Asian Journal of Pharmaceutical and Clinical Research
The Asian Journal of Pharmaceutical and clinical research (AJPCR) welcomes high-quality science that seeks to elucidate the Pharmaceutical and clinical research. The mission of the AJPCR is to bring significant, enduring research to the scientific community in the field of Pharmaceutical sciences and clinical research. AJPCR believe in its responsibility to safeguard the research and publish by providing high-quality review process and maintaining firm standards on data presentation and deposition. AJPCR goal is to help scientists to disclose their findings in the most efficient and effective way possible by keeping review times short, The heart of AJPCR mission is the publication of original research in the form of Articles, which represent top content in the journal and are highlighted with additional coverage.
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PHYSIOTHERAPY STRATEGIES AND CONSERVATIVE MANAGEMENT FOR CERVICAL RADICULOPATHY: A NARRATIVE REVIEW
Cervical radiculopathy (CR) is a common neurological disorder arising from compression or irritation of cervical nerve roots. It typically presents with neck and radiating arm pain, sensory disturbances and motor deficits, and its peak incidence occurs between 40 and 50 years of age. The natural history is often self‑limiting, yet the associated pain and functional limitations prompt many patients to seek care. Conservative treatment—including physiotherapy, manual therapy, cervical traction and exercise—is the initial management approach because it aims to relieve symptoms without surgical risks. However, the evidence base for specific physiotherapy strategies remains heterogeneous and sometimes contradictory. This review synthesises current literature on physiotherapy‑based conservative management of CR, summarises outcomes of randomised controlled trials (RCTs) and recent systematic reviews, and highlights research gaps. We searched PubMed, Cochrane Library, PEDro and Google Scholar for studies up to October 2025. Eleven studies including randomized controlled trials, observational cohorts, a case series, and one systematic review were included. Manual therapy combined with exercise consistently reduced pain and disability; mechanical traction provided no additional benefit. In acute CR, semi‑hard collars or physiotherapy led to greater reductions in arm and neck pain than a wait‑and‑see approach. Cervical vertebral mobilisation improved mechanical pain hypersensitivity and disability in chronic CR. Structured postoperative physiotherapy showed only minor benefits compared with standard postoperative care. Despite promising results, evidence quality is low to moderate, and heterogeneity among interventions limits generalisability. Future well‑designed RCTs with long‑term follow‑up are required.
Copyright (c) 2025 SRIRAM K, JYOTI S JEEVANNAVAR, SANTOSH S JEEVANNAVAR http://creativecommons.org/licenses/by/4.0
EFFECT OF IRON–FOLIC ACID SUPPLEMENTATION ON NUTRITIONAL STATUS: MID-UPPER ARM CIRCUMFERENCE AND BODYWEIGHT CHANGES DURING PREGNANCY
Objective: Chronic energy deficiency is a common condition among pregnant women and can adversely affect both maternal and fetal outcomes. Iron and folic acid (IFA) supplementation is routinely provided in maternal health services to prevent anemia and improve nutritional status. This study aimed to investigate the effect of IFA supplementation on maternal nutritional indicators, including changes in mid-upper arm circumference (MUAC), bodyweight, and prenatal body mass index (BMI) among pregnant women at the Lubuk Buaya Public Health Center in Padang. Method: A descriptive retrospective design was employed using medical records of 976 pregnant women from January to December 2024. Variables included the number of IFA tablets consumed, MUAC, bodyweight change, and prenatal BMI. Data were analyzed using the Compare Means test. Results: Statistical analysis showed that changes in MUAC were small and not clinically significant, despite a formally significant p-value (p=0.000). This likely reflects the absence of MUAC improvement rather than a beneficial effect of supplementation. For bodyweight, the largest group (30 tablets, n=926) showed no measurable change, while smaller groups receiving higher IFA doses (≥60 tablets) showed variable weight reductions, though very small sample sizes limited interpretation. Prenatal BMI was comparable across groups with no significant differences (p=0.183). The unequal distribution of participants, particularly the small number in the 90- and 120-tablet groups, limited statistical power and generalizability. Conclusion: Regular IFA supplementation was associated with improved MUAC, indicating benefits for maternal nutritional status, although effects on bodyweight and BMI were inconclusive due to sample imbalance and variability. Strengthening health education and encouraging adherence to antenatal visits are essential to ensure adequate supplementation and optimize maternal health outcomes.
Copyright (c) 2025 Resti Anwar, Elsa Badriyya, Afifah Machlaurin, Najmiatul Fitria http://creativecommons.org/licenses/by/4.0
PHARMACOVIGILANCE INSIGHTS: A RARE COHORT STUDY ON HYPERSENSITIVITY REACTIONS TO INTRAVENOUS IRON SUCROSE IN POSTPARTUM ANEMIC WOMEN AT TERTIARY CARE HOSPITAL, TAMILNADU
Objectives: This study aims to investigate the incidence, severity, and timeline of hypersensitivity reactions (HSRs) associated with intravenous (IV) iron sucrose and to evaluate the effectiveness of management strategies in postpartum anemic (PPA) women using a structured pharmacovigilance approach. Methods: The 2-year, single-center, prospective observational cohort study was conducted in obstetrics and gynecology at a tertiary care hospital in Tamil Nadu. Among 238 PPA women, 129 received a standard dose of iron sucrose and were categorized into adverse drug reaction (ADR, n=11) and non-ADR (n=118) groups. To identify potential risk factors for HSRs, we performed a nested case–control analysis, comparing the 11 cases who experienced HSRs with the 118 controls from the same cohort who did not. A Delphi panel assessed ADRs and graded HSRs using the World Health Organization-Uppsala Monitoring Centre causality scale and Ring–Messmer classification, respectively. The data were analyzed using Fisher’s exact test. Results: The HSR incidence was 8.5%. Most of the patients experienced Grade 2 HSR (63.64%) moderate ADR, followed by Grade 3, severe, potentially life-threatening (27.27%), requiring emergency management, with no fatalities. Demographics showed no significant association with ADRs (p>0.05). Patients with severe anemia appeared to increase the likelihood of ADRs (odds ratio = 2.77; 95% confidence interval: 0.573–13.42; p=0.204, though statistically non-significant. Over half of HSRs (54.5%) occurred after multiple doses, and 72.7% developed within 15 min of infusion. One medication error caused recurring reactions. Most ADRs (91%) were classified as probable/likely. Conclusion: This study highlights the critical need for active pharmacovigilance in tracking, managing rare and unpredictable ADRs of IV iron sucrose, necessitating pre- and post‐infusion risk assessments, immediate intervention, and infusion policy optimization in the future.
Copyright (c) 2025 Krishna Ravi, Senthilkumar Palaniappan http://creativecommons.org/licenses/by/4.0
ENHANCED WOUND HEALING USING ANTHOCYANIN-LOADED SILK SERICIN/POLYVINYL ALCOHOL NANOFIBERS: A BIOMATERIAL-BASED APPROACH
Objective: The goal of this study was to create a nanofibrous wound dressing using silk sericin (SS) and polyvinyl alcohol (PVA) that included anthocyanin (ACN) phytoconstituents in different amounts to promote wound healing, pH monitoring, and antibacterial activity. Methods: PVA–SS–ACN nanofibers were created by electrospinning with varying concentrations of solution (A1, A4, and A5), yielding average fiber diameters of 144.13 nm, 169.15 nm, and 192.51 nm, respectively. Up to 85 h of continuous herbal ingredient release was demonstrated by the nanofibers’ bead-free shape. Through structural and thermal characterizations using scanning electron microscopy, Fourier transform infrared, and thermogravimetric analysis, the stability of the nanofibrous mats up to 50°C, the chemical integration of ACNs, and the creation of smooth fibers were all confirmed. Results: The most potent antibacterial action against Staphylococcus aureus and Escherichia coli was shown by the nanofibrous mat loaded with 0.1 and 1% w/w ACN. In this study, the comparison between 0.1 and 1% the therapeutic efficacy is higher in 1% because the dose of the drug increased. Histological and in vivo wound healing investigations demonstrated superior healing efficiency, reduced acute and chronic inflammation, and accelerated tissue regeneration compared to untreated control groups. Conclusion: The PVA–SS–CAN nanofibrous dressing’s remarkable antibacterial, anti-inflammatory, and controlled drug-release qualities make it a promising option for advanced wound healing applications. The interwoven network of fibers also aids in exudate control, reducing the discomfort of dressing changes by absorbing excess fluid and preventing the dressing from adhering to the wound.
