Complementary therapies such as biofeedback and music therapy have demonstrated promising results in pharmacoresistant epilepsies. The current emphasis of the review article is to explore the different integrated mechanisms of various treatments for adequate seizure control, and their limitations, and supportive pieces of evidence that show the efficacy and tolerability of these non-pharmacological options.The current research explores in vitro antioxidant characteristics, radiation-induced DNA damage protection and quenching effects of the oxidative stress by the ethanolic leaf extract of Abutilon indicum (EEAI) on human peripheral blood lymphocytes (PBLs). PBLs were incubated with various concentrations of EEAI accompanied by pre- and post-treatment with hydrogen peroxide. Cell viability was investigated by MTT assay. In addition, quenching of free radicals were measured in vitro using DPPH, superoxide anion, hydrogen peroxide, reducing power and nitric oxide radical scavenging assays. These activities were compared with ascorbic acid as standard antioxidants. Furthermore, inhibition of UV radiation-induced strand break formation in plasmid pBR322 DNA and anti-Fenton reactions in calf thymus DNA was evaluated. Cytotoxic effects of hydrogen peroxide on PBLs were significantly reduced with EEAI pre-treatment compared to post-treatment in a dose-dependent manner comparable with similar cytoprotective effects of ascorbic acid (p > 0.05). EEAI has shown strong antioxidant effects in the scavenging of DPPH, superoxide anion, hydrogen peroxide, and nitric oxide. EEAI also has a strong protective effect of UV-induced plasmid pBR322 DNA cleavage and Fenton-induced DNA damage. Overall, the results revealed that Abutilon indicum has a cytoprotective, potent antioxidant and DNA protective effect that provide pharmacological credence to justify its overall biological activity. Furthermore, future studies to identifying bioactive molecules and its molecular mechanisms responsible for promising therapeutic applications in the rescue of disease-induced cellular oxidative damage.

The effect of anticoagulation control on overall Health-Related Quality of Life (HRQoL) in patients taking warfarin in Malaysia has not been explored yet. Therefore, this study aimed to evaluate HRQoL among patients on warfarin in Malaysia.

HRQoL among patients on warfarin was measured using WHOQOL-BREF (World Health Organization Quality of life Assessment Brief Version). Descriptive and inferential statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 22.

Out of 319 patients, more female patients were observed than the males (n=221, 69.3%, and n=98, 30.7% respectively). Mean scores for the physical (61.14±15.96), psychological (68.58±16.11), social (63.55±27.06) and environmental domains (62.78±17.58) were observed. Statistically, a significant association was found between the comorbidities other than CVDs with health satisfaction (

=0.002), physical (

), psychological (

), social (

) and environmental domains of the WHOQOL-BREF. A weak positive correlation between overall health satisfaction and the social domain (

) and a moderate positive correlation between the physical and environmental domains (

) of the WHOQOL-BREF were observed.

Patients had overall better perceived HRQoL scores in the psychological domain as compared with the rest of the domains of the WHOQOL-BREF. Age, gender, employment status, education level, the indication of use and duration of warfarin therapy associated with overall perceived HRQoL.

Patients had overall better perceived HRQoL scores in the psychological domain as compared with the rest of the domains of the WHOQOL-BREF. Age, gender, employment status, education level, the indication of use and duration of warfarin therapy associated with overall perceived HRQoL.In the present study piroxicam loaded starch nanoparticles were prepared to enhance the solubility of piroxicam by nanoprecipitation technique. The preparation of nanoparticles was carried out as per central composite experimental design protocol, having concentration of starch and drug as independent variables and particle size and polydispersity index (PdI) as dependent variables. The particle size and PdI of piroxicam loaded starch nanoparticles was found to be between 282-870 nm and 0.339-0.772, respectively. After the characterization by FT-IR, TGA, XRD and SEM studies, the optimized batch was evaluated for in-vitro release study, anti-inflammatory activity and anti-oxidant activity. The in-vitro anti-inflammatory activity of piroxicam loaded starch nanoparticles was found to be more than the pure drug piroxicam whereas the anti-oxidant activity of starch is found greater than starch nanoparticles. In-vitro release study showed 98.8% release in 2 h dissolution study following supercase II transport mechanism of drug release.Available antiulcer medications reveal partial efficacy and numerous adverse reactions. Tetramethylpyrazine (TMP) was known for its potential antioxidant, anti-inflammatory and angiogenic properties. The aim of current study was to investigate the potential gastroprotective effect of TMP against indomethacin-induced gastric ulcer in rats with possible underlying mechanisms. TMP was tested at 3 doses (15, 30 & 60 mg/kg/d po) three days before indomethacin challenge (25 mg/kg ip). Gastric tissue was evaluated morphologically and histopathologically. Oxidative statuses were assessed via glutathione content (GSH), malondialdhyde (MDA) and catalase (CAT) activity, while TNFα and IL-6 were measured as inflammatory mediators. Gastric PGE2 was investigated in addition to vascular endothelial growth factor (VEGF). TMP was effective (at 30 and 60 mg/kg/d) in promoting mucus secretion and preventing histopathologic changes induced by indomethacin. Mechanistically, TMP significantly enhanced GSH content and CAT activity while reducing lipid peroxidation as expressed by MDA concentration. Moreover, TMP effectively reduced TNFα, IL-6 and intracellular adhesion molecule (ICAM-1) concentrations. On the other hand, TMP enhanced both COX-1 and PGE2 and encouraged angiogenesis via increasing VEGF expression. In conclusion, TMP possesses a protective effect against indomethacin-induced gastric ulcer. This could be explained – at least partly – by its antioxidant, anti-inflammatory and angiogenic effects.

