The main opium alkaloids found in crude
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"4567",leadTitle:null,fullTitle:"Tuberculosis - Expanding Knowledge",title:"Tuberculosis",subtitle:"Expanding Knowledge",reviewType:"peer-reviewed",abstract:"Progress obtained by mycobacteriology in recent years is undeniable with regards to preventing, detecting, and treating cases of tuberculosis, millennial disease that is still present as public health issue worldwide. We present here high-impact research and interest topics related to the application of new methodologies, especially molecular methods for rapid diagnostic such as rapid DST, application of high performance liquid chromatography, molecular epidemiology and molecular diagnostic testing on post mortem. Currently, the constant search for vaccines that prevent the disease is promising through research of the immune response generated by the host towards the bacterium, and the effectiveness that may be achieved from developed vaccines. Another high-impact factor is the one generated by considering tuberculosis as a social disease with an infectious component reflected in research about tuberculosis and human rights. Finally, we present important issues of the pathogen interaction with different hosts. The constant knowledge generation that expands the frontiers of understanding is a key factor for finding solutions and successful activities for public health.",isbn:null,printIsbn:"978-953-51-2139-8",pdfIsbn:"978-953-51-7245-1",doi:"10.5772/58737",price:119,priceEur:129,priceUsd:155,slug:"tuberculosis-expanding-knowledge",numberOfPages:240,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"6620343e9ad62f2984bc393701cee6ff",bookSignature:"Wellman Ribon",publishedDate:"July 8th 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4567.jpg",numberOfDownloads:18608,numberOfWosCitations:40,numberOfCrossrefCitations:26,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:50,numberOfDimensionsCitationsByBook:3,hasAltmetrics:1,numberOfTotalCitations:116,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 4th 2014",dateEndSecondStepPublish:"July 2nd 2014",dateEndThirdStepPublish:"September 29th 2014",dateEndFourthStepPublish:"December 28th 2014",dateEndFifthStepPublish:"January 27th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"88491",title:"Dr.",name:"Wellman",middleName:null,surname:"Ribón",slug:"wellman-ribon",fullName:"Wellman Ribón",profilePictureURL:"https://mts.intechopen.com/storage/users/88491/images/system/88491.jpeg",biography:"Wellman Ribón, bacteriologist and clinical laboratory professional of the Industrial University of Santander, Master\\'s degree in Biochemistry from Universidad Javeriana; with more than fifteen years of experience as public health adviser, Colciencias (Departamento Administrativo de Ciencia y Tecnología de Colombia) senior researcher in scientific and technological development. He has worked at the National Health Institute of Colombia as coordinator of the mycobacteria group, manager of research projects and member of Centro Colombiano de Excelencia de Investigación en Tuberculosis (CCITB), EurolabTB Consortium and the SLAMTB. Ribón was the Microbiology School director and is currently a professor in Medicine School and works as professor and researcher at the Industrial University of Santander,.He is also the director of the Mycobacterium Research laboratory. Mr. Ribón has published articles about tuberculosis, leprosy and mycobacteriosis diseases, and has written four book chapters. His major area of interest and research is Mycobacterium tuberculosis complex.",institutionString:"Industrial University of Santander",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Industrial University of Santander",institutionURL:null,country:{name:"Colombia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1046",title:"Infectious Diseases",slug:"infectious-diseases"}],chapters:[{id:"47993",title:"Tuberculosis (TB) and Human Rights in Chiapas, Mexico",doi:"10.5772/59670",slug:"tuberculosis-tb-and-human-rights-in-chiapas-mexico",totalDownloads:1621,totalCrossrefCites:2,totalDimensionsCites:5,hasAltmetrics:0,abstract:null,signatures:"H.J. Sánchez-Pérez, Anaximandro Gómez-Velasco, G. Leal, A.\nBencomo-Alerm, N. Romero-Sandoval and M. 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\n
Opium alkaloids were first isolated in 1803 by Parisian Derosne, and named ‘opium salt’. Friedrich Wilhem Adam Serturner described the ‘opium salt’ in detail in 1817 and named “morphine\', inspired by the Morpheus (Greek god of dreams). Karl Friedrich Wilhelm Meissner first used the word ‘alkaloid’ in 1818, which we still use. Opioids were widely used for the first time in the Franco-Prussian War and the American Civil War for medical purposes. Tincture and pills were preferred for the purpose of analgesia in wounded soldiers. Repeated use caused opioid dependence on some soldiers, and this event was first described as “soldiers’ disease” [5].
