Mayadah B. Shehadeh

Complementary and alternative medicine utilization by a sample of infertile couples in Jordan for infertility treatment: clinics-based survey

BackgroundAlthough there is little information available to quantify the use of complementary and alternative medicine (CAM), growing evidence suggests that CAM prevalence among patients seeking infertility treatment is increasing worldwide. There are many products available on the market and many infertile patients demand information about CAM from their health care providers. This paper investigates the prevalence of CAM use among infertile couples in Jordan. Additionally, trends and factors contributing to CAM use for infertility treatment among these couples have been evaluated.MethodsA face-to-face questionnaire inquiring demographic information, use of CAM for medical conditions, in general, and types of CAM used for infertility treatment, in specific, was completed by one thousand twenty one infertile patients attending at two types of facilities; in vitro Fertilization (IVF) centers at both public and private hospitals and infertility private clinics. Both types of facilities were distributed in different areas of Amman, the capital city of Jordan. The study was conducted between May and August 2012.ResultsOur results show that CAM therapies for infertility treatment were encountered in 44.7% of the study sample. The vast majority of CAM users were females. The most commonly used CAM therapies were herbs and spiritual healing. A clear correlation between the use of CAM for infertility versus the use of CAM for other chronic medical conditions has been found.ConclusionsThe prevalence of CAM use for infertility treatment in Jordan is relatively high, particularly among young females, well educated and with a low income, in consistence with the studies reported elsewhere. Herbs and spiritual healing are widely used among patients in adjunct to conventional medical interventions. As CAM use is prevalent among patients, there is a clear need for health providers to become more aware of this phenomenon and for further research in this field.

Active educational intervention as a tool to improve safe and appropriate use of antibiotics

Misconception about antibiotics use among the public has been widely outlined to be a main reason for inappropriate use of antibiotics including failure to complete treatment, skipping of doses, re-use of leftover medicines and overuse of antibiotics. The study was devised to evaluate whether education might be a potential strategy to promote safer use of antibiotics and reducing self-medication. Two hundred seventy one adults were asked to complete two questionnaires; a pre and posteducation. The questionnaires comprised of three parts consisting of 17 statements assessing the knowledge on: appropriate use, safe use and resistance of antibiotics. Knowledge score was estimated by calculating the percentage of correct responses. The mean (SD) knowledge score pre-education was 59.4% (20.3). However, posteducation the score was 65.9% (17.9), p < 0.001(t-test). Knowledge scores were classified as poor, adequate and good. Posteducation, participants within poor and adequate knowledge categories were significantly shifted to the good category describing better knowledge, McNemar-χ2 = 28.7, df = 3, p < 0.001. It is concluded that using tailored education material targeting antibiotic need and use with a major aim of improving the public knowledge about antibiotics can be an effective and feasible strategy. This pilot study could be considered as the starting point for a wider scale public educational intervention study and national antibiotic campaign. However, the improvement in participant’s knowledge might not reflect an actual change in antibiotics–seeking behaviour or future retention of knowledge. Future research should seek to assess the impact of education on participant’s behaviour.

Recent progress in prostate-specific antigen and HIV proteases detection.

Proteases mediate a wide variety of biological events and have a critical role in the development of many diseases. Protease detection methods can be hindered by the limitation of assay safety, sensitivity, specificity, time constraints and ease of on-site analysis. Notably, the implementation of various detection methods on biosensing platforms translates them into practical biosensing applications. Currently, the detection of prostate cancer and AIDS at the earliest occasion is one of the major research obstacles. Therefore, recent advances focus on the development of portable detection systems toward point-of-care testing. These detection systems should be highly sensitive and specific for the detection of their prognostic biomarkers, such as the prostate-specific antigen and HIV load assay for prostate cancer and AIDS, respectively. These methods will also facilitate decision-making on a treatment regimen.

