Ala Issa

Adiponectin serum levels correlate with insulin resistance in type 2 diabetic patients

The adipose tissue is not only an inert storage depot for lipids, but also it secretes a variety of bioactive molecules, known as adipokines, which affect whole-body homeostasis. Adiponectin is the most abundant of these adipocytokines and is known to have a regulatory effect on the metabolism of glucose and lipid. The main objectives of this study were to evaluate the serum levels of adiponectin and to establish a correlation between adiponectin serum levels and the degree of insulin resistance in type 2 diabetic patients. Eighty participants were enrolled in this study; 61 type 2 diabetic patients and 19 apparently healthy subjects. Serum level of adiponectin was measured by enzyme-linked immunosorbent assay (ELISA) for each participant. Data collection sheet was filled with all required information for each participant. Adiponectin level in the diabetic patients (5.05 ± 2.61 μg/ml) was lower than in non-diabetic healthy controls (5.71 ± 2.35 μg/ml). When the results were compared according to gender, diabetic females showed significantly higher adiponectin levels (5.76 ± 2.64 μg/ml) than diabetic males (4.366 ± 2.43 μg/ml, P = 0.035). In addition, female diabetic patients with abdominal obesity (waist circumference (WC) ⩾ 88 cm) had lower adiponectin levels (5.58 ± 2.58 μg/ml) than diabetic females without abdominal obesity (6.96 ± 3.12 μg/ml). The correlation analysis indicated that adiponectin had a significant positive correlation with age (r = −0.450, P < 0.001). In conclusion, female diabetic patients had a statistically significant higher adiponectin level than male diabetic patients which could indicate a gender effect. Adiponectin levels were inversely related to insulin resistance; as patients with abdominal obesity had lower serum levels of adiponectin.

Antioxidant, antihyperuricemic and xanthine oxidase inhibitory activities of Hyoscyamus reticulatus.

Context: Xanthine oxidase (XO) is a key enzyme in the pathophysiological homeostasis of hyperuricemia. It catalyzes the oxidation of hypoxanthine to xanthine and then to uric acid, the reaction involves the formation of free radical intermediates and superoxide byproducts. Objectives: This study was undertaken to investigate the antioxidant, antihyperuricemic, and xanthine oxidase inhibitory potentials of Hyoscyamus reticulatus L. (Solanaceae) extract. Materials and methods: The antioxidant potency was measured using the ABTS•+ scavenging capacity system, which includes Trolox as a standard. The xanthine oxidase inhibitory activity of the extract was quantitated in vitro by measuring the decline in the catalytic rate of xanthine oxidase following incubations with the plant extracts and using xanthine as a substrate. The hypouricemic potential of the extract was evaluated using an in vivo model for hyperuricemia. We tested three different doses of the extract and allopurinol was used as standard antihyperuricemic positive control. Results: H. reticulatus aqueous extract exhibited significant antioxidant scavenging properties (533.26 μmol TE/g dry extract weight) and inhibitory effect on xanthine oxidase activity (IC50 12.8 μg/mL). Furthermore, oral administration of the aqueous extract significantly reduced serum urate levels in oxonate-induced hyperuricemic mice in a dose-dependent manner. Discussion and conclusion: Our results suggest that the aqueous extract of H. reticulatus aerial parts might have great potential as an antioxidant and a hypouricemic agent. Our lab is currently identifying the active compounds in the extract to which the biological activities could be attributed.

Xanthine oxidase inhibitory activity of the methanolic extracts of selected Jordanian medicinal plants

Background: The search for novel xanthine oxidase (XO) inhibitors with a higher therapeutic activity and fewer side effects are desired not only to treat gout but also to combat various other diseases associated with the XO activity. At present, the potential of developing successful natural products for the management of XO-related diseases is still largely unexplored. In the present study, we have screened the methanolic extracts of various Jordanian medicinal plants for their XO inhibitory activities using an optimized protocol. Materials and Methods: The methanolic extracts of 23 medicinal plants, belonging to 12 families, were tested in vitro, at 200 μg/ml concentrations, for their XO inhibitory potential. The dose-dependent inhibition profiles of the most active plants were further evaluated by estimating the IC50 values of their corresponding extracts. Results: Six plants were found most active (% inhibition more than 39%). These plants are Salvia spinosa L. (IC50 = 53.7 μg/ml), Anthemis palestina Boiss. (168.0 μg/ml), Chrysanthemum coronarium L. (199.5 μg/ml), Achillea biebersteinii Afansiev (360.0 μg/ml), Rosmarinus officinalis L. (650.0 μg/ml), and Ginkgo biloba L. (595.8 μg/ml). Moreover, four more plants, namely Lavandula angustifolia Mill. (28.7% inhibition), Helianthemum ledifolium (L.) Mill. (28.4%), Majorana syriaca (L.) Kostel. (25.1%), and Mentha spicata L. (22.5%) showed a XO inhibitory activity in the range of 22–30%. Conclusion: The study showed that many of the tested plant species are potential sources of natural XO inhibitors that can be developed, upon further investigation, into successful herbal drugs for treatment of gout and other XO-related disorders.

