Journal of Pharmacology and Pharmacotherapeutics

Surgical wound healing remains challenging in the clinical setting, bedeviled by infection, inflammation, and dysfunctional tissue regeneration. Present treatments rely on dressings and anti-biotics, whose bioavailability and site-specific delivery limitations necessitate more advanced pharmacological approaches. New trends in nanomedicine, drug targeting, and natural therapeutics are promising to overcome this status by promoting tissue repair and minimizing complications.

This review addresses recent advances in pharmacological strategies for facilitating post-surgical wound healing, highlighting the promise of nanotechnology, controlled-release drug delivery, and natural bioactive molecules. Based on recent literature, this review highlights mechanisms, clinical relevance, and potential translational challenges.

A comprehensive literature search was conducted on PubMed, Scopus, and Google Scholar from 2013 to 2024. Studies on nanoparticle-based drug delivery, polymeric scaffolds, phytopharmacology, and controlled-release formulations were reviewed. This review integrates preclinical and clinical evidence to present an updated perspective on the efficacy and safety of these interventions.

Nanomedicine-based therapies, including liposomes, hydrogels, and polymeric nanoparticles, improve drug stability, tissue penetration, and controlled release, thereby improving wound closure. Targeted drug delivery by growth factors, cytokines, and gene therapy has been encouraging in preclinical models but awaits clinical validation. Natural bioactive compounds (e.g., curcumin, aloe vera, honey, and flavonoids) exhibit antioxidant, anti-inflammatory, and anti-microbial activities that complement pharmacological treatments. However, drug stability, scalability of formulations, and regulatory compliance limit clinical translation.

Advances in nanomedicine, targeted drug delivery, and natural therapeutics have transformed postoperative wound healing by providing improved efficacy and safety. However, clinical trials and regulatory guidelines are needed to enable clinical translation. Future research should emphasize biocompatibility, long-term safety, and cost-effectiveness to optimize patient benefits.

Hypertension is a worldwide health issue and an independent risk factor for cardiovascular disease. Endothelial dysfunction is an important mechanism for its pathogenesis, thus compromising vascular homeostasis and causing vascular remodeling. It is supported by reduced availability of nitric oxide, increased oxidative stress, and chronic inflammation, all of which contribute to hypertension as well as cardiovascular morbidity.

The present narrative review is focused on exploring new pharmacological interventions to target endothelial dysfunction and vascular remodeling in the treatment of hypertension. The review brings molecular mechanisms to the forefront. It discusses new therapeutic drugs to target the reversal of endothelial function and improve vascular health, ultimately resulting in better control of hypertension.

A narrative review of the literature was performed, including studies from preclinical studies, clinical trials, and new pharmacological advances. The review is focused on modulation of the nitric oxide pathway, antioxidant therapy, angiotensin receptor blockers, and new therapies for oxidative stress. New endothelial progenitor cell function therapies, hydrogen sulfide (H₂S) donors, and nanoparticle-based drug delivery systems were discussed.

Recent evidence clearly shows that pharmacologic therapy for reversing endothelial dysfunction is effective for treating hypertension. H₂S donors reduce oxidative stress and increase vascular relaxation, and endothelial progenitor cells are explored for vascular repair. Nanoparticles enable targeted delivery of drugs into endothelial cells, with increased therapeutic impact. Further, nitric oxide generation modulating drugs, such as angiotensin receptor blockers, have been reported to improve vascular function and control hypertension.

Pharmacotherapy for endothelial dysfunction is extremely promising in improving hypertension management by targeting the very pathogenesis of the disease. Further research and clinical trials are required to improve these therapies further and establish their long-term clinical benefits.

Doxorubicin (DX)-induced cardiotoxicity involves dose- and time-dependent myocardial injury driven by oxidative stress, mitochondrial dysfunction, and disrupted topoisomerase IIβ signaling, leading to progressive left ventricular dysfunction and heart failure risk. Despite the growing literature in this field, no comprehensive bibliometric investigation has yet mapped the intellectual structure, research frontiers, and thematic evolution of this domain, creating a gap in synthesizing the knowledge landscape of DX-induced cardiotoxicity research (DCTR).