Platelet Aggregation Inhibitors from Aerial Parts of Ruta Chalepensis Grown in Jordan

Objective: To investigate the effects of a daily multinutrient supplement on plasma indicators of glycemic and lipemic control and psychological wellbeing in type 2 diabetic patients. Design: Double-blind, randomised, cross-over pilot intervention study. Subjects: Twenty-nine subjects (15 males and 14 females) with non-insulin-dependent type 2 diabetes. Intervention: Either a multinutrient supplement or placebo were provided daily during two intervention periods of 3 months separated by a 4 week washout. Results: There were no significant changes of multinutrient treatment compared with placebo in HbA1c, fasting or postprandial plasma glucose and insulin concentrations and fasting plasma lipid concentrations. Using a validated wellbeing questionnaire (W-BQ 22) designed for diabetic subjects, the multinutrient supplement resulted in improvements in the secondary outcome of wellbeing of the volunteers in terms of anxiety (p = 0.020), vitality (p = 0.013) and general wellbeing (p = 0.021), relative to placebo. Conclusions: Findings from this pilot study suggest that a multinutrient supplement may enhance the wellbeing of diabetic patients, even in the absence of a significant improvement in clinical parameters. If substantiated in a full clinical study the results would have important implications for the prevention of late complications of diabetes, as psychological factors can hinder successful management of the condition and adversely affect metabolic control.From the aerial parts of Ruta chalepensis L., grown in Jordan, two furanocoumarins (bergapten and chalepensin), one flavonoid glycoside (rutin) as well as several minor compounds have been isolated. The structural elucidation of these compounds was established based on spectral data (UV, IR, MS,1H-NMR and 13C-NMR). In Jordan, R. chalepensis is recommended for the treatment of rheumatism, mental disorders and menstrual problems. Fresh and dried leaves are used as flavoring agent in food and beverages. Antiplatelet activities of the crude methanolic and ethylacetate extracts in addition to the three isolated major compounds were measured by the aggrometric method according to Beretz and Casenave. Optical aggregometer connected to dual channel recorder was used for measuring aggregation. Both, ethylacetate and methanol extracts inhibited ADP- induced platelet aggregation (ADP-IA) of human blood. However, only ethylacetate extract was able to induce 50% inhibition of collagen-induced platelet aggregation (Co-IA) platelet rich plasma. Bergapten was more active against ADP-IA compared to chalepensin while the latter was more active against Co-IA compared to bergapten.Background: Hypertension is a major health problem with serious medical and financial consequences. Experimental studies in animals and clinical studies in humans have demonstrated that acupuncture can reduce blood pressure significantly in hypertensive patients. The objective was to assess the effect of acupuncture on blood pressure in hypertensive patients treated at a complementary medicine clinic. Methods: Blood pressure values measured before and following acupuncture were recorded from the charts of hypertensive patients who came to the clinic for treatment of other problems. The therapy used was the Kiiko Matsumoto technique for blood pressure imbalance. Results: Twenty-nine patients were studied (18 [62%] women). The mean age was 58.5 ± 16.3 years. Systolic blood pressure dropped significantly as a result of the treatment and there was a non-significant trend to reduced diastolic pressure. Weekly acupuncture therapy led to a continuous reduction in systolic blood pressure. Conclusions: Acupuncture has a beneficial effect on hypertension, particularly on systolic pressure. Further studies with larger study groups for longer periods of time can confirm this observation and contribute to our understanding of combination therapy with acupuncture and conventional medications for hypertension.Background: Population-based data about utilization of complementary and alternative medicine (CAM) among those with chronic conditions is lacking. Objective: To describe whether CAM use by California adults with cancer and other chronic conditions reflects condition specific patterns or a general tendency to use CAM modalities. Methods: