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Fulltext Over-the-Counter Herbal Weight Loss Supplements in Egypt: Label Claim, Microbiological and Pharmaceutical Quality, and Safety Assessments

Ahmed N, Nounou MI, Abouelfetouh A, El-Kamel A

Med Princ Pract, 2019;28(2):167-177.
PMID: 30517949 DOI: 10.1159/000495986

OBJECTIVES: Nutraceuticals are advertised and sold with the label claim of being natural and safe herbal products. Due to the absence of clear regulations and guidelines for safety assessments of these products, nutraceuticals are commonly adulterated in order to increase sales. The objective of the current study was to design a comprehensive evaluation system to assess the safety, efficacy, authenticity according to label claim, and pharmaceutical quality of herbal slimming products in between 2015 and 2017.
METHODS: We designed a comprehensive assessment system to evaluate the safety, authenticity according to label claim, and pharmaceutical quality of slimming nutraceuticals. Six different popular products were evaluated (Zotreem Plus®, Zotreem Extra®, Malaysian Super Slim®, AB Slim®, Chinese Super Slim®, and Metabolites®). The pharmaceutical evaluation included analyzing the samples via high-performance liquid chromatography to determine any possible adulterants. Additionally, the products' physical properties were assessed via pharmacopeial tests. Finally, a microbial evaluation and a cross-sectional observational retrospective prevalence study were conducted to assess the products' safety and efficacy. -Results: The tested products were found to be adulterated with unreported active pharmaceutical ingredients such as sibutramine, sildenafil, phenolphthalein, and orlistat. Furthermore, they contained heterogeneous amounts of adulterants and exhibited an unsatisfactory pharmaceutical and microbial quality. Finally, the observational survey conducted on users showed that high percentages of participants suffered from common side effects such as depression, diarrhea, and hypertension.
CONCLUSIONS: These products threaten the health of consumers. There is a need to raise awareness of the lethal consequences of illegal nutraceuticals.
Agricultural drought risk assessment of Northern New South Wales, Australia using geospatial techniques

Hoque MA, Pradhan B, Ahmed N, Sohel MSI

Sci Total Environ, 2020 Nov 17.
PMID: 33248778 DOI: 10.1016/j.scitotenv.2020.143600

Droughts are recurring events in Australia and cause a severe effect on agricultural and water resources. However, the studies about agricultural drought risk mapping are very limited in Australia. Therefore, a comprehensive agricultural drought risk assessment approach that incorporates all the risk components with their influencing criteria is essential to generate detailed drought risk information for operational drought management. A comprehensive agricultural drought risk assessment approach was prepared in this work incorporating all components of risk (hazard, vulnerability, exposure, and mitigation capacity) with their relevant criteria using geospatial techniques. The prepared approach is then applied to identify the spatial pattern of agricultural drought risk for Northern New South Wales region of Australia. A total of 16 relevant criteria under each risk component were considered, and fuzzy logic aided geospatial techniques were used to prepare vulnerability, exposure, hazard, and mitigation capacity indices. These indices were then incorporated to quantify agricultural drought risk comprehensively in the study area. The outputs depicted that about 19.2% and 41.7% areas are under very-high and moderate to high risk to agricultural droughts, respectively. The efficiency of the results is successfully evaluated using a drought inventory map. The generated spatial drought risk information produced by this study can assist relevant authorities in formulating proactive agricultural drought mitigation strategies.
Fulltext Psychological Distress among Adults in Home Confinement in the Midst of COVID-19 Outbreak

Lal A, Sanaullah A, M Saleem MK, Ahmed N, Maqsood A, Ahmed N

Eur J Dent, 2020 Dec;14(S 01):S27-S33.
PMID: 33242914 DOI: 10.1055/s-0040-1718644

