Cardiovascular & Haematological Disorders - Drug Targets - Current Issue

Oroxylin A is primarily sourced from the roots of Scutellaria baicalensis, a medicinal plant commonly used in traditional Chinese medicine. It can also be found in other Scutellaria species. The plant's rich bioactive profile makes it a significant source of various flavonoids, including Oroxylin A.

The proposed aim of this study is to investigate in-vitro anti-oxidant activity, toxicity studies and in-vitro cardioprotective activity of Oroxylin-A against Doxorubicin mediated myocardial damage on H9c2.

The total phenolic content was estimated using Folin-Ciocalteu test and in-vitro activity was performed using DPPH assay. Acute toxicity studies were performed according to OECD 423 guidelines. In vitro cardioprotective activity was performed on H9c2 cells and was estimated for the biomarkers.

Oroxylin-A showed good antioxidant activity. No abnormalities were found in animals upon its usage, indicating that Oroxylin-A was safe at 2000 mg/kg. 150ug/ml of Oroxylin-A significantly increased the cell viability up to 99% and also decreased the LDH and ROS generation indicating that Oroxylin-A showed significant cardioprotective activity on H9c2 cells.

Oroxylin-A demonstrated potent antioxidant and cardioprotective effects by reducing ROS generation and LDH release while enhancing H9c2 cell viability against doxorubicin-induced toxicity. Its safety at higher doses further supports its therapeutic potential. These findings highlight Oroxylin-A as a promising natural cardioprotective agent, warranting further in vivo and mechanistic studies to validate its clinical applicability.

This research underscores the potential of Oroxylin A as a candidate for further investigation as a cardioprotective agent. Also, the present study contributes to the growing body of knowledge aimed at identifying natural compounds that may offer protective effects against myocardial damage, providing hope for future therapeutic interventions in the field of cardiovascular medicine.

Acute lymphoblastic leukemia (ALL), a hematopoietic cancer of T or B lymphoblasts, is the most prevalent cancer in children. Ongoing research aims to better understand the factors contributing to ALL and create more successful treatment options. Therefore, the current study presented cytogenetic, genetic, and hematologic features from 318 ALL patients under eighteen years of age who were referred to Ali Asghar Hospital of Tehran, Iran, from 2013 to 2023.

This study was designed as a retrospective cross-sectional analysis, focusing on 318 children in Tehran, Iran, who had been newly diagnosed with ALL. All data were extracted from the patient case files that included additional information, such as clinical data, and demographic information. The Flow cytometry technique was employed to perform immunophenotyping for various markers. Moreover, the standardized protocol was carried out for conventional cytogenetic analysis.

Out of 318, 179 (56.3%) and 139 (43.7%) were males and females, respectively. The most common subtype of ALL was Common B Cell ALL, accounting for 182 cases (57.23%), followed by Pre B cell ALL with 74 cases (23.27%) and T cell ALL with 27 cases (8.49%). Out of 222 patients, 17 (7.7%) had genetic abnormalities, with the highest incidence of abnormalities being associated with Runx 1 (four cases). Additionally, out of 228 patients, 143 (62.7%) were identified as having cytogenetic abnormalities, with the most prevalent abnormalities being hyperdiploidy (54 cases) and t (12;21) (28 cases).

Our findings showed that some cytogenetic abnormalities, such as t (9;22) and hyperdiploidy, were consistent with previous studies. These results offer valuable foundational insights that can help direct future research on ALL patients and inform potential treatment strategies.

Diabetic Cardiomyopathy (DCM) remains a significant health concern, necessitating innovative therapeutic approaches. This study explores the potential of a polyherbal combination (PHC) in mitigating DCM and delves into the underlying molecular mechanisms.

Rat models with induced diabetes and cardiomyopathy were administered the polyherbal combination. Molecular analyses included the assessment of ICAM-1, VCAM-1, and NF-κB expression in cardiac tissue. Histopathological and functional evaluations of cardiac health were performed.

The polyherbal-treated group showed a significant reduction in blood glucose levels and improved cardiac function, as indicated by increased ejection fraction and cardiac output. Cardiac injury markers, CK-MB and hs-CRP, were significantly reduced by 66.6% and 50% respectively. Lipid profile improvements included lower total cholesterol and triglycerides by 28.5% and 31.1%, respectively. TGF-β levels were markedly reduced, suggesting an anti-fibrotic effect. Additionally, NF-κB, ICAM-1, and VCAM-1 expression were significantly downregulated, confirming the polyherbal formulation's anti-inflammatory potential. These findings highlight its cardioprotective effects, making it a promising therapeutic approach for mitigating diabetic cardiomyopathy.

The study unveils a promising therapeutic strategy for DCM, characterized by the PHC's ability to modulate ICAM-1, VCAM-1, and NF-κB expression. This molecular insight underscores the potential for innovative interventions in managing DCM and offers hope for improved cardiac health in individuals with diabetes.

Stroke is the second leading cause of death and the third leading cause of disability worldwide, with hypertension and diabetes mellitus being its most prominent risk factors. This study aims to assess the utilization trends and clinical outcomes of Alteplase in patients presenting with acute cerebral ischemia and known history of hypertension and/or diabetes, within our local population in Southern Punjab, Pakistan-a region with limited stroke care infrastructure.

