Clinicians', patients' and carers' perspectives on borderline personality disorder in Pakistan: A mixed methods study protocol.

Borderline Personality Disorder (BPD) is a condition characterised by significant social and occupational impairment and high rates of suicide. In high income countries, mental health professionals carry negative attitudes towards patients with BPD, find it difficult to work with patients with BPD, and even avoid seeing these patients. Negative attitudes and stigma can cause patients to fear mistreatment by health care providers and create additional barriers to care. Patients' self-stigma and illness understanding BPD also affects treatment engagement and outcomes; better knowledge about mental illness predicts intentions to seek care. The perspectives of mental health clinicians and patients on BPD have not been researched in the Pakistani setting and likely differ from other settings due to economic, cultural, and health care system differences. Our study aims to understand the attitudes of mental health clinicians towards patients with BPD in Pakistan using a self-report survey. We also aim to explore explanatory models of illness in individuals with BPD and their family members/carers using a Short Explanatory Model Interview (SEMI). The results of this study are important as we know attitudes and illness understanding greatly impact care. Results of this study will help guide BPD-specific training for mental health clinicians who care for patients with BPD and help inform approaches to interventions for patients with BPD in Pakistan.

Pharmacological basis of bergapten in gastrointestinal diseases focusing on H+/K+ ATPase and voltage-gated calcium channel inhibition: A toxicological evaluation on vital organs.

Aim and objectives: This study aimed to establish a pharmacological basis for evaluating the effects of bergapten (5-methoxypsoralen) in gastrointestinal diseases and assessment of its toxicological profile. Methods: The pharmacokinetic profile was evaluated using the SwissADME tool. AUTODOCK and PyRx were used for evaluating the binding affinities. The obtained results were further investigated for a post-dock analysis using Discovery Studio Visualizer 2016. The Desmond software package was used to conduct molecular dynamic simulations of best bound poses. Bergapten was further investigated for antidiarrheal, anti-secretory, charcoal meal transit time, anti-ulcer, anti-H. pylori activity. Results: Bergapten at a dose of 50, 100, and 200 mg/kg was proved effective in reducing diarrheal secretions, intestinal secretions, and distance moved by charcoal meal. Bergapten at the aforementioned doses acts as a gastroprotective agent in the ethanol-induced ulcer model that can be attributed to its effectiveness against H. pylori. Bergapten shows concentration-dependent relaxation of both spontaneous and K+ (80 mM)-induced contractions in the isolated rabbit jejunum model; the Ca2+ concentration-response curves (CRCs) were shifted to the right showing potentiating effect similar to papaverine. For molecular investigation, the H+/K+ ATPase inhibitory assay indicated inhibition of the pump comparable to omeprazole. Oxidative stress markers GST, GSH, and catalase showed increased expression, whereas the expression of LPO (lipid peroxidation) was reduced. Histopathological examination indicated marked improvement in cellular morphology. ELISA and western blot confirmed the reduction in inflammatory mediator expression. RT-PCR reduced the mRNA expression level of H+/K+ ATPase, confirming inhibition of the pump. The toxicological profile of bergapten was evaluated by an acute toxicity assay and evaluated for behavioral analysis, and the vital organs were used to analyze biochemical, hematological, and histopathological examination. Conclusion: Bergapten at the tested doses proved to be an antioxidant, anti-inflammatory, anti-ulcer, and antidiarrheal agent and relatively safe in acute toxicity assay.

Exploring the effect of Jasmonic Acid for Aphids control for improving the yield of Triticum aestivum varieties.

