Advances in Pharmacology and Therapeutics Journal

Comparison of the Efficacy of Topical Sucralfate with New Dressings in the Treatment of Bedsores Grade 1 and 2: A Randomized Single-Blind Clinical Trial

Zahra Lotfi — 2026-06-16

Introduction: A pressure ulcer is a lesion caused by pressure, tension, and friction, leading to skin and tissue damage. Due to its high prevalence in hospitalized patients, especially in the ICU, it affects physical and mental health, prolongs hospitalization, and may cause disability. Various treatments exist, including pressure relief, repositioning, nutritional support, and different types of dressings. This study compared the effects of topical sucralfate and a new dressing on wound healing to identify the most effective, economical approach.

Materials and methods: This single-blind clinical trial was conducted on 30 ICU patients at Shahid Sadoughi Hospital, Yazd, with grade 1 and 2 pressure ulcers. Patients with immunodeficiency, diabetes, or kidney disorders were excluded. Participants were randomly divided into two groups: 15 received topical sucralfate (25% gel) and 15 received a new dressing. Data were collected using patient questionnaires and the PUSH tool, and analyzed with SPSS v24.

Result: The study found that 63.3% of patients were male. Treatment duration in women was significantly longer in the new dressing group than with sucralfate. No significant age-related difference was found. For ulcers ≤ 8 cm, sucralfate reduced treatment time compared with a new dressing, whereas for ulcers > 8 cm, a new dressing was more effective. In non-secreting or low-secreting wounds, the new dressing group had a significantly longer treatment duration than the local sucralfate group. Conversely, for wounds with moderate secretion, the mean treatment duration was significantly longer in the sucralfate group than in the new dressing group. Treatment duration for all wound tissues (closed, epithelial and granulation, slough and necrotic) was shorter with the new dressing.

Conclusion: In patients with grade 1 and 2 pressure ulcers, except in wounds > 8 cm or with moderate secretions, topical sucralfate, compared with the new dressing, decreased treatment duration and led to improvement within a short time.

Clinical Outcomes of Pentoxifylline Use in Hospitalized COVID-19 Patients Compared with Standard Therapy (2020–2021)

Zohreh Akhoundi Meybodi — 2026-06-16

The COVID-19 pandemic, driven by SARS-CoV-2, has challenged global healthcare systems, necessitating exploration of adjunctive therapies to mitigate severe outcomes. This retrospective cross-sectional study, conducted at Shahid Sadoughi Hospital in Yazd, Iran, from 2020 to 2021, compared clinical outcomes in 200 patients with COVID-19, divided evenly between those receiving pentoxifylline (a phosphodiesterase inhibitor with anti-inflammatory properties) in addition to standard treatment and those receiving standard therapy alone (the control group). The outcomes assessed in the study included mortality rates, hospital stay duration, ICU admissions, and inflammatory markers (CRP, LDH, ESR, WBC, and lymphocyte percentage). The group treated with pentoxifylline experienced significantly higher mortality rates, with 30% compared to 11% in the control group (P < 0.05). Additionally, the average hospital stay was longer in the pentoxifylline recipient group (14.74 ± 8.645 days) than in the control group (6.29 ± 4.048 days; P < 0.05). There was also an increased rate of ICU admissions, with 30% in the pentoxifylline recipient group versus 6% in the control group (P < 0.05). Furthermore, elevated CRP and LDH levels and lymphopenia were associated with worse outcomes in the pentoxifylline recipient group (P<0.05). These findings contrast with prior studies suggesting that pentoxifylline may reduce inflammation and improve outcomes, highlighting the need for randomized controlled trials to clarify its role in COVID-19 management.

Characteristics of Milk Thistle (Silybum marianum) and the Association with Liver Diseases: A Review of In Vitro and In Vivo Studies

Ali Nosrati Andevari — 2026-06-16

Milk thistle (Silybum marianum) belongs to the Asteraceae family. This family is noted for its composite flower heads and its broad distribution. This plant boasts glossy green leaves featuring marbled white veins and vibrant purple blooms and has been used in traditional medicine for over 2,000 years, particularly to treat liver disorders. This study aims to determine the characteristics of milk thistle and its association with liver diseases. The biochemical properties of milk thistle are attributed mainly to its complex mixture of bioactive compounds, particularly flavonolignans, collectively known as silymarin. Silymarin complex includes silybin, isosilybin, silychristin, and silydianin. Another active compound in milk thistle is a flavonoid. Flavonoids comprise taxifolin, quercetin, dihydrokaempferol, kaempferol, apigenin, naringin, eriodyctiol, and chrysoeriol. Furthermore, milk thistle contains macronutrients and micronutrients, making it highly nutritious. Milk thistle and its active components help reduce the incidence of liver disease through their anti-inflammatory, antioxidant, and anti-fibrotic effects. These actions are achieved by regulating the levels and activity of the nuclear factor erythroid 2-related factor 2 (NRF2), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), superoxide dismutase (SOD), glutathione peroxidase (GPx), interleukin one beta (IL-1β), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), catalase (CAT), aspartate aminotransferase (AST), bilirubin, cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C).

Main Points: The biochemical properties of milk thistle are largely attributed to bioactive compounds, particularly flavonolignans, collectively known as silymarin. Milk thistle and its active components play a role in decrease the incidence of liver diseases through their anti-inflammatory, antioxidant, and anti-fibrotic effects.

