Impact of common comorbidities on antimicrobial consumption and mortality amongst critically ill COVID-19 patients: A retrospective two center study in Saudi Arabia.

Objectives: To determine the association between common comorbidities, ICU mortality and antimicrobial consumption among critically ill COVID 19 patients in Saudi Arabia. Methods: A retrospective observational study of patients admitted to the ICU from March 1st, 2020, through August 31st, 2021. We excluded patients who stayed <24 h in the ICU and with no confirmed COVID-19 PCR testing. Results: Of the 976 screened ICU patients, 848 were included. While there was no difference in mortality between patients with and without comorbidities, those with at least one comorbidity had a higher severity of illness (p = 0.013). Compared to survivors, non-survivors were more likely to require mechanical ventilation and vasopressor support (P < 0.001). Almost all patients received at least one antimicrobial therapy. Predictors independently associated with ICU mortality were: older age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI], 1.01-1.04), vancomycin use (AOR, 2.69; 95% [CI], 1.65-4.37), linezolid use (AOR, 2.65; 95% [CI], 1.65-4.04), sepsis or septic shock (AOR, 6.39; 95% [CI], 3.68-11.08), Acute Kidney Injury (AKI) (AOR, 2.51; 95% [CI], 1.61-3.92) and Acute Respiratory Distress Syndrome (ARDS) (AOR, 2.03; 95% [CI], 1.61-3.92). Conclusion: Older age, vancomycin and linezolid use, sepsis/septic shock, AKI, and ARDS were negative prognostic factors in critically ill COVID-19 patients. More studies are needed to evaluate the outcomes of survived critically ill patients in relation to their vaccination status.

Poly(ADP-Ribose) Polymerase-1 Inhibitors Drug Discovery, Design, and Development as Anticancer Agents from Past to Present: A Mini-Review.

Cancer treatments are known for their life-threatening toxicities attributed to their low selectivity; hence, new therapeutic approaches are being developed as alternatives. Among those approaches is the DNA repair mechanism, where its inhibition results selectively in the death of cancerous cells. Poly(ADP-Ribose) Polymerase (PARP) is one of the enzymes involved in the repair of damaged DNA. The inhibition of PARP shows to be a promising approach for effective targeted treatment of cancer, especially in tumours with pre-existing Homologous-Repair (HR) defects (i.e., BRCA). Nicotinamide, which is one of the PARP catalytic products, was the first identified PARP inhibitor (PARPi). The first FDA-approved PARPi was Olaparib in 2014 for the treatment of BRCA mutated advanced ovarian cancer. Several clinical trials have been conducted to further improve PARPi. However, there are some concerns related to drug resistance, PARPi sensitive-tumour identification, and toxic accumulation of PARPi. This report will review the uses of PARPi, drug design and development of PARPi from past to present, current issues, and prospective plans.

Ethnobotany, ethnopharmacology, phytochemistry, biological activities and toxicity of Pistacia chinensis subsp. integerrima: A comprehensive review.

Pistacia chinensis subsp. integerrima (J. L. Stewart ex Brandis) Rech. F. is a valuable medicinal plant used in south Asian communities for the treatment of asthma, diarrhea, diabetes, liver diseases, fever, pain and inflammation. This review critically evaluates the available information on P. integerrima's ethnobotany, ethnopharmacology, phytochemistry, pharmacology and toxicology. Electronic databases such as Google Scholar, PubMed, Springer Link, and so forth, books and theses were used to find relevant information about P. integerrima using keywords such as "Pistacia integerrima," "P. integerrima," "Ethnopharmacology," "Phytochemistry," "Traditional uses". A number of in vitro and in vivo pharmacological activities have been reported; however, the most promising and attractive activity observed was its role in Alzheimer, diabetes, convulsions, cancer, asthma, diabetes, diarrhea and as an immunomodulatory, analgesic and antiinflammatory. In addition, Pistagremic acid exerted anti-Alzheimer's activity based on a hitherto unknown mechanism through interference with the amyloidogenic pathway. Most of the pharmacological activities were linked with traditional uses. A range of compounds have been reported from P. integerrima extracts including triterpenes, volatile oils, flavonoids, fatty acids, phenolic, phytosterols, tannins and oligosaccharides as well as unknown triterpenes and flavonoids. Pistagremic acid, a novel triterpene, was attributed to most of the activities. in vivo toxicological studies in animal suggested a toxic dose of 1,500 mg kg-1 , for its methanolic extract. All reported pharmacological activities were carried out in vitro and a gap in research, that is, preclinical and clinical investigation exists. Its outstanding activity as an antiglycating agent is the most promising and a so far unique activity and needs further evaluation. In-depth research and clinical trials on human subjects in order to investigate P. integerrima pharmacological activity, clinical efficacy and safety are crucial next steps.

Ethnopharmacology, phytochemistry, biological activities, and therapeutic applications of Cedrela serrata Royle: A mini review.

