Objective: To report medication adherence among ambulatory patients with diabetes mellitus (DM) using Morisky 8-item medication adherence MMAS-8 scale and assess current standard of knowledge regarding their disease using a especially developed Patient 10-item Knowledge Assessment PKA-X scale. Methods: A quantitative cross sectional study was conducted for 3 months in Karachi, Pakistan using Morisky 8-item medication adherence scale ® documenting the medication adherence of ambulatory patients with DM and to find out their knowledge regarding the disease using a newly developed Patient 10-item knowledge assessment PKA-X scale. Results: The mean MMAS-8 score of the total sample was 4.69 (1.9 SD) which was interpreted as 'Low medication adherence' (P value<0.01). Majority of patients (N=204, 79.4%) had low adherence (P value<0.01). The mean score reported by PKA-X scale was 9.0 (SD 1.4) which was interpreted as 'Excellent knowledge'. Bulk of patients (N=202, 78.6%) had excellent knowledge (P value<0.01). No significant association existed between patient knowledge and their medication adherence (P value>0.05). Conclusion: The medication adherence of the patients is very low and adequate measures are the need of the hour to address this issue though the standard of knowledge has greatly improved. However, having good knowledge about the disease does not guarantee adherence to medication regimen.

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Background: Cancer is a debilitating disease that is on the increase in both developed and developing countries. The plant extract of A. muricata have been known to have a variety of anticancer effects, including anti-angiogenic potential. An in silico study is needed as a preliminary study to understand the mechanism underline this process. Objective: The aim of this study was to investigate the potential of the bioactive compounds of A. muricata in regulating angiogenesis process, primarily by the regulation of hypoxia inducible factor (HIF)-1α expression by in silico study. Methods: This study was performed by in silico analysis including the bioactive compounds preparation, biological activity prediction, protein target and pathway analysis, 3D protein modelling, protein-ligand and protein-protein docking, and the visualization of docking results. Results: There are 3 bioactive compounds of A. muricata with the ability to inhibit HIF-1α expression, including kaempferol, genistein, and glycitein. The inhibition of HIF-1α expression was associated with phosphoinositide 3-kinases (PI3K)/Akt signaling pathway, which involved tyrosine kinase receptor activity on the cell membrane. Based on the silico analysis in this study, we shown that kaempferol, genistein, and glycitein inhibit HIF-1α expression through the disruption of interleukin (IL)-6R and toll-like receptor (TLR)-4 and their respective ligands interaction. Conclusion: The findings of this study show that A. muricata bioactive compounds could inhibit HIF-1α expression through disruption of the tyrosine kinase receptor binding with its ligand.

Sodium nitrite (NaNO2) found in vegetables, drinking water, and cured meats, can damage tissue because it is an oxidant. Plant phytochemicals such as quercetin are antioxidants. This study aimed to determine the potential of red okra pods ethanol extract (ROE) to repair kidney damage in mice (Mus musculus) induced by NaNO2. The red okra pods were extracted three times with saturated ethanol. The experiment used 36 male BALB/c mice aged 6-8 weeks and body weight of about 28 g. There are six research groups, namely, normal control, negative control (exposure to NaNO2 50 mg/kg BW), treatment of exposure to NaNO2 and administration of ROE at doses of 25, 50, 75, and 100 mg/kg BW. Sodium nitrite and ROE were given daily for 23 days by gavage. On day 24, the serum was isolated. Blood urea nitrogen (BUN) and creatinine (Cre) levels are measured to assess kidney function, as well as measuring the oxidant malondialdehyde (MDA) and the antioxidant enzyme of superoxide dismutase (SOD). The kidneys were made histological preparations and analyzed on the proximal convoluted tubule (PCT).  All data were statistically analyzed (α=0.05). This study indicated that the administration of ROE at a 100 mg/kg BW dose is the most optimal in repairing damage to the PCT with increased normal cells and reduced necrosis. Besides, it degraded BUN, Cre, and MDA levels in the serum of mice exposed to NaNO2 compared to the other treatments. All doses of ROE promoted the SOD level. ROE restore kidney tissue, especially on PCT to normal. Kidney damage due to exposure to NaNO2 preservatives can be reduced by administering ROE. ROE prevents kidney damage through an increase in antioxidant enzymes. ROE can be used as a food ingredient as a source of antioxidants, thereby reducing the impact of oxidant compounds.

Borax is still widely used for food in the community. Borax can attack mitochondria and cytoplasm where cellular energy metabolism occurs. The purpose of this study was to analyze the impact of borax on energy metabolism. Settings and Design of this study used Review article. The writing method was based on scientific phenomena that occurred in the research which was then analyzed deeply based on theories taken from the scientific literature. The Result of this study, Boron ions affect the activity of at least 26 different enzymes that are needed for energy metabolism. Boric acid as active substances of borax can form stable complexes with hydroxyl compounds from glucose, protein and fat which are the raw materials for energy metabolism, and inhibit nicotinamide adenine dinucleotide (NAD + ) activity which is a coenzyme in energy metabolism. Decrease in adenosine triphosphate (ATP) due to boric acid through the binding of NAD + and an increase in thermogenic protein pathways. The ATP reduction which disrupts ion pumps and accumulation of boron ions will damage the composition of ions in the cytoplasm where the process of glycolysis occurs. This ion pump disruption will also cause cell swelling, and disrupt the balance of ions which will lead to mitochondrial dysfunction and damage (the site of the Krebs cycle and oxidative phosphorylation). Conclusions of this study, Borax has a negative effect on energy metabolism, through the macronutrient, NAD + , enzymes, ATP, cytoplasm and mitochondria pathway.