OBJECTIVES: The aim of this study was to evaluate psychological distress caused by the novel coronavirus disease 2019 (COVID-19) pandemic among the adult population residing in Pakistan.
MATERIALS AND METHODS: This cross-sectional survey-based study comprised 1,000 adults residing in Pakistan. A questionnaire was formulated and circulated among adult population of Pakistan, the depression and anxiety symptoms using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales were assessed.
STATISTICAL ANALYSIS: Independent t-test, cross tabulation, and regression analysis were used to identify variables having impact on PHQ-9 and GAD-7 scores. A p-value of ≤ 0.05 was considered statistically significant.
RESULTS: Among 1,000 participants, 573 were males and 427 were females who completed the survey. Majority were restricted to home for more than 40 days. Considerable number of participants reported depressive (540, 54%) and anxiety (480, 48%) symptoms. Gender, age, earnings, and occupation have significant relation with psychological distress, although similar was not found with education levels.
CONCLUSION: Psychological distress, a concerning yet addressable issue was found among adults arising amid COVID-19 outbreak. Currently, physical health effects of COVID-19 are being looked, while mental health effects being under-addressed. This issue should be addressed to avoid any psychological impact in future.
Fulltext One year survivor of metastatic renal cell carcinoma treated with pazopanib

Inn FX, Ahmed N, Hing EY, Jasman MH

Urol Ann, 2017 5 10;9(2):194-196.
PMID: 28479777 DOI: 10.4103/0974-7796.204178

Tyrosine kinase inhibitor (TKI) and its side effects are well known. However, these are mainly descriptive, with pictorial data lacking. Here, in we report a case of metastatic renal cell carcinoma, treated with TKI, with classic side effects; supplemented with images that demonstrate the adverse effects of the drug. In addition, we discuss and demonstrate the computed tomography changes.
Helicobacter pylori protein HP0986 (TieA) interacts with mouse TNFR1 and triggers proinflammatory and proapoptotic signaling pathways in cultured macrophage cells (RAW 264.7)

Ansari SA, Devi S, Tenguria S, Kumar A, Ahmed N

Cytokine, 2014 Aug;68(2):110-7.
PMID: 24767863 DOI: 10.1016/j.cyto.2014.03.006

HP0986 protein of Helicobacter pylori has been shown to trigger induction of proinflammatory cytokines (IL-8 and TNF-α) through the activation of NF-κB and also to induce Fas mediated apoptosis of human macrophage cells (THP-1). In this study, we unravel mechanistic details of the biological effects of this protein in a murine macrophage environment. Up regulation of MCP-1 and TNF-α in HP0986-induced RAW 264.7 cells occurred subsequent to the activation and translocation of NF-κB to the cell nucleus. Further, HP0986 induced apoptosis of RAW 264.7 cells through Fas activation and this was in agreement with previous observations made with THP-1 cells. Our studies indicated activation of TNFR1 through interaction with HP0986 and this elicited the aforementioned responses independent of TLR2, TLR4 or TNFR2. We found that mouse TNFR1 activation by HP0986 facilitates formation of a complex comprising of TNFR1, TRADD and TRAF2, and this occurs upstream of NF-κB activation. Furthermore, FADD also forms a second complex, at a later stage, together with TNFR1 and TRADD, resulting in caspase-8 activation and thereby the apoptosis of RAW 264.7 cells. In summary, our observations reveal finer details of the functional activity of HP0986 protein in relation to its behavior in a murine macrophage cell environment. These findings reconfirm the proinflammatory and apoptotic role of HP0986 signifying it to be an important trigger of innate responses. These observations form much needed baseline data entailing future in vivo studies of the functions of HP0986 in a murine model.
18F-FDG PET Uptake in the Scalp After Platelet-Rich Plasma Therapy

Usmani S, Al-Turkait D, Al-Kandari F, Ahmed N

Clin Nucl Med, 2022 Jan 01;47(1):e43-e44.
PMID: 34034312 DOI: 10.1097/RLU.0000000000003707

18F-FDG PET/CT has been found useful for the detection of the source of infection/inflammation in the body. Platelet-rich plasma is a new treatment modality in which plasma is injected subdermally or intradermally for potential hair regrowth into the scalp. We report a case of 43-year-old woman with right breast cancer who underwent surgery, chemotherapy, and radiotherapy 2 years ago and is currently on hormonal therapy. 18F-FDG PET/CT demonstrate incidental findings of increased FDG avidity in the scalp after platelet-rich plasma therapy.
Identification of dual active sites in Caenorhabditis elegans GANA-1 protein: an ortholog of the human α-GAL a and α-NAGA enzymes

