Background Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). Results The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system. Conclusion The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.

Background relevance: A plethora of literature is available regarding the clinical trials for natural products however; no information is available for critical assessments of the quality of these clinical trials. Aim of study: This is a first time report to critically evaluate the efficacy, safety and large scale applications of up-to-date clinical trials for diabetes, based on the three scales of Jadad, Delphi, and Cochrane. Methodology: An in-depth and extensive literature review was performed using various databases, journals, and books. The keywords searched included, “clinical trials,” “clinical trial in diabetes,” “diabetes,” “natural products in diabetes,” “ethnopharmacological relevance of natural products in diabetes,” etc. Results: Based on eligibility criteria, 16 plants with 74 clinical trials were found and evaluated. Major drawbacks observed were; “non-randomization and blindness of the studies,” “non-blindness of patients/healthcare/outcome assessors,” “lack of patient compliance and co-intervention reports,” “missing information regarding drop-out/withdrawal procedures,” and “inappropriate baseline characteristics.” Principal component analysis and Pearson correlation revealed four components with %variability; PC1: 23.12, PC2: 15.83, PC3: 13.11, and PC4: 11.38 ( P ≤ .000). According to descriptive statistics, “non-blinding of outcome assessors” was the major drawback (82%) whereas, “not mentioning the timing of outcome assessment” was observed lowest (6.8%). An in-house quality grading (scale 0–24) classified these clinical trials as; poor (67.6%), acceptable (19.9%), and good quality trials (13.5%). Conclusion: Proper measures in terms of more strict regulations with pharmacovigilance of plants are utmost needed in order to achieve quality compliance of clinical trials.

Background Antimicrobial agents are considered among the most commonly prescribed drugs in pregnancy given the increased susceptibility of infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their prescribing and utilization pattern. Such type of data regarding this issue is scarce in Saudi Arabia and this encouraged us to conduct this research. The aim of this study is to generate data about the most commonly prescribed antimicrobial agents during pregnancy, as well as their indicators and safety. Methods This is a retrospective study focusing on pregnant women with a known antimicrobial consumption at Johns Hopkins Aramco Healthcare (JHAH). The sample size was 344 pregnant women with 688 antimicrobial prescriptions. Data was collected about prevalence of infections and antimicrobial prescriptions in addition to drug safety during pregnancy using FDA risk categorization system. Results The results showed that Urinary Tract Infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during their pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from B, C and D classes according to the FDA risk classification system. Conclusion Overall antimicrobial prescribing practices were appropriate. The study revealed a high prevalence of antimicrobials prescribing during pregnancy that might pose risks to mothers and their fetuses. Future multi center studies are warranted to evaluate the rational prescribing of antimicrobial medications during pregnancy.

In nanotherapeutics, gaining insight about the drug interaction with the pore architecture and surface functional groups of nanocarriers is crucial to aid in the development of targeted drug delivery. Manganese ferrite impregnated graphene oxide (MnFe2O4/GO) with a two-dimensional sheet and spherical silica with a three-dimensional interconnected porous structure (MnFe2O4/silica) were evaluated for cisplatin release and cytotoxic effects. Characterization studies revealed the presence of Mn2+ species with a variable spinel cubic phase and superparamagnetic effect. We used first principles calculations to study the physisorption of cisplatin on monodispersed silica and on single- and multi-layered GO. The binding energy of cisplatin on silica and single-layer GO was ~1.5 eV, while it was about double that value for the multilayer GO structure. Moreover, we treated MCF-7 (breast cancer cells) and HFF-1 (human foreskin fibroblast) with our nanocomposites and used the cell viability assay MTT. Both nanocomposites significantly reduced the cell viability. Pt4+ species of cisplatin on the spinel ferrite/silica nanocomposite had a better effect on the cytotoxic capability when compared to GO. The EC50 for MnFe2O4/silica/cisplatin and MnFe2O4/GO/cisplatin on MCF-7 was: 48.43 µg/mL and 85.36 µg/mL, respectively. The EC50 for the same conditions on HFF was: 102.92 µg/mL and 102.21 µg/mL, respectively. In addition, immunofluorescence images using c-caspase 3/7, and TEM analysis indicated that treating cells with these nanocomposites resulted in apoptosis as the major mechanism of cell death.