Total phenolic and flavonoid contents and antihypertensive effect of the crude extract and fractions of Calamintha vulgaris

BACKGROUND

Calamintha vulgaris L., has been used medicinally in the management hypertension.

PURPOSE

To investigate the antihypertensive mechanisms of extract of C. vulgaris L., in Sprague-Dawley (SD) rat.

STUDY DESIGN

Total phenol and total flavonoid contents were determined in the crude extract through HPLC. In vivo and in vitro pharmacological approaches were utilized to test the crude extract and fractions of C. vulgaris in Sprague-Dawley (SD) rats. The effect on mean arterial pressure (MAP) was compared in normotensive and high salt-induced hypertensive rats.

METHODS

Crude extract and nHexane, chloroform, ethylacetate and aqueous fractions of C. vulgaris were tested. In vitro experiments were carried out in isolated rat and rabbit aortae, to probe vascular mechanism(s). Extract was also evaluated for acute toxicity study in mice.

RESULTS

Crude extract and fractions of C. vulgaris induced a fall in MAP in normotensive and high salt-induced hypertensive rats at different doses. The effect was more significant in the hypertensive rats (Max. fall, 38.67 ± 2.17 vs 44.16 ± 4.67 mmHg). Among the fractions, chloroform was more effective (Max. fall, 53.20 ± 1.23 mmHg) and aqueous the least (Max. fall, 38.66 ± 1.12 mmHg). Normotensive rats pretreated with atropine (2 mg/kg) or _L-NAME (100 µg/kg) ablated fall in MAP to the extract and fractions. In isolated rat aorta, extract induced endothelium-dependent vasodilatory effect, which was ablated with atropine (1 µM), _L-NAME (10 µM), atropine + _L-NAME, TEA (10 µM) pretreatment and denudation of aorta. Indomethacin (10 µM) pretreatment ablated vasodilatation at lower concentrations and unmasked a vasoconstrictor effect, followed by relaxation at higher concentrations. Extract and fractions inhibited high K⁺-precontractions and rightward shifted Ca⁺² concentration response curves, similar to verapamil. Total phenolic and flavonoid contents were found 39.41 ± 0.18 (mg of GAE/g) and 12.03 ± 0.23 (mg of QUE/g), respectively. HPLC analysis showed the presence of quercetin and rutin CONCLUSION: Results obtained indicate that the antihypertensive effect of C. vulgaris is the outcome of vasodilation, which is mediated through combination of muscarinic receptor-linked NO, activation of TEA-sensitive K⁺ channels, prostacyclin and Ca⁺² antagonism.

Observation of a_{0}^{0}(980)-f_{0}(980) Mixing

We report the first observation of a_{0}^{0}(980)-f_{0}(980) mixing in the decays of J/ψ→ϕf_{0}(980)→ϕa_{0}^{0}(980)→ϕηπ^{0} and χ_{c1}→a_{0}^{0}(980)π^{0}→f_{0}(980)π^{0}→π^{+}π^{-}π^{0}, using data samples of 1.31×10^{9}  J/ψ events and 4.48×10^{8}  ψ(3686) events accumulated with the BESIII detector. The signals of f_{0}(980)→a_{0}^{0}(980) and a_{0}^{0}(980)→f_{0}(980) mixing are observed at levels of statistical significance of 7.4σ and 5.5σ, respectively. The corresponding branching fractions and mixing intensities are measured and the constraint regions on the coupling constants, g_{a_{0}K^{+}K^{-}} and g_{f_{0}K^{+}K^{-}}, are estimated. The results improve the understanding of the nature of a_{0}^{0}(980) and f_{0}(980).

Precision Measurement of the e^{+}e^{-}→Λ_{c}^{+}Λ[over ¯]_{c}^{-} Cross Section Near Threshold

The cross section of the e^{+}e^{-}→Λ_{c}^{+}Λ[over ¯]_{c}^{-} process is measured with unprecedented precision using data collected with the BESIII detector at sqrt[s]=4574.5, 4580.0, 4590.0 and 4599.5 MeV. The nonzero cross section near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold is cleared. At center-of-mass energies sqrt[s]=4574.5 and 4599.5 MeV, the higher statistics data enable us to measure the Λ_{c} polar angle distributions. From these, the Λ_{c} electric over magnetic form-factor ratios (|G_{E}/G_{M}|) are measured for the first time. They are found to be 1.14±0.14±0.07 and 1.23±0.05±0.03, respectively, where the first uncertainties are statistical and the second are systematic.

