Journal of Pharmaceutical Research International

Determinants and Spatial Patterns of Dengue Severity in Brazil: A Nationwide Cross-sectional Analysis of Surveillance Data

Jessica da silva Ferreira — 2026-06-12

Background: Dengue remains a major public health challenge in endemic countries, with increasing incidence and severity. Understanding the determinants of severe disease at a national level is essential to guide surveillance and control strategies.

Methods: We conducted a nationwide cross-sectional study using surveillance data from the Brazilian Notifiable Diseases Information System (SINAN) for 2025. A total of 825,586 confirmed dengue cases with valid outcome data were included. Multinomial logistic regression was used to identify factors associated with disease severity. Spatial analysis was performed using incidence rates per 100,000 inhabitants across states.

Findings: Most cases were classified as dengue without warning signs (97.3%), followed by dengue with warning signs (2.5%) and severe dengue (0.2%). Increasing age was associated with higher odds of severe dengue (OR=1.01 per year; 95% CI 1.006–1.014). The presence of comorbidities showed a strong association, with a clear dose–response pattern according to the morbidity index. Individuals without comorbidities had a 69% lower likelihood of severe dengue compared to those with multiple conditions. RT-PCR-confirmed cases were more likely to be severe (OR=1.93; 95% CI 1.51–2.46). Spatial analysis revealed marked heterogeneity, with the highest incidence observed in Goiás (1,280.79 cases per 100,000 inhabitants) and similar patterns for severe dengue.

Interpretation: Dengue severity in Brazil is driven by a combination of demographic, clinical, and contextual factors. Targeted surveillance and clinical management strategies focusing on high-risk groups and high-incidence regions may reduce disease burden and mortality.

Prevalence and Determinants of Elevated Blood Pressure among Undergraduate Health Sciences Students in Saudi Arabia: A Cross-Sectional Study

Sukainah Y. Al Khalaf — 2026-07-02

Background: Elevated blood pressure among young adults is an important public health concern because early identification may support timely prevention of future cardiovascular risk. This study assessed the prevalence of elevated blood pressure and its associated factors among undergraduate health sciences students at Mohammed Al-Mana College for Medical Sciences, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted among 109 undergraduate students recruited by convenience sampling from five academic departments: Nursing, Pharmacy, Physical Therapy, Medical Laboratory Sciences, and Respiratory Therapy. Data were collected using structured interviews to assess sociodemographic characteristics, lifestyle factors, smoking status, physical activity, and perceived stress. Clinical measurements included blood pressure, weight, height, and body mass index. Blood pressure was measured according to standardised procedures using a calibrated mercury sphygmomanometer. Participants were classified as having elevated blood pressure when systolic blood pressure was ≥120 mmHg or diastolic blood pressure was ≥80 mmHg. Elevated blood pressure included both prehypertension and hypertensive-range blood pressure. Data were analysed using SPSS Statistics, version 23. Descriptive statistics, chi-square tests, independent-samples t-tests, and analysis of variance were used, with statistical significance set at p < 0.05. Results: The prevalence of high blood pressure was 27.5% among the study participants, while only 4.6% reported a previous diagnosis of high blood pressure. High blood pressure was more common among male students than female students. Significant associations were observed between blood pressure status and sex, smoking status, body mass index, physical activity, employment during studies, and tuition payment source. Mean systolic and diastolic blood pressure also differed significantly by sex and physical activity status. Conclusion: High blood pressure was common among undergraduate health sciences students in this sample, with several modifiable lifestyle and sociodemographic factors associated with elevated readings. Routine screening and targeted health-promotion activities may support early detection and prevention among university students.

Unveiling the Hidden Therapeutic Potential of Epipremnum aureum: A Review of Phytochemistry and Pharmacological Insights

Guruprasad Sutar — 2026-06-10

Background: Epipremnum aureum is widely recognized in traditional medicine for its diverse therapeutic properties. Recent research has focused on its phytochemical richness and potential biomedical applications, particularly in hepatoprotection and nanotechnology-based formulations.

Objective: This review aims to critically summarize the phytochemical composition, pharmacological activities, and emerging role of E. aureum, with special emphasis on its antioxidant, anti-inflammatory, and hepatoprotective potential, including its application in green synthesis of silver nanoparticles.

