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In this study, MgO-doped CNC-g-PAA hydrogel was synthesized by grafting poly (acrylic acid) (PAA) onto cellulose nanocrystals (CNC) and then doped Magnesium oxide (MgO) using pH 7.0 and 12.0 to obtain an efficient nanocomposite hydrogel for antibacterial and anti-cancer activities. The synthesized nanocomposite hydrogels were evaluated by detailed characterization and confirmed the formation of a well-interconnected porous structure. MgO/CNC-g-PAA (pH = 12.0) exhibited improved bactericidal tendencies towards gram-negative and gram-positive bacteria, which was further investigated by in-silico molecular docking analyses and also examined the reactive oxygen species production by photocatalysis and free radical-scavenging assay. After this, Doxorubicin (DOX), a model anticancer drug, was successfully loaded into nanocomposites (∼79 %) by electrostatic interaction and confirmed pH-triggered based release, which was over 53.7 % in 24 h. Finally, in vitro cytotoxicity-based analysis confirmed the improved antitumor efficacy of nanocomposite hydrogels. These findings revealed that MgO/CNC-g-PAA hydrogels might be prospective carriers for controlled drug delivery.

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that can cause destructive joint disease, significant disability, and increased mortality. RA is the most frequent of all chronic inflammatory joint diseases, and its prevalence frequency in Pakistan is 1.6 per thousand people. Different cytokines and receptors were involved in the triggering of RA, including interleukin-6 (ILR-6), major histocompatibility complex (MHC) antigen human leukocyte (HLA-DR) receptor, and CD20. Several studies illustrated RA as an inherent immune response and triggered due to the “shared epitope.” Therefore, the involvement of all these receptors (IL-6, HLA-DR, and CD20) leads to the neurological, ocular, respiratory, cardiac, skin, and hematological manifestations that have been considered a potential therapeutic target for drug design. Various herbal, natural, and synthetic source inhibitors of interleukin-6 (IL-6), human leukocyte (HLA-DR), and CD20 were studied and reported previously. Reported inhibitors are compared to elucidate the best inhibitor for clinical trials, leading to the orally active drug. In this study, a computer-aided drug designing approach disclosed the potential inhibitors for all receptors based on their distinct binding affinity. Moreover, drug suitability was carried out using Lipinski’s rule by considering the adsorption, distribution, metabolism, and excretion (ADME) of ligands. Results elucidated “calycosin 7-O-glucoside” and “angeliferulate” as putative ligands for IL-6 and HLA-DR, respectively. However, the pharmacokinetic properties (ADMET) revealed angeliferulate as an effete ligand for the biological system compared to calycosin 7-O-glucoside. Based on docking, drug toxicity profiling or pharmacokinetics, and MD simulation stability, this study highlights orally active therapeutic inhibitors to inhibit the activity of pivotal receptors (IL6, HLA-DR, and CD20) of RA in humans. After clinical trials, the resultant inhibitors could be potential therapeutic agents in the drug development against RA.

Background: The objective of the study was to evaluate the impact of classroom versus online Modular object-oriented dynamic learning environment (MOODLE)-based teaching on objective search literature evaluation (OSLE) score, as well as to validate the OSLE method for the assessment of research skills in pharmacy students. Methods: The four-station OSLE method was used to assess the performance and self-reflection at the end of each delivery mode. The students were asked to voluntarily vote for the preference of delivery mode in research courses. A hierarchical regression analysis was performed for variables predicting the “preference” for class-based teaching and/or MOODLE-based learning. Internal face and content validation were performed with students and faculty members not involved in the course teaching. External validation was performed with three professors working in different colleges in United Arab Emirates (UAE), Saudi Arabia and Qatar. Results: Thirty-five students completed the courses and showed significant improvement in self-reported reflection of pre-post knowledge and understanding. Findings suggested that 87.3% (110/126, 95%CI: 75.9 – 89.4, p < 0.001) achieved performance indicators and reported the OSLE method as an effective tool for the assessment of knowledge and understanding of research skills in pharmacy education. The predictive model suggested a strong positive effect associated with article appraisal, article application, self-reporting of knowledge and self-reporting of understating (R2 0.47, F-1.26, p < 0.001). Conclusion: The findings suggested the OSLE method as an effective tool of assessment in pharmacy education. A negative impact of MOODLE-based learning was found with self-reflection on knowledge.

Background: Fagonia arabica, belonging to family Zygophyllaceae, is a medicinal plant widely distributed in the desert areas of the world, including Saudi Arabia, Pakistan, India and South Africa. The present review aims to explore the published information on the traditional uses, ethnobotanical knowledge, phytochemistry and various biological activities like antioxidant, antimicrobial, thrombolytic activities and anticoagulant effects of Fagonia arabica with critical analysis on the gaps and future perspectives. Method: A literature survey was performed by searching the digital libraries and the scientific databases including Scopus, Google Scholar, SciFinder, ACS, Web of Science and published books. Results: Fagonia arabica plant has been reported to have a wide range of traditional uses in sore mouth, smallpox, hematological, neurological, endocrinological, inflammatory, cooling agent in stomatitis, vertigo and endothermic reaction in the body. Several bioactive constituents, including glycosides, flavonoids, terpenoids, saponins, alkaloids and trace elements, were recorded from Fagonia arabica plant. The isolation and identification of two flavonoid glycosides (kaempferol-7- O-rhamnoside and acacetin-7-O-rhamnoside) were also reported. Fagonia arabica has been studied for its wide range of biological activities, which include antioxidant, antimicrobial, cardioprotective and anticoagulant. Conclusion: It is apparent from the literature that Fagonia arabica plant possesses a wide range of medicinal and pharmacological uses and has been studied for its various pharmacological activities and medicinal applications. Critical analysis reveals that the plant has huge potential for pharmaceutical and pharmacological applications.

ObjectivesThis study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals.MethodsStudies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as ‘patient satisfaction’/‘inpatient pharmacist’/‘pharmacist hospital services’/‘clinical pharmacist roles’. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well.Key findingsA total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist’s inpatient counselling (I2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P < 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P < 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48).ConclusionThis meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often.