Interviews of 9,187 respondents including all participants with cancer from a prior representative survey of California households, and a stratified sample of all other respondents. Almost 74% of the respondents reported at least one chronic health problem. Results: Use of all forms of CAM among those with chronic health problems is high. Those with a diagnosis of cancer are more likely to use prayer, dietary supplements, and support groups, and less likely to use CAM providers and special diets. Overall, individuals diagnosed with most chronic problems use a similar set of CAM modalities. Demographic correlates of CAM use differ in their impact and vary according to what type of CAM is being used. Conclusions: Clinicians should be aware that while a diagnosis of cancer is associated with a greater use of some forms of CAM, overall patterns of CAM use are similar to those with most other chronic problems.We propose the formation of an International PsychoSocial and Cultural Bioinformatics Project (IPCBP) to explore the research foundations of Integrative Medical Insights (IMI) on all levels from the molecular-genomic to the psychological, cultural, social, and spiritual. Just as The Human Genome Project identified the molecular foundations of modern medicine with the new technology of sequencing DNA during the past decade, the IPCBP would extend and integrate this neuroscience knowledge base with the technology of gene expression via DNA/proteomic microarray research and brain imaging in development, stress, healing, rehabilitation, and the psychotherapeutic facilitation of existentional wellness. We anticipate that the IPCBP will require a unique international collaboration of, academic institutions, researchers, and clinical practioners for the creation of a new neuroscience of mind-body communication, brain plasticity, memory, learning, and creative processing during optimal experiential states of art, beauty, and truth. We illustrate this emerging integration of bioinformatics with medicine with a videotape of the classical 4-stage creative process in a neuroscience approach to psychotherapy.In this essay, we posit that modern medicine, in its Asclepian focus, has subordinated the need and importance of Hygieian healing and caring, and in so doing has lost a quality that is essential to medicine, and fundamental to its lasting moral value. We argue that an integrative medicine must be based upon a core philosophical foundation that re-enjoins Asclepian and Hygieian approaches in true conceptual and practical dialectic, such that integration represents a synthesis of these orientations in epistemic, humanitarian and ethical domains. While we assert that a core philosophy is critical to the development and sustainability of an integrative medicine, such claims remain vacant in the absence of some meaningful attempt to put these concepts into action. We believe that to apply such philosophical foundations, an approach is necessary that simultaneously engages education, research, practice and policy. This involves not simply studying and co-opting new (or older, more ancient) modalities in a curative paradigm, but represents a paradigm shift that requires and is based upon understanding of, and skills for the application(s) of the most appropriate types of treatment(s) to affect disease, illness and health in a patient-centered model of care.Roughly 90 years of research demonstrate the relevance of dietary nutrients for mental health. Some of the earliest research studies on nutrients relevant to mental illness observed irritability and mood problems in people known to be deficient in the B vitamins1, as well as reported positive improvements in mental illness when treated with such nutrients as manganese2,3 and nicotinic acid;4 regardless of whether or not the patients could be found to be deficient. Although interest in such studies have declined since the introduction of psychiatric medications in the 1950’s, recent work on folic acid (vitamin B9) suggests that low levels may be associated with depressive symptomatology and poor response to antidepressant medication.5 Increasing evidence about the effects of trace elements on brain and behavioral functioning is appearing as well. Zinc, copper, and magnesium may play an important modulatory role in controlling a subtype of glutamate receptor (NMDA receptor),6 