Atypical Presentation of Escherichia coli Monomicrobial Necrotizing Fasciitis in a Renal Transplant Patient: A Case Report

Skin and soft tissue infections (SSTIs) are one of most frequent infectious causes for referral to the emergency department and one of the most frequent infectious causes of hospital admissions. Escherichia coli, the most commonly occurring gram-negative pathogen involved in these infections, contributes to about 7% of all SSTIs cases where gram-positive organisms reign dominant. Patients are more susceptible to these gram-negative SSTIs if they are neutropenic, have hematologic malignancies, have undergone solid organ or hematopoietic transplantation, or have cirrhotic liver disease. Due to their immunocompromised state, the prognosis is very poor and not well understood. We report a case of an atypical presentation of an E coli monomicrobial necrotizing fasciitis in a renal transplant patient. Our findings support improved mortality with rapid aggressive interventions, such as amputation, in immunocompromised patients.

A large-scale study of a poultry trading network in Bangladesh: implications for control and surveillance of avian influenza viruses

BACKGROUND

Since its first report in 2007, avian influenza (AI) has been endemic in Bangladesh. While live poultry marketing is widespread throughout the country and known to influence AI dissemination and persistence, trading patterns have not been described. The aim of this study is to assess poultry trading practices and features of the poultry trading networks which could promote AI spread, and their potential implications for disease control and surveillance. Data on poultry trading practices was collected from 849 poultry traders during a cross-sectional survey in 138 live bird markets (LBMs) across 17 different districts of Bangladesh. The quantity and origins of traded poultry were assessed for each poultry type in surveyed LBMs. The network of contacts between farms and LBMs resulting from commercial movements of live poultry was constructed to assess its connectivity and to identify the key premises influencing it.

RESULTS

Poultry trading practices varied according to the size of the LBMs and to the type of poultry traded. Industrial broiler chickens, the most commonly traded poultry, were generally sold in LBMs close to their production areas, whereas ducks and backyard chickens were moved over longer distances, and their transport involved several intermediates. The poultry trading network composed of 445 nodes (73.2% were LBMs) was highly connected and disassortative. However, the removal of only 5.6% of the nodes (25 LBMs with the highest betweenness scores), reduced the network's connectedness, and the maximum size of output and input domains by more than 50%.

CONCLUSIONS

Poultry types need to be discriminated in order to understand the way in which poultry trading networks are shaped, and the level of risk of disease spread that these networks may promote. Knowledge of the network structure could be used to target control and surveillance interventions to a small number of LBMs.

Nephrotoxic effects of Valeriana wallichii

Aminoglycosides are the commonly used antibiotics against Gram negative bacteria. Their clinical applications are limited due to nephrotoxic side effects. Therefore, the current study was undertaken in an attempt to increase the use of these drugs without causing nephrotoxicity by exploring the nephroprotective effects of a medicinal plant with high flavonoid contents and strong antioxidant properties, namely Valeriana wallichii. A daily dose of 200mg/kg of the extract derived from V. wallichii was employed for a period of three weeks. The results obtained revealed that co-therapy of extract with gentamicin protected some changes in renal functions; however, failed to provide a complete protection as assessed by biochemical, physiological and histological parameters. It can be concluded from the current findings that V. wallichii failed to deliver protective effects against gentamicin induced renal damage in spite of strong flavonoid contents and antioxidant properties.

Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis

BACKGROUND

The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis.

METHODS

We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses.

RESULTS

We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD -0.53, 95% CI -0.63, -0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores.

CONCLUSIONS

AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.

The variability in Oxford hip and knee scores in the preoperative period: is there an ideal time to score?