This observational study was conducted at the emergency department of a tertiary care hospital. A total of 106 patients presenting with acute cerebral ischemia confirmed via CT scan and/or MRI were enrolled. All patients had a documented history of hypertension (n = 91), 
diabetes mellitus (n = 27), or both (n = 64). Patients who presented within 4.5 hours of symptom onset and met standard inclusion criteria were administered intravenous Alteplase as per AHA/
ASA guidelines. Patients were divided into two groups: Group 1 (received Alteplase, n = 56) 
and Group 2 (did not receive Alteplase, n = 82). Outcomes were measured using the modified Rankin Scale (mRS) at 3 months post-intervention, with favorable recovery defined as mRS 0-2.

Of the 44 patients who received Alteplase, 66% (n = 37) achieved favorable outcomes (mRS 0-2). In contrast, only 39% (n = 32) of the 62 patients in the non-Alteplase group had 
favorable recovery. No significant increase in hemorrhagic complications was observed in the Alteplase group.

The findings in this study are consistent with international evidence demonstrating the safety and efficacy of intravenous thrombolysis in carefully selected patients, including those with vascular comorbidities such as hypertension and diabetes. In our study, most patients were treated late due to limited stroke units and long travel times, reflecting barriers in Pakistan’s healthcare system. The mean age of stroke was 52 years, which is younger than that reported in Western populations, and men were more frequently affected, in contrast to existing literature that shows a higher prevalence in women. Left hemisphere involvement predominated. Hypertension and diabetes were universal risk factors, underscoring their role in stroke burden. Overall, timely Alteplase therapy remains crucial, highlighting the need for improved infrastructure and early intervention strategies. The improved functional outcomes observed in our cohort reinforce the need for early recognition, rapid triage, and timely administration of Alteplase. However, limited availability of specialized stroke units, delayed hospital presentations, and lack of trained personnel continue to hinder widespread implementation of thrombolytic therapy in low-resource settings like Southern Punjab.

In patients with acute cerebral ischemia and pre-existing hypertension or diabetes, the timely administration of Alteplase significantly improves functional outcomes. Despite its proven efficacy, access to thrombolytic therapy remains inadequate in public sector hospitals in Southern Punjab. Efforts must be made to expand stroke services and standardize acute stroke care across the region.

Exercise is widely recognized for its various physiological impacts. Furthermore, it has been postulated that watching people engage in physical activities like sports might trigger physiological reactions that mimic actual participation in the activity. This study investigated the effect of watching aerobic exercise videos (walking and stair climbing) versus physically engaging in the exercises on cardiovascular indices, blood glucose, body temperature, pulmonary indices, urine creatinine, and electrolyte levels in healthy male participants at the University of Uyo, Akwa-Ibom State.

Twenty participants, aged 18-25, were randomly assigned to the video group (n=10) and the exercise group (n=10). The video group watched exercise videos of walking and stair climbing, respectively. The exercise group performed walking and stair climbing exercises, respectively. Before the commencement of the experiment, the participants were given a 15-minute rest, after which their blood pressure, pulse rate, body temperature, and blood glucose were measured. They were then given 600 mL of water and 15 g of glucose for hydration and energy. After 45 minutes, their cardiovascular indices, blood glucose, body temperature, pulmonary indices, and urine sample for assessment of urine electrolytes and creatinine levels were taken. After that, the video group watched a video of people engaged in walking exercise, while the exercise group walked for 15 minutes. After the first session, a 30-minute recuperation period was observed before the commencement of the second session (stair climbing). The same procedure was repeated in the second session. Blood pressure, pulse rate, blood glucose, and body temperature were measured immediately after the first session, 15 and 30 minutes after the first session, immediately after the second session, and 15, and 30 minutes after the second session. Pulmonary indices and urine samples were taken immediately after the first session, 30 minutes after the first session, immediately after the second session, and 30 minutes after the second session.

The results showed a significant increase in systolic blood pressure, mean arterial pressure, and pulse rate; however, there was no significant difference in diastolic blood pressure and pulmonary indices in the exercise group compared to the video group. Additionally, the exercise group showed a significant decrease in blood glucose level and an increase in urine potassium level during the 30-minute recuperation period compared to the video group.

Watching sports was postulated to elicit similar responses as though someone were performing the sport; however, the findings of this study showed that the participants who watched exercise videos exhibited no significant change in blood pressure and pulse rate when compared with those who performed the exercises. The inability of our study to uphold this claim might be due to the 15-minute exposure observed in the present study being short; perhaps a longer period of exposure could elicit such physiological responses. Another limitation of the present study is the relatively small sample size, which may have impacted the statistical power of the findings. Consequently, conducting comprehensive studies with a larger sample size is highly recommended.

In conclusion, the results of this study showed that watching exercise videos of walking and stair climbing did not elicit similar cardiovascular effects as actually performing walking and stair climbing exercises, but mimicked the same effects on blood glucose, urine sodium, and chloride levels in healthy male participants. Further research is recommended in this line of study.