Endophytic fungi are microorganisms that colonize living plants’ tissues without causing any harm. They are known as a natural source of bioactive metabolites with diverse pharmacological functions. Many structurally different chemical metabolites were isolated from endophytic fungi. Recently, the increasing trends in human health problems and diseases have escalated the search for bioactive metabolites from endophytic fungi. The conventional bioassay-guided study is known as laborious due to chemical complexity. Thus, metabolomics studies have attracted extensive research interest owing to their potential in dealing with a vast number of metabolites. Metabolomics coupled with advanced analytical tools provides a comprehensive insight into systems biology. Despite its wide scientific attention, endophytic fungi metabolomics are relatively unexploited. This review highlights the recent developments in metabolomics studies of endophytic fungi in obtaining the global metabolites picture.

Introduction: Most of the decisions regarding diagnosis and treatment are based on laboratory test results. Urinary tract infections (UTIs) are among the most common infections in humans. The changing antimicrobial sensitivity in UTI requires appropriate antibiotics. Antimicrobial resistance is an emerging problem in the Kingdom of Saudi Arabia where the complete reversal of antimicrobial resistance is difficult due to irrational use of antibiotics. Objectives: This study aimed to determine the most common bacterial agents causing UTI in different seasons among patients who were admitted to Buraidah Central Hospital (BCH), Saudi Arabia. The study also evaluated the link between prescribing and resistance toward antimicrobials. Materials and Methods: A 6-month retrospective study was conducted among adult patients who were admitted to the inpatient department at BCH. A total of 379 files were collected from microbiological laboratory for inpatients. Results: Most UTI-causing bacteria prevailed in the same season. Of 15 bacterial strains, 12 were significantly correlated with 20 (of a total of 40) antibiotics that were used. Most bacteria were gram-negative. Gram-negative bacilli including Escherichia coli, Klebsiella spp., and Pseudomonadaceae and gram-positive Enterococcus faecalis were most frequently causing UTIs. Conclusion: Overall prevalence of antibiotic resistance was negative in bacterial isolates. However, the relationship between antimicrobial prescribing and antimicrobial resistance was significantly negative among UTI patients in BCH, Saudi Arabia.

Background: Warfarin, an anticoagulant medication, is prescribed regularly despite of its bleeding tendency for the prevention and/or treatment of various thromboembolic conditions, such as deep vein thrombosis, and complications associated with atrial fibrillation, and myocardial infarction, but because of its narrow therapeutic window, it has a lot of interactions with drugs and diet. Methods: Warfarin relies on regular monitoring of International Normalized Ratio which is a standardized test to measure prothrombin time and appropriate dose adjustment. Pharmacometabonomics is a novel scientific field which deals with identification and quantification of the metabolites present in the metabolome using spectroscopic techniques such as Nuclear Magnetic Resonance (NMR). Pharmacometabonomics helps to indicate perturbation in the levels of metabolites in the cells and tissues due to drug or ingestion of any substance. NMR is one of the most widely-used spectroscopic techniques in metabolomics because of its reproducibility and speed. Results: There are many factors that influence the metabolism of warfarin, making changes in drug dosage common, and clinical factors like drug-drug interactions, dietary interactions and age explain for the most part the variability in warfarin dosing. Some studies have showed that pharmacogenetic testing for warfarin dosing does not improve health outcomes, and around 26% of the variation in warfarin dose requirements remains unexplained yet. Conclusion: Many recent pharmacometabonomics studies have been conducted to identify novel biomarkers of drug therapies such as paracetamol, aspirin and simvastatin. Thus, a technique such as NMR based pharmacometabonomics to find novel biomarkers in plasma and urine might be useful to predict warfarin outcome.

Background Grade 1 placental abruption presents significant management challenges. This study evaluated the efficacy of Tranexamic Acid (TXA) in reducing blood loss and improving perinatal outcomes. Methods A multicenter, double-blind, randomized controlled trial was conducted at five teaching hospitals in Iraq and one in Egypt (January 2023–February 2024). We enrolled 115 women with mild vaginal bleeding due to abruption, randomized to receive either TXA (n = 57) or a 5% Dextrose placebo (n = 58). Primary outcomes included bleeding cessation and a composite favorable perinatal outcome (birth weight ≥ 2500 g, Apgar score ≥ 7, and no neonatal intensive care unit admission). Results Bleeding cessation was observed in 93.0% of the TXA group versus 44.8% in the placebo group (OR = 11.17; 95% CI: 3.32–37.60; p < 0.001), with a lower estimated blood loss (0.482 vs. 1.207 mL; p < 0.001). Pregnancy prolongation was noted in the TXA arm, which demonstrated a higher mean gestational age at delivery (35.2 vs. 31.8 weeks) and a lower rate of preterm delivery (38.6% vs. 87.9%; {RR} = 0.439; p < 0.001). Favorable perinatal outcomes were recorded at 75.4% with TXA versus 22.4% with placebo (p < 0.001). Secondarily, the TXA group required fewer packed red blood cell transfusions (38.6% vs. 94.8%; p < 0.001). No maternal thromboembolic or severe adverse events were observed. Conclusion In this sample, TXA was associated with reduced maternal blood loss, lower transfusion dependencies, and prolonged pregnancy, which may help mitigate preterm birth risks in Grade 1 placental abruption. Larger randomized controlled trials are required to confirm these findings and establish definitive clinical efficacy.