Many biotic and abiotic factors influence the production of wheat (Triticum aestivum L.). Among biological agents, aphids are destructive pests effecting wheat yield drastically. This study was designed to evaluate the impact of foliar Jasmonic acid spray on aphid population as well as on plant growth during aphid infestation in two wheat varieties i.e., Borlaug-2015 and Zincol-2015. Plants are cultivated in pots and treated with jasmonic acid at concentrations of 0.1 and 1 mM (JA). The results revealed that length of shoot and roots decreased after aphid stress and was improved (21-24%) by JA spray. Photosynthetic pigments increased after applying the jasmonic acid spray compared to control plants. Jasmonic acid spray helped the plants to recover from aphid stress by enhanced production of antioxidant enzymes CAT (Catalase) (65-71%), SOD (Superoxide dismutase) (71-74%) and POD (Peroxidase) (61-65%). Consequent to improved defence system, plants treated with JA had fewer aphids as compared to control (60-73% reduction), 24 h after spray. The higher concentration of JA (1 mM) proved more effective as compared to 0.1 mM jasmonic acid. Moreover, Zincol-2015 appeared tolerant as compared to Borlaug-2015 against aphid infestation. The application of jasmonic acid as an exogenous foliar application showed an overall positive impact on the physiological and biochemical attributes of both varieties. It helps the plants to enhance resistance against the biotic stress and can be adopted as future alternative for aphid management. However, detailed studies regarding understanding of underlying molecular mechanisms are needed to optimize the mode for field application.

Culturally adapted psychoeducation for bipolar disorder in a low-resource setting: protocol for a multicentre randomised controlled trial.

BACKGROUND: Bipolar disorder is a source of marked disability, morbidity and premature death. There is a paucity of research on personalised psychosocial interventions for bipolar disorder, especially in low-resource settings. A pilot randomised controlled trial (RCT) of a culturally adapted psychoeducation intervention for bipolar disorder (CaPE) in Pakistan reported higher patient satisfaction, enhanced medication adherence, knowledge and attitudes regarding bipolar disorder, and improvement in mood symptom scores and health-related quality of life measures compared with treatment as usual (TAU). AIMS: The current protocol describes a larger multicentre RCT to confirm the clinical and cost-effectiveness of CaPE in Pakistan. Trial registration: NCT05223959. METHOD: A multicentre individual, parallel-arm RCT of CaPE in 300 Pakistani adults with bipolar disorder. Participants over the age of 18, with a diagnosis of bipolar I or II disorder who are currently euthymic, will be recruited from seven sites: Karachi, Lahore, Multan, Rawalpindi, Peshawar, Hyderabad and Quetta. Time to recurrence will be the primary outcome assessed using the Longitudinal Interval Follow-up Evaluation (LIFE). Secondary measures will include mood symptoms, quality of life and functioning, adherence to psychotropic medications, and knowledge and attitudes regarding bipolar disorder. RESULTS: This trial will assess the effectiveness of the CaPE intervention compared with TAU in reducing the time to recurrence for people with bipolar disorder currently in remission in Pakistan and determine the effect on clinical outcomes, quality of life and functioning. CONCLUSIONS: A successful trial might lead to rapid implementation of CaPE in clinical practice, not only in Pakistan, but also in other low-resource settings, including those in high-income countries, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority group patients with bipolar disorder.

New cinnamic acid esters from Ocimum basilicum.

Studies on the chemical constituents of the aerial parts of Ocimum basilicum have led to the isolation of a new ferulate, 4'-carbomethoxy-2'-hydroxy phenyl ferulate (1) and a new cinnamate, (E)-3'-hydroxy-4'-(1''-hydroxyethyl)-phenyl-4-methoxycinnamate (2). Their structures have been elucidated through spectral studies including 2D-NMR experiments (HMQC, HMBC, COSY-45 degrees , NOESY and 2D-J resolved).

Two new triterpenoids and a steroidal glycoside from the aerial parts of Ocimum basilicum.

Studies on the chemical constituents of the aerial parts of Ocimum basilicum have led to the isolation of three new compounds, basilol (1), ocimol (2), and basilimoside (3), along with two known constituents betulinic acid and oleanolic acid. The structures of the new constituents have been elucidated through spectral studies including 2D-NMR experiments (HMQC, HMBC, COSY, NOESY, and J-resolved) and chemical transformation, as p-formylphenyl 3beta-hydroxyolean-12-en-28-oate (1), 2-methoxy-4-carbomethoxyphenyl 3beta-hydroxy-lup-20(29)-en-28-oate (2), and (22E)-24xi-ethyl-25-methylcholesta-5,22-diene-3beta-ol-3-O-D-glucopyranoside (3).