Journal of International Research in Medical and Pharmaceutical Sciences

From Gut to Brain: The Neurohormonal Basis of Appetite Suppression and Gastric Emptying Delay by Semaglutide in Non-Diabetic Obesity

2026-05-28T13:22:03+00:00

Background: Obesity is a chronic disease that is caused by dysregulation of the neurohormonal systems that regulate energy balance. With a weight loss of around 15% in randomized phase 3 trials, Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) with greater weight-loss results than any other approved pharmacotherapy. The efficacy is due to the concurrent activation of hypothalamic appetite pathways, peripheral satiety hormones and enteric motility pathways.

Methods: A narrative review of peer-reviewed literature was performed from 2015 to 2026. The following databases were searched: PubMed (MEDLINE), Scopus, and Google Scholar. The evidence was categorized in five mechanistic areas: the pharmacology of GLP-1 receptor, hypothalamic control of appetite and energy expenditure, peripheral satiety hormones, gut-brain axis signaling, and gastric motility. The strength of the evidence is indicated throughout, based on randomized trials, preclinical models, or observational studies.

Results: Semaglutide acts directly in the arcuate nucleus on GLP-1 receptor (GLP-1R) to inhibit orexigenic (for eating) NPY/AgRP neurons and enhance anorexigenic (appetite suppressant) POMC/CART signaling. This central effect is further enhanced by peripheral ghrelin suppression, increased postprandial insulin secretion, and increased vagal afferent satiety signals. Gastric emptying delay (via enteric GLP-1 receptor activation, vagal efferent cholinergic drive, and suppression of motilin) extends postprandial gastric distention, which strengthens the central satiety signal. This gastric effect is most significant when dosed initially for dose titration and then may decrease following chronic dosing.

Conclusion: Semaglutide acts directly in the arcuate nucleus on GLP-1 receptor (GLP-1R) to inhibit orexigenic (for eating) NPY/AgRP neurons and enhance anorexigenic (appetite suppressant) POMC/CART signaling. This central effect is further enhanced by peripheral ghrelin suppression, increased postprandial insulin secretion, and increased vagal afferent satiety signals. Gastric emptying delay (via enteric GLP-1 receptor activation, vagal efferent cholinergic drive, and suppression of motilin) extends postprandial gastric distention, which strengthens the central satiety signal. This gastric effect is most significant when dosed initially for dose titration and then may decrease following chronic dosing.

Social Media and Antibiotic Resistance: An Online Survey of Awareness and Behavior among Undergraduate Students at Kwara State University, Malete, Nigeria

2026-05-30T11:36:15+00:00

Introduction: Antibiotic resistance (AR) is a major public health issue, with direct deaths totaling 1.27 million in 2019. Self-medication and lack of knowledge about AR are prevalent problems amongst university students in Nigeria, where social media serves as their primary means of getting health-related information. Limited evidence exists regarding the efficacy of social media interventions in improving awareness and attitudes towards AR in this population.

Objective: To assess the effect of exposure to social media campaigns on antibiotic resistance awareness and antibiotic use behaviors among undergraduate students of Kwara State University, Malete.

Methods: An online descriptive, cross-sectional study was conducted among 400 undergraduates from six selected faculties sampled using a multistage sampling technique. Data were collected using a validated, self-administered online questionnaire distributed via Google Forms, and analysis was conducted using SPSS version 26.0. Primary outcomes were perceived influence of social media on antibiotic use behavior and perceived effect of campaigns on AR awareness. Summary statistics was used to describe the results, and the association between sociodemographic factors and campaign effectiveness was determined using Pearson’s chi-square test. Multivariable logistic regression was used to identify independent predictors of perceived negative influence of social media on antibiotic use behavior and perceived positive effect of AMR campaigns. Tables were employed in presenting data and significance level was set at p-value <.05

