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Fulltext The crux of Pakistan's prolonged rabies vaccine shortage: A rising mortal threat in the COVID-19 pandemic

Siddiqui A, Ahmed A, Tanveer M, Arshad A

J Med Virol, 2021 Sep;93(9):5221-5222.
PMID: 33851738 DOI: 10.1002/jmv.27024
Fulltext The mystery of plummeting cases of measles during COVID-19 pandemic in Pakistan: Hidden impact of collateral damage

Tanveer M, Ahmed A, Siddiqui A, Gudi SK

J Med Virol, 2021 Sep;93(9):5236-5238.
PMID: 33942340 DOI: 10.1002/jmv.27045
Fulltext War against COVID-19: looming threat of XDR typhoid battle in Pakistan

Tanveer M, Ahmed A, Siddiqui A, Rehman IU, Hashmi FK

Public Health, 2021 09;198:e15-e16.
PMID: 34187703 DOI: 10.1016/j.puhe.2021.05.019
Fulltext Mechanistic role of boswellic acids in Alzheimer's disease: Emphasis on anti-inflammatory properties

Siddiqui A, Shah Z, Jahan RN, Othman I, Kumari Y

Biomed Pharmacother, 2021 Dec;144:112250.
PMID: 34607104 DOI: 10.1016/j.biopha.2021.112250

The resin/gum of Boswellia species belonging to the family of Burseraceae is a naturally occurring mixture of bioactive compounds, which was traditionally used as a folk medicine to treat conditions like chronic inflammation. Several research studies have also explored its' therapeutic potential against multiple neurodegenerative diseases such as Alzheimer's disease (AD). The main chemical constituents of this gum include boswellic acids (BAs) like 3-O-acetyl-11-keto-β boswellic acid (AKBA) that possess potent anti-inflammatory and neuroprotective properties in AD. It is also involved in inhibiting the acetylcholinesterase (AChE) activity in the cholinergic pathway and improve choline levels as well as its binding with nicotinic receptors to produce anti-inflammatory effects. Multiple shreds of evidence have demonstrated that BAs modulate key molecular targets and signalling pathways like 5-lipoxygenase/cyclooxygenase, Nrf2, NF-kB, cholinergic, amyloid-beta (Aβ), and neurofibrillary tangles formation (NFTs) that are involved in AD progression. The present review focuses on the possible mechanistic therapeutic role of BAs in modulating the 5-LOX/COX pathway in arachidonic acid metabolism, activating Nrf2 through binding of ARE, inhibiting NF-kB and AChE activity. In addition, an inhibition of amyloid plaques (Aβ) and neurofibrillary tangles (NFTs) induced neurotoxicity and neuroinflammation in AD by BAs is also discussed in this review. We have also highlighted that BAs possess beneficial effects in AD by targeting multiple molecular pathways and makes it an emerging drug candidate for treating neurodegenerative diseases.
Fulltext Oncology stewardship: Role of the pharmacists for contribution in low and middle-income countries

Siddiqui A, Shrestha S, Ahmed A, Akhlaq Bhutta O

J Oncol Pharm Pract, 2023 Jun;29(4):956-957.
PMID: 36734132 DOI: 10.1177/10781552231154465
Fulltext Inflammation Drives Alzheimer's Disease: Emphasis on 5-lipoxygenase Pathways

Siddiqui A, Akhtar S, Shah Z, Othman I, Kumari Y

Curr Neuropharmacol, 2021;19(6):885-895.
PMID: 32972344 DOI: 10.2174/1570159X18666200924122732

It is a known fact that inflammation affects several physiological processes, including the functioning of the central nervous system. Additionally, impairment of lipid mechanisms/pathways have been associated with a number of neurodegenerative disorders and Alzheimer's Disease (AD) is one of them. However, much attention has been given to the link between tau and beta- amyloid hypothesis in AD pathogenesis/prognosis. Increasing evidences suggest that biologically active lipid molecules could influence the pathophysiology of AD via a different mechanism of inflammation. This review intends to highlight the role of inflammatory responses in the context of AD with the emphasis on biochemical pathways of lipid metabolism enzyme, 5-lipoxygenase (5- LO).
Oxidative stress correlates (OSC) in diabetes mellitus patients

Azeem E, Gillani SW, Siddiqui A, Mian RI, Poh V, Sulaiman SA, et al.

Curr Diabetes Rev, 2016;12(3):279-84.
PMID: 25989845 DOI: 10.2174/1573399811666150520094631

Background/aim: Diabetes mellitus (DM) is a considerable systemic metabolic disorder to exhibit various metabolic and cardiovascular disorders, mainly hyperglycemia. Our study aims to evaluate oxidative stress markers in DM patients and to determine the clinical correlates affecting the investigational parameters.