To assess the knowledge of Alzheimer disease among healthcare students of King Saud University, Riyadh Saudi Arabia.

This cross-sectional survey was conducted via an online questionnaire using google form as the main platform to collect the data. We included Pharmacy, medical and dental students, who are studying at king Saud University, Riyadh Saudi Arabia during February to March 2019.

A total of 671 healthcare students responded to the study, and a total of 529 participants completely filled the survey with a response rate 79%. Majority (70.1%) of the student studied about Alzheimer disease in their college life, only 16.6% were not and 13.2% of them not remember. Most of the respondents 373 (70%) answered correctly and said that Alzheimer disease is related to mental disorders, although majority of 73.5% knew that Alzheimer disease is a Neurodegenerative disease. There was significant difference in knowledge score of medical and dental students (p=0.001), Pharmacy and dental students (p=0.003) respectively.

Saudi healthcare students have variation in knowledge about Alzheimer disease. To increase levels of knowledge, it is necessary to provide adequate education Programme and training is needed in healthcare colleges. We suggest further studies with large sample sizes to identify the effectiveness of Alzheimer disease education programs healthcare schools are warranted.

Saudi healthcare students have variation in knowledge about Alzheimer disease. To increase levels of knowledge, it is necessary to provide adequate education Programme and training is needed in healthcare colleges. We suggest further studies with large sample sizes to identify the effectiveness of Alzheimer disease education programs healthcare schools are warranted.Folate, also known as vitamin B9, is a co-factor necessary for DNA synthesis. Folate deficiency is associated mainly with hematological findings including megaloblastic anemia and pancytopenia. Many countries have mandated grain fortification with micronutrients including folic acid resulting in a reduced prevalence of folate deficiency. Saudi Arabia imports most of the grain products and folate is usually added after milling. There are no local studies to address the folate deficiency prevalence. In this study we aimed to analyse the clinical appropriateness of ordering practice of serum Folate level.

We reviewed all serum folate requests received at our laboratory in Aseer Central Hospital over one-year period (July 2018 June 2019). We collected patients’ demographics from the electronic requests along with biochemical results of serum B12, ferritin and CBC results. We assessed appropriateness of orders against pre-specified criteria and applied statistical tests to explore for any association or significas are generating unnecessary costs and time loss. Education, phasing out or restricting some tests and introducing laboratory policies like sample storing could help reduce unnecessary requests.

This study identifies a commonly inappropriate serum folate ordering practice that includes ordering all hematinics at the same visit without considering the possible anemia etiologies. The excessive requests might be related to doctors attempt to avoid multiple blood extractions and to try to reduce the time for diagnosis. These policies are generating unnecessary costs and time loss. Education, phasing out or restricting some tests and introducing laboratory policies like sample storing could help reduce unnecessary requests.Gingival recession is defined as apical migration of marginal gingival tissue causing the exposure of root surface. Abnormal brushing techniques, trauma, anatomical presence of tooth, caries, and improper oral hygiene measures are some of the problems leading to gingival recession. Several treatment modalities such as coronary advanced flaps and free gingival grafts have been used for the treatment of gingival recession defects and showed good results. However, while treating multiple gingival recessions, some new treatment modalities were introduced in literature. Vestibular incision subperiosteal tunnel access (VISTA) as a minimally invasive technique for root coverage was introduced with various advantages such as no secondary surgical site needed for harvestment of donor tissue and it provides excellent esthetic results with decreased patient morbidity. The present case report emphasizes on the treatment of multiple gingival recessions in the maxillary anterior teeth region using VISTA with titanium-prepared platelet-rich fibrin.Oral submucous fibrosis (OSMF) is one of the potentially malignant disorders (PMDs), predominantly observed in adults with a habit of chewing areca nut. A rapid increase in the use of commercially available nicotine products, especially among the children and adolescents, is a reason for consequential concern. Nicotine products remain to be the chief etiological factor, which increases the susceptibility of the oral mucosa to different kinds of PMDs irrespective of the age groups. Here is a case report of oral submucous fibrosis in a 5-year-old child, highlighting a strong association of areca nuts in the causation of OSMF.