Cheong CSY, Khan SU, Ahmed N, Narayanan K

J Biomol Struct Dyn, 2023 Jul;41(11):5261-5276.
PMID: 35694994 DOI: 10.1080/07391102.2022.2084162

Fabry disease (FD) is caused by a defective α-galactosidase A (α-GAL A) enzyme responsible for breaking down globotriaosylceramide (Gb3). To develop affordable therapeutics, more effort is needed to obtain insights into the underlying mechanism of FD and understanding human α-GAL A structure and function in related animal models. We adopted C. elegans as a model to elucidate the sequence and 3D structure of its GANA-1 enzyme and compared it to human α-GAL A. We constructed GANA-1 3D structure by homology modelling and validated the quality of the predicted GANA-1 structure, followed by computational docking of human ligands. The GANA-1 protein shared sequence similarities up to 42.1% with the human α-GAL A in silico and had dual active sites. GANA-1 homology modelling showed that 11 out of 13 amino acids in the first active site of GANA-1 protein overlapped with the human α-GAL A active site, indicating the prospect for substrate cross-reaction. Computational molecular docking using human ligands like Gb3 (first pocket), 4-nitrophenyl-α-D-galactopyranoside (second pocket), α-galactose (second pocket), and N-acetyl-D-galactosamine (second pocket) showed negative binding energy. This revealed that the ligands were able to bind within both GANA-1 active sites, mimicking the human α-GAL A and α-NAGA enzymes. We identified human compounds with adequate docking scores, predicting robust interactions with the GANA-1 active site. Our data suggested that the C. elegans GANA-1 enzyme may possess structural and functional similarities to human α-GAL A, including an intrinsic capability to metabolize Gb3 deposits.Communicated by Ramaswamy H. Sarma.
Fulltext Genotypic and phenotypic profiles of Escherichia coli isolates belonging to clinical sequence type 131 (ST131), clinical non-ST131, and fecal non-ST131 lineages from India

Hussain A, Ranjan A, Nandanwar N, Babbar A, Jadhav S, Ahmed N

Antimicrob Agents Chemother, 2014 Dec;58(12):7240-9.
PMID: 25246402 DOI: 10.1128/AAC.03320-14

In view of the epidemiological success of CTX-M-15-producing lineages of Escherichia coli and particularly of sequence type 131 (ST131), it is of significant interest to explore its prevalence in countries such as India and to determine if antibiotic resistance, virulence, metabolic potential, and/or the genetic architecture of the ST131 isolates differ from those of non-ST131 isolates. A collection of 126 E. coli isolates comprising 43 ST131 E. coli, 40 non-ST131 E. coli, and 43 fecal E. coli isolates collected from a tertiary care hospital in India was analyzed. These isolates were subjected to enterobacterial repetitive intergenic consensus (ERIC)-based fingerprinting, O typing, phylogenetic grouping, antibiotic sensitivity testing, and virulence and antimicrobial resistance gene (VAG) detection. Representative isolates from this collection were also analyzed by multilocus sequence typing (MLST), conjugation, metabolic profiling, biofilm production assay, and zebra fish lethality assay. All of the 43 ST131 E. coli isolates were exclusively associated with phylogenetic group B2 (100%), while most of the clinical non-ST131 and stool non-ST131 E. coli isolates were affiliated with the B2 (38%) and A (58%) phylogenetic groups, respectively. Significantly greater proportions of ST131 isolates (58%) than non-ST131 isolates (clinical and stool E. coli isolates, 5% each) were technically identified to be extraintestinal pathogenic E. coli (ExPEC). The clinical ST131, clinical non-ST131, and stool non-ST131 E. coli isolates exhibited high rates of multidrug resistance (95%, 91%, and 91%, respectively), extended-spectrum-β-lactamase (ESBL) production (86%, 83%, and 91%, respectively), and metallo-β-lactamase (MBL) production (28%, 33%, and 0%, respectively). CTX-M-15 was strongly linked with ESBL production in ST131 isolates (93%), whereas CTX-M-15 plus TEM were present in clinical and stool non-ST131 E. coli isolates. Using MLST, we confirmed the presence of two NDM-1-positive ST131 E. coli isolates. The aggregate bioscores (metabolite utilization) for ST131, clinical non-ST131, and stool non-ST131 E. coli isolates were 53%, 52%, and 49%, respectively. The ST131 isolates were moderate biofilm producers and were more highly virulent in zebra fish than non-ST131 isolates. According to ERIC-based fingerprinting, the ST131 strains were more genetically similar, and this was subsequently followed by the genetic similarity of clinical non-ST131 and stool non-ST131 E. coli strains. In conclusion, our data provide novel insights into aspects of the fitness advantage of E. coli lineage ST131 and suggest that a number of factors are likely involved in the worldwide dissemination of and infections due to ST131 E. coli isolates.
Helicobacter pylori in 2013: multiplying genomes, emerging insights

