Anwar Ali Mohammad Alghamdi

Objectives: Curcumin possesses well-documented anticancer activity; however, its clinical translation is hindered by poor aqueous solubility and limited bioavailability. The present study aimed to engineer pH-dependent bovine serum albumin (BSA)–based nanocarriers for curcumin delivery and to evaluate their physicochemical characteristics, controlled release behavior under gastrointestinal pH conditions, and in vitro anticancer efficacy against the human colon cancer cell line Colo-205. Methods: Curcumin-loaded bovine serum albumin nanoparticles (Cu-BSA-NPs) were fabricated using a desolvation technique followed by chemical crosslinking. Particle size, zeta potential, and polydispersity index (PDI) were assessed by dynamic light scattering. Morphology was examined using scanning electron microscopy (SEM), while structural and thermal properties were evaluated by Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). Drug loading capacity and entrapment efficiency were quantified spectrophotometrically. In vitro drug release was investigated using a gastrointestinal pH-transition model (pH 1.2, 6.8, and 7.4). Cytotoxic activity was assessed using the sulforhodamine B (SRB) assay on Colo-205 cells. Results: The engineered Cu-BSA-NPs exhibited particle sizes ranging from 96.7 ± 10.5 to 126.4 ± 35.8 nm, with PDI values between 0.289 and 0.581 and zeta potentials from −18.2 ± 1.01 to −34 ± 1.0 mV, indicating nanoscale dimensions and moderate colloidal stability. SEM analysis revealed spherical nanoparticles with smooth surfaces and uniform morphology. Entrapment efficiency ranged from 6.59 ± 1.11% to 52.98 ± 0.65%, while drug loading efficiency varied between 1.308 ± 0.206% and 16.744 ± 0.266%. In vitro release studies demonstrated minimal drug release under acidic (pH 1.2) and near-neutral (pH 6.8) conditions, followed by significantly enhanced release at pH 7.4, confirming pH-dependent behavior of the albumin matrix. Cytotoxicity studies showed significant antiproliferative activity against Colo-205 human colon cancer cells. Conclusions: The findings demonstrate successful engineering of albumin-based nanocarriers capable of modulating curcumin release under physiologically relevant pH conditions and enhancing in vitro anticancer activity. Although limited to in vitro evaluation, this study highlights the potential of protein-based nanoplatforms as adaptable delivery systems for colon cancer therapy. Further in vivo investigations are warranted to validate their translational and therapeutic potential.

Background: Medication use in paediatric populations is inherently complex and carries a heightened risk of prescribing errors, particularly within primary health-care settings. Despite this concern, evidence describing paediatric prescribing errors in Saudi Arabia remains scarce. Hence, the present study aimed to evaluate the prevalence and patterns of prescribing errors in paediatric primary care and to characterize the pharmacist-led interventions undertaken to resolve these errors. Methods: A prospective, mixed-methods cross-sectional study was conducted over three months at a primary health-care centre. Paediatric outpatient prescriptions were systematically reviewed during routine practice by trained clinical pharmacists. All suspected errors were independently validated and classified for severity by a multidisciplinary expert panel. Descriptive statistics were used to summarise prescribing errors, and associations with patient and prescription characteristics were assessed using chi-square tests. Qualitative data were analysed using a descriptive thematic approach to explore mechanisms of error identification and the nature of corrective pharmacist interventions. Results: A total of 545 paediatric outpatient prescriptions were reviewed, of which 142 prescriptions (26.1%) contained at least one prescribing error. Across these prescriptions, a total of 145 individual prescribing errors were identified. Dose-related errors were the most common (68.3%), followed by inaccuracies in dosing frequency (11.0%) and inappropriate drug selection (9.0%). The occurrence of prescribing errors was significantly associated with patient weight (p = 0.016), the number of medications per prescription (p < 0.001), and the recorded diagnosis (p = 0.018). The majority of errors were intercepted prior to medication dispensing (93.0%), and no cases of patient harm were identified. Qualitative analysis revealed that errors were predominantly detected through cross-checking with authoritative drug references, recalculation of weight-based doses, and application of clinical judgement, and were most often resolved through direct communication with the prescribing clinician. Conclusions: Prescribing errors occur frequently in paediatric outpatient settings; however, most are preventable with appropriate safeguards. Pharmacists play a critical role in identifying and resolving these errors before they result in patient harm. Enhancing paediatric prescribing support systems and strengthening interprofessional collaboration may further advance medication safety within primary health-care services.

The emerging potential of senotherapeutics in the management of chronic pulmonary diseases focuses on the pivotal role of cellular senescence in the pathogenesis of conditions such as idiopathic pulmonary fibrosis (IPF), asthma, and chronic obstructive pulmonary disease (COPD). Senescent cells, characterized by irreversible cell cycle arrest and a pro-inflammatory secretory phenotype, accumulate with age and contribute to chronic inflammation, tissue remodeling, and disease progression in the lungs. The chapter provides an in-depth understanding of the mechanisms by which senescent cells influence pulmonary pathology and presents senolytics and senomorphics as innovative therapeutic strategies. These approaches aim to either eliminate or modulate the effects of senescent cells. While challenges such as adverse drug reactions remain, recent advancements—such as the development of FOXO4-DRI, a senolytic peptide—highlight the therapeutic promise of senotherapy in improving lung function and reducing disease burden. Ultimately, targeting senescent cells offers a dual benefit: alleviating symptoms and addressing the root causes of chronic lung disorders.