Copyright (c) 2025 Jajnadatta Panda http://creativecommons.org/licenses/by/4.0
NETWORK PHARMACOLOGY AND MOLECULAR DOCKING-BASED INVESTIGATION OF CALOTROPIS GIGANTEA LINN. LEAF EXTRACT AGAINST VULVOVAGINAL CANDIDIASIS
Objectives: This study aimed to elucidate the multitarget therapeutic mechanisms of Calotropis gigantea leaf extract against vulvovaginal candidiasis (VVC) using a network pharmacology (NP) approach integrated with molecular docking. Methods: Gas chromatography-mass spectrometry (GC-MS) analysis of the methanolic extract of C. gigantea leaves identified 38 phytochemicals. Drug-likeness was assessed through SwissADME, and target prediction was performed using Super-PRED and UniProt. VVC-related genes from GeneCards were compared using Venny, and common targets were analyzed through STRING for protein–protein interaction. Pathway enrichment and network construction were done through Kyoto Encyclopedia of Genes and Genomes (KEGG) and Cytoscape. Key compounds were docked with hub protein toll-like receptor 4 (TLR4) using Molsoft ICM. Results: GC-MS identified key bioactives like 3,6-Octadienal, 3,7-dimethyl- and 1,3,8-p-Menthatriene. Ten overlapping targets with VVC genes were found, with TLR4 as a major hub. KEGG analysis highlighted four pathways, including Toll-like receptor signaling. Docking revealed strong binding of 3,6-Octadienal, 3,7-dimethyl- to TLR4 (−24.9 kcal/mol), exceeding clotrimazole (-18.82 kcal/mol). Conclusion: C. gigantea Linn. shows promise as a multi-target antifungal agent against VVC by modulating immune pathways. NP and docking highlight 3,6-Octadienal, 3,7-dimethyl, as a key bioactive. Among the identified compounds, 3,6-Octadienal, 3,7-dimethyl- exhibited the strongest binding affinity toward TLR4; however, its low concentration (0.11% relative peak area) indicates that its biological impact may be limited and potentially synergistic with other more abundant phytoconstituents. Further in vitro and in vivo studies are needed to validate these findings and develop clinical formulations.
Copyright (c) 2025 Ms. Vasundhara Bhosale, Dr. Akshada Koparde, Dr. Vandana Thorat, Ms. Mayuri Bhosale http://creativecommons.org/licenses/by/4.0
PURIFICATION AND DETERMINATION OF PHYSICOCHEMICAL PROPERTIES OF α-AMYLASE SECRETED BY PENICILLIUM CITRINUM S1
Objective: The α-amylase is a key industrial enzyme with widespread applications having about 30% share in the world enzyme market. The purpose of the study was to purify the α-amylase produced from Penicillium citrinum S1 and to evaluate the physicochemical and kinetic properties of the enzyme for its potentiality as an industrially valuable enzyme. Methods: Production of extracellular α-amylase was done by using P. citrinum S1 in liquid medium and subjected to purification of the enzyme through ammonium sulfate precipitation, dialysis, followed by gel filtration chromatography. Results: The enzyme was purified to 10.05 fold with a specific activity of 23.32 μg/mL. Sodium dodecyl sulfate–polyacrylamide gel electrophoresis analysis of the enzyme revealed that the molecular weight of the enzyme is ≈43 kDa. From enzyme kinetic study, the Km value of α-amylase was found as 1.1 μg/mL, and the Vmax value was 37.31 U/mL. The optimum temperature showing the highest enzyme reaction is 50°C, and the most ideal pH range is 6.5–7.5. The purified enzyme remained stable at moderately high temperature (50–60°C) and up to 120 min and remained active in alkaline medium (0.1%) of commercial detergents such as Rin and Surf Excel. Conclusion: These distinctive properties of this α-amylase purified from P. citrinum S1, such as low Km value, wide range of pH tolerance, stability of the enzyme at 50–60°C, compatibility with commercial detergents such as rin and surf, may be promising for application in starch processing, brewing, textile desizing, and detergent formulations.
Copyright (c) 2025 Bhisma Narayan Swargiari http://creativecommons.org/licenses/by/4.0
A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE EFFICACY OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING HEMODYNAMIC RESPONSES DURING LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION
Objectives: The objective of this study was to compare the efficacy of two different doses of intravenous dexmedetomidine (0.75 mcg/kg vs. 1 mcg/kg) in attenuating the hemodynamic responses during laryngoscopy and endotracheal intubation in adult patients undergoing elective surgeries under general anesthesia. The study aimed to evaluate the optimal dose that balances effective cardiovascular stabilization with minimal adverse effects. Methods: This prospective randomized study included 60 adult patients (American Society of Anesthesiologists I and II) aged 18–60 years undergoing elective surgeries under general anesthesia. Patients were randomly allocated into two groups: Group A (n=30) received dexmedetomidine 0.75 mcg/kg IV, and Group B (n=30) received dexmedetomidine 1 mcg/kg IV as an infusion in 100 mL normal saline over 15 min 30 min before induction. Hemodynamic parameters (heart rate [HR], systolic blood pressure, diastolic blood pressure, and mean arterial pressure [MAP]) were recorded at baseline before drug administration, at 15 and 30 min following administration of the study drug until induction, after induction, during laryngoscopy and intubation, and subsequently at 1, 3, 5, and 7 min after intubation. Post-operative sedation was assessed using the Ramsay Sedation Score. Results: Both groups showed significant attenuation of hemodynamic responses during laryngoscopy and endotracheal intubation. Group B (1 mcg/kg) demonstrated significantly better control of HR and blood pressure during laryngoscopy and intubation compared to Group A (0.75 mcg/kg). The mean percentage increase in HR from baseline during laryngoscopy and intubation was 11.8±3.2% in Group A compared to 5.8±2.0% in Group B (p<0.001). Similarly, the mean percentage increase in MAP was 9.7±2.8% in Group A versus 4.5±1.8% in Group B (p<0.001). Group B showed a higher incidence of bradycardia (20.0% vs. 6.7%) and hypotension (10.0% vs. 0.0%) compared to Group A, though these were easily managed. Post-operative sedation scores were significantly higher in Group B for the first 90 min after extubation. Conclusion: Dexmedetomidine at a dose of 1 mcg/kg IV provides more effective attenuation of hemodynamic responses to laryngoscopy and endotracheal intubation compared to 0.75 mcg/kg. However, it is associated with a higher incidence of bradycardia and hypotension, requiring vigilant monitoring. The choice of dose should be individualized based on the patient’s cardiovascular status and clinical requirements.
Copyright (c) 2025 Dr. Sara Mary Thomas, Dr. Harsh Rathod, Dr. Jigisha Mehta, Dr. Kalpesh Patil http://creativecommons.org/licenses/by/4.0
METABOLITE PROFILING, CYTOTOXICITY, AND PRO-APOPTOTIC EVALUATION OF CINNAMOMUM MYRIANTHUM MERR. IN HT-29 COLORECTAL CANCER CELLS
Objective: To evaluate the metabolite profile as well as the cytotoxic and pro-apoptotic activities of Cinnamomum myrianthum on HT-29 colorectal cancer (CRC) cells in vitro. Methods: The cytotoxic effects of C. myrianthum crude extract (CmCE) and its fractions were assessed against HT-29 CRC cells using the WST-8 assay. The half-maximal inhibitory concentration (IC50) and selectivity index (SI) were determined. The most bioactive fraction was further subjected to untargeted metabolite profiling using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry. Apoptosis induction was analyzed through Annexin V-FITC/PI staining through flow cytometry, while caspase-3/7 activation was measured using the Caspase-Glo® 3/7 luminescence assay. Results: CmCE exhibited moderate cytotoxic activity against HT29 CRC cells with an IC50 value of 32.7 μg/mL (p<0.001). Among the tested fractions (Cm1A-Cm1E), Cm1C demonstrated the most potent cytotoxic effect, with an IC50 of 25.7 μg/mL (p< 0.001) and a SI of 3.63. Flow cytometry analysis revealed that Cm1C significantly induced late-stage apoptosis in HT29 cells. In addition, Cm1C markedly increased caspase-3/7 activity with 2.7- fold (p<0.001) at higher concentration, indicating activation of the apoptotic pathway. Metabolite profiling of Cm1C identified several polyphenolic compounds, including cinnamtannin B1, rutin, hyperin, and kaempferol glycosides. Conclusion: These findings indicated that Cm1C, a polyphenol-rich fraction of C. myrianthum, exhibited selective cytotoxicity against HT29 CRC cells and induced apoptosis through caspase-3/7 activation. This fraction shows promise as a potential natural candidate for CRC therapy.