Methodology: To evaluate oxidative stress, the following parameters were included: tri-glycerides(TG), total cholesterol, low density lipoprotein cholesterol(LDL), oxidized LDL cholesterol(Ox LDL), superoxide dismutase(SOD), glutathione peroxidase(GSH-Px) and plasminogen activator inhibitor(PAI) which were measured at single observation point. Patient clinical and demographic data were taken from registered medication profiles from the Outpatient Department.

Results: The diabetic subjects have significantly high measured values of endocrine(p<0.01), metabolic(p<0.01) and antioxidant parameters(p<0.05), and have significant higher values of TG(3.69±1.27 vs 1.79±0.84 mmol/L, p< 0.01), Ox LDL(85.37±19.1 vs 77.11±26.64 mmol/L, p<0.05) and SOD enzyme activity(918.78 ± 145.39 vs 880.08±149.52 U/g Hb, p<0.05) compared to the controls. A significant negative correlation was found between Ox LDL and HbA1c(r = -0.6782, p < 0.001) among diabetic subjects.

Conclusion: Elevated Ox-LDL, SOD and GSH-Px are associated with the diabetic patients. However, oxidative stress threshold values also showed high oxidative activity markers among controls. Clinical variables showed predictive information on oxidative activity among diabetes patients.
Diet and Colorectal Cancer Risk in Asia--a Systematic Review

Azeem S, Gillani SW, Siddiqui A, Jandrajupalli SB, Poh V, Syed Sulaiman SA

Asian Pac J Cancer Prev, 2015;16(13):5389-96.
PMID: 26225683

Diet is one of the major factors that can exert a majorly influence on colorectal cancer risk. This systematic review aimed to find correlations between various diet types, food or nutrients and colorectal cancer risk among Asian populations. Search limitations included Asian populations residing in Asia, being published from the year 2008 till present, and written in the English language. A total of 16 articles were included in this systematic review. We found that red meats, processed meats, preserved foods, saturated/animal fats, cholesterol, high sugar foods, spicy foods, tubers or refined carbohydrates have been found by most studies to have a positive association with colorectal cancer risk. Inversely, calcium/dairy foods, vitamin D, general vegetable/fruit/fiber consumption, cruciferous vegetables, soy bean/soy products, selenium, vitamins C,E and B12, lycophene, alpha-carotene, beta-carotene, folic acid and many other vitamins and minerals play a protective role against colorectal cancer risk. Associations of fish and seafood consumption with colorectal cancer risk are still inconclusive due to many varying findings, and require further more detailed studies to pinpoint the actual correlation. There is either a positive or no association for total meat consumption or white meats, however their influence is not as strong as with red and processed meats.
Fulltext Knowledge, attitude and behavior of healthcare providers towards breast cancer in Malaysia: a systematic review

Azeem E, Gillani SW, Siddiqui A, Shammary H A A, Poh V, Syed Sulaiman SA, et al.

Asian Pac J Cancer Prev, 2015;16(13):5233-5.
PMID: 26225658

Breast cancer is the most common cancer among women in Malaysia. Therefore, it is highly important for the public to be educated on breast cancer and to know the steps to detect it early on. Healthcare providers are in the prime position to provide such education to the public due to their high knowledge regarding health and their roles in healthcare. The present systematic review involved studies conducted in recent years to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in attempts to obtain an overall picture of how well equipped our healthcare providers are to provide optimal breast cancer education, and to see their perceptions and actual involvement in said education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references used by eligible studies. Criteria for eligibility included being published from the year 2008 till present, being conducted in Malaysia, and being written in the English language. A total of two studies were eligible for this review. Findings show that Malaysian future and current healthcare providers have moderate knowledge on breast cancer, have a positive towards involvement of breast cancer education, but have poor actual involvement.
Fulltext An overview of procurement, pricing, and uptake of COVID-19 vaccines in Pakistan

Siddiqui A, Ahmed A, Tanveer M, Saqlain M, Kow CS, Hasan SS

Vaccine, 2021 08 31;39(37):5251-5253.
PMID: 34364719 DOI: 10.1016/j.vaccine.2021.07.072
Fulltext Behavioural, genomics and proteomic approach to examine Alzheimer's disease in zebrafish

Siddiqui A, Abidin SAZ, Shah ZA, Othman I, Kumari Y

Comp Biochem Physiol C Toxicol Pharmacol, 2023 Sep;271:109636.
PMID: 37100105 DOI: 10.1016/j.cbpc.2023.109636