Ahmed N, Loke MF, Kumar N, Vadivelu J

Helicobacter, 2013 Sep;18 Suppl 1:1-4.
PMID: 24011237 DOI: 10.1111/hel.12069

We describe features of key additions to the existing pool of publicly accessible Helicobacter pylori genome sequences and sequences of Helicobacter pylori phages from April 2012 to March 2013. In addition, important studies involving H. pylori genomes, especially those pertaining to genomic diversity, disease outcome, H. pylori population structure and evolution are reviewed. High degree of homologous recombination contributes to increased diversity of H. pylori genomes. New methods of resolving H. pylori population structure to an ultrafine level led to the proposal of new subpopulations. As the magnitude of diversity in the H. pylori gene pool becomes more and more clear, geographic and demographic factors should be brought to analysis while identifying disease-specific biomarkers and defining new virulence mechanisms.
A study to examine the ageing behaviour of cold plasma-treated agricultural seeds

Ahmed N, Siow KS, Wee MFMR, Patra A

Sci Rep, 2023 Jan 30;13(1):1675.
PMID: 36717647 DOI: 10.1038/s41598-023-28811-w

Cold plasma (low pressure) technology has been effectively used to boost the germination and growth of various crops in recent decades. The durability of these plasma-treated seeds is essential because of the need to store and distribute the seeds at different locations. However, these ageing effects are often not ascertained and reported because germination and related tests are carried out within a short time after the plasma-treatment. This research aims to fill that knowledge gap by subjecting three different types of seeds (and precursors): Bambara groundnuts (water), chilli (oxygen), and papaya (oxygen) to cold plasma-treatment. Common mechanisms found for these diverse seed types and treatment conditions were the physical and chemical changes induced by the physical etching and the cold plasma on the seeds and subsequent oxidation, which promoted germination and growth. The high glass transition temperature of the lignin-cellulose prevented any physical restructuring of the surfaces while maintaining the chemical changes to continue to promote the seeds germination and growth. These changes were monitored over 60 days of ageing using water contact angle (WCA), water uptake, electrical conductivity, field emission scanning electron microscopy (FE-SEM) and X-ray photoelectron spectroscopy (XPS). The vacuum effect was also investigated to separate its effect from cold plasma (low pressure). This finding offers a framework for determining how long agricultural seeds that have received plasma treatment can be used. Additionally, there is a need to transfer this research from the lab to the field. Once the impact of plasma treatment on seeds has been estimated, it will be simple to do so.
Social Acceptability and Health Concerns of Smoking and Vaping Among University Students: A Cross-Sectional Study

Maqsood A, Shahidan WNS, Mirza D, Ahmed N, Heboyan A

Tob Use Insights, 2024;17:1179173X241300992.
PMID: 39534376 DOI: 10.1177/1179173X241300992