\nAlthough morphine and other opioid alkaloids are exogenous substances, they show agonistic effect by binding to the receptors of endogenous opioids. Opioid receptors were first described by Beckett and Casy in 1954 [6]. In 1965, Portoghese and colleagues shared their views on the existence of multiple opioid receptor types [7]. High-affinity and stereospecific binding sites for opioid alkaloids were also found in brain in 1973 [8]. The presence of specific opioid receptors led to the discovery of endogenous ligands. They are enkephalins [9], β-endorphin [10], and dynorphins [11]. The classic opioid receptors, were discovered in 1976–1977 and named after the prototypic drugs or tissue used in these studies: μ (mu, for morphine), δ (delta, for deferens), and κ (kappa, for ketocyclazocine) [12, 13]. These receptors show seven transmembrane domain structures specific to G protein-coupled receptors, are induced by morphine and antagonized by naloxone, and had similar analgesic effect. In 1995, the fourth opioid receptor, which is similar in structure with and closely related to classic opioid receptors, was also discovered [14, 15]. Fourth opioid receptor initially identified as ORL1 or LY132, it was later updated to N/OFQ by taking the name of its endogenous ligands (nociceptin/ orphanin FQ) [16]. Although the effects of N/OFQ receptor are not fully known, they do not have a similar effect on pain as classical opioid receptors, and their sensitivity to naloxone is very low. σ (sigma), ε (epsilon), and ζ (zeta) receptors and λ (lambda) site are included in other opioid receptors [17]. The σ receptor, discovered in 1976, is not coupled to G protein, and its effects are not antagonized by naloxone [12, 18, 19]. The ε receptor is sensitive to β-endorphin [20]. The λ site regulates cell growth and is not antagonized by naloxone [21, 22]. Further information on opioid receptors is summarized in Table 2.
\n\n | Density (avg%) [3] | \nMolecular formula | \nMolecular weight (g/mol) | \n
---|---|---|---|
Morphine | \n11.4 | \nC17H19NO3\n | \n285.34 | \n
Noscapine | \n8.1 | \nC22H23NO7\n | \n413.4 | \n
Codeine | \n3.5 | \nC18H21NO3\n | \n299.4 | \n
Thebaine | \n3.2 | \nC19H21NO3\n | \n311.4 | \n
Papaverine | \n3.1 | \nC20H21NO4\n | \n339.4 | \n
The main opium alkaloids found in crude
Opioid receptors | \nμ receptor | \nδ receptor | \nκ receptor | \nN/OFQ receptor | \n|
---|---|---|---|---|---|
Other names | \nOP3, MOP, MOPr, Mu 1 | \nOP1, DOP, DOR, DOPr, DOR-1 | \nOP2, KOP, KOPr, KOR-1 | \nOP4, KOR-3, NOCIR, kappa3-related, MOR-C, nociceptin receptor ORL, XOR1, NOP-r, nociceptin/orphanin FQ, NOPr | \n|
Regions with high distribution | \nCNS | \nThalamus Caudate putamen Neocortex Nucleus accumbens (NAc) Amygdala İnterpeduncular complex İnferior and superior colliculi [23] | \nOlfactory bulb Neocortex Caudate putamen NAc Amygdala [23] | \nCerebral cortex NAc Claustrum Hypothalamus [23, 24] | \nCerebral cortex Anterior olfactory nucleus Lateral septum Ventral forebrain Hippocampus Hypothalamus Amygdala Substantia nigra Ventral tegmental area (VTA) Locus coeruleus Brain stem nuclei [25] | \n
Spinal cord | \nSuperficial layers dorsal horn of spinal cord [26] | \nDorsal horn [25] | \n|||
Non-CNS | \nSkin [27] Immune cells [29] Pregnant uterus [31] Gastrointestinal (GI) tract [32] Cochleae [34] | \nSkin [28] Immune cells [30] Pregnant uterus [31] GI tract [33] Cochleae [34] | \nSkin[28] Immune cells [30] Pregnant uterus [31] GI tract [33] Cochleae [34] | \n\n | |
Types of G-protein | \nPrimary: Gi/Go Secondary: Gq/G11 | \nGi/Go | \nPrimary: Gi/Go Secondary: G12/G13 | \nPrimary: Gi/Go | \n|
Endogenous ligands | \nβ-endorphin Enkephalins Endomorphin-1 and -2 | \nβ-endorphin Enkephalins | \nDynorphin A Dynorphin B α-neoendorphin | \nNociceptin Orphanin FQ | \n|
Agonists [from main opium alkaloids] | \nMorphine Codeine | \nMorphine | \nMorphine | \n\n | |
Antagonists | \nNaloxone Naltrexone | \nNaloxone Naltrexone | \nNaloxone Naltrexone | \n[Nphe1]N/OFQ-(1-13)-NH2\n UFP-101 | \n|
Effects | \nAnalgesia Respiratory functions Cardiovascular functions GI motility Neuroendocrine functions Immune system functions Feeding Mood Thermoregulation [35] | \nAnalgesia [36] Cardiovascular functions GI motility Mood Behaviour [15] | \nAnalgesia Neuroendocrine functions Immune system functions Diuresis Feeding [35] | \nNociception Motor and aggressive behaviours Reinforcement and reward Stress response Autonomic system functions Immune system functions [37] | \n
Opioid receptors and their properties.