In this study, soybean straw (SS) as a promising source of glycolaldehyde-rich bio-oil production and extraction was investigated. Proximate and ultimate analysis of SS was performed to examine the feasibility and suitability of SS for thermochemical conversion design. The effect of the co-catalyst (CaCl2 + ash) on glycolaldehyde concentration (%) was examined. Thermogravimetric-Fourier-transform infrared (TG-FTIR) analysis was applied to optimize the pyrolysis temperature and biomass-to-catalyst ratio for glycolaldehyde-rich bio-oil production. By TG-FTIR analysis, the highest glycolaldehyde concentration of 8.57% was obtained at 500 °C without the catalyst, while 12.76 and 13.56% were obtained with the catalyst at 500 °C for a 1:6 ratio of SS-to-CaCl2 and a 1:4 ratio of SS-to-ash, respectively. Meanwhile, the highest glycolaldehyde concentrations (%) determined by gas chromatography–mass spectrometry (GC–MS) analysis for bio-oils produced at 500 °C (without the catalyst), a 1:6 ratio of SS-to-CaCl2, and a 1:4 ratio of SS-to-ash were found to be 11.3, 17.1, and 16.8%, respectively. These outcomes were fully consistent with the TG-FTIR results. Moreover, the effect of temperature on product distribution was investigated, and the highest bio-oil yield was achieved at 500 °C as 56.1%. This research work aims to develop an environment-friendly extraction technique involving aqueous-based imitation for glycolaldehyde extraction with 23.6% yield. Meanwhile, proton nuclear magnetic resonance (1H NMR) analysis was used to confirm the purity of the extracted glycolaldehyde, which was found as 91%.

Background: Lack of knowledge among parents can result in inappropriate administration practices. After analyzing different studies among children, there was no data on challenges and barriers in the administration of medicines among children in this region because of the diverse environmental issues and challenges in the UAE. The objective of this study was to determine the reported administration practices of parents and challenges and barriers in the administration of medicines among children in UAE. Methods: A questionnaire-based survey was conducted. A convenience sampling technique was used to collect the data. An online Raosoft® sample size calculator was applied (n = 248). The inclusion criteria were parents who had a child under 10 years of age and gave consent to participate in this study. Children with vision problems, cognitive/physical disabilities, and caregivers other than parents were excluded from this study. Results: The study reported response rate of 73.2%. The mean ± S.D age of the parents in years was 35.5 ± 7.8, and the mean ± S.D of children aged years was 2.60 ± 1.54. 26.2% of parents reported treatment failure due to oral medicine administration. A total of 22.2% of parents reported that they gave medicines in doses higher than prescribed by the doctor to treat their children more quickly. Similarly, a total of 64.5% of the parents reported self-medication without consultation from a healthcare provider. Conclusions: The study concluded that there were inappropriate medicine administration practices among parents. Parents reported administration of higher doses to treat their children quickly.

The objective of this meta-analysis study was to evaluate the comparative efficacy of empagliflozin (25 mg) with placebo in the treatment and management of type 1 diabetes mellitus. This study is a meta-analysis, so an ethical statement is not required. Different databases and individual journal websites like SCOPUS, Science direct, Cochrane review library etc. were used. The articles were evaluated based on the search and eligibility criteria. A total of five RCTs were incorporated in this meta-analysis. These studies contained a total of 1058 patients, including 526 patients with placebo (or control-treated patients), and 532 patients with empagliflozin (25 mg) treated combination. The mean follow-up time ranged from 7 days to 6 months. Overall, mean reduction in placebo was -0.50% and empa-treated was -0.85%, while the pooled WMD was 3.82 995% CI 1.20 – 5.88, p=0.0001). Regarding urinary glucose excretion, that the pooled WMD was 6.67 (95% CI 4.87-10.14, p=0.001) indicated a significant increase in empa-arm compared to placebo. No heterogeneity was found (I2 – 15.03%). This meta-analysis underlined the therapeutic benefit of empagliflozin as an adjunctive therapy for patients with type 1 diabetes.

Background: This study was aimed to describe the choice of Surgical Antimicrobial Prophylaxis at a tertiary-level care hospital in United Arab Emirates. It also associated the choice between two leading antimicrobials for the SAP to the site of surgery.Methods: A descriptive drug use evaluation was performed retrospectively to study choices of antimicrobials in surgical antibiotic prophylaxis. An analytical cross-sectional study design was used to develop a hypothesis regarding the choice of ceftriaxone. Data were collected from the medical records of Hospital from July 2020 to December 2020. Results were presented in numbers and percentages.Results: SAP data were collected from 199 patients, of which 159 were clean or clean-contaminated. Dirty surgeries (18) needed a higher level of antimicrobials as there were infections to be treated. For other surgeries with no infection, overuse of antimicrobials was found regarding the choice of antimicrobials. Surgical antibiotic Prophylaxis was administered within the recommended time prior to surgeries. Ceftriaxone was preferred over cefuroxime in all types of surgeries based on the timing of Surgical Antibiotic Prophylaxis, wound classification, and the surgical site. A statistically significant association for choice of ceftriaxone over cefuroxime was found regarding surgical sites (p-value Conclusion: Overuse of antimicrobials was found in surgical antimicrobial prophylaxis. Ceftriaxone was preferred more than cefuroxime in all types of surgeries. No surgical site infections were reported. A follow-up comparative study is recommended to decrease antimicrobial use without increasing risk of surgical site infection.

In the modern age, the most important and prevailing issue is the monitoring of human health. To address this, several devices have been developed and a need new materials investigated. The idea of textile-based smart sensors is emerging rapidly. In this regard, ICPs and ECPs have attracted the attention of researchers due to their mechanical adaptability to suit the characteristics of textile fabric. The lighter weight, stretchability and wearability, etc. are considered an advantage while selecting the material for developing sensors not only in health monitoring but also in biomedical, sports, and military fields. The idea behind wearable sensing devices is to enable easy integration of the sensor device into daily life routines. Such wearable sensors also have the potential for real time and online monitoring of human health and integrate with smart monitoring devices. The purpose of this review is to discuss the recent developments in smart monitoring sensors.