OBJECTIVE: This study aimed to assess tobacco and vaping habits among university students, exploring awareness of university policies, attitudes, and behaviors related to smoking and vaping.
METHODS: An online questionnaire was distributed among students from various universities, including institutions in Pakistan, covering demographics, smoking and vaping behaviors, awareness of policies, and beliefs. Data was analyzed using descriptive statistics, Binomial tests, Chi-square tests, and logistic regression.
RESULTS: Out of the total 683 respondents, 65.02% were female, and 34.98% were male. Most participants were undergraduate students (71.31%), with Dentistry being the most represented field (50.36%). Most students perceived smoking or vaping as socially acceptable (58.3%) and were aware of university policies (59.3%). However, 46.6% were aware of cessation programs. Most of the students expressed concern about long-term vaping health risks (74.5%). Logistic regression identified gender (Male) and field of study (Dentistry) as significant predictors of policy awareness.
CONCLUSION: University students exhibit varied perceptions and behaviors related to smoking and vaping. The study highlights the importance of implementing effective policies and interventions to address tobacco and vaping use among them.
Fulltext An Approach for the Optimization of Thermal Conductivity and Viscosity of Hybrid (Graphene Nanoplatelets, GNPs: Cellulose Nanocrystal, CNC) Nanofluids Using Response Surface Methodology (RSM)

Yaw CT, Koh SP, Sandhya M, Ramasamy D, Kadirgama K, Benedict F, et al.

Nanomaterials (Basel), 2023 May 10;13(10).
PMID: 37242013 DOI: 10.3390/nano13101596

Response surface methodology (RSM) is used in this study to optimize the thermal characteristics of single graphene nanoplatelets and hybrid nanofluids utilizing the miscellaneous design model. The nanofluids comprise graphene nanoplatelets and graphene nanoplatelets/cellulose nanocrystal nanoparticles in the base fluid of ethylene glycol and water (60:40). Using response surface methodology (RSM) based on central composite design (CCD) and mini tab 20 standard statistical software, the impact of temperature, volume concentration, and type of nanofluid is used to construct an empirical mathematical formula. Analysis of variance (ANOVA) is applied to determine that the developed empirical mathematical analysis is relevant. For the purpose of developing the equations, 32 experiments are conducted for second-order polynomial to the specified outputs such as thermal conductivity and viscosity. Predicted estimates and the experimental data are found to be in reasonable arrangement. In additional words, the models could expect more than 85% of thermal conductivity and viscosity fluctuations of the nanofluid, indicating that the model is accurate. Optimal thermal conductivity and viscosity values are 0.4962 W/m-K and 2.6191 cP, respectively, from the results of the optimization plot. The critical parameters are 50 °C, 0.0254%, and the category factorial is GNP/CNC, and the relevant parameters are volume concentration, temperature, and kind of nanofluid. From the results plot, the composite is 0.8371. The validation results of the model during testing indicate the capability of predicting the optimal experimental conditions.
Fulltext Synthesis, characterization, optical properties, biological activity and theoretical studies of a 4 nitrobenzylidene) amino) phenyl)imino)methyl)naphthalen-2-ol -based fluorescent Schiff base

AlHazmy SM, Zouaghi MO, Al-Hakimi AN, Alorini T, Alhagri IA, Arfaoui Y, et al.

Heliyon, 2024 Mar 15;10(5):e26349.
PMID: 38495175 DOI: 10.1016/j.heliyon.2024.e26349

A new Schiff base, 1-(E)-(4-((E) 4nitrobenzylidene) amino) phenyl)imino) methyl)naphthalen-2-ol (4NMN), was prepared from the reaction of p-phenylenediamine with 2-hydroxy-1-naphthaldehyde and 4-nitrobenzaldehyde and characterized with spectroscopic analysis. UV-VIS and NMR. Frontier molecular orbitals, molecular electrostatic potential, and chemical reactivity descriptors of the synthesized compound were studied using molecular modeling methods. The antibacterial and antifungal activities of the Schiff base were studied for its minimum inhibitory concentration. The compound showed a higher effect on yeast than against bacteria. Density functional theory (DFT) calculations were performed to study the mechanism of reaction for the synthesis of 4NMN, and the results were consistent with the experimental findings. 4NMN exhibited moderate antibacterial and antifungal activities and demonstrated higher inhibition potential against different resistant strains compared to the reference drug gentamycin. The absorption and fluorescence spectra of 4NMN were measured in different solvents, and the effect of relative polarity and acidity on the medium was observed. An inner filter effect was observed at high concentrations, and the compound showed considerable fluorescence enhancement with increasing medium viscosity and fluorescence quenching by the addition of traces of Cr1+ and Cu2+. Additionally, molecular docking studies were conducted to investigate the efficiency of antibacterial and antifungal targets.
Patient-specific 3D hemodynamics modelling of left coronary artery under hyperemic conditions

Kamangar S, Badruddin IA, Govindaraju K, Nik-Ghazali N, Badarudin A, Viswanathan GN, et al.