The objective of this study was to fill this gap by exploring research frontiers, co-word analysis, theme integration, and thematic developments related to DCTR using a bibliometric network examination from 1974 to 2024.

The analyzes were executed in four sequential stages: (a) collection of data-driven studies from the Scopus database, (b) preprocessing and refining of the dataset, (c) construction and visualization of networks, and (d) analysis and elucidation of the dataset using Visualization of Similarities Viewer (bibliometric network mapping software) (VOSviewer) and Bibliometrix applications. An investigation was conducted using descriptive analysis, bibliometric network analysis, and full quantitative analysis.

The 6,135 keywords extracted from 4,782 abstracts were used to determine the intellectual and thematic framework of the studies on DCTR. Prominent frontiers were identified, along with their corresponding effect measures. Three themes were identified to characterize the evolution of keywords in the structure over a period of 50 years: “Chemotherapy Theme,” “Breast Cancer Theme,” and “DX Theme.” Current emerging topics in this field include pyroptosis, ferroptosis, molecular docking, network pharmacology, and the NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome.

The findings of this study offer significant perspectives for studies pertaining to the DCTR. These data may assist physicians in summarizing future research in this field.

Medical students experience a heightened risk of depression and necessitate effective, low-side-effect interventions.

This study evaluates the efficacy of saffron in decreasing salivary cortisol levels and alleviating mild depressive symptoms in medical students.

A randomized controlled trial (RCT) was conducted with eligible undergraduate medical students. Participants were assigned to either the intervention group, which received saffron tablets, or the placebo group for an 8-week duration. Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HDRS), while salivary cortisol levels were measured via enzyme-linked immunosorbent assay (ELISA). Measurements were taken at baseline, week 4, and week 8.

Among 56 participants (28 in each group), the saffron group exhibited significantly lower HDRS scores compared to the placebo group at week 8 (10.5 vs. 18; p < .001), alongside a notable downward trend (p < .001). No significant differences in HDRS were observed at week 4 (p = .302). Salivary cortisol levels did not show significant differences between groups (p > .05), although the saffron group exhibited a decreasing trend while the placebo group showed an increasing trend.

Saffron demonstrates efficacy in reducing mild to moderate depressive symptoms among medical students, although it does not lead to significant changes in salivary cortisol levels.

Pulmonary hypertension (PH) is a disorder of the pulmonary blood vessels that is often accompanied by other clinical conditions, which can lead to complications in cardiovascular and respiratory diseases. The clinical outcome of patients with PH is influenced by factors such as age at diagnosis and response to therapy. Patients diagnosed at a younger age and who show a good initial response to therapy tend to have better outcomes.

This study aims to evaluate the sociodemographic factors (gender, age, living status) and medication use of PH patients at the Teaching Hospital in Jakarta.

This study was conducted from November to December 2024 at the Teaching Hospital. This is a descriptive analytic study employing a retrospective cohort design. The sampling was done using a convenience sampling technique, with 84 samples meeting the inclusion criteria.

This study showed that female (63.1%) were predominant than male (36.9%). Among 84 respondents, 98.9% of them was categorized as alive. The largest age group was found among respondents aged 60 years. Furosemide was the most used medication in patients with both primary and secondary PH, with prevalences of 14.8% and 15.2%.

Most respondents in this study were alive, and female with the largest age group being 60 years old. Most respondents were categorized as living. Furosemide was the most used medication among patients with both primary and secondary PH, indicating a high prevalence of its use in managing this condition.

The Indian healthcare system faces significant challenges, such as data fragmentation, lack of interoperability, and concerns about data security. The increasing digitization of healthcare requires a robust infrastructure to address issues like counterfeit drugs, medical data breaches, and inefficient supply chain management. Processed healthcare data play an important role in improving the quality of healthcare services and supporting effective decision-making. Advancements in the information technology (IT) sector have facilitated the management and maintenance of electronic health records (EHRs), making it essential for IT infrastructure to ensure confidentiality and access control due to the sensitive nature of healthcare data.