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for enhanced safety standards. This review will examine the existing level of drug-related safety in Saudi Arabia, categorizing the areas for improvement and highlighting concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel and the use of technology and patient education in promoting pharmaceutical safety. The data reveal that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation highlights the deficiencies in ongoing education, such as real-world case scenarios and related trainings, inadequate incorporation of skills in assessment methods, and deficiency in standardized protocols for error reporting. To address these gaps, it is proposed to implement structured competency-based training, simulation exercises must be preferred for periodic skill assessments, and a safe reporting culture should be encouraged for the sake of transparency and learning from errors. We recognize the use of technology, such as electronic health records and computerized physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia.

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi health care providers, with numerous studies outlining the incidence of pharmaceutical mistakes and the need for enhanced safety standards. This review will examine the existing level of drug related safety in Saudi Arabia, categorising the areas for improvement, and highlight concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel, the use of technology, and patient education in promoting pharmaceutical safety. The data reveals that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation emphasizes the significance of ongoing education, skill tests, and creating a culture that nurtures reporting medication errors and adverse drug reactions. We recognise the use of technology, such as electronic health records and computerised physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia.

Background: Globally, many women express the desire to avoid immediate pregnancy for 24 months postdelivery, and only forty percent use contraceptives during this period. There is an enormous demand for postpartum family planning, particularly in developing countries with low- or middle-income grades. Postpartum intrauterine devices such as long-acting reversible contraceptives (LARCs) are among the most effective methods of family planning in the immediate postpartum period, yet their effectiveness is hindered because of a lack of availability and training. Strategies to increase access to LARCs are essential. Hence, the purpose of the current study is to determine the barriers among healthcare providers in providing immediate postpartum family planning services. Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at SIMS, a tertiary care teaching hospital, from January to March 2024. Approximately 293 healthcare providers who fulfilled the inclusion criteria were provided an online questionnaire in the form of a Google Forms link, which included a structured questionnaire focusing on various aspects, including demographics, knowledge, practices, and barriers in their practice. The data collected were analysed through SPSS version 26, which employs chi-square tests and Pearson’s correlation to determine any significant associations among them. Based on the key statistical outcomes and the significant correlations observed related to the data, a thematic analysis through SWOT (strengths, weaknesses, opportunities, threats) was conducted. The study adhered to the method outlined by Braun and Clarke (2006) and compiled with the COREQ (consolidated criteria for reporting qualitative research) checklist to uphold methodological integrity. Results: Among the participants, 92.4% provided family planning counselling after childbirth, predominantly during the antenatal period (75.1%), and the provision of immediate postnatal family planning was reported in 76.1% of the participants, with PPIUDs identified as the most utilized method by 52.6%. Various barriers were identified, including insufficient training on Implanon (33.4%) and the PPIUCD (12.6%), the unavailability of implants (59.0%), and a lack of interest among patients (46.1%). Statistically significant associations were observed between the practice setting and knowledge of postpartum family planning (p = 0.002), as well as deficiencies in training for the PPIUCD (p < 0.001). The study highlights the place of practice and the practitioners’ experience as significant strengths in offering immediate postpartum contraception and referring patients for family planning. However, qualification was identified as a limiting factor for practicing immediate postpartum family planning. Conclusions: This study revealed significant difficulty in delivering prompt postpartum long-acting reversible contraceptives (LARCs), underscoring the necessity of improved education and training for professionals. Focusing on these challenges is important in enhancing postpartum family planning acceptance and decreasing unfulfilled requirements in resource-limited settings.

Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are enzymes that break down and reduce the level of the neurotransmitter acetylcholine (ACh). This can cause a variety of cognitive and neurological problems, including Alzheimer’s disease. Taxifolin is a natural phytochemical generally found in yew tree bark and has significant pharmacological properties, such as being anti-cancer, anti-inflammatory, and antioxidant. The binding affinity and inhibitory potency of taxifolin to these enzymes were evaluated through molecular docking and molecular dynamics simulations followed by the MMPBSA approach, and the results were significant. Taxifolin’s affinity for binding to the AChE–taxifolin complex was −8.85 kcal/mol, with an inhibition constant of 326.70 nM. It was observed to interact through hydrogen bonds. In contrast, the BChE–taxifolin complex binding energy was observed to be −7.42 kcal/mol, and it was significantly nearly equal to the standard inhibitor donepezil. The molecular dynamics and simulation signified the observed interactions of taxifolin with the studied enzymes. The MMPBSA total free energy of binding for AChE–taxifolin was −24.34 kcal/mol, while BChE–taxifolin was −16.14 kcal/mol. The present research suggests that taxifolin has a strong ability to bind and inhibit AChE and BChE and could be used to manage neuron-associated problems; however, further research is required to explore taxifolin’s neurological therapeutic potential using animal models of Alzheimer’s disease.