Results: Majority (76.8%) of respondents knew of antibiotic resistance, but only 30.3% knew that bacteria develop resistance and not the human body. The majority (76.0%) engaged in self-treatment with antibiotics following exposure to information from social media, but 66.0% revealed that the information altered their attitudes towards the use of antibiotics. There was a high level of engagement in AR campaigns (67.5%), with short videos having the strongest influence on respondents (54.3%). The campaigns improved knowledge in 72.8% of students. Age, type of residence, and previous formal education were significantly associated with perceived behavioral influence of social media (p < .05). Age, faculty, and previous formal education were significantly associated with perceived beneficial effects of campaigns (p < .05). Students aged ≥24 years had 1.8 times higher odds of reporting both negative behavioral influence (AOR 1.82, 95% CI 1.15-2.89, p=0.011) and positive campaign effect (AOR = 1.61, p = .025) compared to younger students. Residing in on-campus hostels was associated with negative influence (AOR = 2.94, 95% CI 1.18–7.32, p = .020). Prior formal education on antibiotic use predicted both negative influence (AOR = 1.73, 95% CI 1.05–2.86, p = .032) and positive campaign effect (AOR = 1.57, 95% CI 1.01–2.45, p = .044). Students in Humanities and Social Sciences, Education, and Allied Health Sciences were more likely to perceive a positive campaign effect than those in Pure and Applied Sciences.

Conclusion: Social media has a dual role in influencing antibiotic use, including self-medication and the formation of positive behavioral intentions among undergraduates. Exposure to short video campaigns was independently associated with positive perceived effect, while prior formal education reduced the risk of negative behavioral influence. Engaging and focused campaigns involving short videos can be used to dispel misconceptions and create awareness. Universities need to include digital campaigns in antimicrobial stewardship to turn awareness into practice.

Anthropometric Analysis of the Papillary Muscles of the Heart: A Nigerian Cadaveric Study

2026-06-12T13:23:50+00:00

Background: Papillary muscles are pillar-like structures in the ventricular cavity, anchoring the atrioventricular valves via chordae tendineae. In the right ventricle, they include anterior, posterior, and septal muscles, while the left ventricle has only anterior and posterior muscles. They play a crucial role in ventricular contraction.

Aim: This study aimed to evaluate the morphometric characteristics of the papillary muscles through cadaveric dissection.

Methods: 23 cadaveric hearts preserved in formaldehyde from Nigerian medical schools in the southern region of Nigeria were procured and dissected; only specimens meeting the established inclusion criteria were utilized. A digital vernier calliper capable of measuring with a precision of 0.01 mm was used to measure the length and breadth of the papillary muscles. The length was measured from its attachment at the base to the apex, while the breadth was assessed at the muscle's origin from the ventricular wall. For statistical analysis, both descriptive and inferential methods were conducted using IBM-SPSS version 23.

Results: The anterior papillary muscles measured 13.90±4.84mm in length and 5.94±3.91mm in breadth in the right ventricle, while in the left ventricle, their dimensions were 20.77±6.33mm in length and 10.32±4.38mm in breadth. Additionally, the posterior papillary muscles showed lengths of 12.76±5.86mm in the right ventricle and 18.54±5.82mm in the left ventricle, with breadths of 6.24±3.08mm and 10.02±4.63mm, respectively. Lastly, the septal papillary muscle had a length of 11.23±5.76mm and a breadth of 6.26±2.49mm. Differences in the length and breadth of the anterior and posterior papillary muscles between the right and left ventricles were significant (P<0.05).

Conclusion: The anterior and posterior papillary muscles of the left ventricle are larger in length and width compared to those in the right ventricle, reflecting its higher pressure workload requiring robust mitral valve support.

Integrated GC–MS Characterisation, Molecular Docking, and ADMET Evaluation of Bioactive Compounds from the Methanolic Extract of Barleria longiflora L.f.

2026-06-20T12:03:25+00:00

Plants are important sources of structurally diverse bioactive compounds with potential relevance to drug discovery. Barleria longiflora L.f., a member of the family Acanthaceae, has reported traditional medicinal uses, but its phytochemical profile and predicted pharmacological potential remain insufficiently characterised. This study evaluated the methanolic extract of B. longiflora through preliminary phytochemical screening, gas chromatography-mass spectrometry (GC-MS), molecular docking and in silico ADMET analysis. Qualitative phytochemical screening indicated the presence of tannins, alkaloids, carbohydrates, glycosides and steroids, whereas flavonoids, proteins, saponins, triterpenoids and starch were not detected. GC-MS analysis identified three major compounds: oleic acid, stearic acid and palmitic acid, with peak areas of 76.15%, 22.44% and 1.41%, respectively, and retention times of 6.465, 8.242 and 11.977 min. The identified compounds were docked against selected target proteins, namely Aldose Reductase Enzyme (2FZD), the extracellular domain of human HER2 (1N8Z), Cyclooxygenase protein (6COX) and Sterol Carrier Protein-2 (1PZ4), using AutoDock Vina. Among the evaluated targets, Aldose Reductase showed comparatively stronger predicted binding interactions, with binding affinities of -5.6 kcal/mol for oleic acid, -7.3 kcal/mol for stearic acid and -6.1 kcal/mol for palmitic acid. ADMET prediction indicated molecular weights below 500 g/mol, high intestinal absorption and a bioavailability score of 0.85 for all three compounds. Palmitic acid was predicted to cross the blood-brain barrier, whereas oleic acid and stearic acid were not. Overall, the findings indicate that B. longiflora contains bioactive fatty acids with predicted drug-like properties and ligand-protein interaction potential, supporting further experimental validation in future studies.

