Delonix regia is a species of flowering plant in the pea family (Fabaceae) and subfamily Caesalpinioideae. It is distributed in Madagascar, India, Africa, and Northern Australia. This review article is a summary of significant scientific literature on D. regia from several research databases. The review has revealed that D. regia is rich in alkaloids, flavonoids, steroids, tannins, and phenolic compounds, all of which contribute to a variety of biological properties such as anti-inflammatory, antimicrobial, antidiabetic, wound-healing, hepatoprotective, and antioxidant effects. Most previous reviews on the plant merely provided general phytochemical overviews. In contrast, the present review is focused on the specific phytoconstituents of different parts of the plant (flowers, leaves, bark, seeds, and roots), and these phytoconstituents were correlated with experimentally validated therapeutic outcomes reported in scientific studies. The review highlighted the unique therapeutic potential of D. regia and identified the research gaps, such as limited clinical validation and lack of extract standardization, while proposing directions for future studies. These insights underscore the potential of the plant for use as a source of phytotherapeutic agents.

Purpose: To assess the prevalence of polycystic ovary syndrome (PCOS) among women attending the International Islamic University Malaysia Fertility (IIUM) Center in Kuantan, Pahang, and to explore how lifestyle factors relate to its cause. Methods: This study utilized a cross-sectional design to assess the common occurrence of polycystic ovarian syndrome and its related outcomes in a specified population. Consequently, it explores the connections between contributing factors, like weight and lifestyle, and polycystic ovary syndrome. Results: Of the 759 female patients who visited the IIUM Fertility Center, 57 were diagnosed with PCOS, accounting for 7.5 % (57/759). Among the 40 women with PCOS who participated in the study, 18 (45 %) were categorized as having a high BMI, 16 (40 %) were classified as overweight, while 6 (15 %) were regarded as having a normal BMI. With respect to the stress levels, the medium-stress category reported the highest number, accounting for 22 patients, or 55 %, while the high-stress group had 18 patients, representing 45 %. Remarkably, no patients fell into the low-stress category, as none scored within that range. Furthermore, no significant correlation was identified between obesity and stress scores, as the p-value was above 0.05. Conclusion: Many women who have been diagnosed with PCOS have visited the IIUM Fertility Center in Kuantan, Pahang. While the reported 7.5 % prevalence of PCOS might seem minor in comparison to other fertility issues, this study focused solely on one particular center.

Purpose: To characterize azithromycin inclusion complex for enhanced solubility and improved release from the dosage form. Methods: Azithromycin was formulated as an inclusion complex with hydroxypropyl-β-cyclodextrin (HP-β-CD) and compressed to produce a tablet by direct compression to enhance the dissolution. The nature of azithromycin molecule in its inclusion complex was investigated using the Infra-Red (IR) and Differential Scanning Calorimetry (DSC) analysis. High-performance liquid chromatography (HPLC) analysis was used to monitor the dissolution rate and stability studies of azithromycin tablets. Two USP protocols of storage were applied at 40 °C with 75 % Relative Humidity (RH), and at 30 °C with 65 % RH. Results: Pure azithromycin scan showed a prominent endothermic fusion peak between 115 and 122 °C, indicating its melting point. Both pure azithromycin and the inclusion complex with HP-β-CD had the same melting point values, according to the thermogram of the DSC. The molecular structure of azithromycin did not change upon inclusion complexation with HP-β-CD, according to IR spectroscopy. According to the HPLC results, retention time and ionic separation efficiency indicate the ion-pair reversed-phase mode of separation of the applied method. Conclusion: The inclusion complex of azithromycin with hydroxypropyl-β-cyclodextrin creates tablets with a high dissolution rate, thereby increasing drug absorption and bioavailability. Azithromycin insertion into the structural cavity of HP-β-CD without a chemical reaction protects the drug molecules from environmental factors and enhances their chemical stability.

Purpose: To develop a new domain generalization (DG) framework for diabetic retinopathy (DR) classification using Vision Transformers (VTs). Methods: A deep-learning-based prediction-softening mechanism has been used to allow self-distillation, whereby the knowledge extracted is transferred to intermediate layers. Intermediate representations are further improved with an adaptive convex combination of one-hot labels and internal predictions of the model, which helps regularize the network and counteract overfitting. Various publicly available DR datasets, such as APTOS and EYEPACS, in multi-source and single-source DG settings containing three VT backbones (DeiT, T2T-VT, and CvT) were used. Results: The proposed framework outperforms current DG methods, with better top-1 accuracy, strong calibration and predictive accuracy in unfamiliar domains. Conclusion: The Softening Predictions for Self-Distillation (SPSD)-VT framework is a robust, reliable, and generalizable framework that classifies DR and underscores the important role that domain generalization plays in medical imaging and sets a standard for future studies.