According to the studies, μ receptor was also related with addiction [38], modulation of dopaminergic system [39], learning and memory [40]. The δ receptors along with μ receptors contribute to emotional sensitivity [41].
\nμ, δ, and κ opioid receptors are distributed in peripheral tissue as well as CNS. Stimulation of these receptors in the CNS results in analgesia, drowsiness, euphoria, a sense of detachment, respiratory depression, nausea and vomiting, depressed cough reflex, and hypothermia. When these receptors are stimulated in peripheral tissues, miosis, orthostatic hypotension, constipation, urinary retention etc. emerges.
\nAfter stimulation of these Gi/0-coupled opioid receptors, the adenylate cyclase enzyme is suppressed and the level of cyclic AMP decreases. In addition, the voltage-gated calcium channels in the axon ends or neuron soma are closed and intracellular calcium levels are reduced, potassium channels are opened and leading to an increase in potassium conductance. As a result, inhibition and hyperpolarization of neurons occurs when opioid receptors are stimulated [42, 43].
\nAnalgesic or antinociceptive effects, which are indicated for use of opioids, develop at the level of the brain and spinal cord. At the brain level, attenuation of impulse spread is weakened and the perception of pain is inhibited, and at the spinal cord level, the transmission of pain impulses is suppressed [44].
\nOpioid dependence or addiction is a chronic, recurrent disease that changes neurotransmitter systems in the CNS and affects movement [45, 46]. Opioid dependence develops in both psychic and physical dependence. Physical opioid dependence occurs both when used for treatment and as a result of abuse. Opioid abuse is a relapsing disease with high morbidity and mortality, which is used at higher doses to produce the same effect due to tolerance. The higher the exposure time to opioids, the higher the degree of dependence and tolerance. After physical dependence develops, opioid consumption is maintained to prevent withdrawal symptoms. So the treatment is long and difficult. For this purpose, opioid agonists such as methadone, buprenorphine, an opioid antagonist naltrexone or abstinence-based treatment may be preferred. This disease, referred to as ‘opioid abuse and opioid dependence’ in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSMIV-TR), has been changed to ‘opioid use disorder’ in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [47].
\nThe estimated annual prevalence of opioids in 2010 was 0.6–0.8% of the population aged 15–64 (26 × 106 to 36 × 106). The estimated annual prevalence of opioid use is between 0.3 and 0.5% of the adult population (13 × 106 to 21 × 106 past-year users) [48].
\nThe mesocorticolimbic dopaminergic system, which project from the VTA to the NAc and medial prefrontal cortex (mPFC) are critically important in opioid dependence [49]. Opioids act on VTA and directly or indirectly cause an increase in dopamine release in NAc region [50]. In the pathogenesis of opioid dependence, the presence of a complex mechanism including the dopaminergic system, noradrenergic, serotonergic, etc. systems should be considered [51].
