daily routine activities is required with treatment to curtail the damage, avoid future deformities, and ultimately minimize the aching trouble of the patient

Attributable causes of chronic kidney disease in adults: a five-year retrospective study in a tertiary-care hospital in the northeast of the Malaysian Peninsula

CONTEXT AND OBJECTIVE: Chronic kidney disease (CKD) is an escalating medical and socioeconomic problem worldwide. Information concerning the causes of CKD, which is a prerequisite for reducing the disease burden, is sparse in Malaysia. Therefore, this study aimed to evaluate the attributable causes of CKD in an adult population at a tertiary referral hospital. DESIGN AND SETTING: Retrospective study at Hospital Universiti Sains Malaysia (HUSM). METHODS: This was an analysis based on medical records of adult patients at HUSM. Data regarding demographics, laboratory investigations, attributable causes and CKD stage were gathered. RESULTS: A total of 851 eligible cases were included. The patients’ mean age was 61.18 ± 13.37 years. CKD stage V was found in 333 cases (39.1%) whereas stages IV, IIIb, IIIa, and II were seen in 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. The percentage of CKD stage V patients receiving renal replacement therapy was 15.6%. The foremost attributable causes of CKD were diabetic nephropathy (DN) (44.9%), hypertension (HPT) (24.2%) and obstructive uropathy (9.2%). The difference in the prevalence of CKD due to DN, HPT and glomerulonephritis between patients ≤ 50 and > 50 years old was statistically significant. CONCLUSION: Our results suggest that DN and HPT are the major attributable causes of CKD among patients at a Malaysian tertiary-care hospital. Furthermore, the results draw attention to the possibility that greater emphasis on primary prevention of diabetes and hypertension will have a great impact on reduction of hospital admissions due to CKD in Malaysia

PHYSICOCHEMICAL AND SPECTROSCOPIC PROFILES FOR IDENTIFICATION OF SEED (PITS) OF PHOENIX SYLVESTRIS ROXB.

The present study aimed to provide a number of physicochemical and spectroscopic profiles of seeds (pits) of Phoenix sylvestris (Family: Palmae) for correct identification of the material. The powdered material was subjected to proximate analysis (moisture contents, total ash and total extractives), qualitative and quantitative phytochemical analyses and FTIR spectroscopy. Qualitative phytochemical analyses indicated the presence of steroids, triterpenoids, phenols and tannins, whereas quantitatively the material was found to contain 3.04% glycosaponins, 4.35% proteins, 77.95% carbohydrates and 9.0% lipids. The powder produced brown, green and black fluorescence under UV light, before and after treating with certain reagents. FTIR spectrum indicated the presence of OH, CH, C=O and C-O-C. The findings of this study may be helpful for the correct identification of the pits of Phoenix sylvestris.&nbsp

Pharmacokinetics of Caffeic Acid from Methanol Seed Extract of Syzygium cumini L in Rats

Purpose: To describe caffeic acid-based pharmacokinetics of methanol extract of seed of Syzygium cumini L. in rats.Methods: A dose of the extract (500 mg, equivalent to 37.135 mg caffeic acid) was administered orally to 6 male Wister rats, weighing 200 ± 10 g. Blood samples (0.5 mL), collected from the tail vein at 0, 15, 30, 60, 120, 240 and 720 min, were processed and analyzed using high performance liquid chromatography and detected with florescent light detector (FLD).Results: Following the administration of the extract, caffeic acid achieved maximum plasma concentration (5.96 ± 0.49 μg/mL) in 1.0 h which was also the time to achieve maximum concentration (Tmax). Mean resident time (MRT) and half-life (t1/2) were 4.092 ± 0.94 h and 0.14 ± 0.01 h, respectively.Conclusion: The results indicate that absorption of caffeic acid from the oral route is fast, but lower amounts are absorbed. The method developed for the extraction of caffeic acid from the plasma and HPLC determination may be useful in establishing phyto-bioequivalence between Syzygium cumini seed products.Keywords: Caffeic acid, Pharmacokinetics, Syzygium cumini, Phytobioequivalence, Absorptio

Reverse-phase chromatographic determination and intrinsic stability behavior of 5-[(4-chlorophenoxy)methyl]-1,3,4-oxadiazole-2-thiol

The study describes the development and preliminary validation of a simple reverse phase chromatographic method for determination of a novel drug candidate, 5-[(4-chlorophenoxy)methyl]-1,3,4-oxadiazole-2-thiol (OXCPM), in bulk and stressed solution, in order to find out the intrinsic stability behavior of the compound. Isocratic elution was carried out at a flow rate of 1.0 mL min–1 through a Promosil C18 column maintained at 25 °C, using the mobile phase comprising acetonitrile and aqueous o-H3PO4 (pH 2.67) (1:1, V/V). Detection was performed at 258 nm. The response of the detector was linear in a concentration range of 1.25–50.00 µg mL–1 with the correlation coefficient of 0.9996 ± 0.0001. Cumulative intra-day, inter-day and inter-instrument accuracy (99.5 ± 1.0, 100.2 ± 1.0 and 100.3 ± 0.4 %, resp.) with RSD less than 5 % indicated that the method was accurate and precise. The resolution and selectivity factor (>2 and >1, resp.), particularly in copper metal- and dry-heat-stress solutions, depicted the selectivity of the method. OXCPM remained stable under hydrolytic (acidic and neutral pH, ≤ 37 °C), photolytic and moist heat stress conditions. Under alkaline conditions (hydrolytic and photolytic), polar products were formed and eluted very fast through the column (tR < 3.75 min). At room temperature, the compound was susceptible to oxidation by hydrogen peroxide and transition metals. The ionogram of most of the stress solutions indicated the presence of a product having m/z 256, which may be a result of N- or S- methylation or -SH oxidation. The results of the study indicate that the method is selective, sensitive and suitable to be used for determination of OXCPM in bulk and under stress conditions

