This study was conducted to determine the potential interaction of aged garlic extract (AGE) with carvedilol (CAR), as well as to investigate the role of S-allyl-l-cysteine (SAC), an active constituent of AGE, in rats with isoproterenol (ISO)-induced myocardial dysfunction. At the end of three weeks of treatment with AGE (2 and 5 mL/kg) or SAC (13.1 and 32.76 mg/kg), either alone or along with CAR (10 mg/kg) in the respective groups of animals, ISO was administered subcutaneously to induce myocardial damage. Myocardial infarction (MI) diagnostic predictor enzymes, lactate dehydrogenase (LDH) and creatinine kinase (CK-MB), were measured in both serum and heart tissue homogenates (HTH). Superoxide dismutase (SOD), catalase, and thiobarbituric acid reactive species (TBARS) were estimated in HTH. When compared with other groups, the combined therapy of high doses of AGE and SAC given alone or together with CAR caused a significant decrease in serum LDH and CK-MB activities. Further, significant rise in the LDH and CK-MB activities in HTH was noticed in the combined groups of AGE and SAC with CAR. It was also observed that both doses of AGE and SAC significantly increased endogenous antioxidants in HTH. Furthermore, histopathological observations corroborated the biochemical findings. The cytoprotective potential of SAC and AGE were dose-dependent, and SAC was more potent than AGE. The protection offered by aged garlic may be attributed to SAC. Overall, the results indicated that a high dose of AGE and its constituent SAC, when combined with carvedilol, has a synergistic effect in preventing morphological and physiological changes in the myocardium during ISO-induced myocardial damage.

Background and objectives. Diabetes mellitus is a metabolic illness related to numerous organ damage, dysfunctions, and renal malfunction. In diabetes, oxidative stress plays a crucial part in the biochemical and pathological alterations linked to myocardial ischemia-reperfusion injury (IRI). In this study, an effort was made to evaluate the possible interaction of garlic (Allium sativum) (250 mg/kg) with the biguanide derivative, metformin (MET) (70 mg/kg), on IRI induced myocardial dysfunction in the isolated rat heart. Methods. The study was undertaken on both normoglycemic and alloxan (90 mg/kg) induced diabetic Sprague Dawley rats weighing 150–250 g. At the completion of the treatment phase (30 days for garlic, 250 mg/kg, oral; 10 days for MET, 70 mg/kg, oral), rats were anesthetized and mounted on the modified Langendorff’s apparatus. IRI was produced by myocardial no-flow global ischemia. Developed tension (DT) and heart rate (HR) were recorded both before and after ischemia. The perfusate was collected to estimate the leakage of cardiac biomarkers (Creatine Kinase-MB: CK-MB and Lactate dehydrogenase: LDH). Hearts were removed from the setup and utilized to prepare heart tissue homogenate (HTH) and histological slides. The endogenous antioxidants, superoxide dismutase (SOD) and catalase (CAT), in addition to oxidative thiobarbituric acid substances (TBS), were estimated in HTH. Results. The hemodynamic parameters, including percentage recovery in HR and DT, were found significantly higher in animals pretreated with garlic and MET in diabetic rats (DR). Both SOD and CAT enzyme activities increased significantly while TBS levels were reduced in the HTH of animals treated with garlic and MET. The cardiac markers CK-MB and LDH levels also increased in HTH with a corresponding decrease in the perfusate. The histopathological changes in the heart and pancreas demonstrated noticeable protection of the tissues due to pretreatment with garlic and MET. Taken together, these findings advocate that reactive oxygen species derived from hyperglycemia execute an important function in myocardial global IRI; the therapy of garlic homogenate was found to be effective in alleviating these toxic effects. Conclusion. The combined therapy of MET and garlic provided synergistic cardioprotection, implying that garlic seems to possess promise in lowering toxic parameters by protecting diabetic induced myocardial injury.

Owing to disparities in the intensity of the breakouts, state and federal regulations, accessible means, cultural elements, and social consciousness, the global reaction to the COVID-19 pandemic has been varied. The COVID-19 pandemic, on the other hand, has had an impact on all parts of society, notably efforts to combat antimicrobial resistance (AMR). The pandemic has highlighted that a greater burden on medical infrastructure can contribute to higher, often unnecessary antibiotic usage and a de-prioritization of antimicrobial stewardship and surveillance (AMS). The focus of this research is to see if there is a growth in antibiotic resistance during the covid-19 pandemic in the King Salman Hospital in Riyadh, Saudi Arabia, and to investigate the subcomponent that leads to antibiotic resistance. This is a comprehensive review of patients hospitalized at the King Salman Hospital in Riyadh, Saudi Arabia, who were admitted to the Intensive Care Unit (ICU) during the first wave of the covid-19 pandemic, which occurred between March and August 2020. An analysis of the case dataset was performed to determine the rise in antibiotic resistance and relate it to resistant cases before the pandemic (September 2019 to February 2020). Before and throughout the pandemic, fifteen kinds of bacteria were found, with K. pneumonia being the most prevalent bacteria (49; 30.6%), and Ac. Baum/haem being the most removable bacteria during the pandemic (74; 37.3%). Cephalosporin antibiotics, in notably cefotaxime and ceftazidime (100%), cefazolin (96.3%), ceftriaxone (96%), cefuroxime and ceftazidime (95%), cefotaxime ((94.7%). These antibiotics also had the same amount of resistance during the pandemic. In pre-covid-19 and during covid-19, these findings were congruent with the penicillin antibiotics class, ampicillin, and piperacillin (96.3% and 92.1%), accordingly. It is presently uncertain if COVID-19 patients would develop new or growing antibiotic resistance in locations with low historical prevalence, but this should be investigated in retrospective and future clinical and microbiology research.

Antimicrobial stewardship (AMS) is of vital significance to tackle the antibiotic resistance. Insights of physicians is important for implementation of AMS. Therefore, present study was conducted to assess the knowledge, attitude and practices regarding antibiotic stewardship among professional physicians in Riyadh, Saudi Arabia. A cross-sectional questionnaire-based survey was conducted among professional physicians between January 2020 to April 2020 in clusters of Saudi hospitals. The self-administered and closed ended questionnaire encompassed of informed consent, demographics information and questionnaire which included 7 items for knowledge, 10 for attitude and 8 for practices. Chi-square test and Fisher’s exact test was performed to assess the relationship of knowledge, attitude and practices with gender and medical specialty of the study participants along with descriptive statistics. A p value below (p<0.05) was considered significant for all the statistical purposes. A total of 413 medical practitioners participated in this study. Most of the participants were male 280 (67.8%), aged 31-40 years 163(39.4%). The term antimicrobial stewardship was known to 55.9% of participants and 65% of participants knew the difference between and bactericidal antimicrobial agents (). 71.9% participants opined that can be prevented by using specific . 89% of participants do not prescribe on demand of patients. Health professionals should be adequately trained regarding usage of and their consequences to curb the menace of quickly developing AMA resistance.

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