glutamate being the primary transmitter for most excitatory neurons in the cerebral cortex. This NMDA receptor has been implicated in various forms of cortical functioning;7 therefore it appears that decreased levels of these nutrients may produce abnormal NMDA activity and subsequent abnormal behavior. Given the accumulating evidence from PET and fMRI imaging studies showing that schizophrenia and affective disorders are associated with abnormal cortical activity,8 it is logical to state that such conditions could result, at least in part, from abnormalities in the nutritional status of neurons. Other studies regarding the relevance of nutrients and schizophrenia have been conducted as well. Comparison studies have shown that 26 medication-free schizophrenics were found to have significantly low serum iron,9 in addition to a study in Israel where both the cerebrospinal fluid and serum of people with schizophrenia were tested to be low in magnesium.10 Still others have studied essential fatty acid-related membrane processes. Among 38 schizophrenics and 22 controls, in the cutaneous flushing response to aqueous methyl nicotinate,: 83% of the people with schizophrenia (but only 23% of the controls) exhibited the absence of a flushing response, indicative of deficient levels of arachidonic acid.11 This particular study is relevant due to the fact that some minerals (e.g. Zinc) are thought to be rate-limiting factors in essential fatty acid conversion pathways.12 High dose vitamin therapy has been studied with a number of genetic diseases. The molecular basis of disease arising from as many as one-third of the mutations in a gene is an increased Michaelis constant, or KM (decreasing binding affinity) of an enzyme for the vitamin-derived coenzyme or substrate, which in turn lowers the rate of the reaction.13 The KM is defined as the concentration of ligand required to fill one-half of the ligand binding sites. Therapeutic vitamin regimens are thought to increase intracellular (cofactor) concentration, thus activating a defective enzyme, which alleviates the primary defect and remediates the disease. The proportion of mutations in a disease gene that is responsive to high concentrations of a vitamin or substrate may be one-third or greater.14,15,16 The battle to reduce the stigma associated with nutritional therapies is still very present today, fifty years later. More commonly labeled “alternative medicine/therapy,” nutritional therapies are considered just that: an alternative, a last resort, or are not considered at all. Over the years, major medical textbooks have claimed that “routine prescription of vitamin preparations is indefensible, it is poor medical practice,17 and that “multivitamins are not necessary.18 Goodwin went so far as to say that a bias exists in this particular area; where “positive results are viewed with suspicion,” and “negative results are published in the best journals.”19 One study found that most doctors do not feel comfortable discussing alternative therapies with their patients, despite the fact that 55% of patients have requested more information about herbal (or natural) medicine.20 However, despite the presence of skeptics, criticisms and lack of information to the public, natural therapies continue to be used. We will review a number of substances and their potential use in psychiatry. Essential fatty acids Essential Fatty Acids (EFA) must be obtained either from diet or through supplementation. Premenstrual Dysphoric Disorder (PMDD) affects many women in varying degrees, ranging from only physical symptoms before the menses to varying degrees of irritability, anger, and depression. Ranging from mild to severe, PMDD can be treated with Evening Primrose Oil (EPO). EPO contains two essential precursors for prostaglandin synthesis, 70% cis-linoleic acid, and 8 to 14% gamma-linolenic acid. By providing the body with these essential fatty acids, EPO facilitates the synthesis of Prostaglandin E1 (PGE1); a substance that women with PMDD may lack in the central nervous system as well as in other tissue including the breast tissue.21 In an open trial, 18 women with PMDD of more than 1 year’s duration received 8 capsules/day of evening primrose oil in the last half of the menstrual cycles for 5 cycles.22 Irritability (p < 0.001), depression (p < 0.001), anxiety (p < 0.01), and fatigue (p < 