Major Antioxidant Compounds in Green Tea and Their Properties: Evidence in Human and Preclinical Phases, A Narrative Review

Roghayeh Pourbagher — 2026-06-16

An imbalance between reactive oxygen species (ROS) and antioxidants in the body is characterized as oxidative stress. These unstable molecules, known as ROS, can damage cellular components, including DNA, lipids, and proteins. Reactive species are neutralized by antioxidants, thereby safeguarding cells against oxidative damage. Oxidative stress occurs when ROS are produced in such quantities that the body is unable to remove or neutralize them. This condition can result in cell lesions and is implicated in various disorders, including aging, cancer, cardiovascular diseases, neurological disorders, and inflammatory conditions (1-3). Phytochemicals found in various natural compounds exhibit high therapeutic indices. One notable compound that contains antioxidants is green tea, which helps to debarment various diseases. Green tea comprises bioactive compounds with substantial antioxidant characteristics. These compounds assist in neutralizing hazardous free radicals, suppress lipid peroxidation, mitigate DNA damage induced by oxidative stress, modulate redox-sensitive transcription factors, and upregulate antioxidant enzymes (3-5).

Main Points: The compounds in green tea make it a beneficial beverage for preventing oxidative stress and inflammation, along with their associated complications such as aging, cancer, cardiovascular disease, neurological disorders, and inflammatory diseases.

Chronotherapeutic Effects of Atorvastatin Administration on Lipid Profile in Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial

Sepideh Tavanaei Fard — 2026-06-16

Background: Type 2 diabetes mellitus (T2DM) is commonly associated with dyslipidemia and increased cardiovascular risk. Atorvastatin, a widely used statin, effectively improves lipid profiles. This study aimed to compare the effects of morning versus evening administration of atorvastatin on lipid parameters in patients with T2DM.

Materials and Methods: This randomized controlled trial enrolled 76 patients with T2DM, randomly assigned to receive Atorvastatin 40 mg either in the morning (n=38) or evening (n=38) for 4 weeks. Fasting serum triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at baseline and post-treatment. Baseline lipid values were included as covariates in ANCOVA to compare post-treatment levels between groups.

Results: Atorvastatin significantly improved lipid profiles in both groups: LDL-C, TG, and TC decreased (P<0.05), while HDL-C increased (P<0.001) compared to baseline. After adjusting for baseline values, no significant differences were observed between morning and evening groups in LDL-C, HDL-C, TG, or TC (P>0.05).

Conclusion: Four weeks of Atorvastatin therapy significantly improved lipid profiles in patients with T2DM, irrespective of administration time. These findings suggest that dosing flexibility may enhance patient adherence without compromising efficacy.

Future Immunologic and Nanotechnology-Based Therapeutic Strategies in Rheumatoid Arthritis

Mohammad Taher Tahoori — 2026-06-16

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation, progressive cartilage destruction, and irreversible joint damage. Although conventional disease-modifying antirheumatic drugs (DMARDs), biologic agents, and targeted synthetic therapies such as Janus kinase (JAK) inhibitors have substantially improved disease outcomes, a significant proportion of patients fail to achieve sustained remission or develop treatment-related adverse effects (1). These limitations underscore the need for innovative therapeutic strategies that offer greater specificity, reduced systemic toxicity, and long-term immune regulation

Investigation of COVID-19 Vaccine–Related Side Effects in Cancer Patients Referred to Shahid Sadoughi Hospital, Yazd, Iran

Akram Astani — 2026-06-16

Background: Patients with cancer are at heightened risk for severe COVID-19 outcomes due to immunosuppression caused by the disease and its treatments. While COVID-19 vaccines are recommended for this vulnerable group, limited data are available on their side effects in this population. This study aimed to investigate the adverse effects of COVID-19 vaccination among cancer patients referred to the oncology department and clinic of Shahid Sadoughi Hospital in Yazd, Iran.

Methods: A descriptive cross-sectional study was conducted among 300 patients with cancer aged 18 years or older who had received a COVID-19 vaccine. Participants were chosen through convenience sampling. Data were collected through interviews and medical records using a checklist covering demographic characteristics, cancer type, vaccine type, and vaccine-related side effects. Exclusion criteria included incomplete medical records and patients' unwillingness to be interviewed. Data were analyzed using SPSS version 22.

Results: The study showed that side effects in cancer patients was similar to those in the general population, with common local reactions such as injection-site pain and systemic symptoms such as fatigue and headache. No severe adverse effects were expected, except for mild to moderate symptoms.

Conclusion: COVID-19 vaccines appear to be safe for cancer patients, with tolerable side effects comparable to those reported in the general population. These findings provide reassurance about the timeliness of vaccination in this high-risk group, potentially reducing hesitancy.

Targeted Therapy Based on Peptide– Drug Conjugates

Marzieh Lotfi — 2026-06-16

Peptide–drug conjugates (PDCs) are useful in new targeted therapy, especially in cancer. It has also been established that proteases are highly expressed in cancer types. These enzymes can cleave the linker, releasing the drugs as a key payload within the tumor. Therefore, overexpression of cathepsins in tumor environments is a favorable characteristic for targeted cancer therapy. The linker must exhibit stability in circulation to avoid undefined cargo release. Releasing with no goal can cause some problems with the enhancement of toxins, which can lead to hazardous or even incurable side effects. Payloads as cytotoxic agents usually show low IC50 values and high toxicity. Two payloads applied within PDC types include Taxol and Daunorubicin.