Background: Hepatic fibrosis is a major health problem all over the world, and there is no effective treatment to cure it. Hence, the current study sought to assess the anti-fibrotic efficacy of apigenin against CCl₄-induced hepatic fibrosis in mice. Methods: Forty-eight mice were put into six groups. G1: Normal Control, G2: CCl₄ Control, G3: Silymarin (100 mg/kg), G4 and G5: Apigenin (2 &20 mg/Kg), G6: Apigenin alone (20 mg/Kg). Groups 2, 3, 4, and 5 were given CCl₄ (0.5 mL/kg. i.p.) twice/week for six weeks. The level of AST, ALT, TC, TG, and TB in serum and IL-1β, IL-6, and TNF-α in tissue homogenates were assessed. Histological studies by H&E staining and Immunostaining of liver tissues were also performed. Results: The CCl₄-challenged group showed increased serum AST (4-fold), ALT (6-fold), and TB (5-fold). Both silymarin and apigenin treatments significantly improved these hepatic biomarkers. The CCl₄-challenged group showed reduced levels of CAT (89%), GSH (53%), and increased MDA (3-fold). Both silymarin and apigenin treatments significantly altered these oxidative markers in tissue homogenates. The CCl₄-treated group showed a two-fold increase in IL-1β, IL-6, and TNF-α levels. Silymarin and apigenin treatment considerably decreased the IL-1β, IL-6, and TNF-α levels. Apigenin treatment inhibited angiogenic activity, as evidenced by a decrease in VEGF (vascular endothelial growth factor) expression in liver tissues, and a decline in vascular endothelial cell antigen expression (CD34). Conclusions: Finally, these data collectively imply that apigenin may have antifibrotic properties, which may be explained by its anti-inflammatory, antioxidant, and antiangiogenic activities.

Aims: The aim of this study was to assess the incidence, nature, preventability and severity of adverse drug events (ADEs) across three paediatric intensive care units (PICUs) in England.Methods: A prospective observational cohort study was conducted across three PICUs over a three‐month period during 2019. Included patients were aged ≤18 years and stayed in PICU for a minimum of 24 hours. Identification of suspected ADEs was performed by trained PICU pharmacists. A multidisciplinary expert panel assessed causality, preventability and severity of events.Results: A total of 302 patients were included and 62 ADEs were confirmed (definite/probable causality). One in six patients experienced one or more ADEs. The estimated incidence of ADEs were 20.5 per 100 patients (95% CI 15.3–27.5) and 16.7 per 1000 patient‐days (95% CI 9.3–29.9). The majority of ADEs were judged preventable by the expert panel (36/62, 58.1%). ADEs were commonly involved with medicines prescribing (29/62, 46.8%) and caused temporary patient harm (42/62, 67.7%). Medications for the central nervous system (14/62, 22.6%), infections (13/62, 20.9%) and cardiovascular system (12/62, 19.4%) were commonly implicated with ADEs. Multivariable analysis revealed that patients who stayed in PICU for ≥7 days (OR 6.29, 95% CI 2.42–16.32) were more likely to experience an ADE compared to patients with a stay of 1–6 days.Conclusion: ADEs are common in English PICUs and most of them may be preventable. There is a strong association between ADE occurrence and duration of PICU stay, which represents a target for remedial interventions. Exploring contributory factors of preventable ADEs is now necessary to inform preventive policies.

Background Critically ill neonates and paediatric patients may be at a greater risk of medication-related safety incidents than those in other clinical areas. Objective This study aimed to examine the nature of, and contributory factors associated with, medication-related safety incidents reported in neonatal and paediatric intensive care units (ICUs). Methods We carried out a mixed-methods analysis of anonymised medication safety incidents reported to the National Reporting and Learning System that involved children (aged ≤ 18 years) admitted to ICUs across England and Wales over a 9-year period (2010–2018). Data were analysed descriptively, and free-text descriptions of harmful incidents were examined to explore potential contributory factors associated with incidents. Results In total, 25,567 eligible medication-related incident reports were examined. Incidents commonly occurred during the medicines administration (n = 13,668 [53.5%]) and prescribing stages (n = 7412 [29%]). The most commonly implicated error types were drug omission (n = 4812 [18.8%]) and dosing errors (n = 4475 [17.5%]). Neonates were commonly involved in reported incidents (n = 12,235 [47.9%]). Anti-infectives (n = 6483 [25.4%]) were the medications most commonly associated with incidents and commonly involved neonates. Incidents that were reported to have caused patient harm accounted for 12.2% (n = 3129) and commonly involved neonates (n = 1570/3129 [50.2%]). Common contributing factors to harmful incidents included staff-related factors (68.7%), such as failure to follow protocols or errors in documentation, which were often associated with working conditions, inadequate guidelines, and design of systems and protocols. Conclusions Neonates were commonly involved in medication-related incidents reported in children’s intensive care settings. Improvements in staffing and workload, design of systems and processes, and the use of anti-infective medications may reduce this risk.