0.01) were significantly less compared to baseline after the first cycle of treatment. Total PMS scores were significantly improved (p < 0.001). A Cochran Database review concludes that limited evidence gives support to a hypothesis suggesting that the symptoms of schizophrenia may result from altered neuronal membrane structure and metabolism.23 The latter are dependent on blood plasma levels of certain essential fatty acids (EFAs) and their metabolites. They found several studies showing that those with schizophrenia often have low levels of the particular EFAs necessary for normal nerve cell membrane metabolism. Four relatively small trials (total n = 204) showed low levels of loss to follow up and adverse effects for those taking essential fatty acids. Early results from a few trials suggest a positive effect of eicosapentaenoic acid (EPA) over placebo for scale-derived mental state outcomes. The data, however, was limited, making these results difficult to analyze and interpret with confidence. A single small study (n = 30) investigated the value of using EPA as sole treatment for people hospitalized for relapse. Results suggested that EPA could help one third of people avoid instigation of standard antipsychotic drugs for 12 weeks (RR 0.6, CI 0.4–0.91). There were no clear effects of primrose oil (omega-6) EFA supplementation. Omega-3-Fatty acids have been used as treatment for depression,24 especially eicosapentaenoic acid.25,26,27Introduction The history of the European Union goes back to the 1950’s, when a new approach in economic cooperation started between some states of the continent. As it gradually developed, the four basic freedoms (free movement of persons, goods, services, and capital) assured by the participating countries became the basis of the cooperation. The creation of the European Union in 1992 brought forth a wider sphere of authority than already existed regarding the common economic issues. Some of the provisions related to health care even gained a great publicity, like the introduction of the E111 card or the European Court decision concerning the Simap and Valencia case (as a result of the latter, the member states are bound to regard the time spent on call by doctors in primary health care teams in its entirety as working time)(1). Although matters connected to alternative medicine generally fall within the authority of the member states, policies of the EU do have a certain impact in this area as well. Since a specifi c legal regulation is absent or incomplete in several countries, an indirect unifying impact of EU activities might emerge and reach a signifi cant level (2)(3). Alternative medical practices and products are widely used and applied by the citizens of the member states (4). Due to this increasing acceptance some might experience a growing EU activity, like speeches in the parliament, consultations with EU institutions, and advisory panels (2). However promising these manifestations might be at a fi rst glance, all but the directives are not binding for the member states. Up to now, beyond the favoring voices no specifi c law or signifi cant fi nancial support appeared. Two programs, starting in 2007 might become a turning point in the relation of the EU to alternative medicine. First, the ‘‘Programme of Community Action in the Field of Health 2007–2013” attempts to support mobility between patients and providers of the member states and stresses the assurance of patients’ free choice within health care (5). Second, the Seventh Framework Programme (FP7)—that will be approved before 2006—enables the fi nancial support of research in the case of alternative medicine also (6). The legal activity of the EU by means of its provisions or specifi c policies infl uences even unintentionally, or indirectly the developmental pathways of alternative medicine. Attempting to highlight some of them, the paper discusses the impact of education, research and migration policies on alternative medicine.It has been well reported that complementary medicines can significantly alter the way the body handles conventional drugs, leading to potential fatal herb-drug interactions. The aim of the present study was to investigate the molecular mechanism of drug interactions involving St John’s wort (SJW) (Hypericum perforatum L), a popular herbal medicine widely used for depression, particularly