Background All NHS-funded providers are required to collect and report patient-reported outcome measures for hip and knee arthroplasty. Although there are established guidelines for timing such measures following arthroplasty, there are no specific time-points for collection in the preoperative period. The primary aim of this study was to identify whether there was a significant amount of variability in the Oxford hip and knee scores prior to surgical intervention when completed in the outpatient clinic at the time of listing for arthroplasty or when completed at the preoperative assessment clinic. Methods A prospective cohort study of patients listed for primary hip or knee arthroplasty was conducted. Patients were asked to fill in a preoperative Oxford score in the outpatient clinic at the time of listing. They were then invited to fill in the official outcome measures questionnaire at the preoperative assessment clinic. The postoperative Oxford score was then completed when the patient was seen again at their postoperative follow up in clinic. Results Of the total of 109 patients included in this study period, there were 18 (17%) who had a worse score of 4 or more points difference and 43 (39.4%) who had an improvement of 4 or more points difference when the scores were compared between time of listing at the outpatient and at the preoperative assessment clinic. There was a statistically significant difference (P = 0.0054) in the mean Oxford scores. Conclusions The results of our study suggest that there should be standardisation of timing for completing the preoperative patient-reported outcome measures.

Heterocyclic boronic acids display sialic acid selective binding in a hypoxic tumor relevant acidic environment

A group of heterocyclic boronic acids demonstrating unusually high affinity and selectivity for sialic acids are described, with strong interactions under the weakly acidic pH conditions associated with a hypoxic tumoral microenvironment.

Boronic acids are well known for their ability to reversibly interact with the diol groups found in sugars and glycoproteins. However, they are generally indiscriminate in their binding. Herein we describe the discovery of a group of heterocyclic boronic acids demonstrating unusually high affinity and selectivity for sialic acids (SAs or N-acetylneuraminic acid), which are sugar residues that are intimately linked with tumor growth and cancer progression. Remarkably, these interactions strengthen under the weakly acidic pH conditions associated with a hypoxic tumoral microenvironment. In vitro competitive binding assays uncovered a significantly higher ability of 5-boronopicolinic acid, one of the derivatives identified in this work as a strong SA-binder, to interact with cell surface SA in comparison to a gold-standard structure, 3-propionamidophenylboronic acid, which has proven to be an efficient SA-binder in numerous reports. This structure also proved to be suitable for further chemical conjugation with a well-preserved SA-binding capability. These findings suggest an attractive alternative to other ongoing boronic acid based chemistry techniques aiming to achieve tumor-specific chemotherapies and diagnoses.

Effects of Heliotropium strigosum and Trapa bicornis in hyperactive gut disorders

<p>The current study was aimed to investigate the extracts from <em>Heliotropium strigosum</em> and <em>Trapa bicornis</em> phytochemically for various constituents and pharmacologically for gastro-intestinal disorders. Phytochemical analysis indicated the presence of alkaloids, flavonoids, glycosides and tannins in both the extracts. In castor oil-induced diarrhea, <em>H. strigosum</em> and <em>T. bicornis</em>, at 100-1000 mg/kg dose provided protection of 10-83% and 14-76% respectively. In isolated rabbit jejunum preparations, <em>T. bicornis</em> (0.01-5 mg/mL) relaxed the spontaneous and K+ (80 mM)-induced contractions with EC&lt;sub&gt;50&lt;/sub&gt; values of 1.2 mg/mL and 2.6 mg/mL respectively, suggesting that spasmolytic effect was possibly mediated through calcium channel blockade. This was further authenticated when pretreatment of tissues with <em>T. bicornis</em> (1-5 mg/mL) caused rightward shift of Ca++ concentration–response curves, similar to verapamil. In acute toxicity test, both extracts were safe up to 10 g/kg dose. These results indicated the usefulness of <em>H. strigosum</em> and <em>T. bicornis</em> in the treatment of hyperactive gut disorders.</p>

A systematic review of Vancouver B2 and B3 periprosthetic femoral fractures

Aims

The aim of this study was to investigate the outcomes of Vancouver type B2 and B3 fractures by performing a systematic review of the methods of surgical treatment which have been reported.

