Pharmaceutical and Biomedical Research
Volume:7 Issue: 3, Sep 2021

Medicinal herbs remain a vital source of new chemical entities, instead of the attempt of pharmaceutical companies using combinatorial and synthetic chemistry techniques for developing new drugs.

The primary aim of review is to highlight the different phytochemcial ingredients and their therapeutic potential in Cynara scolymus

Cynara scolymus, commonly known as artichoke is a rich source of polyphenolic compounds, mainly caffeoylquinic acids and flavonoids, isolated in the polar extracts of the plant, together with the polysaccharide inulin. The worldwide scientific databases were comprehensively and systematically reviewed and summarized.

The beneficial effects of artichoke in experimental studies include antidiabetic, anti-obesity, anti-inflammatory, anti-hypercholesterolemic, hepatoprotective, nephroprotective, gastrointestinal protectant, reproductive, and anticancer properties. Studies with artichoke conducted in experimental animals reported no mortality or significant toxicity. Increasing attention is being paid to developing herbal medicines as a newly emerging treatment for the welfare of the patients in the last few decades.

The present review detailed the versatile therapeutic efficiency and diverse application of C. scolymus. This medicinal herb has been appropriately used in conventional medicine for a long and helps cure various ailments.

There is an intense search for the Coronavirus Disease 19 (COVID-19) cure, to stem the spread and burden of the disease worldwide. Studies revealed that epigenetic modifications impact the pathogenesis of some COVID-19 cases, which can be used as therapeutic targets. 

This review articulated the role of epigenetics in the pathogenesis and management of COVID-19.

Relevant articles published between January 2000 and November 2020 were retrieved from reputable academic databases, including PubMed, SpringerLink, Scopus, and Google Scholar.

Epigenetic modifications in the COVID-19’s pathogen, called the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and host’s cells may influence susceptibility or resistance to the disease. Notably, abnormal Deoxyribonucleic Acid (DNA) methylation and histone modification involving immune regulatory genes and molecules, such as cytokines and interferon-regulated genes may compromise immune function and enhance the host’s susceptibility and disease severity. The hypomethylation of SARS-CoV-2’s receptor, called the Angiotensin-Converting Enzyme 2 (ACE2), causing its overexpression, can also enhance SARS-CoV-2’s infectivity. Moreover, SARS-CoV-2 can hijack the host’s MicroRNA (miRNA) using its miRNA and compromise the immune function, increasing its infectivity. Fortunately, epigenetic changes are reversible; thus, a therapy that targets the epigenetic changes in the affected case may reverse COVID-19. 

Modifications in the SARS-CoV-2 or host epigenome promote the pathogenesis and severity of COVID-19. Epigenetic changes are reversible, so healthcare providers are advised to formulate therapeutic procedures that target the causal mechanisms in the affected individual.

Chronic ethanol consumption presents toxic effects on liver tissue by inducing oxidative stress and inflammation. The antioxidant and anti-inflammatory properties of lemon verbena were established. 

The present study aimed to evaluate the protective effects of the hydroalcoholic extract of Aloysia citriodora (A. citriodora) on ethanol-induced hepatotoxicity in male rats by evaluating inflammatory and oxidative stress factors. 

The study animals were randomly divided into 7 groups, (6/group) including control, extract alone (400mg/kg), ethanol 10 mg/kg, vitamin C 500 mg/kg + ethanol 10 mg/kg, and the fifth, sixth and seventh groups respectively received an intraperitoneal injection of 100, 200, and 400 mg/kg of A. citriodora extract plus ethanol once a day for 6 weeks. Oxidative stress parameters, such as glutathione content, lipid peroxidation, protein carbonyl, and reactive oxygen species were measured. Furthermore, inflammation parameters (nitric oxide) and liver damage were evaluated by determining the levels of liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and histopathological examinations.

In the liver tissue of the ethanol-receiving group, a significant increase (P<0.001) was observed in ALT, AST, and ALP levels and pathological changes, compared to the control group. There was also a significant increase in the levels of oxidative stress and inflammatory factors. Interestingly, A. citriodora extract could inhibit ethanol-induced liver damage by suppressing oxidative stress and inflammation.

