Radiation therapy is used as the primary treatment for cancer. Eighty percent of cancer patients require radiation therapy during treatment or for medical purposes. During treatment, radiation causes various biological defects in the cells. The prevalence of cytotoxicity limits the dose used for effective treatment. This method is designed to strike a balance between removing cancer cells and protecting normal tissues. Unfortunately, effective radiation is unavailable once acute toxicity occurs during clinical radiation therapy. Therefore, a lot of research interest is needed in the discovery of radioprotective drugs to accelerate treatment to reduce this toxicity (i.e., normal tissue toxicity to cancer cell death). Radiation protectors may be chemicals or drugs that minimize the damage caused due to radiation therapy in living organisms. The determination of effective and nontoxic radiation protection is an essential goal for radiation oncologists and basic radiobiologists. However, despite the advantages, many radioprotectors were found to have disadvantages which include cost, less duration, toxicity, and effect on the central nervous system. Therefore in recent years, the focus has been diverted to finding out optimal natural products to act as radioprotectors. Natural radiation protectors are plant compounds that protect normal (noncancerous) cells from damage from radiation therapy. Natural herbal products are nontoxic with proven therapeutic benefits and have long been used to treat various diseases. In conclusion, we find that there are various radiation protectors with different purposes and mechanisms of action.

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Background: Complementary and alternative medicine (CAM)/natural products/herbs are frequently used for therapeutic purposes as a homemade remedy in Saudi Arabia. The use of CAMs is rising globally. However, special attention or precaution should be paid when using CAMs along with other drugs. Objective: The current study aims to examine the perception, attitude, knowledge, and awareness of the general population about CAMs and their utilization. Material and Methods: A cross-sectional study was conducted in March 2020 in the Dammam region of Saudi Arabia. The study included both the gender participants of the general population of Dammam, Saudi Arabia. The questionnaire contains the following sections including socio-demographic data, knowledge, attitude, and behavior of participants related to CAMs, and the prevalence of CAMs utilization in Dammam. Results: Participants were closely sex-matched (male: 50.93% and female: 49.07%), consisting of 97.1% Saudis and only 2.9% expats. The response rate was 67%; out of 559 participants, only 375 participants completed the questionnaire. Approximately 53% of participants had some knowledge of CAMs. Mass media (media/web/internet, advertisement, and television (TV), academic education, and family friends/relative represented the main source of the CAMs information (50%, 8.8%, and 15.2%, respectively). Among 77.3% of the participants, one of their family members has used some form of CAMs earlier. 90% of the participants or their family members using CAMs reported that olive oil (95.7%), green tea (89.1%), thyme (85.3%), cinnamon bark (84.8%), star anise (84.5%), and black seeds (78.4%) were the most used CAMs. Participants used CAMs for cold (28.3%), cough (14%), constipation (11.97%), ease of menstruation (10.8%), diarrhea (9.87%), and fever (8.62%). Approximately 75% of participants did not observe any side effects. Only 1% of participants reported that the CAMs are not useful therapeutically whereas the majority of the participants reported them as very useful (32.7%), useful (45.5%), and good (20.7%). Conclusion: Current study demonstrates that there is a positive attitude and perception toward CAMs. It is influenced by their traditional use as well. However, a community awareness program is essential for the adverse effects of CAMs.

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Background: It would be rational to describe the pattern of the clinical characteristics of the survivors and the nonsurvivors during the critical intensive-infection era of coronavirus disease 2019 (COVID-19). The explicit objective of the current scoping review was to delineate the predictive risk factors associated with case fatality rate (CFR). Methods: Six retrospective studies of subjects infected with COVID-19 published between December 1, 2020, and March 30, 2020, describing nonsurvivors in Wuhan/Hubei, China, were identified. Results: There were 1769 subjects with a mean age of 52 years, and 65.9% were male. The highest comorbidity reported was cardiovascular diseases at 22.2% (393/1769). The overall number of cases admitted to the intensive care unit was 228 (12.9%). The reported overall CFR was 7.7% (136/1769), with the highest at 28.2% (54/191), and the lowest at 1.4% (15/1099). The mean duration of onset until death for nonsurvivors was 15.3 days. Conclusion: We have found that older age, male gender, the longer duration from onset till death (days), development of acute respiratory distress syndrome/shock, preexisting diabetes, and preexisting cardiovascular diseases were the major risk factors associated with high CFR.