Blockchain technology provides a decentralized and tamper-proof solution, ensuring secure, interoperable, and transparent management of EHR across healthcare providers. The proposed research work addresses the issues related to confidentiality and access control of EHR by proposing the Hyperledger blockchain-based healthcare framework, which connects multiple public health centers for secure data sharing.

The role-based access control mechanism helps the participants maintain data privacy in the system. Compared to existing Indian healthcare frameworks, the proposed blockchain framework supports additional features such as authentication, access control, and privacy.

The framework satisfies the patient-centric need for EHR in the Indian healthcare context by guaranteeing the safe storage and private access to patient healthcare data in the blockchain environment. As the volume of data and the number of users in a blockchain network grow, latency and throughput become critical concerns that must be addressed.

The performance analysis of the proposed blockchain framework achieved a latency of 0.57 s and a throughput of 170 transactions per second (TPS) for 10 MB block size and 1,000 transactions, which shows outperforming results reported in previous studies.

The utilisation of vasoconstrictors like clonidine with local anaesthetics during subarachnoid blockade is a well-established practice.

This study aims to compare the effects of oral clonidine premedication versus placebo on the onset and duration of spinal anaesthesia with hyperbaric bupivacaine.

A randomised, double-blind, placebo-controlled trial was conducted with 90 patients, divided into three groups: placebo (n = 30), clonidine-A (100 µg, n = 30) and clonidine-B (150 µg, n = 30). The primary outcomes measured were the onset of sensory blockade, duration of sensory and motor blockade and two-segment regression time. Secondary outcomes included haemodynamic parameters and sedation levels. Statistical analysis was performed using analysis of variance (ANOVA) and chi-square tests, with significance set at p < .05.

Clonidine significantly reduced the time to achieve maximum sensory blockade compared to placebo (clonidine-A: 11.68 ± 1.860 min, clonidine-B: 9.18 ± 1.793 min, placebo: 15.55 ± 2.784 min; p < .001). Both clonidine groups demonstrated prolonged sensory blockade and two-segment regression times (clonidine-A: 107 ± 8.799 min, clonidine-B: 125.31 ± 8.372 min, placebo: 69.35 ± 6.309 min; p < .001). Motor blockade recovery was significantly longer in the clonidine groups, although no significant difference was found between clonidine-A and clonidine-B (p < .05). Haemodynamic stability was maintained, with significant reductions in heart rate and systolic blood pressure (SBP) observed in the clonidine groups. Sedation was notably higher in the clonidine groups compared to placebo (p < .001).

Oral clonidine premedication significantly accelerates the onset and prolongs the duration of spinal anaesthesia with hyperbaric bupivacaine. The 150 µg dose exhibited a dose-dependent enhancement of effects without compromising haemodynamic stability. While clonidine offers promising benefits in improving the efficacy of spinal anaesthesia, its sedative and bradycardic effects necessitate careful monitoring in clinical practice.

We have reported that the renal kallikrein–kinin system is involved in the diuretic action of potassium or furosemide in rats.

The aim of this study was to investigate whether the renal kallikrein–kinin system is involved in the diuretic action of thiazides in rats.

In the first study, indapamide (INDP) was administered at 0.1 or 0.3 mg/kg/day, or a solvent, and urine was collected using metabolic cages at 0–6, 6–12, and 12–24 h. Urine output, urinary excretion of sodium, chloride, and potassium, and urine kallikrein activity were measured. In the second study, a bradykinin B₂ receptor antagonist, icatibant, or a solvent was administered before INDP administration in a crossover design with a washout period, which was conducted under conditions with and without saline loading. Urine output and urinary excretion of sodium, chloride, and potassium were measured at 0–6 h after INDP administration.

