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Pistacia integerrima grows in some areas of Pakistan and some other south Asian countries such as Afghanistan, India, Nepal, and Myanmar. It is an important medicinal plant which has been traditionally used for the treatment of asthma, cough, and dysentery. In the present study, we intend to re-isolate bioactive compounds (I–III) from P. integerrima galls extracts. The chloroform extract was subjected to column chromatography that afforded three reported chemical constituents, 7-methoxynaringenin (I), 7-methoxy-3,5,7,4′-tetrahydroxyflavanone (II), and β-sitosterol (III). Compounds (I–III) were evaluated for multi-drug resistance (MDR) reversing effect by assessing their activity on various genes including transfected mouse gene, human mdrl gene, and transfected mouse T-lymphoma cell lines (L5178 and L5178Y). Compounds (I–III) exhibit significant dose-dependent MDR reversing effect against the T-lymphoma (mouse cell line). in-silico molecular docking investigations performed on compounds (I–III) showed a common binding site for these compounds and Rhodamine 123. Our findings indicated that the relative docking scores correlate satisfactorily with in vitro activities. It could be concluded that the inhibitory activity of compounds (I–III) is largely due to their interactions with the P-glycoprotein (P-gp). The present work could also contribute to the isolation of novel natural compounds that act as potent inhibitors for cancer treatment. [ABSTRACT FROM AUTHOR]

Summary: Objective: To determine resistance trends including the emergence of extensive drug resistance (XDR) in Mycobacterium tuberculosis (MTB) isolates from Pakistan. Methods: This was a retrospective analysis of MTB isolates (January 1990–June 2007) collected from the four provinces of Pakistan. Standard methods were used to isolate MTB. Susceptibility against rifampin, isoniazid, streptomycin, ethambutol, ethionamide, capreomycin, cycloserine, and ciprofloxacin was tested using the agar proportion method, while susceptibility to pyrazinamide was determined using BACTEC. Resistance over the study period was assessed using Chi-square for trend analysis. Results: Resistance in 15343 MTB isolates showed a steady increase over the study period; a significant trend of increasing resistance was noted in three of the four provinces included in the study. XDR-tuberculosis was first seen in 1998; to date 22 XDR cases have been documented. MTB resistance was significantly lower (p <0.001) in patients under 5 and over 60 years of age, and significantly higher in males than females (p <0.001). MTB resistance was also higher in pulmonary than extrapulmonary isolates (p <0.001). Conclusion: This study documenting a steady increase in resistance among MTB isolates and the emergence of XDR strains is concerning. The data highlight the need to ensure adequate treatment of cases in order to prevent a further increase in multidrug resistance within the country. The importance of developing systems for monitoring drug resistance through nationwide surveillance is emphasized. [Copyright &y& Elsevier]