Background and objective: Essential hypertension is a leading risk factor for chronic kidney disease, yet there is no conclusive evidence that lowering blood pressure alone improves renal outcome measures. Angiotensin-II receptor blockers (ARBs) proposed to have renal-protective effects independent of their antihypertensive effect. This systematic review of animal studies aims to collect available information from the published literature about the ARBs' consequences in murine models and analyze it in a structured way to provide a pre-clinical baseline for future analysis of similar clinical investigations. Methods: Following the PRISMA checklist, we conducted a systematic review for quasi non-randomized controlled studies using PubMed, Embase, Science-Direct, SCOPUS, and Google Scholar to determine the effects of ARBs on kidney functions. Eligible articles report the ARBs' effect on proteinuria, albuminuria, and glomerular filtration rate in murine models of hypertension. Outcomes were present as Mean ± Standard Error of Mean (SEM) with 95% confidence intervals (CIs). Results: This preliminary analysis includes ten out of 56 total eligible articles after quality assessment, reporting twelve renal outcome measures. Two studies showed improvement in CrCl versus one study showing no difference. Four out of five studies showed a reduction in proteinuria compared to the control group. All three studies showed a significant reduction in albuminuria compared to control and other antihypertensives. A study Evaluating BUN showed no difference. Nine outcomes supported the reno-protective effect of ARBs on different hypertensive models with various ARBs and different follow-up durations. Low dose valsartan 10mg/kg was showing no significant effect across two different studies. Conclusion: Preliminary results are encouraging. ARBs contribute to improvement in renal biomarkers in different hypertensive models regardless of their BP-lowering effect.

Background Chronic Kidney Disease (CKD) is highly prevalent among hypertensive population. Previous date from studies and experiments have confirmed the reno-protective effect and tolerability of angiotensin receptor blockers in diabetic nephropathy. However, clinical data are lacking in hypertensive population. Objectives This is the first meta-analysis to evaluate the surrogate outcomes of renal protection with ARBs in hypertensive rodents to serve as a baseline for further studies. Methods The systematic review was conducted following the PRISM checklist. Four different databases were searched including PubMed, EMBASE, ScienceDirect and SCOPUS. No restrictions were applied on dose, duration of follow up or ARBs used. Inclusion was restricted to experimental studies reporting means and SEM, published in English, addressing the PICO question and having a moderate to high quality. 37 total eligible articles were identified and Results: Of 25 reported primary outcomes in comparison to hypertensive untreated controls, 23 studies showed positive results supporting that ARBs induce reduction in proteinuria and/or albuminuria compared to hypertensive untreated controls. Similarly, in comparison to normotensive untreated controls, 9 of 12 studies showed positive results supporting that ARBs’ induced reduction in proteinuria and/or albuminuria can reach levels similar to normotensive controls. For the secondary outcomes, 12 of 18 reported outcomes showed significant improvement in CrCl or reduction in BUN compared to hypertensive untreated rats. Similarly, 10 of 17 outcomes reported showed that the improvement in secondary outcomes reached levels that are comparable to normotensive controls. Conclusion: Qualitative data from this systematic review support that ARBs have a Reno-protective effect in different hypertensive models and the effect is independent of BP lowering.

Our main objective was to investigate the effect of chronic administration of hydrogen sulphide donor (sodium hydrosulphide) on the expression of intercellular adhesion molecule-1 (ICAM-1) and concentration of nuclear factor-kappa B (NF-kB) in a renal ischemia-reperfusion injury (IRI) model of WKY and L-nitro-arginine-methyl-ester (L-NAME)-induced hypertensive rats. Sodium hydrosulphide (NaHS) was administered intraperitoneally (i.p.) for 35 days while cystathionine gamma lyase (CSE) inhibitor dL-propargylglycine (PAG) was administered at a single dose of 50 mg/kg. Animals were anesthetised using sodium pentobarbitone (60 mg/kg) and then prepared to induce renal ischemia by clamping the left renal artery for 30 min followed by 3 h of reperfusion. Pre-treatment with NaHS improved the renal functional parameters in both WKY and L-NAME-induced hypertensive rats along with reduction of blood pressure in hypertensive groups. Oxidative stress markers like malondialdehyde (MDA), total superoxide dismutase (T-SOD) and glutathione (GSH) were also improved by NaHS treatment following renal IRI. Levels of ICAM-1 and NF-kB concentration were reduced by chronic treatment with NaHS and increased by PAG administration after renal IRI in plasma and kidney. Treatment with NaHS improved tubular morphology and glomerulus hypertrophy. Pre-treatment with NaHS reduced the degree of renal IRI by potentiating its antioxidant and anti-inflammatory mechanism, as evidenced by decreased NF-kB concentration and downregulation of ICAM-1 expression.

Objective. To evaluate efficacy and adverse events of ceftolozane/tazobactam in complicated UTI including acute pyelonephritis. Method. Databases that include PubMed, Embase, Scopus, and TRIP were searched. All randomized controlled trials and cohort studies were considered for the study. Statistical analysis was done using a fixed effects model, and results were expressed in proportion for dichotomous data and risk ratio for continuous data with 95% confidence intervals (CI). Results. A clinical cure of ceftolozane/tazobactam was found to be 92% with 95% CI of 90-94 while that of piperacillin/tazobactam was only 78% (95% CI, 74-82) in patients with complicated UTI. Microbiological eradication was still higher in the ceftolozane/tazobactam group (83%, 95% CI 81-88) when compared with piperacillin/tazobactam (63% 95% CI, 58.77-65.2). Ceftolozane/tazobactam was more effective in the treatment of complicated urinary tract infections other than acute pyelonephritis as compared to piperacillin/tazobactam ( RR = 1.21 , 95% CI, 1.07-1.23). Serious adverse events were found comparable in both groups ( RR = 1.15 , 95% CI, 0.64-2.09). Conclusion. The analysis showed that ceftolozane/tazobactam has better clinical outcomes including cure rates and low resistance for the treatment of complicated urinary tract infection.