Copyright (c) 2025 RHIAN JAYMAR RAMIL, YUKIE SATO, KYOKO KOBAYASHI, KENROH SASAKI, FRANCISCO HERALDE III http://creativecommons.org/licenses/by/4.0
PREPARATION AND CHARACTERIZATION OF AZILSARTAN COCRYSTALS USING AMINO ACIDS AS COFORMERS
Objective: This study aimed to improve the solubility and dissolution of azilsartan by forming cocrystals with D-alanine. Methods: Azilsartan-D-alanine cocrystals were prepared using a 1:2 molar ratio through the solvent evaporation technique. Cocrystal formation was confirmed through Fourier transform infrared spectroscopy (FT-IR), DSC, PXRD, and scanning electron microscope (SEM). In vitro dissolution was evaluated using a USP Type II paddle apparatus with 900 mL of dissolution medium maintained at 37±0.5°C. Results: FT-IR analysis confirmed the presence of hydrogen bonding through significant shifts in the functional group peaks. The DSC analysis exhibited a sharp endothermic peak, signifying the development of a new crystalline phase, whereas PXRD results displayed unique diffraction peaks not observed in the individual drug or coformer, validating the formation of cocrystals. SEM analysis showed a morphological transformation into a homogeneous and compact structure. The cocrystals exhibited enhanced dissolution performance, achieving a 1.35-fold increase in drug release at 60 min compared to pure azilsartan. Conclusion: The study successfully demonstrates that cocrystallization with D-alanine significantly improves the solubility and dissolution of azilsartan. This method provides an effective way to tackle solubility issues while potentially improving the oral bioavailability of drugs with poor water solubility. The study also underscores the value of amino acid-based coformers in pharmaceutical cocrystal development.
Copyright (c) 2025 Gorre Venkata Nagaraju http://creativecommons.org/licenses/by/4.0
ADVANCES IN ANALYTICAL TECHNIQUES FOR TOMATO SEED OIL: GC-MS QUANTIFICATION AND SIMPLIFIED PUFA ANALYSIS
Objectives: The objective of this study was to delineate the fatty-acid profile of tomato seed oil (TSO) and assess the analytical efficacy of a streamlined one-step extraction-methylation approach in comparison to the traditional Folch protocol utilizing gas chromatography-mass spectrometry (GC-MS). Methods: TSO was extracted, transformed into fatty-acid methyl esters, and analyzed by GC-MS. The method validation encompassed linearity, precision, recovery, limits of detection (LOD), limits of quantification (LOQ), and statistical comparison by paired t-test and Bland-Altman analysis. Results and Discussion: Linoleic acid (48.16%), palmitic acid (17.22%), and oleic acid (9.18%) were recognized as the predominant fatty acids. Calibration demonstrated exceptional linearity (R2≥0.9999), with precision (%relative standard deviation≤5%) and recovery (95–105%) validating accuracy. The LOD ranged from 0.012 to 0.018 mg/mL, while the LOQ spanned from 0.036 to 0.054 mg/mL, demonstrating elevated sensitivity. No notable discrepancies were seen between the approaches (p>0.05), and Bland-Altman plots indicated robust agreement. Conclusion: TSO is an oil abundant in polyunsaturated fatty acids, and the streamlined method provides a swift, precise, and sustainable alternative for regular fatty acid profiling.
Copyright (c) 2025 Revathi Haldorai http://creativecommons.org/licenses/by/4.0
DESIGN, IN VITRO, AND EX VIVO EVALUATION OF BUDESONIDE BUCCAL PATCH USING XANTHAN GUM AS A NATURAL POLYMER MATRIX
Objectives: The present study aimed to formulate sustained-release mucoadhesive buccal patches of bio-pharmaceutical classification class II drug budesonide (BUD) using the mucoadhesive polymer xanthan gum (XG) and the film-forming agent hydroxypropyl methylcellulose (HPMC) E-15. Methods: To enhance the solubility of BUD, a solid dispersion of BUD (B-SD) was prepared using Soluplus as a solubilizing agent through the solvent evaporation method. Buccal patches of B-SD (BU1–BU9) were formulated using the solvent casting technique. The patches were evaluated for drug content, weight variation, thickness, folding endurance, moisture content, mucoadhesive strength, swelling index, and in vitro drug release. Results: The formulations exhibited statistically significant differences in physical properties (p<0.05). Formulation BU9, containing higher polymer concentrations, showed significantly greater swelling index, mucoadhesive strength, and sustained in vitro drug release (96.41±0.003%) compared to the pure drug patch (PDP) (40.13±0.015%, p<0.0001). Drug release followed a non-Fickian Super Case II transport mechanism. Ex vivo permeation studies of BU9 demonstrated a cumulative permeation of 4.26±0.042 mg/cm2 with a flux of 0.133 mg/cm2/h, both significantly higher than the PDP (p<0.05). The optimized BU9 patch was further characterized by FT-IR, differential scanning calorimetry, and X-ray diffraction, confirming the absence of drug-excipient interactions. Conclusion: Buccal patches of BUD can be successfully formulated using XG in combination with HPMC E-15 to achieve sustained drug release with enhanced mucoadhesive and permeation properties.
Copyright (c) 2025 Preethi GB http://creativecommons.org/licenses/by/4.0
ACHIEVING ANALYTICAL EXCELLENCE: QBD-DRIVEN DEVELOPMENT AND VALIDATION OF REVERSED PHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY-BASED SIMULTANEOUS ESTIMATION METHOD FOR AZILSARTAN MEDOXOMIL AND CILNIDIPINE
Objectives: This article aimed to develop a method for the simultaneous estimation of Azilsartan medoxomil (AZT) and cilnidipine (CIL) by incorporating a quality-by-design approach, which is used to develop the most accurate and precise analytical method in comparison with traditional method development. Methods: At the initial phase, researchers conducted high-performance liquid chromatography (HPLC) trials as per the traditional method development protocol, and factors such as mobile phase, flow rate, and column temperature were taken into consideration for finalizing the most suitable trial. Quality-by-Design approach is then implemented for further study. As per the Box–Behnken design (BBD) system, the method was optimized. The most suitable optimized solution is used for validation. Results: Based on traditional method development, methanol and 0.1% v/v ortho phosphoric acid selected as a mobile phase in an 82:18 ratio, the flow rate was selected as 1 mL/min, and column temperature was selected at 40°C. Based on these factors, 17 HPLC runs were performed as per BBD protocol the p-values for quadratic model for all factors was found <0.0500, which shows the quadratic model is best for proposed study by which method get optimized, and the validation was carried out on the most appropriate optimized solution. The R2 for AZT and CIL was found to be 0.9998 and 0.9999, respectively. The method was linear for both the drugs, and accuracy was found to be 100.45% for AZT and 99.49% for CIL. Other validation parameters were also found within limits. Conclusion: At the end of the study, it was found that the developed method was accurate, precise, linear, specific, and reproducible. Method is cost-effective and can be able to used for routine analysis in laboratories as well as in industries.