Med Biol Eng Comput, 2017 Aug;55(8):1451-1461.
PMID: 28004229 DOI: 10.1007/s11517-016-1604-8

The purpose of this study is to investigate the effect of various degrees of percentage stenosis on hemodynamic parameters during the hyperemic flow condition. 3D patient-specific coronary artery models were generated based on the CT scan data using MIMICS-18. Numerical simulation was performed for normal and stenosed coronary artery models of 70, 80 and 90% AS (area stenosis). Pressure, velocity, wall shear stress and fractional flow reserve (FFR) were measured and compared with the normal coronary artery model during the cardiac cycle. The results show that, as the percentage AS increase, the pressure drop increases as compared with the normal coronary artery model. Considerable elevation of velocity was observed as the percentage AS increases. The results also demonstrate a recirculation zone immediate after the stenosis which could lead to further progression of stenosis in the flow-disturbed area. Highest wall shear stress was observed for 90% AS as compared to other models that could result in the rupture of coronary artery. The FFR of 90% AS is found to be considerably low.
Effect of socio-demographic factors on endogenous biomarkers (cystatin C and creatinine) among elderly chronic kidney disease patients: a cross-sectional study

Khan I, Khan AH, Adnan AS, Sulaiman SAS, Hamzah ABA, Ahmed N, et al.

Int Urol Nephrol, 2018 Jun;50(6):1113-1121.
PMID: 29536424 DOI: 10.1007/s11255-018-1834-9

PURPOSE: Creatinine is normally used to evaluate kidney function among elderly patients in clinical practice, which has been reported to be affected by socio-demographic factors like BMI and age. Cystatin C a newly introduced biomarker may be more efficient in identifying kidney function in obese and aged CKD patients. The aim of the current study was to assess the effect of BMI on endogenous biomarkers (cystatin C and creatinine) among elderly CKD patients in Malaysia, a first such study in the country.
METHODS: The current study was conducted at the Hospital University Sains Malaysia, Kelantan. A total of 300 elderly Malay participants ≥ 65 years, with CKD, were taken in study. Demographic data, blood pressure, weight, and height were documented. Serum creatinine was assayed by Chemistry Analyzer Model Architect-C8000 (Jaffe Method), while serum cystatin C was examined by Human cystatin C ELISA kit (Sigma-Aldrich) using Thermo Scientific Varioskan Flash ELISA reader.
RESULTS: The study participants were divided into three groups on the basis of age. There was a statistically significant difference at the p value
Fulltext Inactivation of nuclear factor κB by MIP-based drug combinations augments cell death of breast cancer cells

Subramaniam M, Liew SK, In L, Awang K, Ahmed N, Nagoor NH

Drug Des Devel Ther, 2018;12:1053-1063.
PMID: 29750018 DOI: 10.2147/DDDT.S141925

Background: Drug combination therapy to treat cancer is a strategic approach to increase successful treatment rate. Optimizing combination regimens is vital to increase therapeutic efficacy with minimal side effects.
Materials and methods: In the present study, we evaluated the in vitro cytotoxicity of double and triple combinations consisting of 1'S-1'-acetoxychavicol acetate (ACA), Mycobacterium indicus pranii (MIP) and cisplatin (CDDP) against 14 various human cancer cell lines to address the need for more effective therapy. Our data show synergistic effects in MCF-7 cells treated with MIP:ACA, MIP:CDDP and MIP:ACA:CDDP combinations. The type of interaction between MIP, ACA and CDDP was evaluated based on combination index being <0.8 for synergistic effect. Identifying the mechanism of cell death based on previous studies involved intrinsic apoptosis and nuclear factor kappa B (NF-κB) and tested in Western blot analysis. Inactivation of NF-κB was confirmed by p65 and IκBα, while intrinsic apoptosis pathway activation was confirmed by caspase-9 and Apaf-1 expression.
Results: All combinations confirmed intrinsic apoptosis activation and NF-κB inactivation.
Conclusion: Double and triple combination regimens that target induction of the same death mechanism with reduced dosage of each drug could potentially be clinically beneficial in reducing dose-related toxicities.
Indole alkaloids and anti-nociceptive mechanisms of Tabernaemontana divaricata (L.) R. Br. flower methanolic extract