\nWithdrawal is a condition that occurs when the use of an exogenous substance that is used for a long time and develops physical dependence is interrupted. In opioid dependence, the mesocorticolimbic dopaminergic system activates and induces dopamine release in the NAc region. The adaptive increase in dopaminergic activity in CNS in opioid dependence is suppressed during withdrawal and withdrawal symptoms appear [52]. In addition to dopamine, different neurotransmitters and neuromodulators, such as noradrenaline, GABA, vasopressin, substance P, neuropeptide Y, and nitric oxide, are thought to play a role in the development of opioid withdrawal [53, 54, 55]. In opioid withdrawal syndrome, symptoms such as pain, insomnia, yawning, tremor, lacrimation, rhinorrhea, sweating, dehydration, goosebumps, mydriasis, restlessness, anorexia, nausea, vomiting, diarrhea, weight loss, hyperglycemia, hypotension, decrease in respiratory rate, hyperthermia and abdominal muscle cramps are seen [45].
\nInternational Union of Pure and Applied Chemistry (IUPAC) name: (4R,4aR,7S,7aR,12bS)-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline-7,9-diol.
\nATC Code | \nN-Nervous system | \nN02-Analgesics | \nN02A-Opioids | \nN02AA-Natural opium alkaloids | \nN02AA01-Morphine | \n
Morphine is one of the major opium alkaloids isolated from plant
Absorption of morphine is variable, an almost complete absorption mainly done in the upper intestine as well as in the rectal mucosa. Morphine presents significant first-pass metabolism and oral bioavailability within 17–33% [57]. Morphine distributes to brain, skeletal muscle, liver, kidneys, lungs, intestinal tract, and spleen [58]. Hepatic metabolism occurs via glucuronic acid conjugation primarily to morphine-6-glucuronide (M6G, 10–15%) and morphine-3-glucuronide (M3G, 45–55%). Other metabolites include morphine-3,6-diglucuronide, morphine-3-ethereal sulphate, normorphine, normorphine-6-glucuronide, normorphine-3-glucuronide and codeine. M6G and normorphine show active analgesic effect by binding to opioid receptors, but M6G, which is formed more than normorphine, can contribute to analgesic effect of morphine. M3G does not contribute to the analgesic effect of morphine, because it has low affinity to opioid receptors [59]. Half-life elimination is variable according to age group: in neonates 4.5–13.3 h, in children 1–2 h, and in adults 2–4 h. Excretion occurs with urine (2–12%) and feces (7–10%).
\nMorphine leads to death in amounts of 0.15–0.2 g (sc) or 0.3–0.4 g (oral) in adults. Babies and young children are much more susceptible, and death has been observed at doses of 30 mg [60]. Morphine blood concentration within 10–100 μg/dL is toxically; if it is above 400 μg/dL is lethally [61].
\nCommon adverse reactions are drowsiness, headache, constipation, nausea, vomiting, urinary retention. Although less common adverse reactions, such as depression, insomnia, paresthesia, dizziness, anxiety, abnormal dreams, confusion, seizure, myoclonus, agitation, amnesia, euphoria, pain, dyspnea, hypoventilation, respiratory depression, tremor, fever, flu-like symptoms, rhinitis, edema, hypotension, syncope, palpitations, skin rash, amblyopia, blurred vision, conjunctivitis, diplopia, miosis, nystagmus, amenorrhea, impotence, gynecomastia, urinary hesitancy, diaphoresis, anorexia, biliary colic, dyspepsia, gastroesophageal reflux disease, hiccups, xerostomia, anemia, thrombocytopenia can be seen.
\nContraindications are hypersensitivity to morphine, significant respiratory depression, acute or severe bronchial asthma in the absence of resuscitative equipment, GI obstruction.
\n\n
\n
\n
IUPAC name: (3S)-6,7-dimethoxy-3-[(5R)-4-methoxy-6-methyl-7,8-dihydro-5H-[1,3]dioxolo[4,5-g]isoquinolin-5-yl]-3H-2-benzofuran-1-one.
\nATC Code | \nR-Respiratory system | \nR05-Cough and cold preparations | \nR05D-Cough suppressants, excl. combinations with expectorants | \nR05DA-Opium alkaloids and derivatives | \nR05DA07-Noscapine | \n
Noscapine, also known as narcotine, is the second opioid alkaloid according to its density in raw
Noscapine in terms of antitussive potency, onset, and duration of action is similar to codeine, one of the main opium alkaloids [74]. Noscapine has a relatively low bioavailability due to a first-pass metabolism [79]. Noscapine is inactivated by converting into meconin and o-demethylated metabolites. Meconin is major urinary metabolite of noscapine [80].