Copyright (c) 2025 GADEKAR M.B. MANGESH BHIKAJI GADEKAR, SHAMKUWAR P.B. http://creativecommons.org/licenses/by/4.0
SITAGLIPTIN IN TYPE 2 DIABETES MANAGEMENT: A STUDY OF ADD ON THERAPY IN BALI, INDONESIA
Objectives: Dipeptidyl peptidase-4 (DPP-4) inhibitors are gaining popularity in several hospitals across Bali, particularly among patients with specific comorbid conditions, as they are included in Indonesia’s National Formulary. In clinical practice, sitagliptin (SITA) is one of the most commonly used DPP-4 inhibitors. This observational study aims to assess the effectiveness of SITA as an add-on therapy in the treatment of Type 2 Diabetes Mellitus (T2DM) in Bali. Methods: A hospital-based observational study was carried out at four different hospitals in Bali over the course of 2024. Data were obtained from the medical records of T2DM outpatients. Of the 354 medical records, 156 samples were obtained and categorized into four treatment regimens, including three groups receiving SITA as an add-on therapy and one comparator group (metformin+sulfonyl urea [SU]). Demographic and glycemic parameters were analyzed using ANOVA and post hoc Tukey Test. Results: A significant difference was observed in the mean Hemoglobin A1c (HbA1c), HbA1c reduction, fasting plasma glucose reduction, and random plasma glucose (RPG) levels across the groups, with p-values of 0.04, 0.00, 0.03, and 0.03, respectively. Post hoc test showed that the combination of metformin and SITA was superior to reduce HbA1c compared to SU and SITA (p=0.04). The highest incidence of hypoglycemia was found in the Metformin and SU combination group, with 16.7%. However, there was no significant association between SITA and hypoglycemia statistically. Conclusion: As a second- or third-line therapy, SITA therapy is effective in significantly lowering HbA1c and RPG levels, while also reducing the risk of hypoglycemia.
Copyright (c) 2025 Anak Agung Ketut Purnama Sari, Phebe Hendra, Dita Maria Virginia http://creativecommons.org/licenses/by/4.0
BIOMEDICAL APPLICATION OF SELENIUM NANOPARTICLES SYNTHESIZED USING LINUM USITATISSIMUM AND WITHANIA SOMNIFERA HERBAL FORMULATION
Objectives: This study aimed to synthesize and characterize selenium nanoparticles (SeNPs) using phytochemical-rich extracts of Linum usitatissimum (flaxseed) and Withania somnifera (ashwagandha), and to evaluate their biological efficacy and safety for biomedical applications. Methods: SeNPs were synthesized through a green method employing aqueous extracts of flaxseed and ashwagandha as reducing and stabilizing agents. Characterization was performed using ultraviolet (UV)-visible spectroscopy, X-ray diffraction (XRD), scanning electron microscopy, transmission electron microscopy (TEM), and Fourier transform infrared spectroscopy to determine morphology, crystallinity, and functional groups. Biological activities were assessed through antioxidant assays (2,2-diphenyl-1-picrylhydrazyl, Ferric reducing antioxidant power, ABTS), anti-inflammatory tests (bovine serum albumin and egg albumin denaturation), and antimicrobial evaluations (agar well-diffusion and time-kill assay). Cytotoxicity and embryonic toxicology were analyzed using brine shrimp lethality and zebrafish embryo viability assays. Results: The UV-visible spectra confirmed nanoparticle formation with a characteristic peak at 270–280 nm. XRD and TEM analyses revealed crystalline SeNPs of ~25 nm stabilized by phytochemicals. SeNPs exhibited strong antioxidant activity (>75% inhibition), anti-inflammatory efficacy comparable to diclofenac sodium, and significant antimicrobial zones of inhibition at 100 μg/mL. Cytotoxicity was minimal at therapeutic doses, whereas zebrafish embryonic studies indicated dose-dependent toxicity at higher concentrations. Conclusion: Green-synthesized SeNPs demonstrate potent antioxidant, anti-inflammatory, and antimicrobial properties, with good biocompatibility at therapeutic concentrations. Their eco-friendly synthesis and biological efficacy suggest strong potential as sustainable therapeutic agents, warranting further in vivo studies and clinical translation.
Copyright (c) 2025 Kalaimathi Janakiraman, Suriya M, Revathi S, Deena Mol J, Karthika R, Suresh K, Rajeshkumar S http://creativecommons.org/licenses/by/4.0
CORRELATION BETWEEN DIETARY SELENIUM INTAKE AND CHANGES IN FAT-FREE MASS INDEX AND HANDGRIP STRENGTH IN HEAD-AND-NECK CANCER PATIENTS UNDERGOING CHEMORADIATION THERAPY
Objectives: The purpose of this study was to analyze the correlation between dietary selenium intake in fat-free mass index (FFMI) and handgrip strength among head-and-neck cancer patients undergoing chemoradiation therapy. Methods: A 2-week prospective cohort study was conducted at the Radiotherapy Unit of Dr. Cipto Mangunkusumo National General Hospital. Dietary selenium intake was estimated using the semi-quantitative food frequency questionnaire. FFMI was measured using bioelectrical impedance analysis (seca mBCA 525) and handgrip strength (HGS) using a Jamar dynamometer. Results: Fifty-three patients (median age 49 years) were included. Median dietary selenium intake was 81.3 μg/day. No significant correlation was observed between dietary selenium intake and changes in FFMI or HGS after adjustment for confounders. A weak correlation was found in the non-active hand (p=0.045), which should be interpreted with caution due to the short duration of observation and possible confounding. Conclusion: Within this short 2-week observation, dietary selenium intake was not significantly associated with changes in FFMI or HGS. The borderline finding in the non-active hand is likely an anomalous result and should be interpreted with caution. Longer-term studies with biomarker assessments are warranted.
Copyright (c) 2025 Nadiyah Wijayanthie http://creativecommons.org/licenses/by/4.0
DISCOVERY OF PHOTOCYTOTOXIC CHLOROPHYLL DERIVATIVES FROM ANTARCTIC, ARCTIC, AND TROPICAL CHLORELLA
Objective: The objective of the study is to investigate tropical and polar Chlorella strains as natural sources of photosensitizers and determine how environmental adaptation to extreme habitats influences photocytotoxic metabolite production for photodynamic therapy (PDT). Methods: Four Chlorella strains, tropical (TRP), Antarctic (ANS and ANT), and Arctic (ARC) were cultured under controlled laboratory conditions for 10 and 15 days. Methanolic and butanolic extracts were screened for photocytotoxicity against HL60 leukemia cells using an MTT assay under broad-spectrum light irradiation. Active extracts were dereplicated by ultra-performance liquid chromatography-photodiode array-mass spectrometry (UPLC-PDA-MS) and high-resolution mass spectrometry (HRMS)/MS to identify known and novel photosensitizers. Results: Of the 16 extracts tested, only day-15 methanolic extracts showed strong light-dependent cytotoxicity. TRP and ANT reduced HL60 viability by more than two-fold upon irradiation compared to dark controls. Metabolomic profiling identified nine known chlorophyll-derived photosensitizers and revealed three previously unreported chlorophyll-based compounds (m/z 623, 531, 663) with distinct Soret and Q-band absorptions. The tropical strain TRP, adapted to high irradiance and thermal stress, yielded the highest diversity and abundance of photosensitizers. In contrast, polar strains produced lower levels, possibly reflecting culture conditions that did not replicate their native extreme light regimens. Conclusion: This study highlights Chlorella as a sustainable reservoir of photosensitizers and shows that adaptation to extreme environments shapes their biosynthetic potential. The discovery of three novel chlorophyll derivatives expands the repertoire of natural photosensitizers and underscores the promise of microalgae as biofactories for next-generation PDT agents.