Ali Khan MS, Misbah, Ahmed N, Arifuddin M, Rehman A, Ling MP

Food Chem Toxicol, 2018 Jun 05.
PMID: 29883785 DOI: 10.1016/j.fct.2018.06.007

Flowers of Tabernaemontana divaricata (L.) R. Br., (Apocynaceae) are used in traditional medicine for analgesic property. The present study was performed to isolate the active principles and investigate the mechanisms involved in the anti-nociception caused by T. divaricata flower methanolic extract (TDFME). The extract in the doses of 125, 250 and 500 mg/kg, p.o was subjected to various assays in acetic acid induced abdominal writhing and formalin induced paw licking test models. Naloxone, L-Arginine, Glibenclamide and Glutamate were used as inducers while Morphine, L-NAME, Methylene blue and Aspirin served as standard drugs. The phytochemical analysis led to the isolation of three indole alkaloids namely Voacangine, Catharanthine and O-acetyl Vallesamine. The anti-nociception produced by TDFME was attenuated significantly (p< 0.001) by the intra-peritoneal pretreatment of naloxone, L-Arginine and glibenclamide. The nociception produced by glutamate was inhibited by TDFME. TDFME also enhanced the antinociceptive activity of L-NAME when given in combination. However TDFME co-administration did not produce significant results with methylene blue indicating lack of cGMP involvement. These results indicate that TDFME produces anti-nociception action mediated by opioid, nitric oxide, K+-ATP and glutamate mechanisms and the effect is largely related to the indole alkaloids.
Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent

Inn FX, Ahmed N, Hou LG, Abidin ZAZ, Yi LL, Zainuddin ZM

Int Urol Nephrol, 2019 Nov;51(11):1949-1953.
PMID: 31441009 DOI: 10.1007/s11255-019-02262-7

PURPOSE: The internal drainage provided by a ureteral stent helps with the relief and prevention of ureteral obstruction. By definition, correct stent placement is one with a complete loop in both the renal pelvis and bladder. This prevents stent migration proximally or distally despite urinary flow, patient movement, and ureteral peristalsis.
METHODS: We performed a comparative prospective cross-sectional study assessing the impact of intravesical stent position on the quality of life in 46 patients with a ureteral stent. This is done using the Ureteral Stent Symptom Questionnaire (USSQ).
RESULTS: 52.5% of patients had an ipsilateral positioned intravesical stent, while the remaining had their stent positioned contralaterally. Intravesical stent position significantly influenced the quality of life. The USSQ score was worse for the contralateral group. Subscore analysis found that urinary symptoms and body pain index contribute significantly to the morbidity. Majority of patients in the ipsilateral group reported no discomfort as compared to the contralateral group.
CONCLUSIONS: To the best of our knowledge, this is the first study assessing the impact of intravesical stent position on the quality of life in the Asian population. Intravesical stent position has a significant influence on patient's morbidity and quality of life in particular towards their urinary irritative symptoms and body pain. It is imperative to ensure correct distal placement of ureteric stent that does not cross the midline to the contralateral site. We believe that the USSQ should be used in daily clinical practice in assessing the symptoms related to indwelling ureteric stents.
Fulltext Embelin Protects Against Acute Pentylenetetrazole-Induced Seizures and Positively Modulates Cognitive Function in Adult Zebrafish