Methods: A comprehensive literature survey was conducted using peer-reviewed articles, focusing on in vitro, in vivo, and nanotechnology-based studies. Key aspects analyzed include phytochemical profiling, biological activities, and mechanistic pathways involved in liver protection and oxidative stress reduction.

Results: E. aureum contains bioactive compounds such as flavonoids, phenolics, alkaloids, and terpenoids, which contribute to its significant antioxidant and anti-inflammatory effects. Studies demonstrate its efficacy in mitigating hepatotoxicity induced by agents like CCl₄ through reduction of oxidative stress, lipid peroxidation, and inflammatory mediators. Furthermore, green-synthesized silver nanoparticles using E. aureum extract enhance bioavailability and therapeutic efficiency, showing improved hepatoprotective and cytoprotective effects in experimental models.

Conclusion: The findings highlight E. aureum as a promising natural source for hepatoprotective agents and nanomedicine development. However, further clinical studies and standardization are required to validate its safety and efficacy for therapeutic applications.

Artemisia pallens Wall. Ex Dc. (Davana): Phytochemistry, Traditional Uses, Pharmacological Activities, Safety Profile and Future Prospects: A Comprehensive Review

Guruprasad Sutar — 2026-06-10

Background: Artemisia pallens, commonly known as davana, is an aromatic medicinal herb belonging to the Asteraceae family and is native to India. The plant has been traditionally used in Ayurvedic and folk medicine for the treatment of various ailments and is also valued in the perfumery industry because of its pleasant aroma. In recent years, Artemisia pallens has attracted considerable scientific attention due to its diverse phytochemical constituents and wide range of therapeutic properties. Phytochemical investigations have revealed the presence of important bioactive compounds such as cis-davanone, flavonoids, phenolic compounds, sesquiterpenes, monoterpenes, and sesquiterpene lactones, which are responsible for its biological activities.

Methodology: A comprehensive literature search was conducted using electronic databases such as PubMed, Scopus, Google Scholar, and ScienceDirect. Relevant peer-reviewed studies were critically reviewed to compile and evaluate available information on the botany, phytochemistry, traditional uses, pharmacological activities, toxicology, and future perspectives of Artemisia pallens.

Results: Available studies demonstrated that A. pallens possesses a broad spectrum of pharmacological activities, including antimicrobial, antioxidant, anti-inflammatory, antiasthmatic, hepatoprotective, antidiabetic, antiviral, anticancer, wound-healing, antitubercular, antihypertensive, antimalarial, and anthelmintic effects. Experimental investigations reported significant inhibition of microbial growth, reduction of oxidative stress, suppression of inflammatory responses, and protective effects against disease-induced tissue damage. These biological activities are mainly attributed to the presence of terpenoids, flavonoids, and phenolic compounds. Toxicological studies further indicate that the plant exhibits relatively low acute toxicity at therapeutic doses.

Conclusion: Artemisia pallens shows promising therapeutic and industrial potential; however, further studies focusing on standardization, chronic toxicity, mechanism-based investigations, and clinical trials are essential for its development as a scientifically validated herbal medicine.

Terminalia catappa Linnaeus: A Critical Appraisal of Its Phytochemistry, Pharmacological Potential and Applied Significance

G. Elakkiyamani — 2026-07-07

Terminalia catappa Linnaeus (Combretaceae), commonly known as the tropical or Indian almond, is a pantropical coastal tree whose leaves, bark, fruit and seed have long featured in folk medicine across Asia, Africa, the Caribbean and the Pacific. Over the past decade, a substantial body of laboratory and pre-clinical evidence has accumulated around the species, reporting antioxidant, antimicrobial, antidiabetic, hepatoprotective, anti-inflammatory, anticancer, antiparasitic and wound-healing properties, alongside an expanding footprint in aquaculture, food technology and green nanotechnology. This review draws this literature together critically, tracing the principal bioactivities back to their phytochemical basis, which centres on a rich pool of hydrolysable tannins, flavonoids and triterpenoids. The pharmacological findings are weighed alongside toxicological and safety data, which point to a broadly favourable margin at conventional experimental doses but leave important gaps around chronic exposure, reproductive safety and chemical standardisation. Applications in fish and crustacean farming are examined as a maturing translational niche, supported by a growing nutritional and industrial literature on the seed oil and kernel. The ecological behaviour of the species, valued in coastal agroforestry yet naturalised or invasive in some island settings, is also considered. Across the pharmacological domains reviewed, mechanistic clarity, dose standardisation and clinical translation lag well behind the sheer volume of in vitro and rodent data now available. The review concludes that T. catappa is a pharmacologically promising but clinically unproven botanical resource, and that rigorous chemical standardisation, well-designed in vivo and human studies, and transparent reporting of phytochemical variability should now be the field's main priorities if the species is to move from ethnomedical use towards evidence-based application.