Copyright (c) 2025 Kwok-Wen Ng, Kai-Huey Wong, Yen-Ping Ng, Boon-Seng Tan, Jing Ng http://creativecommons.org/licenses/by/4.0
PHARMACOLOGICAL EVALUATION OF COMBINED MIXTURE OF FRACTIONS FOR ANALGESIC AND ANTI-INFLAMMATORY POTENTIAL IN RODENT MODELS
Objectives: The aim of this research was to evaluate the analgesic and anti-inflammatory effects of a combination mixture of fractions (CMF) from the fruits of Piper nigrum, Piper longum, Melia azedarach, and Azadirachta indica; and to investigate pharmacology rationale for the CMFs for analgesic and anti-inflammatory effects, which will be used as an anti-hemorrhoid treatment in future investigations as a potential candidate of choice. Methods: Five simulated combinations termed A plus B; C plus D (CMF doses 2:2:1:1, Piperaceae enriched) (400 mg); CMF doses 1:1:2:2 (Meliceae enriched) (400 mg) and CMF (1:1:1:1) (400 mg) were evaluated for their analgesic and anti-inflammatory effects. The hot plate and tail immersion methods were used to test for analgesic effect that the created formulation would have. Formalin and carrageenan-induced paw edema in Wistar rats was used to test for anti-inflammatory activity. For the statistical analysis, we used one-way analysis of variance and Dunnett’s test. Results: All the combinations of extract were significantly (p<0.05) soothing and anti-inflammatory as compared to the control. The Piperaceae-enriched (2:2:1:1) and Meliaceae-enriched (1:1:2:2) mixtures had the highest effect, comparable to Pentazocine and Aspirin. Both formulations significantly slowed down the reaction time when it comes to pain models. Furthermore, they decreased paw edema volume in inflammation models. Conclusion: The CMF formulations demonstrated potent analgesic and anti-inflammatory effects across all experimental models. The enriched ratios (2:2:1:1 and 1:1:2:2) produced the strongest responses, indicating synergistic benefits from combining the plant fractions. These findings support CMF as a promising natural candidate for further development as an anti-hemorrhoid treatment.
Copyright (c) 2025 Ishan Aggarwal, SUKIRTI UPADHYAY, ARVIND KUMAR http://creativecommons.org/licenses/by/4.0
FORMULATION AND EVALUATION OF GLICLAZIDE NANOSUSPENSION FOR SOLUBILITY AND DISSOLUTION ENHANCEMENT
Objectives: The present aim of this research was to develop and characterize a gliclazide-containing nanosuspension using various polymers. Methods: There are many approaches to enhance the low solubility and dissolution rate of medications and drug substances. A gliclazide nanosuspension with Soluplus, hydroxypropyl methylcellulose, and polyvinylpyrrolidone was formulated using the high-pressure homogenization method. Results: The physiochemical properties of the drug, polymers, and evaluation characterization of nanosuspension were carried out using Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry, X-ray diffraction (XRD), viscosity, zeta potential, particle size, and solubility of nanosuspension were also checked. FTIR study explained that characteristic peaks of gliclazide were observed in all prepared batches. XRD study indicates that the crystalline structure of the drug was preserved in nanosuspension. The particle size of the formulation decreased using a nanosuspension. Conclusion: Drug solubility was pH dependent, and the effect of nanosuspension on solubility was more pronounced at low pH values. Nanosuspension bioavailability is also influenced by the preparation of the nanosuspension. It was concluded that the nanosuspension method seems to be a promising technique for increasing the solubility, dissolution, and bioavailability of poorly water-soluble drugs.
Copyright (c) 2025 ravindra hanwate http://creativecommons.org/licenses/by/4.0
A STUDY OF DEVELOPMENT AND VALIDATION OF A METHOD FOR SIMULTANEOUS ESTIMATION OF LOBEGLITAZONE SULFATE AND GLIMEPIRIDE USING REVERSEDPHASE HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY IN DOSAGE FORM AND CHARACTERIZATION OF DEGRADANTS USING LIQUID CHROMATOGRAPHY–MASS SPECTROMETRY
Objectives: A novel, speedy, and accurate high-performance liquid chromatography approach has been established for quantitatively analyzing lobeglitazone sulfate and glimepiride. Methods: In this method, the drugs were separated using Inertsil Octadecylsilyl (ODS) 250 × 4.6 mm, 5 μm column with a flow rate of 1 mL/min. The buffer consists of 1 mL of formic acid, which is dissolved in 1 L Milli-Q water, and a mobile phase consisting of a 50:50 (v/v) mixture of 0.1% formic acid and acetonitrile. The 260 nm wavelength was used for detection. Results: Lobeglitazone sulfate concentrations ranging from 12.5 μg/mL to 75 μg/mL and glimepiride concentrations from 25 μg/mL to 150 μg/mL show good linearity in the suggested approach. The limit of detection and limit of quantification values were 0.3 μg/mL, 1.0 μg/mL and 0.15 μg/mL, 0.5 μg/mL for glimepiride and lobeglitazone sulfate, respectively. All the parameters of accuracy, specificity, and method precision were all within the acceptable limit. Conclusion: In the forced degradation studies, the degradation products were characterized by the use of liquid chromatography–mass spectrometry. The current method was found to be simple, economical, suitable, and validated according to the International Council for Harmonization guidelines.
Copyright (c) 2025 Ravi CH http://creativecommons.org/licenses/by/4.0
ROLE OF FIRST-TRIMESTER ULTRASOUND (UP TO 12 WEEKS) IN EARLY PREGNANCY CARE: A RETROSPECTIVE OBSERVATIONAL STUDY
Objectives: To evaluate the diagnostic and descriptive role of first-trimester ultrasound (FTU) in early pregnancy at a tertiary healthcare center. Methods: A retrospective observational study was conducted in which 120 pregnant women who underwent FTU (≤12 weeks gestation) between March 2024 and February 2025. Archived imaging and hospital records were reviewed to analyze obstetric and ultrasound data. Outcomes assessed included gestational age confirmation, detection of fetal cardiac activity, yolk sac evaluation, and diagnosis of early pregnancy complications. Statistical analysis was performed using the Statistical Package for the Social Sciences v23.0. Results: Of the 120 cases, 77.5% were viable singleton intrauterine pregnancies. Multifetal gestation was identified in 5.8% with chorionicity assessment possible in all twin pregnancies. Ectopic pregnancies and anembryonic gestations were each diagnosed in 5% of cases. Embryonic cardiac activity was present in 83.3% and yolk sac abnormalities were noted in 11.6%. The nuchal translucency was measured in 16.6% of cases (Mean NT 1.34±0.29 mm). Additional findings included subchorionic hematomas (3.3%) and adnexal masses (4.2%). Crown-rump length-based gestational dating closely agreed with last menstrual period-based estimates. Conclusion: FTU plays an important role in early pregnancy care by ensuring early diagnosis of both normal as well as abnormal pregnancies. It improves obstetric decision-making through accurate dating, identification of viability, and early detection of complications.
Copyright (c) 2025 MUNAGALA SAHITHI, GAUTAM MUTHU http://creativecommons.org/licenses/by/4.0
HARMONIZING THE TAPESTRY OF BREAST LESIONS IN WOMEN: AN INTEGRATED EXPLORATION OF CLINICAL, RADIOLOGICAL, CYTOLOGICAL, HISTOPATHOLOGICAL, AND IMMUNOHISTOCHEMICAL PATTERNS
Objectives: The study aimed to evaluate and compare the diagnostic validity of clinical examination, radiological imaging, Breast Imaging Reporting and Data System (BIRADS), and cytological examination in women presenting with breast lumps, using histopathology as the gold standard. Methods: A cross-sectional study was conducted among 96 women with palpable breast lumps at a tertiary teaching hospital over a 2-year period. Each patient underwent clinical examination, mammography (BIRADS scoring), and fine-needle aspiration cytology. The triple test scores were analyzed for diagnostic concordance, and histopathological examination was performed in all cases. Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and 95% confidence intervals (CIs). Results: Among 96 participants, 61 (63.5%) had benign and 35 (36.5%) had malignant lesions confirmed histopathologically. Clinical diagnosis showed the highest sensitivity (93.5%; 95% CI: 78.6–98.2), cytology showed perfect specificity (100%; 95% CI: 94.1–100), and radiology demonstrated moderate sensitivity (77.4%; 95% CI: 59.2–88.7) and specificity (96.9%; 95% CI: 88.2–99.5). The triple test achieved an overall concordance rate of 83.3%. PPV and NPV for clinical, radiological, and cytological evaluations were 93.5%, 77.4%, 100%, and 96.9%, 96.9%, 100%, respectively. Conclusion: The triple assessment method provides a highly accurate, non-invasive, and cost-effective diagnostic approach for breast lumps. Clinical examination and cytology together offer optimal diagnostic reliability. Integrating histopathology and immunohistochemistry enhances diagnostic precision and guides treatment, particularly in resource-limited settings.