examining changes in the expression of cytochrome P450 CYP3A, the most abundant drug metabolising CYP enzymes in man. Eighteen Sprague-Dawley (SD) rats were assigned randomly into 3 groups (n = 6/group): control, low dose and high dose (500 and 1000 mg/kg/day of SJW, equal to 1500 and 3000 μg/kg/day of Hypericin). Each group was treated with SJW or control preparation, by gastric gavage, for 14 consecutive days. Liver and intestinal CYP3A activity and protein and mRNA levels, from fi ve segments of the intestine, were examined using CYP3A-dependent erythromycin N-demethylation activity assay, quantitative immuno-blotting and real-time RT-PCR. Increase in CYP3A activity and protein level by SJW was observed in some intestinal regions, with a 3.0 fold increase in liver CYP3A activity and a 10.6 fold increase in liver CYP3A1 mRNA (p 0.05) in a dose dependent manner. The results suggested that up regulation of liver CYP3A mRNA and differential induction of intestinal CYP3A play an important role in the molecular mechanism of herb-drug interactions.The Women’s Health Initiative found that combination estrogen and progesterone hormone replacement therapy increases breast cancer and cardiovascular disease risk, which compelled many women to seek herbal alternatives such as black cohosh extract (BCE) to relieve their menopausal symptoms. While several clinical trials document the efficacy of BCE in alleviating menopausal symptoms, preclinical studies to determine how BCE works have yielded conflicting results. Part of this is because there is not a universally accepted method to standardize the dose of black cohosh triterpenes, the presumed active ingredients in the extract. Although the mechanism by which BCE relieves symptoms is unknown, several hypotheses have been proposed: it acts 1) as a selective estrogen receptor modulator, 2) through serotonergic pathways, 3) as an antioxidant, or 4) on inflammatory pathways. We found that while the most prominent triterpene in BCE, 23-epi-26-deoxyactein, suppresses cytokine-induced nitric oxide production in brain microglial cells, the whole BCE extract actually enhanced this pathway. A variety of activities have been reported for black cohosh and its compounds, but the absorption and tissue distribution of these compounds is unknown.Background: Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) have modulating effects in several chronic inflammatory conditions. The aim of the present study was to test whether prior short-term dietary supplementation with n-3 (fish or seal oil) or n-6 (soy oil) PUFA rich oils would protect the development of dextran sulfate sodium (DSS)-induced colitis in rats. Methods: Forty-eight male Wistar rats were divided into 6 groups: no intervention, sham, DSS, seal oil + DSS, fi sh oil +DSS and soy oil + DSS. Following 7 days of acclimatisation, 1 mL oil (seal, fish or soy) or distilled water (sham) was administered by gavage day 8 to 14. Colitis was induced by 5% DSS in drinking water from day 15 to 21. Rats were sacrificed on day 23. Histological colitis (crypt and inflammation) scores, faecal granulocyte marker protein (GMP) and quantitative fatty acid composition in red blood cells were measured. Results: Pretreatment with fish or seal oils did not significantly influence DSS induced inflammation. In fact, all the oils tended to exacerbate the inflammation. Soy oil increased the mean crypt score (P < 0.04), but not the inflammation score or GMP. The ratio of n-6 to n-3 fatty acids (FAs) was 11 to 1 and 10 to 1 in standard diet and in red blood cells of control rats, respectively. Following administration of DSS, the ratio fell in all treatment groups (P < 0.001). The lowest ratios were seen in the groups receiving DSS + fi sh or seal oils (around 6 to 1). Conclusion: Short-term pretreatment with fish or seal oils did not protect against subsequent induction of colitis by DSS in this rat model. Whether the high ratio of n-6 to n-3 FAs in the standard diet concealed effects of n-3 FA supplementation should be further investigated.This feasibility study investigated the effects of Tai Chi, a mind-body exercise, on management of Type 2 diabetes mellitus. A total of 25 subjects (20-70 years) were recruited to participate in two 60-minute instructed Tai Chi exercise sessions each week for 12 weeks. The primary outcome measures (physiological variables) were