BACKGROUND: Prevention is the best way to manage a pandemic like COVID-19. The World Health Organization has issued public advice to create awareness by providing people knowledge to prevent/protect them from COVID-19. Hence, the present study was planned to assess knowledge of prevention and its practical use amongst samples from the Saudi Arabian population. It can be used to bring awareness among the masses not only in expanding their knowledge about COVID-19 but also on how to enforce a practicing behavior in relation to the prevention of COVID-19. The study is among the pioneer studies on the issue related to knowledge and practice of the prevention of COVID-19 among Saudis and foreign nationals residing in Saudi Arabia. OBJECTIVE: The prime objective of this study is to examine the existence of knowledge among the Saudi and non-Saudi nationals about COVID-19 and its impact on their behavior to practice the protocols to prevent the disastrous infection of COVID-19. This study has also examined how the residents in Saudi Arabia react to the methods and protection measures adopted by the government for their dominions to eradicate the spread of COVID-19. METHODS: The study used a survey-based methodology and data was collected from Saudi nationals as well as expatriates living and working in five different regions of Saudi Arabia. Non-probability snowball sampling was used to reach and select the population of the current study. A self-designed, structured, and validated questionnaire was electronically distributed among the respondents. SPSS version 21 was used to analyze the data of the current study. RESULTS: Out of the 443 respondents, 356 respondents (84%) knew they had to wash their hands for 20 seconds and did this as well, 303 respondents (75%) knew that sneezing or coughing into the arm/elbow can prevent the spread of COVID-19 and were doing this as well, 357 respondents (82%) knew that COVID-19 can be transferred by shaking hands and avoided this, 333 respondents (79%) knew that they had to maintain a safe distance of at least one meter and kept this distance, 315 respondents (76%) knew that touching one’s face can transfer the virus and avoid this, and 414 respondents (95%) knew that staying at home can decrease the chances of getting infected. The relationship between different regions and most of the knowledge-based and practice-based questions was significant (p

Background: This study is an original contribution to the gender-based perspective of measuring knowledge and practice towards COVID-19 among the Saudi population. Objective: This study investigates the existing knowledge of COVID-19 among both genders and its likely use in practice to combat COVID-19. Design and Setting: Cross-sectional study with an online survey and data collected from all the five regions of Saudi Arabia. Participants and Methods: A structured, self-reported validated questionnaire was developed based on the World Health Organization (WHO) general public advice towards COVID-19 prevention. This study has employed snow-ball sampling technique. Sample Size: 627 participants (Male n=343, 54.7%) and (Females n=284, 45.3%). Results: This study has found that women not only carry better knowledge, but their practicing behavior is far better than the male respondents. Females practiced their knowledge of hands hygiene more in comparison to males (86% vs. 80 %, p >0.05). Female respondents were also practicing more about sneezing/coughing into their elbows as compared to males (79% vs. 71%, p < 0.05). Likewise, the practice of knowledge of staying at home to prevent infection (females 98.2% vs males 95.5%, p > 0.05), and (females 83.2% vs. males 81.5%, p > 0.05), respectively. Conclusion: This study shows that women were more compliant with the WHO public health COVID-19 prevention advice than men, which can decrease the chances of COVID-19 infection.

Objective The aim of this study was to compare the clinical outcomes associated with different combinations of oral diabetic drugs among patients with type 2 diabetes mellitus. Method A prospective multicenter longitudinal, noninterventional observation study design was applied. At baseline (0 month), clinical parameters including glucose profile, renal function, lipid profile and risk assessment for cardiovascular risks were calculated. Mean Weighted difference (MWD) with heterogeneity and effect z was calculated to determine the risk reduction at the end of the study. Results A total of 1,657 were enrolled to different cohorts with response rate of 75.5%. The distribution of patients was based on prescribed drug. A total of 513 (30.9%) in G1 (metformin alone), 217 (13.09%) in G2 (metformin with Glimepiride), 231 (12.85%) in G3 (Metformin with Gliclazide), 384 (23.17%) in G4 (metformin with Sitagliptin) and 312 (18.89%) in G5 (Metformin with Saxagliptin). There was no significant different in all clinical and social variables at baseline. The Intergroup analysis showed significant differences with all the primary outcome variables except BMI (p = 0.217) and eGFR (p = 0.782) among patients using sulphonylurea (SU) combination (G2 & G3). Findings also showed significant high frequency of emergency visit and hospitalization in G1 (78.16% & 30.8%) as compared to SU (70.1% & 28.3%, p = 0.001) and DPP-4 (56.6% & 20.4%, p = 0.001). The overall reported effect was z = 2.58, p = 0.001 for ASCVD risk reduction assessment. Conclusion The study concluded that significant effect of Dipeptidyl peptidase-4 inhibitor on reduction of hospitalization, lipid profile and also ASCVD risk score of type-II diabetes mellitus patients regardless of clinical comorbidities. Also, sulfonylurea combinations have showed significant reduction in LDL and triglycerides values.

In the published publication [...]

Background. This study is aimed at investigating the various disease-specific and health-related psychosocial concepts of HRQOL among insulin-dependent diabetes mellitus (IDDM) and understanding the gender differences in HRQOL among IDDM patients. Methods. A cross-sectional observational study was conducted to assess the effect of health-related and psychosocial correlates on HRQOL of IDDM patients in Penang, Malaysia. The participants were recruited from five governmental diabetic clinics. Patients with insulin use only, IDDM diagnosed at least 1 year earlier, were identified from clinical registers. The sample was then age stratified for 20–64 years, and severe complications (e.g., end-stage renal failure, hemodialysis, and liver cirrhosis) were excluded; a total of 1003 participants were enrolled in the study. Multivariate regression analysis was used to predict the response. Results. A total of 853 (100%) participants were enrolled and completed the study. Women exhibited significantly higher/better mental health (p<0.013) and health perception scores (p<0.001) despite high prevalence of impaired role (49.2%), social (24.2%), and physical (40.5%) functionings as compared to men. Women with longer diabetes exposure and uncontrolled glycemic levels (HbA1c) have poorer HRQOL. Availability of social support showed no significant association with either HRQOL or diabetes distress levels. Diabetes distress levels remained not associated with social support. Women also showed significantly higher association with health perception (15% versus 13% men, p<0.001) and mental health (13% versus 11% men, p<0.001) in diabetes-specific psychosocial factors. Thus, among women alone, diabetes-related specific and psychosocial factors explained 15% and 13% of variations in HRQOL extents, respectively. Conclusion. Women exhibit extensive and significant patterns with health-related factors and diabetes-specific psychosocial factors (self-efficacy, social support, and DLC) to improve HRQOL. Also, women have significantly high reported distress levels and low social functioning compared to men.