Materials and Methods

A systematic search was performed in Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials. For inclusion, studies required a minimum of ten patients with a Vancouver type B2 and/or ten patients with a Vancouver type B3 fracture, a minimum mean follow-up of two years and outcomes which were matched to the type of fracture. Studies were also required to report the rate of re-operation as an outcome measure. The protocol was registered in the PROSPERO database.

Results

A total of 22 studies were included based on the eligibility criteria, including 343 B2 fractures and 167 B3 fractures. The mean follow-up ranged from 32 months to 74 months. Of 343 Vancouver B2 fractures, the treatment in 298 (86.8%) involved revision arthroplasty and 45 (12.6%) were treated with internal fixation alone. A total of 37 patients (12.4%) treated with revision arthroplasty and six (13.3%) treated by internal fixation only underwent further re-operation. Of 167 Vancouver B3 fractures, the treatment in 160 (95.8%) involved revision arthroplasty and eight (4.8%) were treated with internal fixation without revision. A total of 23 patients (14.4%) treated with revision arthroplasty and two (28.6%) treated only with internal fixation required re-operation.

Conclusion

A significant proportion, particularly of B2 fractures, were treated without revision of the stem. These were associated with a higher rate of re-operation. The treatment of B3 fractures without revision of the stem resulted in a high rate of re-operation. This demonstrates the importance of careful evaluation and accurate characterisation of the fracture at the time of presentation to ensure the correct management. There is a need for improvement in the reporting of data in case series recording the outcome of the surgical treatment of periprosthetic fractures. We have suggested a minimum dataset to improve the quality of data in studies dealing with these fractures. Cite this article: Bone Joint J 2017;99-B(4 Supple B):17–25.

Bacterial cellulose–TiO2 nanocomposites promote healing and tissue regeneration in burn mice model

The development of novel cutaneous wound treatments particularly for burns is of paramount importance due to complex pathophysiology, prevalent infection and clinical complexities associated with burn care.

Chemical composition and vascular and intestinal smooth muscle relaxant effects of the essential oil from Psidium guajava fruit

CONTEXT

Psidium guajava L. (Myrtaceae) is widely used in traditional medicine for the treatment of various ailments including cardiovascular and gastrointestinal disorders.

OBJECTIVES

The current study investigated the chemical composition and cardiovascular and gastrointestinal effects of the essential oil of P. guajava.

MATERIALS AND METHODS

The chemical composition of the essential oil was investigated using gas chromatography-mass spectrometry (GC-MS) technique. The biological activity of the essential oil was tested on rabbit aorta and jejunum. All changes in isometric tension were recorded through a force transducer coupled with a bridge amplifier data acquisition system.

RESULTS AND DISCUSSION

GC-MS analysis showed the presence of butanoic acid methyl ester, 3-methyl glutaric anhydride, 1-butanol, 3-hexenal, cinnamyl alcohol, 1-hexanol and hexane as the major components. In isolated rabbit aorta preparations, the essential oil showed vasorelaxation at doses of 3-10 mg/mL against high K⁺and phenylephrine pre-contractions with EC₅₀ values of 5.52 (5-6.04) and 6.23 mg/mL (5.0-7.46). The essential oil inhibited spontaneous and high K⁺induced contractions in isolated rabbit jejunum with EC₅₀ values of 0.84 (0.3-1.38) and 0.71 mg/mL (0.3-1.12) and shifted Ca ^+ 2 concentration curves to the right, similar to verapamil, suggesting spasmolytic activity mediated possibly through Ca ^+ 2 channel blockade.

CONCLUSIONS

In summary, the data indicated the presence of seven different phytoconstituents in the essential oil of P. guajava and calcium channel blocking activity, which provides a pharmacological base to the traditional use of P. guajava in cardiovascular and gastrointestinal disorders. Further studies are suggested to explore the molecular nature of these effects.