hemoglobin A1C (HbA1c) taken at baseline and after 12 weeks of intervention, and self-reported fasting blood glucose level measured at baseline, 3, 6, 9, and 12 weeks of intervention. The secondary outcome measures (psychosocial variables) were Diabetes Quality of Life Questionnaire (Diabetes-39) and Exercise Self-Effi cacy administered at baseline and 12 weeks. A semi-structured interview was conducted at the end of the study (week 12). Paired t-tests was employed to determine all pre- and postintervention measurement changes, while individual growth curves were generated to show changes in fasting blood glucose levels during the study period. A rather high attrition rate of 48% was observed among the participants. The data showed no signifi cant effect of Tai Chi on HbA1c and self-reported fasting blood glucose, although there seemed to be a trend of lowered HbA1c. Analysis of subjects’ response suggested a positive experience for those who completed the intervention.In cancer treatment, apart from studying the effectiveness of chemo or radiotherapy in killing cancer cells, studies should examine ways of reducing drug side effects on patients and ways of enhancing the bodies’ immune system at the same time. Our defence system not only includes immune response, there are also detoxifying enzymes, antioxidant mechanisms, the ability for DNA damage repair and regulation of the hormone metabolism. Harmful environmental oestrogens that enter the human body can cause an increase of 16-α-hydroxyestrone as a harmful estradiol metabolite, the ratio between 16-α-hydroxyestrone and 2-hydroxyestrone relates to the risk of breast cancer. It is suggested that choosing nutritional products (that decrease the amount of 16-α-hydroxyestrone to regulate the hormone metabolism) can help with prevention of breast cancer. Increasing the ratio of monounsaturated fatty acid omega-3 (Ω-3) benefits health. Unsaturated fatty acid omega-6 (Ω-6) appears to be easily oxidised which can lead to DNA damage and increase the occurrence of cancer. The most important aspect to this approach is to reduce the ratio between saturated fatty acid and polyunsaturated fatty acid Ω-6, which is harmful to health. Olive oil has a high content of Ω-3 that benefits health. Ω-3 fatty acid can also be obtained from some fish, green vegetables and nuts. Linoleic acid is the most important source of Ω-6 fatty acid. Linolenic acid is the most important source of Ω-3 fatty acid. Natural foods e.g., purslane, is rich in Ω-3; the mustard family vegetables can increase the activity of detoxifying enzymes. Chinese Kiwi fruit drink reduces the side effects of the chemotherapy drug cyclophosphamide, which is also a DNA damaging agent. Soybean, job’s tears, garlic, mushroom varieties and tea have anti-cancer effects. Properly used nutritional products may assist treatment and recovery. Good balanced nutrition is essential for cancer healing.Spirituality seems to be an important cultural factor for African American women when thinking about their health. It is, however, not clear how spiritual health locus of control (SLOC) impacts health-related outcomes in the context of health message processing models, such as the Extended Parallel Process and the Risk Perception Attitude framework. Using a survey of African American and Caucasian women in the context of breast cancer, the role of SLOC and its interactions with perceived efficacy and risk was examined on four health outcomes—message acceptance, talking about breast cancer, information seeking, and behavioral intentions. For African American women, SLOC had a positive impact for talking about breast cancer through an interaction with risk and efficacy such that women high in both SLOC and perceived efficacy, but low in perceived risk were more likely to talk about breast cancer than when efficacy was low. However, high SLOC exacerbated the negative effects of efficacy on talking about breast cancer regardless of the risk level for Caucasian women. SLOC also had a positive influence on attending to breast cancer information in the media for African American women. SLOC played no role in attending to breast cancer information for Caucasian women. Interestingly, SLOC played no role for African American women on behavioral intentions, however, it worked to decrease behavioral intentions for Caucasian women when risk was high.