Copyright (c) 2025 Dr. Sangeetha Nagalingam http://creativecommons.org/licenses/by/4.0
PAPANICOLAOU SMEAR ABNORMALITIES IN REPRODUCTIVE AGE WOMEN: A CROSS-SECTIONAL STUDY ON CLINICAL IMPLICATIONS
Objectives: To delineate the spectrum of Papanicolaou (Pap) smear abnormalities in reproductive-age women attending a South Indian tertiary center and to correlate Bethesda categories with presenting symptoms, particularly patterns of vaginal discharge. Methods: This cross-sectional descriptive study included 1,800 consecutive women aged 20–50 years who underwent clinically indicated Pap testing from June 2024 to May 2025. Conventional cervical smears were collected, stained with Pap, and reported as per the 2014 Bethesda System. Demographic data, symptom profile, and examination findings were recorded on a structured requisition. Cytology findings were summarized as frequencies and proportions, and clinicocytologic associations and age-stratified patterns were analyzed using appropriate statistical tests. Results: Most women presented with white vaginal discharge (95.8%), followed by greenish-white frothy discharge (3.7%) and contact bleeding with low back pain and an unhealthy cervix (0.5%). Cytology was predominantly non-neoplastic: Non-specific inflammation constituted 85.3% of smears, while organism-associated infections accounted for 10.8% (candidiasis 3.9%, trichomoniasis 3.6%, and bacterial vaginosis 3.3%). Epithelial abnormalities were detected in 3.9% of smears (atypical squamous cells of undetermined significance 1.5%, low-grade squamous intraepithelial lesion 1.1%, high-grade squamous intraepithelial lesion [HSIL] 0.7%, and malignancy 0.6%). Curdy white discharge is mapped chiefly to candidiasis, frothy discharge to trichomonas, and leukorrhea with cervical erosion to bacterial vaginosis. High-grade lesions and malignancies clustered in women aged 40–50 years, who contributed 60% of all epithelial abnormalities and 80% of malignancies. Conclusion: In symptomatic reproductive-age women, Pap smears are largely inflammatory yet still reveal a clinically important burden of HSIL and malignancy, particularly among women in their forties with contact bleeding and an unhealthy cervix. These findings emphasize the dual role of conventional cytology in detecting infections and epithelial atypia and support strengthening opportunistic, symptom-linked Pap screening within gynecology outpatient settings in similar South Asian contexts.
Copyright (c) 2025 ANIL MOHAN RAO S http://creativecommons.org/licenses/by/4.0
INFLUENCE OF ANTIHYPERTENSIVE PHARMACOTHERAPY ON ORTHOSTATIC BLOOD PRESSURE AND HEART RATE
Objectives: This study aimed to assess posture-induced variations in blood pressure (BP) and heart rate (HR) among hypertensive patients receiving different classes of antihypertensive medications and to compare these hemodynamic responses with normotensive controls. Methods: A cross-sectional study was conducted on 100 adults, including 50 hypertensive patients and 50 age- and sex-matched normotensive controls attending a tertiary care center. The hypertensive participants were divided into four groups based on their current pharmacotherapy: Group A – angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) with or without thiazide diuretics; Group B – beta-adrenergic blockers; Group C – calcium channel blockers (CCBs); and Group D – combination therapy involving two or more of these classes. After a 10-min period of supine rest, BP and HR were recorded in supine, sitting, and standing postures at 1 and 3 min. Orthostatic hypotension (OH) was defined as a reduction in systolic BP (SBP) ≥20 mmHg, diastolic BP ≥10 mmHg, or an increase in HR >20 beats/min. Statistical analysis was performed using analysis of variance with Tukey’s post hoc test, and multivariate regression was applied to adjust for confounders such as age, sex, body mass index, dosage, and treatment duration. Results: Participants on beta-blockers (Group B) exhibited the greatest postural SBP fall (−22±6 mmHg, p<0.001) and a blunted HR rise (+6±2 bpm). Moderate changes were seen with ACEI/ARB±diuretic therapy (−14±5 mmHg; +12±4 bpm), while CCB users had minimal alterations (−10±4 mmHg; +9±3 bpm). The prevalence of OH was 32% in Group B, 20% in Group A, 14% in Group C, and 4% among controls. Conclusion: The antihypertensive drug class markedly affects orthostatic cardiovascular responses. Beta-blockers confer the highest risk of OH, followed by ACEI/ARB-based regimens, whereas CCBs show minimal impact. Tailored drug selection, cautious dose titration, and patient counseling can reduce postural BP fluctuations and enhance treatment safety.
Copyright (c) 2025 SAIMA AZIZ, SYEDA PARVEEN FATIMA, VEMAIAH ADIMULAM, BLESSY NIHARIKA MEDE, PRASHANTH KUMAR PATNAIK http://creativecommons.org/licenses/by/4.0
NOVEL APPROACHES FOR ANEMIA IN CARDIORENAL SYNDROME: A RANDOMIZED CONTROLLED TRIAL OF HYPOXIA-INDUCIBLE FACTOR PROLYL HYDROXYLASE INHIBITOR VS SGLT2 INHIBITOR
Objectives: The study was designed to compare and discern the effects of desidustat versus dapagliflozin in managing anemia in addition to the standard treatment in cardiorenal syndrome (CRS). Methods: Patients were randomly allocated into three groups: Group A (standard heart failure therapy+oral hypoglycemics), Group B (standard therapy+dapagliflozin), and Group C (standard therapy+desidustat). At baseline, 12 weeks, and 24 weeks, the hematology, iron-related parameters were estimated. The Kidney Disease Quality of Life questionnaire (KDQOL-36) was used to evaluate the quality of life of these patients. Results: After 24 weeks, Group C exhibited significant improvements with a rise in hemoglobin (Hb) (p=0.001), other hematology, and iron parameters. Group B showed a modest but significant increase in Hb (p=0.04) alongside improved glycemic parameters. In contrast, KDQOL scores improved in Group C, specifically for the burden of kidney disease (p=0.03), symptoms (p=0.001), and daily life impact (p=0.001). Group B also showed significant changes in the burden of kidney disease (p=0.04), symptoms (p=0.002), and daily life impact (p=0.001). In Group A, significant changes were observed in the burden of kidney disease (p=0.001) and the impact on daily life (p=0.01). Conclusion: Desidustat demonstrated greater hematopoietic efficacy compared to dapagliflozin and standard therapy alone, hence emerging as a better treatment choice over conventional treatment in managing anemia in CRS.
Copyright (c) 2025 LAXMI SANKALPA BHAGANAGARAPU, SARUMATHY SUNDARARAJAN http://creativecommons.org/licenses/by/4.0
ISOLATION, MOLECULAR CHARACTERIZATION, AND ANTIMICROBIAL RESISTANCE TEST OF UROPATHOGENIC ESCHERICHIA COLI WITH ASSESSMENT OF INTERLEUKIN-10 IN RHEUMATOID ARTHRITIS PATIENTS WITH UTI
Objectives: It was aimed to isolate Escherichia coli bacteria in rheumatoid arthritis (RA) patients with urinary tract infection (UTI), examination of the antimicrobial sensitivity test, molecular detection of 16SrRNA, UidA virulence gene of the pathogens, and assessment of the level of interleukin (IL)-10 in the sera of RA patients. Methods: Two hundred and sixteen (116 RA patients with suspected UTI and 100 healthy controls without RA or UTI) were enrolled, midstream urine samples (MSU) and blood were collected from different ages and both sexes. All isolates were diagnosed based on microscopic examinations and morphological characteristics using suitable media. The diagnosis was confirmed by the Vitek2 system. Molecular identification was carried out by the polymerase chain reaction (PCR) technique. The evaluations of the immune marker were determined through an enzyme-linked immunosorbent assay (ELISA) test, which was the first investigation in Iraqi RA patients. Results: The results showed that E. coli had the highest percentage, representing 25.8%. Molecular methods, such as the PCR technique, were used to identify the E. coli by 16sRNA and UidA virulence genes; therefore, 26 of the isolates (86.66%) were identified through the presence of both genes. Testing antibiotic sensitivity against 13 different antimicrobial agents showed that E. coli isolates were highest resistance with high significant differences (p≤0.01) for rifampicin25 (83%), ampicillin/sulbactam 20 (67%), cefotaxime 19 (63%), trimethoprim/sulfamethoxazole 17 (57%), ciprofloxacin 16 (53%), gentamicin 12 (40%), while there is intermediate resistance to cefotrixone 10 (33%) with non-significant susceptibility rate 20 (67%), (p=0.068). In contrast, the isolates showed high susceptibility to imipenem 29 (79%), meropenem and amikacin 28 (94%), piperacillin/ tazobactam 27 (90%), and tigecycline 26 (87%) respectively, with highly significant differences (p=001). In addition, high significant sensitivity to cefotazdime 21 (70%), (p=0.0001). The current study demonstrated that E. coli possessed a multi-drug resistance against most of used antibiotics. Molecular detection of 26 bacterial isolates containing 16SrRNA and UidA virulence genes using a conventional PCR test. Five milliliters of venous blood sample from each patient under aseptic technique, the blood samples were collected from the same people from whom urine samples were collected for immunological analysis, such as rheumatoid factor, erythrocyte sedimentation rate, C-reactive protein, and anti-CCP, results exhibited positive reaction and clear elevation levels of antibodies in the serum of RA-infected patients. Analysis of IL-10 in patients’ sera, which was separated from 5 mL of venous blood sample for (30 patients with positive bacterial growth cultures of E. coli and 8 healthy controls), and the level was measured using the ELISA technique. The level of IL-10±SE increased non-significantly (p≥0.05) in RA patients with E. coli UTI (con 24.95 pg/mL±2.64 vs. 18.39 pg/mL±2.52), respectively, in comparison to healthy controls. The mean level of IL-10 reached 25.6 pg/mL differs significantly in RA patients’ era with UTI who were infected with E. coli. Conclusion: E. coli is the most predominant multidrug-resistant pathogen responsible for UTIs in RA patients, who had virulence genes to enhance the immune reaction, and IL-10 may have a role in RA risk.