\nAdverse reactions are not expected when used in therapeutic doses [74]. When taken in high doses, drowsiness, headache, nausea, vasomotor rhinitis, conjunctivitis may be seen [81].
\n\n
\n
IUPAC Name: (4R,4aR,7S,7aR,12bS)-9-methoxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-ol
ATC Code | \nR-Respiratory system | \nR05-Cough and cold preparations | \nR05D-Cough suppressants, excl. combinations with expectorants | \nR05DA-Opium alkaloids and derivatives | \nR05DA04-Codeine | \n
Codeine, a 3-methylether derivative of morphine, is the third opioid alkaloid according to its density in the raw
Absorption is rapidly in oral use and bioavailability is higher due to less first-pass metabolism (about 53%). Codeine is distributed to a variety of tissues, with priority being to the liver, spleen and kidney [84]. Codeine-6-glucuronide, morphine, and norcodeine is formed as a result of hepatic metabolism. Morphine is then metabolized to M3G and M6G, and contributes to analgesic effects of codeine. The half-life elimination is about 3 h and excretion is mostly done through urine and with less feces.
\nIn adults 7–14 mg/kg, in children more than 5 mg/kg intake leads to death [85]. Codeine blood concentration within 20–50 μg/dL is toxically, if it is above 60 μg/dL is lethally [86].
\nAbnormal dreams, insomnia, depression, paresthesia, agitation, anxiety, ataxia, dizziness, disorientation, sedation, euphoria, fatigue, hallucination, headache, bradycardia, tachycardia, circulatory depression, flushing, pruritus, skin rash, urticaria, bronchospasm, dyspnea, respiratory depression, abdominal cramps, anorexia, constipation, diarrhea, nausea, urinary hesitancy, urinary retention, blurred vision, diplopia, miosis, nystagmus, laryngospasm, muscle rigidity, tremor, hypogonadism, etc. may occur due to codeine use.
\nContraindications are hypersensitivity to codeine, pediatric patients <12 years of age, postoperative management in pediatric patients <18 years of age who have undergone tonsillectomy and/or adenoidectomy, significant respiratory depression, acute or severe bronchial asthma in the absence of resuscitative equipment, GI obstruction.
\n\n
\n
\n
IUPAC Name: (4R,7aR,12bS)-7,9-dimethoxy-3-methyl-2,4,7a,13-tetrahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline.
\nThebaine, also known as paramorphine, which is not used for medicinal purposes and is used for the production of other opioids, is the fourth opioid alkaloid according to its density in the raw
IUPAC name: 1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxyisoquinoline
ATC Code | \nA-Alimentary tract and metabolism | \nA03-Drugs for functional gastrointestinal disorders | \nA03A-Drugs for functional gastrointestinal disorders | \nA03AD-Papaverine and derivatives | \nA03AD01-Papaverine | \n
G-Genito urinary system and sex hormones | \nG04-Urologicals | \nG04B-Urologicals | \nG04BE-Drugs used in erectile dysfunction | \nG04BE02-Papaverine | \n
Papaverine, which has no opioid-like effect, is the fifth opioid alkaloid based on its density in the raw
Absorption is nearly total in oral use. Oral bioavailability is higher due to less first-pass metabolism (about 54%). Papaverine is distributed to a variety of tissues, with priority being to the adipose tissue and liver. 6-Desmethylpapaverine (6-DMP, major metabolite) and 4′,6-didesmethylpapaverine (4,6-DDMP) is formed as a result of hepatic metabolism [96]. Half-life elimination is 0.5–2 h. The excretion of papaverine is through primarily urine [97]. No information on toxic blood concentrations is available. The oral median lethal dose in rats is 360 mg/kg, unknown in humans [98].
\nAdverse reactions are flushing, hypertension, tachycardia, headache, malaise, sedation, abdominal distress, anorexia, constipation, etc.
\nUse in the complete AV block is contraindicated.
\n\n
\n
Although information about opium alkaloids was about 3000 BC, it was first isolated in the 1800s. Opioid-like effects occur after opioid alkaloids bind to conventional opioid receptors, such as μ, δ, and κ. In particular, as a result of the agonistic effect on μ receptors, strong analgesia, physical dependence, tolerance and increased dopaminergic activity develop in the mesocorticolimbic system responsible for dependence. Increased dopaminergic activity in the mesocorticolimbic system, is a sign of developing physical dependence, decreases in the absence of opium alkaloids, leading to withdrawal syndrome. Hypogonadism in opium alkaloids users supports the idea that it has a suppressive effect on reproduction. In addition to the risk of teratogenicity, use in both pregnancy and lactation may lead to the development of abstinence syndrome in infants.