Proteinases as Biomarkers in Breast Cancer Prognosis and Diagnosis

BACKGROUND Breast cancer is the second leading cause of cancer-related deaths among women in the Western World. METHOD Upon diagnosis and treatment in the preinvasive state, the five years survival rate levitate up to 93%, making early detection crucial for dedicative diagnosis and treatment. Currently, mammography is the most efficacious diagnostic modality. However, this technique does not match the ultimate sensitivity. Other routinely used biomarkers include tumor size, histological type, nuclear and cellular characteristics, mitotic index, vascular invasion, hormonal and axillary lymph node status were not good enough to predict the course of cancer. To date, researchers revealed a change in the level of some proteinases in breast cancer tissue and reported the role of these proteinases in tumor aggressiveness and patient response to therapy. CONCLUSION This review summarizes the potential role of serine proteinases (including urokinasedependent plasminogen activator and kallikreins) and zinc metalloproteinases (including matrix metalloproteinase and A disintegrin and metalloproteinase) as either a prognostic and/or diagnostic breast cancer biomarkers. These proteinases plus genetic biomarkers could be implemented in the development of multiplex bio sensing platform toward early breast cancer detection, diagnosis, monitor progression and therapeutic success.

Design, Synthesis and in Vivo Evaluation of Novel Glycosylated Sulfonylureas as Antihyperglycemic Agents.

Sulphonylurea compounds have versatile activities such as antidiabetic, diuretic, herbicide, oncolytic, antimalarial, antifungal and anticancer. The present study describes the design, synthesis and in vivo testing of novel glycosylated aryl sulfonylurea compounds as antihyperglycaemic agents in streptozocine-induced diabetic mice. The rational for the introduction of the glucosamine moiety is to enhance selective drug uptake by pancreatic β-cells in order to decrease the cardiotoxic side effect commonly associated with sulfonylurea agents. 2-Deoxy-2-(4-chlorophenylsulfonylurea)-d-glucopyranose was found to be the most potent antihyperglycaemic agents among the synthesized compounds in diabetic mice. This investigation indicates the importance of this novel class as potential antihyperglycaemic agents.

Pharmacophore and QSAR Modeling of Neuronal Nitric Oxide Synthase Ligands and Subsequent Validation and In Silico Search for New Scaffolds

UNLABELLED Neuronal Nitric Oxide synthase (nNOS) is an attractive challenging target for the treatment of various neurodegenerative disorders. To date, several structure-based studies were conducted to search novel selective nNOS inhibitors. OBJECTIVE Discovery of novel nNOS lead scaffolds through the integration of ligand-based threedimensional (3D) pharmacophore (s) with quantitative structure-activity relationship model. METHOD The pharmacophoric space of ten structurally diverse sets acquired from 145 previously reported nNOS inhibitors was scrutinize to fabricate representative pharmacophores. Afterwards, genetic algorithm together with multiple linear regression analysis was applied to find out an optimal pharmacophoric models and 2D physicochemical descriptors able to produce optimal predictive QSAR equation (r(2) 116 =0.76, F = 353, r(2) LOO = 0.69, r(2) PRESS against 29 external test ligands =0.51). A minimum of three binding modes between ligands and nNOS binding pocket rationalized by the emergence of three pharmacophoric models in the QSAR equation were illustrated. The QSAR-selected pharmacophores were validated by receiver operating characteristic curves analysis and afterward invested as a tool for screening national cancer institute (NCI) database. RESULTS Low micro molar novel nNOS inhibitors were revealed. CONCLUSION Two structurally diverse compounds 148 and 153 demonstrated new scaffolds toward the discovery of potent nNOS inhibitors.

Topical Anti-Inflammatory Potential of Six Salvia Species Grown in Jordan

Inflammation is a host defense mechanism to get rid of injurious stimuli and to induce tissue healing process. In Jordan, Salvia species are traditionally used to treat inflammation and other ailments. The aim of this study was to evaluate the potential of six Salvia species grown in Jordan to inhibit cutaneous inflammation. Topical anti-inflammatory activities of hexane (Hex), ethyl acetate (EtOAc) and methanol (MeOH) extracts from Salvia species aerial parts (S. ceratophylla, S. dominica, S. multicaulis, S. palaestina, S. spinosa and S. syriaca) were evaluated for the inhibition of croton oil-induced mouse ear oedema. Almost all extracts reduced oedema at the tested dose (300 µg/cm2). Hex and EtOAc extracts exhibited the best anti-inflammatory effect in a dose-dependent pattern. Dose inducing 50% oedema inhibition (ID50) in vivo was found to be in the range of 87 - 300 µg/cm2 and 47-146 µg/cm2 for Hex and EtOAc extracts, respectively. In comparison with indomethacin (ID50 96 µg/cm2), S. palaestina and S. multicaulis EtOAc extracts were two folds more potent (ID50 47 and 50 µg/cm2, respectively).Whereas, the ID50 of S. syriaca Hex extract (87µg/cm2) was comparable to that of indomethacin. In conclusion, the results illustrated that S. multicaulis, S. palaestina and S. syriaca can be regarded as promising natural sources of anti-inflammatory drugs.