Advances in biomedical and pharmaceutical applications of functional bacterial cellulose-based nanocomposites

Bacterial cellulose (BC) synthesized by certain species of bacteria, is a fascinating biopolymer with unique physical and mechanical properties. BC's applications range from traditional dessert, gelling, stabilizing and thickening agent in the food industry to advanced high-tech applications, such as immobilization of enzymes, bacteria and fungi, tissue engineering, heart valve prosthesis, artificial blood vessels, bone, cartilage, cornea and skin, and dental root treatment. Various BC-composites have been designed and investigated in order to enhance its biological applicability. This review focuses on the application of BC-based composites for microbial control, wound dressing, cardiovascular, ophthalmic, skeletal, and endodontics systems. Moreover, applications in controlled drug delivery, biosensors/bioanalysis, immobilization of enzymes and cells, stem cell therapy and skin tissue repair are also highlighted. This review will provide new insights for academia and industry to further assess the BC-based composites in terms of practical applications and future commercialization for biomedical and pharmaceutical purposes.

Intestinal and vascular smooth muscle relaxant effect of Viscum album explains its medicinal use in hyperactive gut disorders and hypertension

Background

Viscum album has shown inhibitory effect on different smooth muscles but underlying mechanisms in gut and vascular smooth muscles are not well defined. Additionally, the plant has also importance in managing hyperactive gut and cardiovascular disorders. The current study was aimed to probe a pharmacological base of the smooth muscle relaxant effect of V. album in gut and vascular preparations.

Methods

V. album crude extract (Va. Cr) and its ethyl acetate fraction (Va. EtAc) were studied using in vitro techniques. The antispasmodic activity was performed using isolated rabbit jejunum while the vasorelaxant effects were studied in rabbit aortic rings.

Results

Va. Cr and Va. EtAc inhibited spontaneous and high K⁺-induced contractions with EC₅₀ values of 0.31 mg/mL (0.15–0.57) and 0.62 mg/mL (0.3–0.95), respectively. This advocates an antispasmodic effect probably operated through calcium channels blockade (CBB). The proposed mechanism was confirmed by a pretreatment of the tissue with Va. Cr (0.01–0.3 mg/mL), which shifted the Ca⁺⁺ concentration-response curves (CRCs) rightward, similar to verapamil. Moreover, Va. Cr showed a partial relaxation against high K⁺ and PE (1 μM) induced contractions in isolated rabbit aorta rings. Va. EtAc caused complete relaxation of high K⁺ precontraction and partially relaxed PE (1 μM) induced contractions, suggesting inhibitory effect on Ca⁺⁺ entry, in addition to other possible mechanisms. CRCs were shifted to the right correspondingly to verapamil when the aortic rings were pretreated with Va. Cr and Va. EtAc.

Conclusions

These data indicated that Va. Cr possesses smooth muscle relaxant effect mediated through voltage-dependent Ca⁺⁺ channel blockade (CCB), which explains its spasmolytic and vasorelaxant activity. The CCB activity is concentrated more in Va. EtAc. This study provides an evidence for the medicinal importance of V. album in gut spasm and possibly hypertension.

Factors associated with poor outcomes in patients with lupus nephritis

The objective of this study was to identify the factors associated with important clinical outcomes in a case-control study of 213 patients with lupus nephritis. Included were 47% Hispanics, 44% African Americans and 9% Caucasians with a mean age of 28 years. Fifty-four (25%) patients reached the primary composite outcome of doubling serum creatinine, end-stage renal disease or death during a mean follow-up of 37 months. Thirty-four percent African Americans, 20% Hispanics and 10% Caucasians reached the primary composite outcome ( P < 0.05). Patients reaching the composite outcome had predominantly proliferative lupus nephritis (WHO classes: 30% III, 32% IV, 18% V and 5% II, P < 0.025) with higher activity index score (7 ± 6 versus 5 ± 5, P<0.05), chronicity index (CI) score (4 ± 3 versus 2 ± 2 unit, P<0.025), higher baseline mean arterial pressure (MAP) (111 ± 21 versus 102 ± 14 mmHg, P<0.025) and serum creatinine (1.9 ± 1.3 versus 1.3 ± 1.0 mg/dL, P<0.025), but lower baseline hematocrit (29 ± 6 versus 31 + 5%, P<0.025) and complement C3 (54 ± 26 versus 65 + 33 mg/dL, P<0.025) compared to controls. More patients reaching the composite outcome had nephrotic range proteinuria compared to controls (74% versus 56%, P<0.025). By multivariate analysis, CI (hazard ratio [95% CI] 1.18 [1.07-1.30] per point), MAP (HR 1.02 [1.00-1.03] per mmHg), and baseline serum creatinine (HR 1.26 [1.04-1.54] per mg/dL) were independently associated with the composite outcome. We concluded that hypertension and elevated serum creatinine at the time of the kidney biopsy as well as a high CI are associated with an increased the risk for chronic renal failure or death in patients with lupus nephritis.