A. citriodora extract significantly attenuated inflammation and oxidative stress caused by ethanol. Therefore, it can be suggested as a beneficial supplement for treating ethanol-induced hepatotoxicity.

Proton Pump Inhibitors (PPIs) are the most common medicine for the treatment and prophylaxis of acid peptic conditions. The inappropriate use of the PPIs, mainly the intravenous form of pantoprazole may lead to excessive cost and unexpected adverse effects. 

The present study aimed to evaluate the use of intravenous pantoprazole in the International Heart Center in the north of Iran.

The current retrospective study was performed on 215 patients hospitalized in Fatemeh Zahra Hospital in Sari City, Iran. Patients’ demographics, the type and doses of pantoprazole, and other relevant clinical data were recorded from their documentation. The appropriate use of pantoprazole was evaluated according to recommendations provided by Medscape 2020, and UpToDate 2020.

Prescribing PPI was appropriate for 53.5% of the examined patients; however, the majority of intravenous prescription cases were inappropriate (76.7%). Oral PPIs could have been used in 93.5% of the cases; however, they received the parenteral form of pantoprazole. The main cause of pantoprazole prescription in the explored hospital was stress ulcer prophylaxis, with the median 4/18 days used, which internal specialists in most of the cases (45.6%) prescribed.

In the current study, administrating intravenous pantoprazole was inappropriate in most of the cases. As a result of this improper administration, the extensive cost is exposed to the healthcare system, i.e., likely to be unsafe for patients. Accordingly, risk and indication evaluation for the prescription of pantoprazole should be a priority in each patient. Finally, it seems necessary to determine a protocol for PPI prescription per hospital for the rational use of drugs.

Barleria cristata Linn. belongs to the family Acanthaceae and is commonly known as Raktajhinti and VajraDanti. It is widely distributed in countries, such as India, Nepal, Bangladesh, Pakistan, and Asian tropical regions. This plant has been observed to bear multifarious ethnomedical uses in treating lung disorders, inflammatory conditions, toothache, anemia, and snakebite. A wide range of major chemical constituents, such as triterpenes, phenolic compounds, flavonoids, and glycosides are reported to be present in this plant. The plant exhibited diverse pharmacological actions, such as anti-inflammatory, antibacterial, antifungal, and antioxidant activities. The literature revealed insufficient information concerning the standardization of Barleria cristata Linn.

The present study aimed to explore the pharmacognostic and phytochemical characteristics of Barleria cristata Linn. (leaf). 

The present study addressed quality control parameters, including loss on drying, ash values, extractive values, pharmacognostic parameters (e.g. macroscopic & microscopic characters and powder microscopy) as per the World Health Organization (WHO) guidelines. 

Biochemical analysis revealed total ash (16.11±0.38), acid insoluble ash (1.50±0.18), water-soluble ash (11.10±0.23), alcohol-soluble extractive (19.34±0.79), and water-soluble extractive (25.06±0.17), respectively. The transverse section of the leaf revealed the presence of the epidermis, covering trichomes, vascular bundle, and so on. The other parameters such as phytochemical investigation, fluorescence analysis, and thin-layer chromatography were also performed to explore the crucial values of these examinations. 

The obtained data would be useful in the future for preparing a monograph for the authentication and standardization of this crude drug.

Irrational use of drugs is a serious global problem, especially in developing countries. Scientific evidence has announced albumin and intravenous pantoprazole as expensive drugs, i.e., relatively irrationally applied in hospitals without following the guidelines. 

Considering health cost management policy in Iran, this study aimed to evaluate the effects of implementing pharmaceutical guidelines to rationalize and reduce the use of albumin and intravenous pantoprazole and the related inappropriate costs.

This quasi-experimental study was conducted from January 2016 to October 2018 in two teaching Hospitals in Jahrom City, Iran. Pharmaceutical guidelines were implemented throughout the physical training as well as a pharmacist-led intervention and supervising. All inpatient prescriptions of the studied medicines were evaluated. 