Circulating Levels of Sex Hormone Binding Globulin, Estradiol, and Lipid Parameters in Female Infertility: A Cross-sectional Study in Owerri, Imo State, Nigeria

2026-06-23T10:25:30+00:00

Background: Female infertility is broadly defined as the failure to achieve conception after twelve months of regular, unprotected sexual intercourse with a male partner of confirmed fertility. Despite its widespread impact across sub-Saharan Africa, including Nigeria, the condition has only recently gained the attention it deserves in research and policy discourse. The inability to conceive carries profound psychological, social, and economic consequences for affected women and their families. Against this backdrop, the present study sought to assess the concentrations of sex hormone-binding globulin (SHBG), estradiol (E2), and lipid parameters in women with infertility attributable to hormonal dysfunction.

Aim: The present study explore about Circulating Levels of Sex Hormone Binding Globulin, Estradiol, and Lipid Parameters in Female Infertility

Methodology: This investigation adopted a cross-sectional design and enrolled 160 female participants between the ages of 20 and 45 years, all attending the Federal Teaching Hospital, Owerri (FTHO), Nigeria. The sample comprised two groups: 80 women with a confirmed diagnosis of hormonal infertility who were not currently receiving any pharmacological treatment (case group), and 80 apparently healthy, fertile women who served as controls. The following biochemical markers were quantified using standard laboratory procedures: SHBG, estradiol (E2), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and very low-density lipoprotein cholesterol (VLDL-c).

Results: Serum concentrations of SHBG, E2, TG, and VLDL-c were all significantly lower in the infertile group relative to the fertile controls (P < 0.05). In contrast, TC, HDL-c, and LDL-c levels were significantly elevated in infertile women compared with fertile participants (P < 0.05). Pearson correlation analysis revealed a strong positive association between TC and LDL-c in both groups, while TG showed a significant positive correlation with VLDL-c in both infertile and fertile women. A notable negative correlation between LDL-c and VLDL-c was observed exclusively in the fertile group (P < 0.05).

Conclusion: The observed hormonal and lipid abnormalities suggest that steroidogenesis may be functioning inadequately in hormonally infertile women, which may in part explain their difficulty in achieving pregnancy.

Optimising Insulin Therapy in Modern Type 2 Diabetes Care: A Narrative Review

2026-05-23T16:47:39+00:00

Background: Type 2 diabetes mellitus is a chronic metabolic condition affecting millions of adults worldwide. Despite newer treatment modalities such as GLP-1 receptor agonists, SGLT2 inhibitors, and tirzepatide, insulin remains vital for many patients. This is particularly the case for those with advanced beta-cell dysfunction, severe hyperglycaemia, or inadequate glycaemic control despite non-insulin therapies.

Objective: This narrative review outlines the changing landscape of insulin therapy for type 2 diabetes, and focuses on personalisation of treatment, combination therapy, minimising adverse events, digital technologies and safe de-intensification.

Methods: Literature was reviewed from PubMed, Scopus, and Google Scholar, focusing mainly on clinical trials, systematic reviews, meta-analyses, major guidelines, and relevant expert reviews published between 2016 and 2026. Landmark older studies were included where clinically relevant.

Key Findings: The use of insulin is still strongly influencing glycaemic control but is now more guided by new therapies and technologies. GLP-1 receptor agonists, SGLT2 inhibitors, and tirzepatide can be combined to lower the amount of insulin needed for treatment, help prevent weight gain, improve cardiometabolic outcomes, and decrease treatment burden in certain patients. New technologies such as smart insulin pens and digital titration devices facilitate more accurate insulin dosing and decrease the risk of hypoglycaemia. Patient-led titration and safe de-intensification are also important particularly for high-risk individuals for hypoglycaemia.