Purpose: To investigate the dissolution profile of ionic liquid forms of diclofenac sodium. Methods: Three ionic liquids, namely 1-butyl-3-methylimidazolium chloride, cholinium chloride, and benzalkonium chloride, were converted into corresponding diclofenac-ionic liquid formulations by reacting each ionic liquid with diclofenac sodium at a 1.1:1 molar ratio. The prepared diclofenac-ionic liquids were solidified by adsorption onto microcrystalline cellulose (Avicel PH-102) and characterized using Fourier-transform infrared spectroscopy, powder X-ray diffraction, and differential scanning calorimetry to prove ionic interactions as well as partial amorphization of the diclofenac. Results: Percentage yield of the prepared ionic formulations was > 94 %. There was significant improvement in solubility, with the imidazolium diclofenac ionic liquid exhibiting a 5.3-fold and 4-fold increase in solubility in distilled water and phosphate buffer (pH 6.8), respectively (p < 0.05). In addition, the imidazolium diclofenac-ionic liquid showed an excellent dissolution profile. Conclusion: These results highlight the potential applicability of imidazolium diclofenac ionic liquid as an efficient dissolution rate enhancer for diclofenac. This study justifies applying ionic liquids as recovery-enhancing carriers in drug delivery systems, especially for poorly soluble drugs.

Purpose: To determine changes in selected inflammatory parameters as potential markers and risk factors for hypertension. Methods: A case-control design with 150 participants comprising 100 hypertensive patients (study group) and 50 healthy individuals that served as controls was evaluated. The study was carried out from October 2023 to July 2024 in AL Nasiriyah Teaching Hospital, Basra, Iraq. Demographic parameters such as age, gender, family history, smoking status and other sociodemographic information of the patients were documented using questionnaire. Lipid profiles, urea, serum creatinine and other chronic disease inflammatory parameters, including Pro B-type natriuretic peptide (BNP), malondialdehyde (MDA), tumour necrosis factor-α (TNF-α), hydrogen peroxide (H2O2), and interleukin-6 (IL-6) were also analyzed. Results: There were significantly increased levels of IL-6, TNF-α, MDA, H2O2, and Pro B-type natriuretic peptide (BNP) in sera of hypertensive patients compared to control group (p < 0.05). Hypertensive patients had higher lipid profiles (cholesterol, triglyceride (TG), very low-density lipoprotein (VLDL), and low-density lipoprotein (LDL)) than control group (p < 0.05), except for HDL (42.3650 ± 9.24 mg/dL), which was lower. The study group had significantly higher concentrations of urea and serum creatinine when compared with control group (p < 0.05). Conclusion: Inflammatory and metabolic mediators are risk factors for hypertension. As the levels of these variables increase, the likelihood of developing or worsening hypertension also increases. Further studies are needed to validate the findings reported.

Purpose: To examine the potential of vitamin D supplementation in reducing norovirus replication andalleviating diarrhea severity in a murine model. Methods: This study involved three groups of mice (n = 7 mice/group): Group K (-), Group K (+) and Group P. Mice in the K (+) and P groups were intraperitoneally inoculated with 1 mL of Human Norovirus (HuNoV) suspension, containing approximately 10⁵ genome copies per mL. Thereafter, mice in the treatment group received oral vitamin D3 once daily for five consecutive days, at a dose of 0.75 μg/kg body weight. Diarrhea severity was assessed daily starting from day 1 post-infection using the paper towel method by scoring fecal moisture and consistency. On day 8 post-infection, mice were sacrificed using an overdose of anaesthetic agents and colonic fecal samples were subsequently collected for RT-qPCR analysis to quantify the viral load. Results: Mice receiving vitamin D3 supplementation exhibited a significant reduction in viral load compared to the untreated group (p = 0.000). Additionally, treatment groups showed improved fecal consistency, indicating a protective effect on intestinal tissue. Conclusion: Vitamin D3 administration reduces norovirus viral load and mitigates diarrhea severity in BALB/c mice infected with HuNoV. Therefore, vitamin D3 could be used as an adjunctive therapy for viral gastroenteritis.