Kundap UP, Choo BKM, Kumari Y, Ahmed N, Othman IB, Shaikh MF

Front Pharmacol, 2019;10:1249.
PMID: 31708779 DOI: 10.3389/fphar.2019.01249

Purpose of the research: Epilepsy is a continuous process of neurodegeneration categorized by an enduring tendency to generate uncontrolled electrical firing known as seizures causing involuntary movement all over the body. Cognitive impairment and behavioral disturbances are among the more alarming co-morbidities of epilepsy. Anti-epileptic drugs (AEDs) were found to be successful in controlling epilepsy but are reported to worsen cognitive status in patients. Embelin (EMB) is a benzoquinone derived from the plant Embelia ribes and is reported to have central nervous system (CNS) activity. This study aims to evaluate the effectiveness of EMB against pentylenetetrazole (PTZ) induced acute seizures and its associated cognitive dysfunction. This was done via docking studies as well as evaluating neurotransmitter and gene expression in the zebrafish brain. The principal results: Behavioral observations showed that EMB reduced epileptic seizures and the T-maze study revealed that EMB improved the cognitive function of the fish. The docking study of EMB showed a higher affinity toward gamma-aminobutyric acid (GABAA) receptor as compared to the standard diazepam, raising the possibility of EMB working via the alpha subunit of the GABA receptor. EMB was found to modulate several genes, neurotransmitters, and also neuronal growth, all of which play an important role in improving cognitive status after epileptic seizures. Healthy zebrafish treated with EMB alone were found to have no behavioral and biochemical interference or side effects. The immunohistochemistry data suggested that EMB also promotes neuronal protection and neuronal migration in zebrafish brains. Major Conclusions: It was perceived that EMB suppresses seizure-like behavior via GABAA receptor pathway and has a positive impact on cognitive functions. The observed effect was supported by docking study, T-maze behavior, neurotransmitter and gene expression levels, and immunohistology study. The apparatus such as the T-maze and seizure scoring behavior tank were found to be a straightforward technique to score seizure and test learning ability after acute epileptic seizures. These research findings suggest that EMB could be a promising molecule for epilepsy induced learning and memory dysfunction.
Fulltext Evaluation of Patient's Knowledge, Attitude, and Practice of Cross-Infection Control in Dentistry during COVID-19 Pandemic

Ahmed MA, Jouhar R, Adnan S, Ahmed N, Ghazal T, Adanir N

Eur J Dent, 2020 Dec;14(S 01):S1-S6.
PMID: 33321543 DOI: 10.1055/s-0040-1721295

OBJECTIVES: The aim of this study was to evaluate the patient's knowledge, attitude, and practice of cross-infection control in dentistry during coronavirus diseases 2019 (COVID-19).
MATERIALS AND METHODS: This cross-sectional observational study was conducted at Altamash Institute of Dental Medicine, Karachi from June 2020 to August 2020. A total of 775 patients participated to fill questionnaire. After scrutiny, 25 questionnaire forms were excluded due to incomplete information. Questionnaire was divided in to four sections. First section obtained patients sociodemographic information, while knowledge of patients regarding cross-infection control during COVID-19 pandemic was evaluated in second section. Similarly, the purpose of third section was to assess attitude and fourth section was designed to evaluate practice. Likert's 3-point scale was used for registration of participant's response. The reliability of questionnaire was assessed through Crohnbach's α (α = 0.74). Statistical analysis was performed after entering data in to SPSS version 25. Independent t-test was used to evaluate the difference in patients' knowledge, attitude, and practice. A p-value ≤ 0.05 was considered as statistically significant.
RESULTS: Majority of the participants agreed that COVID-19 is a highly contagious disease (631, 97%) and daily screening of staff, dental assistants, dentists, and patients is necessary (568, 75.7%) along with proper sterilization of instruments and disinfection of dental operatory (650, 86.66%). A large number of participant also agreed that proper disposal of waste is utmost important for cross-infection control (601, 80.24%) and patient's waiting area should also be marked with social distancing sign (620, 82.66%). However, when asked about the common route of COVID-19 transmission in dentistry, 341 (45.5%) participants disagreed that it is not through aerosol (water droplets) generated during dental procedures.
CONCLUSIONS: Dental health professionals should take additional measures to educate dental patients on mechanism of potential spread of COVID-19 through the aerosols and droplets generated during dental procedures. They should also encourage the dental patients to be vigilant and question the cross-infection control measures practiced by the dentist to whom they go for dental treatment, and to decrease their chances of acquiring an infection during their visit to the dental office.

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