Conclusion: Insulin therapy remains indispensable in type 2 diabetes care, but its optimal use now requires a more digitally supported, and patient-centred approach. The key concern is no longer whether insulin remains necessary, but how its use can be optimised to improve effectiveness and fit safely within modern type 2 diabetes care.

Evolution of Electronic Health Records in Modern Healthcare: From Digital Documentation to Precision Medicine and Artificial Intelligence

2026-05-27T07:35:58+00:00

Electronic Health Records (EHRs) have transformed modern healthcare by improving the storage, accessibility, and utilization of patient information in both clinical practice and medical research. The evolution of EHR systems began with early paper-based documentation and progressed through innovations such as the Problem-Oriented Medical Record and the Regenstrief Medical Record System, which established the foundation for modern digital healthcare infrastructure. Over the years, EHRs have expanded beyond simple recordkeeping and now support clinical decision-making, pharmacovigilance, disease surveillance, public health monitoring, and large-scale biomedical research. The integration of big data analytics, artificial intelligence, genomic information, and natural language processing has further enhanced the role of EHRs in precision medicine and personalized healthcare. During the COVID-19 pandemic, EHR systems demonstrated their value in real-time surveillance, patient monitoring, and rapid healthcare response. Despite these advancements, challenges related to interoperability, data standardization, privacy protection, cybersecurity, and unequal global access continue to affect their optimal implementation. Future EHR systems are expected to become more intelligent, interconnected, and patient-centered through integration with wearable technologies, telemedicine, digital therapeutics, and social determinants of health, ultimately improving healthcare quality, research efficiency, and clinical outcomes worldwide.

Novel Drug Delivery Systems in Film-Forming Sprays: Formulation Principles, Polymeric Architectures, Therapeutic Applications, and Emerging Frontiers

2026-06-18T12:51:34+00:00

Film-forming sprays (FFS) are topical and transdermal drug delivery platforms in which polymer-based formulations are applied to biological surfaces and spontaneously consolidate into thin, adherent, drug-loaded films upon solvent evaporation. Offering uniform coverage of irregular anatomical surfaces, customisable release kinetics, and an aesthetically superior patient experience compared with conventional semi-solid preparations, FFS have attracted growing scientific and clinical investment. Their polymeric backbone—encompassing cellulose derivatives, polymethacrylates, chitosan, alginate, polyvinyl alcohol, and thermoresponsive copolymers—determines film adhesion, mechanical flexibility, moisture vapour transmission, and drug permeation characteristics. The incorporation of nanostructured carriers, including solid lipid nanoparticles, nanostructured lipid carriers, liposomes, ethosomes, and polymeric nanoparticles, has further diversified achievable release profiles. This review critically appraises FFS technology across formulation principles, polymer systems, drug release mechanisms, therapeutic applications in wound care, dermatology, nail delivery, mucosal systems and ocular delivery, characterisation methodologies, regulatory frameworks, and emerging innovations. The evaluative conclusion reached is that clinical maturity is most evident in wound care and nail drug delivery; dermatological, mucosal, and ocular applications, whilst scientifically promising, remain supported predominantly by in vitro and pre-clinical data of uncertain clinical translatability. Several unresolved controversies characterise the field. The tension between hydroalcoholic and aqueous solvent systems—where formulation performance and patient safety interests diverge, particularly for application to compromised skin—remains without consensus. Whether nanocarrier-loaded FFS confer genuine clinical benefit over well-optimised conventional film matrices is an open and insufficiently investigated question, given the near-complete absence of robust human clinical data. The boundary between drug product and medical device classification for antimicrobial wound film sprays continues to generate regulatory uncertainty within both European and United States frameworks. On the question of stimuli-responsive FFS, this review takes the position that the translational gap between laboratory proof-of-concept and clinical practice is wider than the current literature acknowledges, and that the field would benefit from more critical self-appraisal of developmental readiness. Validated in vitro–in vivo correlations, standardised characterisation protocols, and dosage-form-specific regulatory guidance from the EMA and FDA represent the most pressing unmet needs constraining the responsible advancement of this promising drug delivery modality.