\nThe authors declare no conflict of interest.
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The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ezekwesili-Ofili",slug:"josephine-ezekwesili-ofili",fullName:"Josephine Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"76640",title:"Control of Clinical Laboratory Errors by FMEA Model",slug:"control-of-clinical-laboratory-errors-by-fmea-model",totalDownloads:1112,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Patient safety is an aim for clinical applications and is a fundamental principle of healthcare and quality management. The main global health organizations have incorporated patient safety in their review of work practices. The data provided by the medical laboratories have a direct impact on patient safety and a fault in any of processes such as strategic, operational and support, could affect it. To provide appreciate and reliable data to the physicians, it is important to emphasize the need to design risk management plan in the laboratory. Failure Mode and Effect Analysis (FMEA) is an efficient technique for error detection and reduction. Technical Committee of the International Organization for Standardization (ISO) licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. FMEA model helps to identify quality failures, their effects and risks with their reduction/elimination, which depends on severity, probability and detection. Applying FMEA in clinical approaches can lead to a significant reduction of the risk priority number (RPN).",book:{id:"9808",slug:"contemporary-topics-in-patient-safety-volume-1",title:"Contemporary Topics in Patient Safety",fullTitle:"Contemporary Topics in Patient Safety - Volume 1"},signatures:"Hoda Sabati, Amin Mohsenzadeh and Nooshin Khelghati",authors:[{id:"340486",title:"M.Sc.",name:"Hoda",middleName:null,surname:"Sabati",slug:"hoda-sabati",fullName:"Hoda Sabati"},{id:"348872",title:"M.Sc.",name:"Amin",middleName:null,surname:"Mohsenzadeh",slug:"amin-mohsenzadeh",fullName:"Amin Mohsenzadeh"},{id:"348874",title:"MSc.",name:"Nooshin",middleName:null,surname:"Khelghati",slug:"nooshin-khelghati",fullName:"Nooshin Khelghati"}]},{id:"65467",title:"Anesthesia Management for Large-Volume Liposuction",slug:"anesthesia-management-for-large-volume-liposuction",totalDownloads:5710,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The apparent easiness with which liposuction is performed favors that patients, young surgeons, and anesthesiologists without experience in this field ignore the many events that occur during this procedure. Liposuction is a procedure to improve the body contour and not a surgery to reduce weight, although recently people who have failed in their plans to lose weight look at liposuction as a means to contour their body figure. Tumescent liposuction of large volumes requires a meticulous selection of each patient; their preoperative evaluation and perioperative management are essential to obtain the expected results. The various techniques of general anesthesia are the most recommended and should be monitored in the usual way, as well as monitoring the total doses of infiltrated local anesthetics to avoid systemic toxicity. The management of intravenous fluids is controversial, but the current trend is the restricted use of hydrosaline solutions. The most feared complications are deep vein thrombosis, pulmonary thromboembolism, fat embolism, lung edema, hypothermia, infections and even death. The adherence to the management guidelines and prophylaxis of venous thrombosis/thromboembolism is mandatory.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Sergio Granados-Tinajero, Carlos Buenrostro-Vásquez, Cecilia\nCárdenas-Maytorena and Marcela Contreras-López",authors:[{id:"273532",title:"Dr.",name:"Sergio Octavio",middleName:null,surname:"Granados Tinajero",slug:"sergio-octavio-granados-tinajero",fullName:"Sergio Octavio Granados Tinajero"}]},{id:"30178",title:"Chest Mobilization Techniques for Improving Ventilation and Gas Exchange in Chronic Lung Disease",slug:"chest-mobilization-techniques-for-improving-ventilation-and-gas-exchange-in-chronic-lung-disease",totalDownloads:30993,totalCrossrefCites:0,totalDimensionsCites:5,abstract:null,book:{id:"648",slug:"chronic-obstructive-pulmonary-disease-current-concepts-and-practice",title:"Chronic Obstructive Pulmonary Disease",fullTitle:"Chronic Obstructive Pulmonary Disease - Current Concepts and Practice"},signatures:"Donrawee Leelarungrayub",authors:[{id:"73709",title:"Associate Prof.",name:"Jirakrit",middleName:null,surname:"Leelarungrayub",slug:"jirakrit-leelarungrayub",fullName:"Jirakrit Leelarungrayub"}]},{id:"46082",title:"Fecal Incontinence",slug:"fecal-incontinence",totalDownloads:3523,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"3835",slug:"fecal-incontinence-causes-management-and-outcome",title:"Fecal