Objective: To identify the prevalence of dental fluorosis in Kingdom of Saudi Arabia. Material and Methods: Literature search for the present study aimed to include all the relevant studies conducted in Saudi Arabia that reported prevalence of dental fluorosis. A literature search was done using keywords (dental, fluorosis, prevalence) using three databases (Scopus, PubMed, and Web of Science). Grey literature was also searched using Google Scholar and research gate. Literature was searched from 1939 till April 2020. The risk of bias was reported using JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data . Twelve studies were included based on inclusive criteria. The only inclusive criteria were studies that were conducted among people living in Saudi Arabia, and studies that reported the prevalence of dental fluorosis. Samples from all age groups that reported prevalence of dental fluorosis were included. MedCalc statistical software was used to perform the analysis . Results: The overall prevalence of dental fluorosis was found to be 46.52%, 95 CI (26.52% to 67.12%). I2 value was reported 99.8%, 95 CI (99.78% to 99.83%), indicating high heterogeneity amongst the finding of studies. Funnel plots indicate the presence of a strong publication bias. Overall, we found some contrasting findings. One study reported prevalence of dental fluorosis as 0% and other with a comparatively large sample size found dental fluorosis to be 90.6% . Conclusion: The present study adds to the literature regarding dental fluorosis in Saudi Arabia by providing an overview of its prevalence. It is concluded that prevalence of dental fluorosis was a bit high. However, findings indicate publication bias. We did not account for severity of dental fluorosis. All the available data was analyzed to measure dental fluorosis prevalence without considering the sample size and sampling technique.

Background Traditional medicine has always been Pakistan’s cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy. Methods A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22). Results Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones. Conclusion In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum. Electronic supplementary material The online version of this article (10.1186/s12906-019-2503-y) contains supplementary material, which is available to authorized users.

We aimed to evaluate and determine the effect of diabetes mellitus (DM) on overall survival (OS) and cancer-specific survival (CSS) in early stage cervical cancer (CC) patients. Patients with primary cervical cancer and newly diagnosed were selected from ten different cancer specialist hospitals of Malaysia. Patients’ demographic and clinical data were obtained for the prognostic analysis. Kaplan-Meier method was used to estimate patients’ survival time (CSS and OS) with DM status and values were compared using the log-rank test. A total of 19,785 newly diagnosed CC patients were registered during 2010–2016, among them only 16,946 (85.6%) with primary CC tumor. There was no difference in treatment modality between DM and non-DM patients. However intergroup assessment showed that type 2DM have significantly higher rate of mortality in both overall mortality (28.3%) and CC-specific (11.7%) as compared to Type 1DM (17.3%; 5.5%) and non DM patients (12.7%; 9.1%) (p p p

Background: Diabetes Mellitus is a progressive, chronic and multifactorial endocrine disorder characterized by elevated serum glucose levels. It has a direct effect to social and health related quality of life. Objective: This study aimed to determine the health-related quality of life among patients with type II diabetes mellitus (T2DM) using insulin therapy. Methods: Cross-sectional observational study design was used to collect data from Malaysian patients with T2DM. Subjective and objective assessments were made either by using several questionnaires or each patient's specific medication profile registered to care sites. Study participants were recruited from both public hospitals and community health clinics located in Kuala Lumpur, Malaysia. Results: A total of 430 patients with T2DM were recruited in this study with a response rate of 94.7%. The oral antidiabetic medication (OAM) group consisted of 63.0% of the study population and the rest (37.0%) were Insulin users. The body mass index and glycosylated hemoglobin patterns were significantly different between groups (P < 0.011 and P < 0.001). Insulin users showed high percentages of healthy body mass index index (44.7%) compared with OAM users (35.8%) and controlled glycemic index (glycosylated hemoglobin ≤7.5%) was significantly (P = 0.001) better among the insulin-user group compared with the OAM group. The Euro Quality of Life–5 dimension domain analysis indicated significant differences with domains of usual work (P < 0.047), pain and discomfort (P < 0.041), and anxiety and depression (P < 0.001) among insulin users versus OAM users. We also observed a significant difference between the groups regarding diet, monitoring, and disease-specific knowledge. The mean (SD) adherence score showed that insulin users were significantly (P < 0.001) more adherent (6.09 [2.98]) than OAM were nonadherent (4.19 [4.68]). Conclusions: This study suggests the valuable effect of insulin therapy among patients with T2DM compared with OAMs on health-related quality of life, medication adherence, and health state. Insulin users reported they had better diabetes-related knowledge and treatment adherence characteristics than noninsulin users. Key words: Adherence, Cross-sectional study, Diabetes knowledge, Health perception, Health care quality of life, Insulin use

This article explores the relationship between the renal expression of cystathionine gamma lyase (CSE) and endothelial nitric oxide synthase (eNOS) and the responsiveness of α1A adrenergic receptors in the renal vasculature following left ventricular hypertrophy (LVH) in rats. LVH was established by administering isoprenaline (5 mg/kg, 5 injections subcutaneously, 72 h apart) with 62 mg/L caffeine in drinking water for 2 weeks. Renal vasoconstrictor responses were measured using local administration of adrenergic agonists noradrenaline (NA), phenylephrine (PE), and methoxamine (ME) and the selective α1A adrenergic antagonist 5-methylurapidil (5- MeU). Mean arterial blood pressure was higher (144 ± 9 vs. 116 ± 4 mmHg) and renal cortical blood perfusion was lower in the LVH group (102 ± 5 vs. 157 ± 19 bpu) compared to the control group (P < 0.05). There was a 68% downregulation of mRNA for renal CSE and 79% for eNOS in the LVH group compared to the control group (taken as 100%) (P < 0.05). The high dose of 5-MeU attenuated the vasoconstrictor responses to NA by 33%, PE by 44%, and ME by 43% in the LVH group compared to the same dose in the control group. The reductions in basal renal cortical perfusion and α1A adrenergic receptor vasoconstrictor responses in LVH were associated with the downregulation of the CSE/H2S and eNOS/NO pathways.

