Translation and validation of the Sindhi version of the general medication adherence scale in patients with chronic diseases.

Background: There is no medication adherence scale available in Sindhi language currently. Hence, the Sindhi speaking population will either use a translator or provide their medical history in another language for documentation of medical conditions. This poses a challenge in monitoring and evaluating adherence to medications within this linguistic community. Aim: The aim of this study was to translate and validate the Sindhi version of the General Medication Adherence Scale (GMAS-S) in patients with chronic diseases. Methods: This was a cross-sectional study of 4 months duration and was conducted in out-patient department of a university affiliated hospital in Karachi, Pakistan. All adults with chronic diseases, who were on long-term medications, and able to read and understand Sindhi language were invited. Convenience sampling was employed and a questionnaire consisting of demographic questions and the Sindhi version of GMAS was used. The translation of the scale was carried out. Confirmatory factor analysis (CFA) was conducted, and a structural equation model (SEM) was developed. Fit indices, namely, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were reported. Reliability was assessed using Cronbach's alpha (α), intraclass correlation coefficient (ICC), corrected item-to-total correlation (ITC) and item deletion. Data were analysed through IBM SPSS version 23 and IBM AMOS version 25. The study obtained ethical clearance. Results: A total of 150 responses were analysed. The reliability of the Sindhi version of GMAS was (α) = 0.696. The intraclass correlation coefficient (ICC) was reported at 0.696 (95% CI: 0.618-0.763). The values for the fit indices were as follows: χ2/df = 1.84, GFI = 0.918, TLI = 0.920, CFI = 0.942, AGFI = 0.864, and RMSEA = 0.075. All values except AGFI were in the acceptable ranges and indicated good fitness. Most participants (80.7%) appeared non-adherent to their medications. Conclusion: The results of the study demonstrate that the Sindhi version of the GMAS is a valid and reliable scale to measure adherence in Sindhi speaking persons with chronic diseases.

Pharmacological basis for the antihypertensive activity of Grewia asiatica fruit extract.

In the management of cardiovascular disorders, medicines from herbal sources have played a vital role through centuries. The following study was commenced in order to lay possible pharmacological foundation associated with medicinal uses of edible fruit of Grewia asiatica in hypertension through in-vitro method. In this study isolated atrial preparation of Guinea pig was used where crude ethanolic extract of Grewia asiatica fruit (Ga.Cr) decreased the force and rate of spontaneous atrial contractions (0.03-10mg/kg). In isolated rat aortic ring preparations previously vasoconstricted by phenylephrine and High K+, it also resulted in dose dependent vasodilation (0.01-10 mg/kg).In the presence of L-NAME, the relaxation curve of Ga.Cr was partially inhibited showing involvement of Nitric oxide (NO) mediated pathway. The speculative analysis contemplated that Ga.Cr has blood pressure reducing potentials through inhibition of Ca++ influx via Ca++ channels, its release from intracellular stores and through other means like NO mediated pathways.

Formulation and evaluation of natural antitussive cough syrups.

Among respiratory complications, cough is an important defensive pulmonary reflex that removes fluids, irritants or foreign substances from the respiratory tract. Rosa damascene Mill, petal extract is a traditional medicine and reported to use in the management of cough. In the present study rose petals extract samples were used to prepare natural antitussive cough syrups containing ivy leaf extract to observe synergistic effect of rose water in managing coughing in rats. Four cough formulations (A1, A2, A3 and A4) were prepared. The antitussive activity was observed at three dosage levels; 5ml, 10ml and 15ml. Cough was induced by the standard procedure using sulfur dioxide gas and ammonia. The antitussive activity was recorded by observing the coughing bouts. The result indicated that all formulations had a good effect on cough reduction at 90min but comparing the effect of formulations in all doses formulations, A2 followed by A3 and A4 at 30 minute time interval which is good in comparison with standard Diphenhydramine HCL and Dextromethorphan HBr 10ml in sulfur dioxide gas and ammonia induced cough. Hence, the results of the present study indicated the synergistic effect of rose water in the management of cough ailments.

Determination of anxiolytic and antidepressant like activity of hydro alcoholic fruit extract of Pyrus communis (L.) and its impact on the memory after chronic dosing in animal models.

The purpose of this study was to evaluate the anxiolytic and antidepressant activity of ethanolic fruit extract of Pyrus communis (pear), in comparison with escitalopram in rodents (rats and mice). Thirty Wistar rats of about 200-250gm and albino mice of 25-30gm, male gender were divided into three groups each comprising of (n=10) animal respectively. Control group received distilled water, positive control received 10mg escitalopram & treated group received 200mg/kg/day of Pyrus communis ethanolic fruit extract orally for 30 days. They were evaluated by using the open field test, forced swim test (FST), plus maze test, light and dark test, hole poking test, stationary rod test, water maze test & cage crossing activity. Results were expressed as mean ± SD. Data was analyzed by using SPSS software (VERSION 21) one way ANOVA followed by Tukey test was used for post hoc analysis. Our result showed that fruit extract had significant antidepressant-like behavior in FST (p<0.001), open field (p<0.05), cage crossing (p<0.001) , significant anxiolytic activity in light and dark box test, plus-maze activity and significantly enhanced learning in water maze and stationary rod test when compared with control. The Pyrus communis fruit extract showed the anxiolytic and antidepressant-like profile in rats and mice. However, further studies need to be carried out in clinical trials for its use in different neuropsychological disorders.

Comparison of the antidepressant like activity of homeopathic remedies (Argentum nitricum, Staphysagria and Ignatia amara) and their effect on the behavior of rodents.

The majority of the world population suffers from mental and behavioral disorder. It is the need of the time to find an alternate of presently available medicines in order to decrease the medical expense. Homeopathic remedies are available and prescribed by homeopaths for treatment of anxiety and depression. Unfortunately, no data are available that proves its potential to relieve mental illness. The current study is designed to assess neuro behavioral and antidepressant like effects of homeopathic remedies Staphysagria, Argentum nitricum and Ignatia amara in comparison with standard drug (escitalopram). Different neuro behavioral activities were analyzed. The animals were administered the doses of all homeopathic remedied (60 µl to the rats) and escitalopram (0.042 mg to rats) through the oral route. The activities were observed on day 30th and day 60th. Our result suggests that the swimming time in Staphysagria treated group were significantly improved (p<0.001) after day 60th and significance rise was observed (p<0.01) in Ignatia amara treated animals, whereas significant decline (p<0.05) in struggling time was observed in Argentum nitricum administered animals after the 60th day as compared to 30th day. The central square crossings were improved highly significantly (p<0.001) after the 30th day dosing, by all three remedies and peripheral squares crossing were found highly significantly increased (p<0.001) after chronic dosing in Staphysagria and Ignatia amara treated groups. It is concluded from the results that all three homeopathic remedies produce comparable effects like standard drug while among all three remedies Staphysagria possess a potent antidepressant activity. To the best of our knowledge the current study reports first time the anti-depressant potential of homeopathic remedies in rodents.