The results showed that the diuretic actions of INDP increased with high-dose INDP and reached a maximum at 0–6 h: urine outputs were 5.0 (median, interquartile range 4.7–5.9) versus 1.8 (1.4–2.1, p < .05) mL/100 g body weight (b.w.), and urinary excretions of sodium, chloride, and potassium were 0.21 (0.18–0.23) versus 0.06 (0.05–0.07, p < .01), 0.18 (0.16–0.19) versus 0.05 (0.05–0.05, p < .01), 0.11 (0.08–0.13) versus 0.04 (0.03–0.05, p < .05) mmol/mg urinary creatinine (Cr) in the INDP versus control groups. Urinary kallikrein activity did not change with either dose of INDP. Icatibant did not inhibit the diuretic action of INDP under either condition.

The conclusions were that although the crossover design was used to evaluate the urine data collected by a metabolic cage in rats, the study could not determine whether the renal kallikrein–kinin system is involved in the diuretic actions of thiazides. Future studies should improve regarding fluid loading and long-term sodium loading.

Noni (Morinda citrifolia Linn.) fruit has a long history of traditional use for treating several health conditions, including symptoms of major depression and anxiety.

This study focused on evaluating the therapeutic potential of the methanolic extract of Morinda citrifolia Linn. fruit (MMC) and its ethyl acetate fraction (EAMMC) against alcohol withdrawal-induced symptoms like convulsion, anxiety, and anhedonia in mice using handling-induced convulsion (HIC), elevated plus maze (EPM), open field test (OFT), marble burying test (MBT), and sucrose preference test (SPT), respectively.

Swiss albino mice (male) weighing 30–35 g were used. Animals were grouped as saline withdrawn (SW) control alcohol withdrawn (AW), control, positive control (AW + diazepam 1 mg/kg i.p.), and MMC- and EAMMC-treated groups (AW + MMC 500 and 1,000; AW + 50 and 100 mg/kg p.o.), respectively. All test groups intraperitoneally received 1.25 mL/100 g b.w. of (20% v/v ethanol + 0.1% v/v 4-methylpyrazole) except the SW group, which received saline (1.25 mL/100 g, i.p.) instead of ethanol twice a day for 3 days. HIC, OFT, EPM, MBT, and SPT were performed subsequently.

These results reveal that MMC (500 and 1,000 mg/kg p.o.) and EAMMC (50 and 100 mg/kg p.o.) attenuated the handling-induced seizures (HIS), anxiety, and anhedonia in AW mice by facilitating the benzodiazepine-GABAAergic and serotonergic (5-HT1A) mediated mechanisms in the brain.

MMC and EAMMC protect against alcohol withdrawal symptoms such as handling seizures, anxiety, and anhedonia in mice.

In Serbia, as well as worldwide, clinical trials are a significant and unavoidable part of the development of new medicines. There is limited research on prospective risk management in clinical trials in Serbia, underscoring the need for systematic approaches, such as the failure mode and effects analysis (FMEA) method. The effectiveness of this complex process largely depends on knowledge and experience in the field of management. Like any other process, clinical trials are subject to various risks for both the company and the patient.

The purpose of this article is to conduct a prospective, qualitative study on the risk management of clinical trials in the Republic of Serbia, to identify, assess, and reduce risks for both patients and companies, and to offer corrective measures for reducing their frequency and consequences.

A focus group applied the FMEA method to identify, assess, and mitigate risks. Each risk was assessed based on severity, probability, and detectability, and then a risk priority number (RPN) value was calculated. For the most significant risks, corrective measures were proposed, and the RPN was recalculated. The research was conducted from December 12, 2022 to March 8, 2023.

In total, 20 risks were identified with RPN values ranging from 10 to 192, of which five had RPN > 100. The minimum RPN value among the five most significant risks was 105, and the maximum was 192. After the proposed corrective measures, there was a significant reduction in the RPN values across all five risks, ranging from 57.14% to 83.33% when compared to the initial values.

The FMEA method has proven to be a useful instrument not only for identifying and predicting potential risks, but also for their control.

Sickle cell anemia is a monogenic hemoglobinopathy caused by a mutation in the β-globin gene (hemoglobin subunit beta, HBB), leading to the production of hemoglobin S (HbS). Under deoxygenated conditions, HbS polymerizes abnormally, causing red blood cells to adopt a sickled shape. This results in vaso-occlusion, hemolysis, and chronic organ damage. Current treatment options remain limited, necessitating the identification of novel therapeutic agents that can target the molecular mechanisms underlying the disease.