Aim This study investigated the role of the renal innervation in arterial and cardiopulmonary baroreflex regulation of renal sympathetic nerve activity (RSNA) and heart rate (HR) in rats fed a high-fat diet to induce obesity. Methods Rats received either a normal (12% kcal) or high (45% kcal) fat diet for 60 days. On day 61, rats were anesthetized and prepared for recording left RSNA. In one group, the renal nerves remained intact, while in the other, both kidneys were denervated. Baroreflex gain curves for RSNA and HR were generated by increasing and decreasing blood pressure. Low-pressure baroreceptors were challenged by infusing a saline load. Results Mean blood pressure was 135 mmHg in the fat-fed and 105 mmHg (P

Until recently hydrogen sulfide (H2S) was the least appreciated of the three gasotransmitters but now recognized as 3Y gaseous mediator after nitric oxide(NO) and carbon monoxide (CO). H2S regulates a number of physiological processes like vasorelaxation, prevention of inflammation, leukocyte adhesion, anti-prolifera- tive effects, anti-thrombotic effects, resistance to oxidative stress and protection against ischemia reperfusion injury (IRI). However, considerable amount of research is still needed to evaluate the mechanisms involved in the therapeutic effects of H2S in IRI such as its effects on nuclear factor-kappa B (NF-KB) concentration and intercellular adhesion molecule-1 (ICAM-1) expression in renal IRI and ARF (acute renal failure). More than a decade of good repute among researchers, H2S research has certain results that need to be clarified more such as whether H2S is pro-inflammatory or anti-inflammatory agent. Moreover, pathways adopted by H2S in the protein modification and its effects on cell signalling specially its effect on NF-KB in the process of inflamma- tion are not fully elucidated. H2S has delighted researchers and a great deal of information is being generated every year.The main purpose of the review is to provide an update on the development in the research of H2S in renal IRI due to uncertainty of the exact role of H2S on ICAM-1 expression and NF-KB concentration whether it inhibits or activates them.

Telfairia occidentalis possesses high antioxidant activity. However, the antioxidant components of the plant have not yet been identified. This study was undertaken to identify the phenolics in the leaf of the plant. Extract and fractions of the leaf of the plant were analysed using the HPLC and GCMS. HPLC analysis revealed the presence of gallic acid (22.19μg/mg), catechin (29.17μg/mg), caffeic acid (9.17μg/mg), ferulic acid (0.94μg/mg), sinapic acid (1.91 μg/mg) and 4-hydroxy benzoic acid (43.86 μg/mg) in the aqueous extract. Phenolics fraction contained gallic acid (0.88 μg/mg), catechin (2.70μg/mg), caffeic acid (7.92μg/mg), ferulic acid (2.72μg/mg), benzoic acid (6.36μg/mg), p-coumaric acid (1.48μg/mg), quercetin (12.00μg/mg). Only caffeic acid (2.50μg/mg), ferulic acid (0.44μg/mg) and quercetin (8.50μg/mg) were detected in the flavonoid fraction. While GCMS analysis showed the presence of methylparaben; ethylparaben; benzoic acid; 4-hydroxy-2-methoxy-3,5,6-trimethyl-, methyl ester; 4-hydroxy-3-methoxy; phenol, 5-methoxy-2-(methoxymethyl)-; phenol, 5-methoxy-2, 3- dimethyl; and phenol, 2-(2-benzothiazolyl)-. This study is the first to reveal the identity of some phenolics components of the leaf of Telfairia occidentalis.

Ethnopharmacological relevance Citrullus colocynthis (L.) Schrad is a valuable cucurbit plant, widely distributed in the desert areas of the world. Citrullus colocynthis fruits are usually recognized for its wide range of medicinal uses as well as pharmaceutical and nutraceutical potential. This review aims to appraise the published information on the ethnobotanical knowledge, phytochemistry, ethnopharmacology, nutraceutical potential and safety studies of Citrullus colocynthis (bitter apple) fruit, with critical analysis on the gaps and potential for future studies. Material and methods A literature survey was performed by searching the scientific databases including PubMed, Scopus, SciFinder, Google Scholar, Web of Science, ACS as well as published books. Results The plant has been reported to possess a wide range of traditional medicinal uses including in diabetes, leprosy, common cold, cough, asthma, bronchitis, jaundice, joint pain, cancer, toothache, wound, mastitis, and in gastrointestinal disorders such as indigestion, constipation, dysentery, gastroenteritis, colic pain and different microbial infections. Several bioactive chemical constituents from fruits were recorded, such as, glycosides, flavonoids, alkaloids, fatty acids and essential oils. The isolation and identification of curcurbitacins A, B, C, D, E, I, J, K, and L and Colocynthosides A, and B were also reported. The fruit of Citrullus colocynthis has been studied extensively for its wide range of biological activities, which include antioxidant, cytotoxic, antidiabetic, antilipidemic, insecticide, antimicrobial and anti-inflammatory. The plant was also shown to be rich in nutritional value with high protein contents and important minerals as well as edible quality of seed oil. Conclusion It is evident from the literature that Citrullus colocynthis possesses a wide range of medicinal uses and has been well studied for its antidiabetic, anticancer, antioxidant, antimicrobial and anti-inflammatory activities, while its therapeutic potential for gut, airways and cardiovascular disorders remains to be explored. Critical analysis revealed that the plant has the huge potential for pharmaceutical and nutraceutical application, with some indications for the presence of synergistic and /or side effects neutralizing combinations of activities.