Purpose: To investigate the male contraceptive potential of the ethanol leaf extract of Hibiscus rosa-sinensis (EEHR) in male Sprague Dawley rats. Methods: The extracts of Hibiscus rosa-sinensis (HR) leaves were prepared by maceration using distilled water, ethanol, and methanol as solvents. Phytochemical analysis and antioxidant potential were assessed using DPPH (2,2-diphenyl-1-picrylhydrazyl) and hydrogen peroxide scavenging assay. Sprague Dawley rats were administered EEHR daily and its effect on sperm count, sperm motility, biochemical parameters, organ weight analysis and histopathological changes was assessed after 21 days of treatment. Molecular docking studies of target proteins (1D2S,1E3G) with phytochemical constituents reported in leaves of HR were also carried out. Results: Phytochemical analysis revealed the presence of phenol, tannin, flavonoids, terpenoids, triterpenes and diterpenes. Antioxidant effect of EEHR was significantly higher in aqueous and methanol extracts compared to ethanol extract (p < 0.05). Sperm count, sperm motility, and weight reduction of epididymal caput/corpus, and absence of changes in biochemical content were significantly reduced in EEHR compared to control (p < 0.05). Histopathological analysis revealed alterations in seminiferous tubules and intraepithelial vacuolation in EEHR-treated rats. Molecular docking results showed that quercitrin, (-)-epicatechin, and quercetin showed the most effective binding with the target protein (1D2S), whereas quercetin, rhamnetin, and quercitrin showed effective binding with the target protein (1E3G). Conclusion: Ethanolic extract of leaves of Hibiscus rosa-sinensis (EEHR) significantly reduces sperm count, sperm motility, epididymal caput/corpus weight, and induces alterations of seminiferous tubules. Furthermore, docking study results clearly support the contraceptive potential of EEHR.

Purpose: To assess the pharmacognostic and antioxidant activities of the leaf and flower extracts of Lawsonia inermis Lythraceae. Methods: Pharmacognostic analysis involved wet and dry analyses, such as determination of total ash, extractive values, moisture content and phytochemical analysis, while antioxidant activity of plant extracts (100 - 500 μg/mL) was determined through ferric reducing antioxidant power assay. Ascorbic acid in different concentrations (100 - 500 μg/mL) was used as the standard. Apart from fluorescence studies, high-performance thin-layer chromatography (HPTLC) was used to identify novel compounds. Results: For the pharmacognostic analysis, total ash values of leaf and flowers were 5.57 ± 0.06 and 3.10 ± 0.03 %, respectively. The results indicated that the total ash value was significantly greater in the leaf than flower (p < 0.05). Low moisture content of the flower extract implied a lesser tendency of bacterial, fungal, or yeast contamination. The phytochemical evaluation revealed the presence of secondary metabolites in leaf and flower extracts of L. inermis. The greater proportion of these metabolites in the leaf extract may be ascribed to significantly higher reducing power potential (p < 0.05). Conclusion: The leaf extract possesses superior antioxidant activity compared to the flower extract of Lawsonia inermis and this could be due to the occurrence of a diversity of phytochemicals in the leaves.

Purpose: To compare the impact of pharmacist independent prescribers (PIPs) with that of regular physician-based prescriptions in the Madinah Region, Saudi Arabia. Methods: This prospective interventional study was conducted over 4 months and involved 40 critically ill patients in an adult medical intensive care unit (ICU) in a medium-sized non-teaching (private) hospital in the Kingdom of Saudi Arabia (KSA). Data from 20 patients based on typical physician prescriptions were compared with data from 20 patients under PIP prescriptions. The primary outcomes comprised the rate of medication errors (MEs), length of hospital stay (LOS), cost-effectiveness of prescriptions, and patients’ status. The secondary outcomes were guideline adherence and mortality rates. Results: There were significant PIP-mediated reductions in MEs. A total of 156 errors were identified: 23 by PIP (14 %) and 133 (86 %) by physicians. Moreover, PIP had 75 % guideline adherence when compared to physicians. The difference in cost-effectiveness was statistically significant in favor of PIP, resulting in a lower LOS of 7½ days compared to the physician group. Conclusion: These results indicate that integrating PIP into a multidisciplinary team will enhance medication use, reduce the rate of MEs, improve cost-effectiveness, and enhance patients’ outcomes. Further studies with larger sample size are needed to measure the effect of PIP on mortality rate.