This study aimed to investigate the therapeutic potential of 12 antioxidant alkaloids for targeting mutant HbS through a computational approach. The primary goal was to evaluate binding interactions, drug-likeness, and pharmacokinetic profiles to identify lead candidates for further development in sickle cell anemia therapy.

Target validation of the HBB gene was performed using the STRING database to confirm its relevance in disease pathology. The three-dimensional structure of mutant HbS (Protein Data Bank ID: 2HBS) was retrieved and used to evaluate interactions with selected antioxidant alkaloids. Molecular interaction simulations were conducted to determine binding affinities, followed by drug-likeness screening based on Lipinski’s rule of five. Pharmacokinetic and bioavailability profiling was carried out using absorption, distribution, metabolism, excretion, and toxicity-based prediction tools.

The selected compounds exhibited binding affinities ranging from −5.5 to −10.7 kcal/mol, with rutaecarpine, harmine, and vindoline showing the strongest interactions with HbS. In total, 10 of the 12 compounds complied with drug-likeness criteria. Pharmacokinetic modeling predicted favorable gastrointestinal absorption for most compounds, with no predicted blood–brain barrier penetration. Radar plot analysis revealed that vindoline, capsaicin, and harmine displayed optimal bioavailability profiles across key physicochemical parameters, indicating their suitability for oral administration.

The study identified vindoline, harmine, and rutaecarpine as top candidate alkaloids with strong binding affinity, favorable pharmacokinetics, and bioavailability for therapeutic targeting of HbS. These findings support the continued exploration of natural antioxidant alkaloids as viable leads for developing novel interventions in sickle cell anemia, pending further in vitro and in vivo validation.

Opioids have been an integral part of pain management for many years. With the increasing global burden of opioid dependence, the development of non-opioid therapies provides a new framework for pain management. Suzetrigine is a stepping stone toward non-opioid treatment methods.

To summarize the pharmacological profile, preclinical and clinical trial evidence of suzetrigine in opioid-free pain management.

Published research, clinical trial data, and review articles from PubMed, Cochrane, and Google Scholar were reviewed from January to July 2025. The findings have been consolidated in this article to summarize them in relation to suzetrigine to provide an overview from pharmacological and clinical perspectives.

In vitro and in vivo studies demonstrated the voltage-gated sodium channel, Na_V1.8, selective property of the drug. Vertex Pharmaceuticals has conducted four randomized controlled trials (two Phase 2 and two Phase 3 [NAVIGATE-1 and NAVIGATE-2]) and one open-label trial to assess the efficacy and safety profile of suzetrigine. Significant pain reduction was observed with suzetrigine compared to that with placebo. Nausea was the most common adverse effect observed with the drug; however, the drug was otherwise well tolerated and showed low abuse potential. The United States Food and Drug Administration approved suzetrigine for the treatment of moderate to severe acute pain on January 30, 2025. Several trials for the application of the drug in the management of chronic pain are ongoing, among which some have reported promising results. This review summarizes the pharmacological profile of suzetrigine, its future perspectives, current trends, and potential changes in pain management.

Suzetrigine is a first-in-class non-opioid analgesic and Na_V1.8 inhibitor, approved only for the treatment of moderate to severe acute pain. With a less addictive nature and good safety profile, its potential in the management of conditions with chronic pain is yet to be elucidated from clinical trials with a long-term follow-up period.

Hand hygiene is the key to prevent spread of infections in any health care setting. It is vital to understand and assess health care students knowledge and understanding towards hand hygiene so that effective infection control can be ensured.

To examine the handwashing knowledge and practice of final year pharmacy, nursing, and medical students from Saudi Arabia.