Oxidative stress and suppressed H2S production lead to increased renal vascular resistance, disturbed glomerular hemodynamics, and abnormal renal sodium and water handling, contribute to the pathogenesis and maintenance of essential hypertension in man and the spontaneously hypertensive rat. This study investigated the impact of H2S and tempol alone and in combination on blood pressure and renal hemodynamics and excretory functions in the SHR. Groups of WKY rats or SHR (n=6) were treated for 4 weeks either as controls or received NaHS (SHR+NaHS), tempol (SHR+Tempol), or NaHS plus tempol (SHR+NaHS +Tempol). Metabolic studies were performed on days 0, 14, and 28, thereafter animals were anaesthetized to measure renal hemodynamics and plasma oxidative and antioxidant markers. SHR control rats had higher mean arterial blood pressure (140.0 ± 2 vs. 100.0 ± 3 mmHg), lower plasma and urinary H2S, creatinine clearance, urine flow rate and urinary sodium excretion, and oxidative stress compared to WKY (all p0.05). Treatment either with NaHS or with tempol alone decreased blood pressure and oxidative stress and improved renal hemodynamic and excretory function compared to untreated SHR. Combined NaHS and tempol therapy in SHRs caused larger decreases in blood pressure (∼20-22% vs. ∼11-15% and ∼10-14%), increases in creatinine clearance, urinary sodium excretion and fractional sodium excretion and up-regulated the antioxidant status compared to each agent alone (all p0.05). These findings demonstrated that H2S and tempol together resulted in greater reductions in blood pressure and normalization of kidney function compared with either compound alone.

Aim This investigation explored the hypothesis that in obesity an inflammatory response in the kidney contributed to a renal nerve-dependent blunting of the baroreflex regulation of renal sympathetic nerve activity. Methods Rats received a normal (12%Kcal) or high-fat (45%Kcal) diet for 8 weeks plus daily injections of vehicle (0.9% NaCl i.p) or tacrolimus (0.25mg kg−1day−1i.p) from weeks 3-8. Following anaesthesia, left renal sympathetic nerve activity was recorded, baroreflex gain curves were generated, by infusing phenylephrine and sodium nitroprusside, and cardiopulmonary baroreceptors challenged by infusing a saline load. Results The high-fat diet elevated weight gain and adiposity index by 89 and 129% (both, P

The aim of the present study was to quantify phenolic acids and flavonoids from Citrullus colocynthis roots (CCR), leaves (CCL) fruits (CCF) and compare the antioxidant and free radical scavenging activities of their extracts and major compounds. Reverse phase high performance liquid chromatography method was developed and validated for the simultaneous quantification of phenolic acids and flavonoids from ethanol and hexane extracts of CCR, CCL and CCF. The antioxidant activity of CCR, CCL and CCF extracts was investigated by measuring total phenolics, total flavonoids contents, DPPH free radical scavenging activity, inhibition of linoleic acid peroxidation and reducing power. The RP-HPLC analysis of C. colocynthis extracts revealed the presence of ferulic acid, vanillic acid, p-coumeric acid, gallic acid, p-hydroxy benzoic acid and chlorogenic acid being the major phenolic acids and quercetin, myricetin and catechin being the most prominent flavonoids compounds. The amounts of TP (3.07–18.6 mg/g of dry plant material, measured as gallic acid equivalent) and TF (0.51–13.9 mg/g of dry plant material, measured as catechin equivalent) were higher in ethanol extracts of CCL, followed by CCR and CCF. Ethanol extract of CCL exhibited the highest antioxidant and DPPH radical scavenging activities followed by ethanol extracts of CCR and CCF. However, only hexane extract of CCF showed considerable DPPH radical scavenging activity. The results suggested that CCR, CCL and CCF extracts showed a wide variability of their phenolic acids and flavonoids composition and antioxidant activity.

This research work was carried out to investigate the effect of different extraction techniques on antioxidant potential of peanut (Arachis hypogaea) hulls. The antioxidant extracts of peanut hulls (PH) were prepared using different extraction methods such as soaking, stirring, shaking, and sonicated-assisted stirring with methanol/water (80:20) and ethanol/water (80:20) solvents systems. The antioxidant potential of extracts was measured using different in vitro antioxidant assays like estimation of total phenolic contents (TPC), estimation of total flavonoids contents (TFC), DPPH-scavenging capacity, percentage inhibition of linoleic acid peroxidations, and bleachability of s-carotene in linoleic acid system. TPC and TFC of different PH extracts were found in range of 1.23–8.43 mg/g of dry plant material, measured as gallic acid equivalent, 0.33–5.06 mg/g of dry plant material, measured as catechin equivelent (CE), respectively. All the PH extracts exhibited good free radical scavenging potential and moderate inhibition of linoleic acid peroxidation. Significant (p ≤ 0.05) variations were observed in the antioxidant potentials of various extraction methods and solvent systems. Among all the extraction methods, sonicated-assisted stirring showed better yield and antioxidant capacity. In view of the present findings, it is reasonable to say that different extracts of peanut hulls exhibited varying degree of antioxidant activity, which might be attributed to various mechanisms involved in extraction procedures.

