Saponins are triterpenoid or steroidal glycosides and are an important group of naturally occurring compounds of plant origin. They exhibit diverse pharmacological potentials including radical scavenging, as well as neuroprotective, anti-diabetic and anti-inflammatory activities, owing to their diverse chemical scaffolds. Saponins consist of an aglycone part (non-sugar) and a glycone part (sugar) and have at least one glycosidic (C–O sugar bond) linkage present between the glycone and aglycone mostly at C-3. On the basis of the aglycone part, saponins are classified into triterpenoid glycosides, steroid glycosides and alkaloid glycosides. Saponins exhibit neuroprotective activities against various disorders of the central nervous system (CNS) including stroke, Alzheimer’s disease (AD), Huntington’s disease (HD) and Parkinson’s disease (PD). They mediate their therapeutic effects by modulation of various pathological targets. This study highlights various neuroprotective mechanisms of saponins including free radical scavenging, modulation of neuroprotective signaling pathways, activation of neurotrophic factors, modulation of neurotransmitters, inhibition of BACE1 enzyme and tau hyper-phosphorylation. The study concludes that saponins have considerable efficacy against various pathological targets of neurological disorders, especially AD, and might be an important source of leads against neurodegenerative disorders.

Incentives for better performance in health care have several modes and methods. They are designed to motivate and encourage people to perform well and improve their outcomes. They may include monetary or non-monetary incentives and may be applied to consumers, individual providers or institutions. One such model is the Pay-for-Performance system. In this system, beneficiaries are compared with one another based on a set of performance indicators and those that achieve a high level of performance are rewarded financially. This system is meant to recognise and primarily to reward high performers. Its goal is to encourage beneficiaries to strive for better performance. This system has been applied in several countries and for several recipients and settings. Early indications show that this system has had mixed effects on performance.

Objective. () Epicatechin (EP) is a naturally occurring antioxidant flavonoid found in some green plants. The current study was designed to evaluate the potential role of antioxidant mechanisms in the hepatoprotective properties of EP using the carbon tetrachloride (CCl₄)-induced acute liver injury model. Materials and Methods. Rats (n=7 per group) were divided into five groups including control group, () epicatechin group (20mg·kg⁻¹ body weight), CCl₄ group (1mL⁻¹ body weight), CCl₄-EP treatment group, and CCl₄-silymarin (SILY) group. The levels of enzymes including hepatic malondialdehyde (MDA), glutathione (GSH), catalase (CAT), glutathione S-transferase (GST), nitric oxide synthase (NOS), glutathione peroxidase (GPx), and cytochrome P450 (CYP450) were analyzed via enzyme-linked immunosorbent assay (ELISA). Histological studies were performed on all groups to assess the regenerative effects of test sample and compare it with the control group. Results. Test compound EP and standard drug silymarin (SILY) considerably reduced liver function enzyme levels in the blood, which were raised by CCl₄ administration, and increased serum albumin and total protein (TP) concentrations. The hepatic malondialdehyde (MDA) level was considerably declined, whereas glutathione (GSH), catalase (CAT), glutathione S-transferase (GST), nitric oxide synthase (NOS), glutathione peroxidase (GPx), and cytochrome P450 (CYP450) levels were upregulated in the EC-treated groups. The hepatoprotective results of the study were further confirmed via the histological assessments, which indicated a regeneration of the damaged hepatic tissue in treated rats. Conclusions. The results of this study revealed a significant protective efficacy of EP against CCl₄-induced liver injury, which was potentially mediated via upregulation of antioxidant enzymes and direct scavenging effects of the compound against free radicals.

Background: As part of Vision 2030, the Saudi Health Sector Transformation Program (SHSTP) introduced hospital clustering and digital health to strengthen patient-centered care. However, limited empirical evidence exists on its real-world impact. SHSTP represents one of the first large-scale digital integration reforms in the Gulf region, aligning with international frameworks such as the WHO Integrated People-Centred Health Services (IPCHS) and the Wagner Chronic Care Model. This study therefore contributes policy-relevant evidence on how national digital health reforms translate into measurable improvements in care coordination and patient experience. Methods: A convergent mixed-methods study was conducted across two regions (Mecca and Eastern Province) and four public hospitals (two clustered, two non-clustered) from 2016 to 2024. Quantitative indicators included patient satisfaction, Patient-Centered Care Index (PCCI), follow-up compliance, digital engagement (telemedicine, Sehat app/EMR), operational efficiency, and readmissions. Analyses used t-tests, ANOVA, and multivariable regression. Qualitative data from 53 semi-structured interviews (patients and physicians) were thematically analyzed and integrated with quantitative results through triangulation. Results: Clustered hospitals showed higher patient satisfaction (87.6% vs. 75.0%), stronger care coordination (PCCI: 89.4 vs. 69.7; p < 0.001), and better follow-up compliance (83.6% vs. 71.2%; p = 0.006). Digital engagement was greater (telemedicine 0.53 vs. 0.30; Sehat app 0.55 vs. 0.26; both p < 0.05). Regression identified hospital clustering (β = 12.49; p = 0.022), physician role (β = 19.92; p < 0.001), and digital literacy (β = 4.03; p = 0.047) as significant predictors of care coordination. Qualitative findings supported these results but highlighted challenges with digital literacy and workforce stability. Conclusions: SHSTP clustering improves patient experiences, digital engagement, and operational performance in chronic care. Sustained progress requires investment in digital literacy, workforce development, and change management. Broader longitudinal evaluation is warranted to confirm scalability and system-wide effects. These results extend the global evidence base on health system transformation by illustrating how digital and structural integration can operationalize patient-centered care in emerging-economy settings.

Alzheimer’s disease (AD), a neurodegenerative disorder of the aging brain, is associated with behavioral and cognitive issues and poses a huge burden on the global health care system. One of the key features of AD is the deposition of abnormal proteins called amyloid-beta (Aβ) in the brain, causing inflammatory changes, oxidative stress, and neuronal loss. Recent advancements in the anti-Aβ therapies have considerably improved the management of AD, resulting in better clinical outcomes for patients and caregivers. This review offers an inclusive update on current drug discovery efforts, innovative approaches, and ongoing clinical trials targeting Aβ, a key player in AD pathogenesis. We have evaluated the most recent developments in monoclonal antibodies, including aducanumab (discontinued November 2024), lecanemab, and donanemab, emerging therapeutic options, as well as emerging strategies such as tau-targeting therapies, gene therapy, and small molecule inhibitors. Moreover, we highlighted the challenges and opportunities in AD research, including the need for early diagnosis, personalized medicine, and combination therapies. Our review will offer a concise and informative overview of the current landscape and future directions in anti-Aβ therapeutics for AD, shedding light on potential treatments and prospects for improving patient outcomes.