A cross-sectional study was conducted using an online study questionnaire. Students from various health sciences disciplines were approached to participate in this study. The Shapiro–Wilk test was employed to assess the normality of distribution, and the reliability of the knowledge and perception survey was evaluated; Cronbach’s alpha values were .88 and .75, respectively. The Shapiro–Wilk test was employed to assess the normality of the distribution. One-way Kruskal–Wallis and Mann–Whitney U tests were used to assess the difference in the knowledge among different groups. A p value less than .05 was considered statistically significant.

Results have shown that 65.9% of participants were male and 52.3% were in the 21–25 age group. 41.05% were pharmacy students, followed by the other disciplines. It was revealed that 92.9% were aware of the significance of hand hygiene and had the most understanding of the concept, methods, and time required for the procedure of hand hygiene. However, 21.3% of respondents also held misconceptions about the effectiveness of alcohol-based hand sanitizers. According to personal practices, 89.1% cleaned their hands after coming into contact with body fluids, and 83.2% did so both before and after interaction with patients. It was observed that female respondents had significantly greater knowledge (10.11 ± 0.19, p = .001) about hand hygiene practices and applied practices in day-to-day care (5.11 ± 0.25, p = .037).

Overall, the understanding of the concept of hand hygiene among the respondents was good. Being a female and a medical student were found to be the two main factors associated with better knowledge and understanding of hand hygiene practices.

Cancer is a complex condition defined by the uncontrolled growth and proliferation of cells. Brain neoplasms, both primary and secondary, present a rising global health burden. Newer classification integrates key molecular markers; IDH mutation, 1p/19q co-deletion, and methylation promoter, enhancing diagnostic precision and guiding therapeutic targeted therapies.

This review provides comprehensive molecular insights into the multistep pathophysiology of brain tumours, highlighting early genomic and epigenomic alterations that drive malignancy and metastasis.

Advancements in neuroimaging, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans, have significantly improved the early detection and precise localization of brain tumors. Moreover, molecular and genetic profiling has revolutionized the classification and prognostication of these tumors, enabling more personalized therapeutic strategies.

Treatment modalities for brain tumors include surgical resection, radiotherapy, and chemotherapy, often employed in combination to maximize efficacy. Innovations in surgical techniques and radiotherapy, such as stereotactic radiosurgery, have enhanced the precision of tumor removal and minimized damage to surrounding healthy tissue. Despite these advancements, the prognosis for many brain tumor patients remains challenging, with high-grade gliomas, like glioblastoma multiforme, having particularly poor outcomes.

Comprehensive literature collection was conducted using various scientific databases, including PubMed, ScienceDirect, and Google Scholar, focusing on the molecular mechanisms underlying tumorigenesis and therapeutic resistance, with the objective of identifying molecular therapeutic targets. Emerging diagnostic and therapeutic innovations, including liquid biopsy, MR-guided blood–brain barrier modulation, and nanotechnology-based drug delivery, are providing novel, targeted, and minimally invasive strategies for the effective management of central nervous system malignancies.

Traditional teaching methods can pose challenges for learners, particularly when it comes to applying theoretical knowledge in practical settings. In contrast, Peyton’s four-step approach provides a structured, learner-centered framework that facilitates better understanding and skill acquisition.

To evaluate and compare the effectiveness of Peyton’s four-step approach with conventional teaching methods for teaching intramuscular and intravenous injection techniques among undergraduate medical students.

This prospective, interventional crossover study was conducted at Nootan Medical College, Gujarat, with 150 Phase II MBBS students. Participants were randomly assigned to either Peyton’s approach or the conventional method for intramuscular and intravenous injection training. Assessments included multiple choice questions (MCQs), performance checklists, and feedback on a Likert scale.

Peyton’s approach significantly outperformed the conventional method, with higher post-test MCQ scores (Group A: 4.68 ± 0.52 vs. 3.98 ± 0.70; Group B: 4.34 ± 0.86 vs. 3.48 ± 1.14, p < .0001). Performance evaluations showed enhanced skill acquisition, with significant improvements in both intramuscular and intravenous injection techniques.

Peyton’s four-step approach is an effective teaching strategy that enhances skill acquisition, retention, and student confidence, offering significant advantages over conventional methods in medical education.