α1D-Adrenoceptors are involved in the genesis/maintenance of hypertension in spontaneously hypertensive rats (SHR). This study aims to investigate the role of α1D-adrenoceptors in the antinatriuretic and antidiuretic responses in SHR subjected to high sodium (SHRHNa) and normal sodium (SHRNNa) intake for six weeks. Renal inulin clearance study was performed in which the antinatriuretic and antidiuretic responses to phenylephrine were examined in the presence and absence of α1D-adrenoceptors blocker BMY7378. Data, mean±S.E.M. were subjected to ANOVA with significance at p

Background. This study examined the effect of renal sympathetic innervation on adrenergically and angiotensin II (Ang II)induced renal vasoconstriction in Wistar-Kyoto (WKY) rats. Methods. Forty-eight WKY rats were treated with either losartan (10 mg/kg/day p.o.) or carvedilol (5 mg/kg/day p.o.) or a combination of them (10 mg/kg/day + 5 mg/kg/day p.o.) for 7 days. On day 8, the rats were anaesthetized, and renal vasoconstrictor experiments were carried out. A group of rats was subjected to acute unilateral renal denervation during the acute study. Changes in the renal vasoconstrictor responses were determined in terms of reductions in renal blood flow caused by Ang II, noradrenaline (NA), and methoxamine (ME). Results. In normal animals, losartan decreased (P < 0.05) the renal vasoconstrictor response to Ang II but not to NA or ME. Carvedilol treatment, however, blunted (P < 0.05) the renal vasoconstrictor responses to Ang II and adrenergic agonists. Combination of losartan and carvedilol blunted (P < 0.05) the renal vasoconstrictor response to Ang II but augmented the responses to NA and ME (all P < 0.05). Interestingly, when denervated rats were treated with the same combination, there was a reduction (P < 0.05) in the renal vasoconstrictor responses to Ang II and adrenergic agonists. Conclusions. Data suggest that the renal sympathetic nerve contributes to adrenergic agonist-mediated renal vasoconstrictions in normal rats. The data further indicate an interactive relationship between renin-angiotensin and sympathetic nervous systems in modulating adrenergically and Ang II-induced renal vasoconstriction in WKY rats.

Aim: This study investigated the impact of hypertension combined with diabetic nephropathy on rat renal α1-adrenoceptor subtype composition. Methods: In streptozotocin-induced diabetic spontaneously hypertensive rats (SHR), diabetic nephropathy developed as reflected by increased kidney index, plasma creatinine, albumin excretion, creatinine clearance and fractional excretion of Na+ (all p < 0.05). Renal vasoconstrictions caused by electrical stimulation of renal nerves and intrarenally administered noradrenaline (α-adrenoceptor agonist), phenylephrine (α1-adrenoceptor agonist) and methoxamine (α1A-adrenoceptor agonist) were determined in the presence and absence of intrarenally administered amlodipine (Ca2+ channel blocker), 5-methylurapidil (α1A-adrenoceptor antagonist), chloroethylclonidine (α1B-adrenoceptor antagonist) and BMY 7378 (α1D-adrenoceptor antagonist). Results: In diabetic nephropathy SHR, there was a significant (all p < 0.05) attenuation of all adrenergically induced vasoconstrictor responses in the antagonists, except chloroethylclonidine, which caused a significant (all p < 0.05) enhancement of the responses. Conclusion: The data demonstrated that there was a functional coexistence of α1A- and α1D-adrenoceptors in the renal vasculature of SHR irrespective of the presence of diabetic nephropathy. However, there was a minor contribution of pre-synaptic α-adrenoceptors to the adrenergically mediated vasoconstrictor responses in the diabetic nephropathy SHR.

Purpose : To examine the hypothesis that in hypertensive diabetic rats hydrogen sulphide (H 2 S) reduces blood pressure through diuretic action in addition to its vasodilating effect. Methods : Spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats were used. SHR were divided into three groups: SHR (II), SHR diabetic (III), and SHR diabetic NaHS-Treated (IV) with a group of WKY (I) rats serving as normotensive nondiabetic control. Diabetes was produced in two SHR groups using intraperitoneal streptozotocin (STZ). One diabetic group received NaHS, a donor of H 2 S (56 μM/kg i.p.) daily for five weeks. Blood pressure was measured in conscious and anesthetized states in surgically prepared animals. Plasma and urinary H2S levels and electrolytes were measured weekly throughout the 35-day period. Results : SHR and diabetic SHR had higher blood pressure and lower plasma and urinary H 2 S levels compared to WKY controls (p < 0.05). Moreover, the SHR diabetic group had higher plasma sodium, higher absolute and fractional sodium excretions (p < 0.05) but with similar blood pressure compared to SHR controls. NaHS treatment reduced blood pressure and restored H2S and plasma sodium (p < 0.05) levels. Moreover, SHR diabetic-NaHS treated group had higher urine output and absolute urinary sodium excretion compared to the untreated SHR diabetic group (p < 0.05). Conclusion : These results suggest a possible diuretic effect of exogenous H 2 S in spontaneously hypertensive diabetic rats. Keywords : Spontaneously hypertensive rats, Diabetes, Hydrogen sulphide, Diuretic, Sodium excretion, Urine output

Aim: There is evidence that in chronic renal failure, the sympathetic nervous system is activated. This study investigated the role of the renal innervation in suppressing high- and low-pressure baroreflex control of renal sympathetic nerve activity and heart rate in cisplatin-induced renal failure. Methods: Renal failure was induced using cisplatin (5 mg kg 1 , i.p.) and the rats used 7 days later. Groups of rats were anaesthetized and prepared for measurement of renal sympathetic nerve activity and heart rate. Acute unilateral or bilateral renal denervation was performed, and renal sympathetic nerve activity and heart rate baroreflex gain curves were generated while the cardiopulmonary receptors were stimulated using an acute saline volume load. Results: Cisplatin administration reduced (P < 0.05) glomerular filtration rate by 27%, increased sodium fractional excretions fourfold, plasma creatinine and kidney index by 39 and 30% respectively, (all P < 0.05) compared with control rats. In the renal failure rats, baroreflex sensitivity for renal sympathetic nerve activity and heart rate was reduced (P < 0.05) by 29% and 27% (both P < 0.05) compared with control animals. Bilateral, but not unilateral, renal denervation restored baroreflex sensitivity to normal values. Volume expansion reduced (P < 0.05) renal sympathetic nerve activity by 34% in control rats, but remained unchanged in the renal failure rats. Unilateral and bilateral renal denervation progressively restored the volume expansion induced renal sympathoinhibition to control values. Conclusion: These findings reveal a significant role of the renal sensory innervation in cisplatin-damaged kidneys which blunt the normal baroreflex control of renal sympathetic nerve activity.