Incontinence",fullTitle:"Fecal Incontinence - Causes, Management and Outcome"},signatures:"Arzu Ilce",authors:[{id:"30672",title:"Dr.",name:"Arzu",middleName:null,surname:"Ilce",slug:"arzu-ilce",fullName:"Arzu Ilce"}]}],onlineFirstChaptersFilter:{topicId:"16",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81890",title:"Coronary Arteries Bypass Grafting as a Salvage Surgery in Ischemic Heart Failure",slug:"coronary-arteries-bypass-grafting-as-a-salvage-surgery-in-ischemic-heart-failure",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.104939",abstract:"Ischemic cardiomyopathy accounts for approximately two-thirds of all Heart Failure (HF) cases. Recent studies indicates that revascularization provides superior outcomes compared with optimal medical therapy (OMT) alone. Current European and American guidelines recommend an invasive approach in patients with reduced left ventricular ejection fraction (LVEF) less than 35% and with multivessel disease (MVD). Randomized controlled trials in these patients have proven that long-term survival is greater following coronary artery bypass grafting (CABG) than with OMT alone. Patients with ischemic cardiomyopathy and coronary artery disease that is amenable to surgical revascularization should undergo combination of surgical revascularization and medical therapy rather than medical therapy alone. In some cases, combined CABG with other surgeries are vital salvage procedures, such as atrial fibrillation, mitral valve, tricuspid valve, and LV remodeling. Based on small but, nontrivial, early mortality risk associated with CABG surgery as well as other post-CABG morbidities, patients may also reasonably choose medical therapy as initial treatment option. Revascularization remains an important treatment option for patients with ongoing anginal symptoms despite optimal medical therapy. In this chapter, we will highlight the role of CABG in heart failure treatment and when to use it as a salvage surgery before referring the patient for heart transplantation.",book:{id:"11235",title:"Coronary Artery Bypass Surgery",coverURL:"https://cdn.intechopen.com/books/images_new/11235.jpg"},signatures:"Samuel Jacob, Pankaj Garg, Games Gramm and Saqib Masroor"},{id:"81872",title:"Benign Prostatic Hyperplasia: Epidemiology, Pathophysiology, and Clinical Manifestations",slug:"benign-prostatic-hyperplasia-epidemiology-pathophysiology-and-clinical-manifestations",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.104823",abstract:"The prostate secretes 20% of the seminal fluid. One of its main pathologies is benign prostatic hyperplasia (BPH), the most common benign disease in older men. It has an 8–10% prevalence in men 40 years of age and older, increasing to more than 90% in men over 90 years, with lower urinary tract symptoms being one of its main complications. Although the etiology of BPH is not still fully known, testosterone and estradiol have shown a permissive role. Likewise, other factors have emerged, such as inflammation, growth factors, and prolactin, which influence the development of BPH. These factors act through binding to specific receptors, intervening in BPH and prostate cancer development. Existing treatments significantly reduce clinical symptoms, including lower urinary tract symptoms. However, it is a nonpreventable disease; some factors can reduce its incidence: diet, physical activity, and moderate consumption of alcohol and tobacco, some of which have been proposed to have a protective role. Therefore, this chapter aims to update the preclinical and clinical evidence on the etiology of this disease, briefly describing the epidemiology, clinical manifestations, and therapeutic and preventive modalities in managing BPH.",book:{id:"10793",title:"Molecular Mechanisms in Cancer",coverURL:"https://cdn.intechopen.com/books/images_new/10793.jpg"},signatures:"Luz Irene Pascual Mathey"},{id:"81837",title:"Unshielded Magnetocardiography in Clinical Practice: Detection of Myocardial Damage in CAD Patients and in Patients Recovered from COVID-19",slug:"unshielded-magnetocardiography-in-clinical-practice-detection-of-myocardial-damage-in-cad-patients-a",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.104924",abstract:"The chapter deals with magnetocardiography—a specific section of electrocardiography, which is designed to analyze the magnetic component of the electromagnetic field of the heart. Magnetocardiography is described as clinical information technology (IT), i.e., a set of methods, software, and hardware combined into a technological chain, the product of which is an automated diagnostic report. There are several examples of magnetocardiographic information technology implementation in clinical routine, aiming to register and evaluate subtle changes in the electromagnetic field of the heart for