Before conducting the intervention (June 2016), an average of 357 albumin vials were monthly used; after performing the interventions, 166 and 167 vials were used in 2017 and 2018, respectively. Reduced albumin use rate equaled 48%, i.e., significant (P=0.002). Annual cost-saving was estimated to be 25000 USD. In comparison to the previous year, there were 46% and 70% reductions in the mean number of pantoprazole vials prescribed in 2017 and 2018, respectively (P=0.005).
Consuming pantoprazole was measured to be 1457 vials per month in 2017 and 795 in 2018, i.e., significant (P=0.002). Cost-Saving in intravenous pantoprazole was estimated to be 16000 USD in 2017 and 25000 USD in 2018. 

Prescription strategies, such as pharmaceutical guidelines with educational measures, pharmacist-led intervention, monitoring the prescribing drug, and feedback to prescribers can significantly decrease the inappropriate use of expensive drugs and their costs.

Mangrove plants, often possessing a unique collection of metabolites, have extensively been used for the primary healthcare of coastal residents.

To determine the safety level and enrich the scientific data, the present study aimed to investigate the toxicity of Avicennia officinalis and Excoecaria agallocha. 

Ethanolic leaf and stem extracts were evaluated for cytotoxicity by brine shrimp lethality assay. The obtained extracts were administered to Swiss albino in a single dose (200, 400, 800, 1600, & 3200 mg/kg body weight) by oral-gavage for acute toxicity assay. Furthermore, systematic observation was performed by close monitoring for any toxic manifestations and mortality after dosing for the first 4 h, at 24 h and twice daily for 6 days. Evaluating the adverse effects were estimated by comparing the test groups with the controls. After sacrificing all group animals, relative organ weight was measured and histopathological analysis was conducted. 

Having Lethal Concentration (LC50) of 44.66 µg/mL, E. agallocha leaf was found with the highest toxicity against brine shrimp nauplii. The toxicological study data demonstrated no death and noticeable change in behavioral patterns in the test mice groups, compared with the control group. Moreover, no significant (P>0.05) differences were found in body weight and relative organ weights, compared to the controls. The histological structures of the liver in the treated mice displayed regular tissue configurations similar to the control group.

In this study, the mice model exhibited no harmful effects; thus, the reported results indicated that the ethanolic extracts of leaf and stem of these two mangrove plants are safe for therapeutic use. Further long-term toxicological impact of the extracts should be determined for well-founded confirmation.

Acetone or propanone is a volatile liquid that can be absorbed by ingestion, inhalation, and dermal routes, and is distributed throughout the body. 

This study presented a case of an employee of the Emergency Medical Center of North Khorasan Province, Iran, who died due to acetone poisoning. He was last seen alive approximately 4 hours before his body was found. Thus, the deceased was found 4 hours after death. He was a 25-year-old unmarried male nurse. He had a history of smoking for the last 4 years and reported diarrhea and nausea on the day before death. There was no history of diabetes or alcoholism as well as no other definite causes. According to interviews with his colleagues and family, he had no history of depression. A postmortem examination was performed to define the cause of death. Postmortem quantitative toxicological analysis with Gas Chromatography with Flame-Ionization Detection (GC-FID) presented acetone in the vitreous (35 mg/dL), blood (28 mg/dL), and urine (77 mg/dL) samples. Furthermore, in postmortem pathological analysis, highly microvascular changes and the diffuse necrosis of hepatocytes were reported. Other pathological changes in the brain and lungs were observed. No other definite medical cause of death was found. The cause of death was determined to be acute acetone intoxication. 

Contrary to public opinion, acetone is a toxic and dangerous substance; thus, it is necessary to improve and implement public safeguards concerning acetone usage, as well as its handling, and disposal. Organ toxicity due to acetone can be a major cause of death. Other alcohol-related poisoning deaths, such as acetone and other metabolites, should be considered.