The Impact of Lack of Pharmacist Contribution on the Prescription Patterns and the Appropriateness of Indications of NSAIDs, A Cross-Sectional Study

Purpose: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide. However, recent literature strongly points to gastrointestinal (GI) and cardiovascular (CV) risks associated with NSAIDs use. The current study was carried out in Jordan University Hospital. The main objective was to evaluate the role of pharmacists in directing the current prescription patterns and appropriateness of NSAID therapiesto establish strategies for medication reconciliation in the healthcare systems in the region. Methods: This is a prospective cross-sectional qualitative study that enrolled a total of 400 patients over a period of 10 months. The NSAID use was evaluated in patients with and without established CVD and various GI risk stratifications. In addition, 30 physicians were recruited into the study to determine the current prescription patterns. A structured questionnaire was validated and handed to physicians to determine strengths and weaknesses in the current system. NSAID-related drug interactions were evaluated in 200 of the patients. Results: Sixty five percent of the patients without CVD were at moderate GI risk and 12% were at high risk. Sixty nine percentof patients with CVD were at high GI risk and 28% were at moderate risk. Pharmacists were not involved in decision therapies pertaining to NSAIDs, which led to serious drug-related problems in the therapeutic regimens for patients using the NSAIDs.In 64% of the patients without CVD, NSAID therapy did not meetthe recommendations of current guidelines. There was no drug therapy monitoring or patient counseling by a proficient clinical pharmacist, whichled to virtually no identification of potential drug interactions or optimization of medication therapy. Conclusions: The study unraveleda great opportunity to improve the clinical outcomes in patients on NSAID therapy. The lack of pharmacist involvement puts patients at major health risks. Updating physicians on practice guidelines, including a clinical pharmacist in therapy decisions, and modifying hospital formularies are the most urgent recommendations.

Impact of Medical Specialty on the Prescription Patterns of Topical Corticosteroid Among Healthcare Professionals = أثر التخصص الطبي لمقدمي الرعاية الصحية على أنماط كتابة و صرف الوصفات الطبية للستيرويدات الموضعية

Background: Topical corticosteroids are among the most commonly prescribed skin preparations for the management of a plethora of inflammatory and allergic conditions. Objective: The main aim of this study is to assess the discrepancies in topical corticosteroid prescription patterns and practice recommendations among various healthcare professionals and to identify factors leading to such discrepancies. Methods: The current study is a prospective cross-sectional observational study that was conducted over a period of six months. A validated structured questionnaire was handed out to one hundred community pharmacists working in independent and chain pharmacies with only one pharmacist interviewed per pharmacy store. Prescriptions for topical corticosteroids over a period of six months were reviewed for discrepancies in prescription patterns between general practitioners and dermatologists in one hundred independent and chain community pharmacies included in the study. Results: The most commonly prescribed topical corticosteroid for initial treatment of mild symptoms of atopic dermatitis in children by general practitioners was hydrocortisone acetate (45%), followed by mometasone furoate (33%). In contrast, dermatologists prescribed mostly mometasone furoate (48%), for the aforementioned indications followed by combination products of topical corticosteroid with an antibiotic or an antifungal (22%) for children and adults. On the other hand, Pharmacists mostly recommended an emollient as an initial treatment. Only 14 % of pharmacists interviewed in the study recommended using the fingertip unit to quantify the proper amount of topical corticosteroids. None of the prescribers provided written instructions to patients in fingertip units. Interestingly, only 15% of pharmacists in the study were found to have adequate knowledge about topical corticosteroids use. Adequacy of knowledge was not significantly associated with age of the pharmacist (p value 0.447), gender (p value 0.628), years of experience (p value 0.288), and pharmacy degree (B.SC vs Pharm D, p value 0.444). Conclusion: This study shows that Physician and pharmacist adherence to clinical guidelines for safe prescription of topical corticosteroids was poor. Updating Physicians and pharmacists on practice guidelines is the most urgent recommendation to improve treatment of atopic dermatitis.

Famotidine inhibits glycogen synthase kinase-3β: An investigation by docking simulation and experimental validation

Famotidine was investigated as an inhibitor of glycogen synthase kinase-3β (GSK-3β) in an attempt to explain the molecular mechanism of its hypoglycemic side effects. The investigation included simulated docking experiments, in vitro enzyme inhibition assay, glycogen sparing studies using animal models and single dose oral glucose tolerance test (OGTT). Docking studies showed how famotidine is optimally fit within the binding pocket of GSK-3β via numerous attractive interactions with some specific amino acids. Experimentally, famotidine could inhibit GSK-3β (IC50 = 1.44 μM) and increased significantly liver glycogen spares in fasting animal models. Moreover, a single oral dose of famotidine was shown to decrease the glycemic response curve after 75 g OGTT