Therapeutic Potential of Strobilanthes Species: A Critical Narrative Review of Phytochemical and Pharmacological Evidence

Guruprasad Sutar — 2026-07-07

The genus Strobilanthes (Acanthaceae) comprises several hundred species distributed across tropical and subtropical Asia, several of which occupy a long-standing place in traditional medicine systems in Malaysia, Indonesia, India, China and Taiwan. Renewed scientific interest in this genus reflects a broader search for plant-derived leads against metabolic, neoplastic, microbial and inflammatory disease. This review synthesises phytochemical and pharmacological evidence on therapeutically relevant Strobilanthes species, with particular attention to Strobilanthes crispus, Strobilanthes cusia, Strobilanthes kunthiana, Strobilanthes glutinosus and Strobilanthes sarcorrhiza. Extracts and isolated constituents of these species, including indole alkaloids such as tryptanthrin and indirubin, flavonoids, phenolic acids and phytosterols, demonstrate antidiabetic, anticancer, antimicrobial, antiviral, anti-inflammatory, hepatoprotective and nephroprotective activities in preclinical models. The clearest translational evidence relates to indigo naturalis, a traditional preparation derived in part from Strobilanthes cusia, for which randomised clinical trials in psoriasis exist. Beyond this preparation, however, evidence for most species remains confined to in vitro and rodent studies, with considerable heterogeneity in extraction methods, dosing and outcome measures. Mechanistic work increasingly draws on network pharmacology and molecular docking to propose multi-target actions, particularly for cancer-related signalling and glycaemic control. The review identifies a persistent gap between promising preclinical pharmacology and the near-absence of standardised, adequately powered clinical trials across the genus. Future research priorities include pharmacokinetic characterisation, toxicological profiling, standardisation of plant material and extraction, and well-designed human studies. Strobilanthes species represent a chemically rich and pharmacologically diverse, but still substantially underexploited, source of candidate therapeutic agents.

Redefining Rheumatoid Arthritis Management: Molecular Mechanisms, Extra-Articular Manifestations, and Next-Generation Therapeutic Strategies

Sachin Sajane — 2026-07-10

Rheumatoid arthritis remains the most common chronic inflammatory joint disease in adults and continues to impose substantial disability, premature cardiovascular mortality, and systemic morbidity despite four decades of therapeutic innovation. Although disease-modifying antirheumatic drugs and biologic agents have transformed outcomes for many patients, a persistent minority fail to reach sustained remission, and the disease's extra-articular face, spanning the lungs, vasculature, and gut, remains comparatively under-addressed in routine practice. This review synthesises contemporary evidence on the molecular and immunological architecture of rheumatoid arthritis, including genetic susceptibility, citrullination-driven autoimmunity, the aggressive phenotype acquired by synovial fibroblasts, and the cytokine and intracellular signalling networks that sustain joint destruction. It then turns to the systemic dimensions of the disease, considering pulmonary, cardiovascular, vasculitic, and mucosal manifestations that frequently determine prognosis independently of articular disease activity. The therapeutic discussion examines the maturing landscape of targeted synthetic and biologic agents, the expanding role of biosimilars in widening access, early clinical experience with chimeric antigen receptor T-cell and other cell-based approaches, and the slow but meaningful progress towards biomarker-guided precision prescribing. A dedicated discussion addresses the treat-to-target paradigm and the emerging recognition that a sizeable proportion of patients meet criteria for difficult-to-treat disease, a state that demands an integrated rather than purely pharmacological response. Throughout, the review highlights where mechanistic insight has, and has not yet, been translated into changes in clinical practice, and proposes that future progress will depend less on new drug classes alone than on better matching of existing and emerging tools to the right patient at the right time.