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED).Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health.Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses.Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk factor

Evaluating the antidiabetic and antioxidant properties of 5- benzyl-1,3,4-oxadiazole-2-thiol

Purpose: To evaluate 5-Benzyl-1,3,4-oxadiazole-2-thiol (OXPA) for antidiabetic and antioxidant properties. Methods: Antidiabetic activity was evaluated using three in vitro models, glucose uptake by yeast cells, alpha amylase inhibition assay and hemoglobin glycosylation inhibition assays. Antioxidant potential was determined by DPPH radical scavenging, reducing power and lipid peroxidation assays. Results: OXPA showed antidiabetic activity in all the three models. The activity of the compound was comparable with that of metronidazole in glucose uptake by yeast cells, but the alpha amylase inhibition activity of the compound was slightly lower than that of acarbose, whereas the hemoglobin glycosylation inhibition activity of the compound was higher than that of vitamin E. DPPH free radical and hydrogen peroxide scavenging activity of the compound was comparable with that of vitamin C. In reducing power assay, the activity of the compound was lower than that of vitamin C (p &gt; 0.05). Conclusion: The results of antidiabetic and antioxidant activity indicate that OXPA may be a drugcandidate for treating both diabetes and its associated oxidative stress

Bryophyllum pinnatum: BOTANICAL DESCRIPTION, VERNACULAR NAMES, PARTS USED, TRADITIONAL USES, PHYTOCHEMICAL AND PHRMACOLOGICAL ACTIVITIES

Bryophyllum pinnatum (Family: Crassulaceae) is a traditional herb that has widely been used for removal of kidney stones and is found to possess a number of pharmacological activities such as antiviral, antipyretic, antimicrobial, anti-inflammatory, antitumor, hypocholesterolemic, antioxidant, diuretic, antiulcer, styptic, antidiabetic, astringent, antiseptic, antilithic, cough suppressant, anticancer, antihypertensive, fungitoxic and uterine relaxant. The plant contains flavonoids, tannins, anthocyanins, glycosides, alkaloids, phenols, bufadienolides, saponins, coumarins, carotenoids, sitosterols, quinines, tocopherol and lectins. The flavonoids rutin, quercetin, luteolin and luteolin 7-O-&beta;-d-glucoside detected in the plant might be a responsible factor for the anti-inflammatory effect. Diuretic and antioxidant activity of the plant could be responsible for its wide use against urolithiasis. Anthocyanidines could be responsible for the antimicrobial activity of the plant. Kaempferol 3-O-&alpha;-l-arabinopyranosyl (1&rarr;2) &alpha;-l-rhamnopyranoside) and two other polar flavonoids (quercetin 3-O-&alpha;-l- arabinopyranosyl (1&rarr;2) &alpha;-l-rhamnopyranoside and 4&prime;, 5-dihydroxy-3&prime;, 8-dimethoxyflavone 7-O-&beta;-d- glucopyranoside) are responsible for the antileshmanial activity. Bufodienolides are found to have cytotoxic property and hence might be responsible for the anticancer effect. The present study is undertaken to update and ease the researchers to get a comprehensive summary of the plant regarding its botanical description, common name, parts used, traditional uses, phytochemical evaluation and pharmacological activities

QUANTIFICATION OF SINENSETIN IN EXTRACTS OF ORTHOSIPHON STAMINEUS USING HIGH PERFORMANCE THIN-LAYER CHROMATOGRAPHY

The present study aimed to develop a high performance thin layer chromatography method for the determination of sinensetin and apply it to standardize the extracts Orthosiphon stamineus. The samples and a series of standards were applied in duplicate on silica gel plate, which was then developed using mobile phase comprising chloroform and ethyl acetate (6:4, v/v) to a distance of 5 cm. Afterwards, the plate was dried and subjected to densitometry at 366 nm for the quantification of sinensetin. The limit of detection (LOD) and limit of quantification (LOQ) was found to be 0.05 and 0.50 &micro;g/ml, respectively. The method showed linearity in a range of 0.50-100.00 &micro;g/ml with correlation coefficient 0.9988. The recovery, intra- and inter day accuracy were found to be 95.67-97.65, 97.64-99.54 and 97.83-98.57%, respectively, with relative standard deviation (RSD) less than 5%. The extracts contained sinensetin from 0.470-1.335 mg/g/. The results of this study indicate that the developed method is sensitive, reliable, repeatable and reproducible and may be applied to standardize extracts of Orthosiphon stamineus