Globally around 24 million elderly population are dealing with dementia, and this pathological characteristic is commonly seen in people suffering from Alzheimer's disease (AD). Despite having multiple treatment options that can mitigate AD symptoms, there is an imperative call to advance our understanding of the disease pathogenesis to unfold disease-modifying treatments/therapies. To explore the driving mechanisms of AD development, we stretch out further to study time-dependant changes after Okadaic acid (OKA)-induced AD-like conditions in zebrafish. We evaluated the pharmacodynamics of OKA at two-time points, i.e., after 4-days and 10-days exposure to zebrafish. T-Maze was utilized to observe the learning and cognitive behaviour, and inflammatory gene expressions such as 5-Lox, Gfap, Actin, APP, and Mapt were performed in zebrafish brains. To scoop everything out from the brain tissue, protein profiling was performed using LCMS/MS. Both time course OKA-induced AD models have shown significant memory impairment, as evident from T-Maze. Gene expression studies of both groups have reported an overexpression of 5-Lox, GFAP, Actin, APP, and OKA 10D group has shown remarkable upregulation of Mapt in zebrafish brains. In the case of protein expression, the heatmap suggested an important role of some common proteins identified in both groups, which can be explored further to investigate their mechanism in OKA-induced AD pathology. Presently, the preclinical models available to understand AD-like conditions are not completely understood. Hence, utilizing OKA in the zebrafish model can be of great importance in understanding the pathology of AD progression and as a screening tool for drug discovery.
Examining clinical pharmacist interventions and identifying opioid medication-related issues in patients with cancer

Anwar A, Malik N, Siddiqui A, Shrestha S, Bhutta OA, Mazhar S, et al.

J Oncol Pharm Pract, 2024 Aug 28.
PMID: 39196917 DOI: 10.1177/10781552241279027

INTRODUCTION: Opioid medications are crucial for managing pain among patients with cancer. Yet, inappropriate prescribing and medication issues can compromise patient safety and quality of care. Clinical pharmacists play a significant role in optimizing opioid therapy and addressing issues related to opioid medication use.
OBJECTIVES: This study aimed to examine clinical pharmacist interventions and identify opioid medication-related issues in patients with cancer.
METHOD: We conducted a retrospective observational study at Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, conducting a chart review from 1st July 2021 to 31st December 2021.
RESULTS: Out of 10,534 opioid medication orders, we documented a total of 974 interventions based on our inclusion criteria. Tramadol and morphine accounted for most of these interventions, comprising 49.27% (n = 475) and 40.04% (n = 386), respectively. Regarding clinical significance, 41.70% (n = 406) were deemed significant, while 37.36% (n = 365) were somewhat significant. The majority of interventions, i.e., 54.05% (n = 521), primarily aimed at optimizing patient outcomes, followed by a secondary aim of improvements in communication, i.e., 25.52% (n = 246).
CONCLUSION: This study establishes the evaluation of clinical pharmacist interventions on opioid medication use in patients with cancer, an issue particularly in oncology settings in Pakistan. The findings emphasize the crucial role of clinical pharmacists in addressing issues related to opioid issue medications, thus improving patient safety and optimizing opioid use for patient well-being.
Levosimendan: mechanistic insight and its diverse future aspects in cardiac care

Akhtar MS, Hassan MQ, Siddiqui A, Alavudeen SS, Afzal O, Altamimi ASA, et al.

Acta Cardiol, 2023 Apr;78(2):170-187.
PMID: 36222590 DOI: 10.1080/00015385.2022.2115761

Inotropic agents are generally recommended to use in patients with acute decompensated heart failure (HF) with reduced ejection fraction (HFrEF) concurrent to end-organ dysfunction. However, due to certain pharmacological limitations like developing life threatening arrhythmia and tolerance, cannot be employed as much as needed. Meanwhile, Calcium ion (Ca2+) sensitisers exhibits their inotropic action by increasing the sensitivity of the cardiomyocyte to intracellular Ca2+ ion and have been reported as emerging therapeutic alternative in HF cases. Levosimendan (LEVO) is an inodilator and with its unique pharmacology justifying its use in a wide range of cardiac alterations in HF particularly in undergoing cardiac surgery. It is also reported to be better than classical inotropes in maintaining cardiac mechanical efficacy and reducing congestion in acute HF with hypotension. This review paper was designed to compile various evidence about basic pharmacology and potential clinical aspects of LEVO in cardiac surgery and other HF associated alterations. This will benefit directly to the researcher in initiating research and to fill the gaps in the area of thrust.
Fulltext Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1

Klionsky DJ, Abdel-Aziz AK, Abdelfatah S, Abdellatif M, Abdoli A, Abel S, et al.

Autophagy, 2021 Jan;17(1):1-382.
PMID: 33634751 DOI: 10.1080/15548627.2020.1797280

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.

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