Objectives: The present study was undertaken to evaluate anxiolytic effect of Camellia sinensis (CS) and possible mechanism on acute and chronic administration in rats. Materials and Methods: Eight groups of rats with six in each group were used. Group I served as control. Group II received diazepam (1 mg/kg). Groups III, IV, and V received CS in doses of 3.3, 16.5, and 33 mg/kg, respectively. Three pharmacologically validated experimental models – elevated plus maze (EPM), light and dark box (LDB), and open field tests (OFT) – were employed. Each animal was tested initially in the EPM and then in the LDB, followed by the OFT in a single setting. In EMP, number of entries into, time spent in, and number of rears in each arm in a 5-min period were noted. In LDB, number of entries and time spent in bright arena, number of rears, and duration of immobility were noted. In OFT, number of peripheral and central squares crossed, time spent, and number of rears in central squares were observed for a 5-min period. One-way ANOVA followed by post hoc least significant difference test was performed. Results: In EPM and LDB, CS at 3.3, 16.5, and 33 mg/kg (acute and chronic models) increased the number of entries and time spent and rearing in the open arms and bright arena, respectively, compared to control. In the OFT, CS at 16.5 and 33 mg/kg significantly increased the number of squares crossed, time spent, and the number of rears in the central squares compared to control. Anxiolytic effect was dose dependent in EPM and LDB and CS at 33 mg/kg showed better anxiolytic activity compared to diazepam (1 mg/kg) in all models. Flumazenil (0.5 mg/kg) and bicuculline (1 mg/kg) completely inhibited while picrotoxin (1 mg/kg) partially inhibited the anxiolytic effect of CS. Diazepam and CS at 33 mg/kg reduced the locomotor activity in rats. Conclusion: CS has dose-dependent anxiolytic activity which is comparable to diazepam. Anxiolytic action of CS is likely mediated through GABA_A-benzodiazepine receptor – Cl − channel complex – since flumazenil and bicuculline inhibited the anxiolytic effect.

Pediatric cancer treatment has evolved significantly in recent decades. The implementation of risk stratification strategies and the selection of evidence-based chemotherapy combinations have improved survival outcomes. However, there is large interindividual variability in terms of chemotherapy-related toxicities and, sometimes, the response among this population. This variability is partly attributed to the functional variability of drug-metabolizing enzymes (DME) and drug transporters (DTS) involved in the process of absorption, distribution, metabolism and excretion (ADME). The DTS, being ubiquitous, affects drug disposition across membranes and has relevance in determining chemotherapy response in pediatric cancer patients. Among the factors affecting DTS function, ontogeny or maturation is important in the pediatric population. In this narrative review, we describe the role of drug uptake/efflux transporters in defining pediatric chemotherapy-treatment-related toxicities and responses. Developmental differences in DTS and the consequent implications are also briefly discussed for the most commonly used chemotherapeutic drugs in the pediatric population.

Background and Objective: The complexity of antiretroviral therapy (ART) regimens in people living with HIV (PLHIV) poses significant challenges for medication management, impacting adherence and overall health outcomes. The Medication Regimen Complexity Index (MRCI) is a tool that quantifies regimen complexity, yet its correlation with hospitalization rates and adverse drug reactions (ADRs) in PLHIV remains underexplored. Materials and Methods: This prospective study, which was conducted at a government-funded antiretroviral treatment center, investigated the relationships among MRCI scores, hospitalization due to ADRs, and the ADR rates in 285 PLHIV participants over 18 months. Results: The study revealed a significant association between higher baseline MRCI scores and hospitalization due to ADRs, with a threshold MRCI score of 8 indicating increased risk. There was no significant association between average MRCI scores and overall ADR rates or non-ADR-related hospitalizations. Conclusions: These findings emphasize the importance of monitoring medication regimen complexity in PLHIV, particularly in the context of preventing hospitalizations related to ADRs. Further research is needed to understand the multifactorial influences on ADR occurrence and to optimize ART regimens for better patient outcomes.

Objective: To determine the perceived usefulness of a virtual case scenario developed and delivered through the OpenLabyrinth platform among medical students and teachers. Methods: 20 second-year medical students and 12 teachers of pharmacology were invited to complete a virtual case scenario exercise. The participants accessed the case scenario using their laptops or mobile devices. Participants’ feedback was obtained using the electronic virtual patient consortium-developed questionnaire. Results: 19 students and 12 teachers provided feedback. All the faculty members and 95% of students felt that they had to make the same decisions a doctor would have to make in real life; ‘authenticity of patient encounter’ received the highest percentage of positive responses and ‘the learning effect’ the least. Conclusions: The feedback obtained suggests that virtual case scenarios are likely to be well received by students and teachers. The availability of open-source software enables the use of this technology in resource-limited settings.

Aged type 2 diabetes mellitus (T2DM) patients are linked with lower serum levels of total antioxidant activity, magnesium and zinc, particularly under uncontrolled hyperglycemia. Uncontrolled oxidative stress is an established contributor to diabetic complications. Magnesium is a cofactor for ∼600 enzymes, while zinc is a part of ∼3000 human proteins, essential for intermediary metabolism. A multi-targeted approach combining β-carotene, Magnesium and Zinc (BMZ) with metformin or vitamin E, Magnesium and Zinc (EMZ) with metformin for daily use in aged rats with T2DM identified astonishing findings compared to metformin monotherapy. Over three months, compared to metformin monotherapy, BMZ with metformin provided excellent glycemic control, outstanding protection against potential neuropathy and sensorimotor coordination, maintained robust retinal integrity and provided significant control for diabetic nephropathy. Mechanistically, the significant improvement in BMZ with metformin in controlling retinopathy, nephropathy, and neuropathy are directly linked to (1) Increased glycemic control (antihyperglycemic effect), (2) increased insulin sensitivity as evidenced by reduced HOMA-IR levels, (3) reduced oxidative stress (4) increased antioxidant activity through increased glutathione levels and increased GSH/GSSG ratio, and (5) improved regulation of carbohydrate and lipid metabolism as evidenced by metabolomic data. This study provides robust and direct evidence to support the use of affordable, proven antioxidant and mineral combinations with metformin to reduce diabetes-related complications in aging.