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Introduction: Cleistanthin A (CA) is an aryl naphthalene lignan, which has a potent anticancer activity by regulating the tumor microenvironment. The objective was to develop a new technique for the isolation of cleistanthin A from the acetone extract of Cleistanthus collinus utilizing reverse phase flash chromatography. Materials and Methods: Cleistanthus collinus leaves were shade dried, defatted using n-hexane and then macerated to obtain acetone extract which was further subjected to reverse phase flash chromatography for the isolation of cleistanthin A using the gradient mobile phase of 0.1% formic acid (v/v) in water and acetonitrile. Gradient elution of chromatographic run was performed for 80 min. The separated peaks that showed absorbance at λ_max 254 nm were collected for the chemical characterization. Cell viability of the isolated cleistanthin A was studied on hepatocellular cancer cell line HePG2 and prostate cancer cell line PC3 using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results: The chemical characteristics of the isolated compound cleistanthin A was further characterized using spectral techniques such as ¹H and ¹³C nuclear magnetic resonance (NMR), Fourier-transform infrared spectroscopy (FT-IR), and electron spray ionization-tandem mass spectrometry (ESI-MS/MS). Cleistanthin A has decreased the cell viability of the HePG2 cell line to 52.25% at 32 μg/ml and PC3 cell line to 51.82% at 16 μg/ml in a dose-dependent manner. Conclusion: Cleistanthin A was successfully isolated from the natural source using reverse phase flash chromatography and the MTT assay has shown that cleistanthin A has decreased the cell viability in both the HePG2 and PC3 cell lines in a dose-dependent manner.

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Background: Recently, a plethora of events have affected the statin arena such as muscle-induced myalgia, myopathy, myositis, rare rhabdomyolysis, and new-onset diabetes. The latest statin pitavastatin has emerged with descent stamina (optimum efficacy and improved safety). Objective: The objective of the current review is to explore the pros and cons of pitavastatin as a novel second-generation statin in terms of efficacy and safety that delineate its clinical utility. Methods: The review was conducted via EBSCO hosted Medline search (AL Ain University, UAE subscription) for relevant English written literature articles containing “pitavastatin” as the primary search term “pitavastatin and safety;” “pitavastatin and efficacy” and “pitavastatin and safety and randomized clinical trials;” and “pitavastatin and efficacy and randomized clinical trials.” Results: The number of articles containing the word “pitavastatin” as the primary search term used was (n = 901). The next retrieves MeSH term was “pitavastatin and safety” (n = 99) and then “pitavastatin and efficacy” (n = 132). Furthermore, narrowing down the search by adding study design terms revealed: “pitavastatin and safety and randomized clinical trials,” (n = 10) and “pitavastatin and efficacy and randomized clinical trials” (n = 13). Combining the two main searches (safety and efficacy) has yielded 23 items, of which 15 articles were satisfying the current mini-review criteria. The prominent efficacy of pitavastatin was depicted by the increase in high-dense lipoprotein cholesterol and a decrease in low-dense lipoprotein cholesterol as illustrated by the clinical trials in the results and discussions section. The safety was enlightened with a very low propensity to cause new-onset diabetes and a low tendency for statin-induced muscular adverse events. Conclusion: Pitavastatin might be suitable for patients with the acute coronary syndrome (ACS), metabolic syndrome, and patients with diabetes. We highly recommend rational individualization for the selection of statin, especially in patients with diabetes and/or with ACS.

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Rising antibiotic use is a serious threat to the success of therapy in dentistry for bacterial resistance and side effects to the patients. The dentist community in Albania prescribing too many antibiotics. This survey assesses the mode of antibiotic use among Albanian dentists, with appropriate dosage and regimen, and antibiotic stewardship and their knowledge of relevant guidelines. Material and Methods: This survey study was conducted among 180 Albanian dentists. The questionnaire was distributed through e-mail addresses found in the database of the Faculty of Dental Medicine, University of Medicine of Tirana. We assessed 180 dentists out of which 154 (85.56%) completed the entire questionnaire. Results: There were 24,870 prescriptions in adult patients from 154 dentists for a period of six months with an average of 1,243 prescriptions per week. The most used antibiotics were fixed combinations of amoxicillin–clavulanic acid (67.43%) and azithromycin (39.3%) for allergic patients to beta-lactams. The results for antibiotic stewardship were incorrect in 37.01% of total providers, and gastrointestinal disorders were reported as side effects. Conclusion: This survey conducted among Albanian dentists shows a different trend of using antibiotics than in other countries. To tackle the current antibiotic resistance, dentists must be an important part of the antimicrobial stewardship program of the Public Health Institution in Albania to change individual behavior.

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This case series reports on clinical challenges faced during the rehabilitation of custom ocular prosthesis. Each of these cases relate the challenges of making ocular impressions for an improved retention and support of ocular prosthesis and presents the significance of scleral contouring in overcoming cosmetic defects of the eye. In addition, evaluation of scleral wax pattern, methods of iris location and scleral characterization methods in ocular rehabilitation are further discussed.

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