early diagnosis of the most common and dangerous heart diseases, especially coronary heart disease. It is shown that new metrics of analysis of spatial structure of 2D and 3D magnetocardiographic maps of current density distribution allow diagnosis with high accuracy of various forms of myocardial ischemia as well as myocardial damage in patients, recently recovered from COVID-19.",book:{id:"11218",title:"Electrocardiograms",coverURL:"https://cdn.intechopen.com/books/images_new/11218.jpg"},signatures:"Illya Chaikovsky, Anatoly Kazmirchyk, Sergey Sofienko, You-Bin Liu, Ya-Feng Zhou, Xie Feng, Lin Xu and Yan-Fei Huang"},{id:"81886",title:"Protocols for Bleeding and Thrombosis in Pediatric Intensive Care Units",slug:"protocols-for-bleeding-and-thrombosis-in-pediatric-intensive-care-units",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.104882",abstract:"Bleeding and thrombosis are the common hematological complications found in children who are admitted in the pediatric intensive care units (PICUs). Some of those complications could be mild, however some could be serious or life-threatening for critically-ill children. The etiologies of those conditions could be due to the underlying diseases, i.e., congenital bleeding disorders, complications of the diseases, i.e. coagulopathy due to disseminated intravascular coagulation (DIC), and also the side effects from the treatments themselves, i.e., massive transfusion or extracorporeal membrane oxygenation (ECMO). Early detection and management and prevention of those complications could decrease the morbidity and mortality of the children in PICUs. Although most guidelines of management of those bleeding and thrombosis in adults is well established, the evidences for the management of those conditions in children are limited. In addition, developmental hemostasis during the childhood, which is different from adulthood, could challenge the management of those conditions in children admitted in PICUs.",book:{id:"11297",title:"ICU Management and Protocols",coverURL:"https://cdn.intechopen.com/books/images_new/11297.jpg"},signatures:"Rungrote Natesirinilkul"},{id:"81589",title:"Celiac Disease, Management, and Follow-Up",slug:"celiac-disease-management-and-follow-up",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.104652",abstract:"Celiac disease (CD) is a systemic immune-mediated disorder characterized by a specific serological and histological profile triggered by gluten ingestion, which is given in genetically predisposed subjects. Heterogeneous clinical presentation is characteristic in CD, affecting any organ or tissue with gastrointestinal, extraintestinal, seronegative, or nonresponsive manifestations. CD diagnosis is based on several criteria, including genetic and serological tests, clinical symptoms and/or risk conditions, and duodenal biopsy. Currently, the available treatment for CD is a strict gluten-free diet (GFD) that essentially relies on the consumption of naturally gluten-free foods, such as animal-based products, fruits, vegetables, legumes, and nuts, as well as gluten-free dietary products that may not contain more than 20 mg of gluten per kg of food according to Codex Alimentarius. However, it is difficult to maintain a strict oral diet for life and at least one-third of patients with CD are exposed to gluten. 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Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424836",title:"Dr.",name:"Orsolya",middleName:null,surname:"Borsai",slug:"orsolya-borsai",fullName:"Orsolya Borsai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",country:{name:"Romania"}}},{id:"422262",title:"Ph.D.",name:"Paola Andrea",middleName:null,surname:"Palmeros-Suárez",slug:"paola-andrea-palmeros-suarez",fullName:"Paola Andrea Palmeros-Suárez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Guadalajara",country:{name:"Mexico"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. The endocrine and nervous systems play important roles in maintaining homeostasis in the human body. Integration, which is the biological basis of physiology, is achieved through communication between the many overlapping functions of the human body's systems, which takes place through electrical and chemical means. Much of the basis of our knowledge of human physiology has been provided by animal experiments. Because of the close relationship between structure and function, studies in human physiology and anatomy seek to understand the mechanisms that help the human body function. The series on human physiology deals with the various mechanisms of interaction between the various organs, nerves, and cells in the human body.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:null,editorThree:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. 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