ETHNOPHARMACOLOGICAL RELEVANCE: Cedrela serrata Royle (C. serrata) is a medicinal plant not only used for constructions but also an important conventional medicine for the treatment of various diseases such as; diabetes, jaundice, liver diseases, diarrhea, fever, chronic infantile dysentery, intestinal worms, hypertension, skin and blood diseases. AIMS: This review article documents and critically assesses, for the first time; up to date categorized information about C. serrata including its reported pharmacological activities, cultural uses, active compounds, and botanical description. MATERIALS AND METHOD: s: All provided information about C. serrata was collected using the electronic databases (e.g. Google Scholar, Web of Science, Scopus, PubMed, Science Direct and Springer Link), books (e.g. Trees of Pakistan and Herbalism, Phytochemistry, and Ethnopharmacology) and thesis. RESULTS: Qualitative and quantitative phytochemical studies on C. serrata revealed the presence of important chemical constituents such as; flavonoids, phenolic acids, alkaloids, saponins, tannins, and cardiac glycosides. The phytochemicals showed various in vitro activities like antioxidant, anti-infective, antiglycation, cytotoxic activities. Major areas of research conducted on C. serrata are its antioxidant and anti-infective activities. Few historical uses of C. serrata are supported by modern in vitro pharmacological studies such as; antidiarrheal, antidiabetic, and leishmanicidal activity. CONCLUSION: There were convincing evidence in in vitro studies supporting C. serrata antioxidant, anti-infective, anti-diabetic, anti-glycating, and cytotoxic activities. Nevertheless, all reported pharmacological activities were carried out in vitro and a gap in research i.e. preclinical and clinical investigation still exists. The authors emphasize the need for future in-depth research and clinical trials to investigate C. serrata pharmacological activity, clinical efficacy and safety. The potential chemical compounds with suggestive classes may need to be isolated and pharmacological activities must be established for these compounds. The plant has very limited information about pharmacological activities and the data available for supportive cultural uses needs proper validation.

Ethnopharmacological uses, phytochemistry, biological activities of Debregeasia salicifolia: A review.

ETHNOPHARMACOLOGICAL RELEVANCE: Debregeasia salicifolia Rendle (DS) is used traditionally for the treatment of several diseases including; urinary system diseases, bone fractures, boils, diarrhea accompanied with blood, carbuncles, pimples, dermatitis, skin rash, eczema, and tumors. Additionally, it is used as an antiseptic and antifungal agent. AIM OF THE STUDY: To document up to date information regarding D. salicifolia and link the traditional uses with its reported pharmacological evidences. The review covers taxonomy, distribution, traditional uses, active phytochemical constituents and pharmacological activities for DS. MATERIALS AND METHODS: The electronic databases such as Google Scholar, E-Resource Portal of Imam Abdulrahman bin Faisal University, Scopus, PubMed, Springer Link, etc. as well as textbooks were used to gather all relevant information about DS. RESULTS: Ethnomedicinal studies revealed a wide use of DS for various traditional purposes in the south Asian community. The uses for diarrhea, cancer, urinary complaints and skin diseases were supported by pharmacological studies. In-vitro pharmacological studies confirmed its therapeutic activities e.g. antimicrobial, anticancer, and antioxidant. Moreover, analgesic and anti-diarrheal activities were also established in animal's in-vivo activities. Despite enormous literature regarding DS, the main focus of research and interest was antimicrobial and cytotoxic activities. Quantitative and qualitative phytochemical analysis proved the presence of various classes of phytochemicals in DS extract; triterpenes, phytosterols, tannins, flavonoids and anthraquinone. CONCLUSION: Though most of the traditional uses for the plant were supported by in-vitro and in-vivo pharmacological studies, however lack of clinical trials and shortage of in-depth mechanistic in-vivo studies was noted in the review. Hence, more elaborative in-vivo studies with quality clinical trials may be focused in order to confirm the safety and efficacy of reported activities in humans which will help explore the plant's therapeutic potentials.

Ethnopharmacological Uses and Public Knowledge Regarding Cinnamomum zeylanicum in Khobar, Saudi Arabia.

BACKGROUND: Cinnamon (Cinnamomum zeylanicum) is a herb that is used traditionally as a flavoring agent as well as for its health benefits in different parts of the world. Its use may vary among cultures. AIM: To observe the knowledge and uses regarding cinnamon in the Saudi population. MATERIALS AND METHODS: A 2-month cross-sectional study was conducted in Khobar, Saudi Arabia, using a novel questionnaire in Arabic language. RESULTS: A total of 585 responses were collected. Most respondents were female (91.5%), adults (74.4%), married (65.6%), and had bachelor's degree (58.1%). A total of 84.3% knew about cinnamon and used cinnamon as bark (38.6%) and as a flavoring agent (74.7%). Most common reason for use was to ease menstruation and menstrual pain (49.9%), as antidiabetic (35.9%), and for weight loss (5.6%). The source of information for cinnamon use and its knowledge was family and relatives who were using cinnamon (75.9%), that is, folkloric use. CONCLUSION: Folkloric use of cinnamon was found to influence the knowledge and usage of cinnamon in the Saudi population.