Copyright (c) 2025 ZEINAB JASEM AL-AZZAWI, ASHWAK BASIM AL-HASHIMY http://creativecommons.org/licenses/by/4.0
PHENOTYPIC AND GENOTYPIC CHARACTERIZATION OF MULTIDRUG-RESISTANT KLEBSIELLA PNEUMONIAE PRODUCING EXTENDED-SPECTRUM Β-LACTAMASE AND CARBAPENEMASE
Objective: Antimicrobial resistance poses a worldwide health challenge with significant social and economic consequences. The increasing prevalence of extended-spectrum β-lactamases (ESBL) and carbapenemase (CP)-producing Klebsiella pneumoniae calls for urgent research and new drug development. These genes undermine infection control efforts because of their association with multidrug resistance (MDR). Methods: This cross-sectional study was conducted from April 2022 to April 2025 at the microbiology department of MMIMSR, Mullana, Ambala. Identification and antibiotic susceptibility testing for K. pneumoniae were performed using the Vitek-2 Compact (BioMérieux). The presence of ESBL and CP-producing isolates was phenotypically confirmed using the combined disc method. Genes KPC, NDM, IMP, VIM, OXA-48, TEM, CTX-M, and SHV were detected using singleplex conventional polymerase chain reaction. Results: Out of 612 K. pneumoniae isolates, 375 non-repetitive MDR strains were obtained from patients at M.M. Hospital, Ambala. The majority of these isolates came from males (57.6%), urine samples (61.3%), and hospitalized patients (75.5%). All isolates demonstrated complete resistance (100%) to β-lactams (Cephalosporins and carbapenems), with high resistance rates shown by cefepime (96.8%), ciprofloxacin (95.2%), gentamicin (93.6%), and trimethoprim-sulfamethoxazole (76%). Tigecycline (62%) and nitrofurantoin (53%) showed the most activity. ESBL production was identified in 51.2% of isolates, and CP production in 48.3%; Modified carbapenem inactivation method positivity was 70.1%, with 42.1% metallo- β-lactamase and 10.6% serine CPs. Among resistance genes, CTX-M (45.8%) and TEM (23.7%) were the most common ESBL determinants, while NDM (48.2%) and OXA-48 (37.8%) were the most prevalent CPs, followed by KPC (13.6%). The co-occurrence of genes was frequent, notably NDM+OXA-48 (16.2%) and triple KPC+NDM+OXA-48 (0.8%). All isolates were negative for SHV, IMP, and VIM genes. Conclusion: The findings highlight the need for urgent infection control. Policymakers should establish guidelines for regulating antibiotic sales and require susceptibility testing before prescribing antibiotics. Nationwide monitoring of carbapenem resistance and gene profiling is essential for better antimicrobial use.
Copyright (c) 2025 Harit Kumar http://creativecommons.org/licenses/by/4.0
EFFICACY OF TAUROURSODEOXYCHOLIC ACID ON BIOCHEMICAL AND HISTOPATHOLOGICAL CHANGES IN 1-METHYL-4-PHENYL-1,2,3,6-TETRAHYDROPYRIDINE INDUCED PARKINSON’S DISEASE MICE MODEL
Objectives: One of the main pathological features of Parkinson’s disease (PD) is the loss of dopaminergic neurons in the nigrostriatal pathway. Pre-clinical research has shown that tauroursodeoxycholic acid (TUDCA) monotherapy can alleviate the neuropathological complications of PD. The present study aimed to compare the therapeutic benefits of combination TUDCA and syndopa therapy with those of TUDCA and syndopa monotherapy in a mouse model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Methods: Male C57BL/6 mice received MPTP (30 mg/kg body weight/day, intraperitoneal, 5 days) to induce PD, followed by TUDCA (150 mg/kg body weight/day, intraperitoneal), syndopa (12 mg/kg body weight/day, oral), or both for 21 days. The midbrain reactive oxygen species (ROS), malondialdehyde (MDA), peroxynitrite, nitric oxide (NO), and urea contents, as well as the total antioxidant capacity (TAC), were measured. Midbrain and liver histopathology and histomorphometry assessed neuronal and hepatic damage. Results: MPTP increased the ROS (2.41-fold, p<0.01), MDA (2.07-fold, p<0.01), peroxynitrite (1.62-fold, p<0.01), NO (2.23-fold, p<0.01), and urea (1.88-fold, p<0.01) contents and reduced the TAC (1.92-fold, p<0.01) compared with the control. Combination therapy reduced the ROS content by 2.33 fold, the MDA content by 2.12 fold, the urea levels by 1.83 fold, peroxynitrite levels by 1.59 fold, NO by 2.65 fold, and neuronal loss by 3.68 fold (all p<0.05 vs. the MPTP group), outperforming both TUDCA (1.66 fold reduction in the ROS content, p>0.05, NS) and syndopa (1.38 fold reduction in the ROS content, p>0.05, NS) monotherapy. The same trend followed for other parameters, such as urea, TAC, MDA, NO and peroxynitrite. Moreover, the histopathology and histomorphometric results confirmed that TUDCA monotherapy and combination therapy markedly attenuated MPTP-induced neuronal and liver damage, with the combination therapy showing superior efficacy. Conclusions: TUDCA + syndopa offers synergistic neuroprotection and represents a novel therapeutic strategy for PD.
Copyright (c) 2025 MAHALAKSHMI RAJAN, SENTHILKUMAR SIVANESAN, KALPANA RAMACHANDRAN, ASHOKVARDHAN N http://creativecommons.org/licenses/by/4.0
ANTIOXIDANT MODULATION OF THE RYFA SRNA STRESS AXIS TO RE-SENSITIZE UROPATHOGENIC ESCHERICHIA COLI TO CIPROFLOXACIN: VITAMIN C AS AN ADJUVANT
Objectives: To test whether Vitamin C (ascorbate) at urinary-plausible concentrations can re-sensitize ciprofloxacin-resistant uropathogenic Escherichia coli (UPEC) in a simple agar model, and to interpret any adjuvant signal through the RyfA small-RNA oxidative-stress axis. Methods: In vitro Kirby–Bauer testing on Mueller–Hinton agar (35–37°C) using ciprofloxacin-resistant UPEC CFT073. Arms: Media control, Vitamin C 5 or 10 mg/mL alone, ciprofloxacin 5 μg alone, and combinations (ciprofloxacin disc spotted with 10 μL Vitamin C solution). Triplicate plates per arm were read at day-1/3/5 by two blinded readers. The primary endpoint was day-5 zone size for combination arms versus a 0 mm reference (ciprofloxacin-alone remained 0 mm). One-sample t-tests (α=0.05) were applied; reads beyond 24 h were treated as exploratory kinetics. Results: Vitamin C alone yielded 0 mm at all time points; ciprofloxacin alone also remained 0 mm. Ciprofloxacin+Vitamin C produced measurable halos that increased over time. Day-5 means (±standard deviation) were 15.1±0.8 mm for 5 mg/mL and 15.9±0.9 mm for 10 mg/mL (both p<0.05 vs. 0 mm). Kinetics showed early growth with 5 mg/mL (8.8 mm day-1; 10.2 mm day-3), whereas 10 mg/mL lacked an early halo but converged by day-5. A modest dose trend was suggested but not formally tested. Conclusion: In this single-strain, in-vitro, ascorbate at 5–10 mg/mL restored measurable ciprofloxacin activity against a ciprofloxacin-resistant reference UPEC strain (CFT073) in an agar system, consistent with attenuation of a RyfA-linked oxidative-stress program. These proof-of-concept findings require confirmation in broader clinical strain panels, MIC/time-kill assays in urinary matrices, and RyfA-axis expression studies before any clinical extrapolation.
Copyright (c) 2025 RAJAPPAYYA T DESAI, ANNAPURNA SAJJAN, SUNEEL I MAJAGI, AKRAM NAIKWADI http://creativecommons.org/licenses/by/4.0
IMMUNE DYSREGULATION IN PREECLAMPSIA: DIFFERENTIAL EXPRESSION OF TUMOUR NECROSIS FACTOR-ALPHA AND INTERLEUKIN-10 AND THEIR ASSOCIATION WITH CLINICAL, LABORATORY, AND PERINATAL OUTCOMES
Objective: Preeclampsia (PE) is a multifactorial hypertensive disorder of pregnancy characterized by systemic inflammation and endothelial dysfunction. Aberrant immune responses, particularly an imbalance between pro-inflammatory and anti-inflammatory cytokines, have been implicated in their pathogenesis. This study evaluated the expression of tumor necrosis factor-alpha (TNF-á) and interleukin-10 (IL-10) in earlyonset PE (EOPE) and late-onset PE (LOPE) compared with normotensive pregnancies, and examined their correlation with clinical, laboratory, andperinatal outcomes. Methods: A total of 200 pregnant women were recruited, including EOPE (n=50), LOPE (n=50), and healthy controls (n=100). Demographic, clinical, and laboratory parameters were recorded. Quantitative real-time polymerase chain reaction was used to assess messenger RNA expression of TNF-á and IL-10 in peripheral blood samples. Statistical analyses included analysis of variance with post hoc testing, Pearson’s correlation, and regression modeling. Results: EOPE and LOPE groups demonstrated significantly higher systolic and diastolic blood pressures (BP) and proteinuria compared with controls (p<0.001). TNF-á expression was markedly upregulated in EOPE compared with LOPE and controls (p<0.001), whereas IL-10 expression was significantly downregulated in both PE groups (p<0.01). The TNF-á/IL-10 ratio was highest in EOPE, reflecting a pronounced pro-inflammatory shift. Correlation analysis revealed that TNF-á positively correlated with BP, proteinuria, and adverse perinatal outcomes, while IL-10 levels negatively correlated with these parameters. Composite analysis integrating molecular and clinical data reinforced the stronger immune dysregulation in EOPE compared with LOPE. Conclusion: This study highlights a distinct immunological profile in PE characterized by elevated TNF-á, reduced IL-10, and an exaggerated TNF-á/IL-10 ratio, particularly in EOPE. These findings underscore the role of immune imbalance in disease severity and suggest that cytokine profiling may serve as a potential biomarker and therapeutic target in PE management.
Copyright (c) 2025 POGULA ASHALATHA, SRIKANTH TOKALI, KALAKANTI SHWETA, MUTHULAKSHMI R, ASHOK VARDHAN N http://creativecommons.org/licenses/by/4.0
STIMULI-RESPONSIVE SMART POLYMERS: INNOVATIONS, APPLICATIONS, AND FUTURE HORIZONS IN ADAPTIVE MATERIAL SCIENCE
Stimuli-responsive smart polymers have emerged as a transformative force in adaptive material science, offering unprecedented versatility and responsiveness to environmental changes. These polymers, capable of altering their properties in response to physical, chemical, or biological stimuli, have garnered significant attention across diverse fields, including medicine, engineering, and biotechnology. This review provides a comprehensive overview of recent innovations in stimuli-responsive polymers, highlighting their applications in drug delivery, tissue engineering, biosensing, and industrial technologies. Key advancements include the development of light-, temperature-, pH-, and enzyme-responsive polymers, each tailored for specific applications such as targeted drug delivery and smart coatings. The future of smart polymers lies in the design of multi-stimuli responsive materials, self-healing polymers, and bio-inspired systems. However, challenges such as scalability, biocompatibility, and toxicity must be addressed. The integration of AI and machine learning in polymer design and the development of sustainable materials are envisioned as critical future directions. Ultimately, stimuli-responsive smart polymers hold immense potential to revolutionize various sectors by providing adaptive solutions to complex challenges.
Copyright (c) 2025 Zoya Sheikh, Mahin khan, Arfana sheikh, Mujibllah Sheikh, Anjum Hasnain http://creativecommons.org/licenses/by/4.0
THE ROLE OF TURMERIC TABLETS IN ALLEVIATING INFLAMMATION AND OXIDATIVE STRESS IN CHRONIC KIDNEY DISEASE PATIENTS
chronic kidney disease is a progressive condition characterized by ongoing inflammation and oxidative stress. which plays an essential role in pathophysiology and complications Recent studies highlight the possible therapeutic role of curcumin, the active compound in turmeric, in preventing these harmful processes. The effects of turmeric tablets have been evaluated in terms of their mechanism of action. Clinical efficacy and safety There is substantial evidence that curcumin supplementation is positively associated with TNF-α, IL-6, and C-reactive protein, and improving antioxidant activity by inducing erythrocyte nuclear factor2.It is associated with a reduction in inflammatory cytokines. However, curcumin's effects on traditional markers of kidney function remain controversial. Most studies reported no change in GFR or serum creatinine. Further studies will be necessary to establish an optimal dosing plan and dosing regimen to increase bioavailability and therapeutic activity. Overall, curcumin is a potential adjuvant therapy for managing inflammation and stress from Oxidative reactions in patients with chronic kidney disease and deserves further study in a clinical environment.
Copyright (c) 2025 POLLOB KUMER ROY, CHANDAN KUMAR, SHITAL A CHANDEWAR http://creativecommons.org/licenses/by/4.0
VITAMIN D–VITAMIN D RECEPTOR AXIS IN BREAST CANCER: MECHANISMS, EVIDENCE, AND CLINICAL IMPLICATIONS
The Vitamin D-Vitamin D receptor (VDR) axis is biologically important in breast cancer because breast tissue can locally activate and break down Vitamin D, allowing direct control of cell growth, death, DNA repair, and the tumor microenvironment. In many breast cancers, this system is disturbed, with reduced effective VDR signaling and altered Vitamin D-metabolizing enzymes, changes that tend to appear in more aggressive disease. Experimental studies show that activating VDR can slow proliferation, limit stem-like behavior, reduce invasion and metastasis, and help maintain genomic stability and balanced immune responses. Human data generally link low blood Vitamin D levels and a disrupted VDR pathway with higher breast cancer risk and poorer outcomes, especially in hormone receptor-positive and some triple-negative or BRCA1-related tumors, although these patterns are weakened by lifestyle confounding and mostly neutral prevention trials. At present, the most realistic clinical use is routine testing and correction of Vitamin D deficiency, mainly for bone and general health, with any anticancer benefit framed as possible but unproven. Future work should focus on biomarker-guided, subtype-specific trials that combine Vitamin D-based approaches with endocrine, cytotoxic, or other targeted therapies, positioning the Vitamin D-VDR axis as a precision co-modulator rather than a stand-alone treatment.
Copyright (c) 2025 VEMURI HELENA, ARUMUGAM SURESH, KUPPUSAMY BASKARAN, NATRAJAN MUNINATHAN http://creativecommons.org/licenses/by/4.0