Calcium entry blocking activity of the <i>Elaeagnus umbellata</i> fruit extract explains its use in diarrhea and gut spasm

<p class="Abstract">This study was aimed to explore the pharmacological basis of potential medicinal use of <em>Elaeagnus umbellata</em> in gut disorders. Crude extract of <em>E. umbellata</em>, which was found positive for flavonoids, terpenoids and tannins, provided 9.9-71.9% protection in castor oil-induced diarrhea in mice, like verapamil. In isolated rabbit jejunum preparations, crude extract caused inhibition of spontaneous and high K⁺-induced contractions, with respective EC₅₀ values of  0.3 (0.1-0.5) and 0.5 mg/mL, suggesting Ca⁺⁺ channel blockade (CCB). Pretreatment of tissue with crude extract (0.1–1 mg/mL) caused a rightward shift in Ca⁺⁺ concentration-response curves. With the exception of aqueous fraction, <em>n</em>-hexane, chloroform and ethyl acetate inhibited spontaneous and high K⁺-induced contractions and displaced rightward Ca⁺⁺ concentration-response curves. Extract was found safe up to 10 mg/kg in mice. Our data shows that anti-diarrheal effect of crude extract of <em>E. umbellate</em> is due to CCB-mediated spasmolytic effect, concentrated in the ethyl acetate fraction and suggests its medicinal importance in diarrhea and spasm.</p><p><strong>Video Clip</strong></p><p><a href="https://youtube.com/v/Qo_y3ULC4E0">Isolation of rat jejunum</a>:  2 min 32 sec </p>

A Fellowship Further Afield

In the current climate of uncertainty over trainee working conditions and uneasy medical politics, more and more trainees are choosing to take planned time out of training. This is no longer considered an activity that unnecessarily prolongs one's training, and is generally welcomed by trainees and training programme directors alike.

Production, characterization and biological features of bacterial cellulose from scum obtained during preparation of sugarcane jaggery (gur)

Bacterial cellulose (BC) has been given an ample attention due to its high potential for many industrial applications. However, the high cost of production medium has hindered the commercialization of BC. Several efforts have been made to explore cheep, raw and waste sources for BC production. The current study aims at investigating the BC production from a waste source; the scum obtained during preparation of sugarcane jaggery or gur (JS). JS was five-fold diluted with distilled water and used as culturing medium without any additional nutrients. The production of BC was monitored till 10th days of cultivation both at static and shaking culturing conditions. A maximum of 2.51 g/L and 2.13 g/L BC was produced in shaking and static cultures, respectively, after 10 days. The structure features of BC were confirmed through FTIR, XRD and SEM analysis. The chemical structure and physical appearance strongly resembled the BC produced form synthetic media. It was noteworthy that the BC produced from JS showed higher mechanical and thermal properties. The cell adhesion and proliferation capabilities of produced BC were observed that depicted definite animal cell adhesion without any considerable cytotoxicity. Besides providing an economically feasible way for BC production, the high level of physico-mechanical and biological properties insured the importance in medical fields.

Nephro-protective potential of Morus alba, a prospective experimental study on animal models

CONTEXT

Morus alba L. (Moraceae) is traditionally used for the treatment of urinary incontinency due its strong diuretic properties.

OBJECTIVE

The present study explores the renal protective effects of M. alba, due to its free radical scavenging properties, in order to provide experimental evidence for its established use.

MATERIALS AND METHODS

Ethanolic extract (200 mg/kg/d) derived from M. alba fruit was employed in rabbits as a co-therapy (GM-al) with gentamicin (80 mg/kg/d) for a period of 3 weeks. Biochemical kidney functioning parameters, urinary isozymes, and histopathological examination were performed.

RESULTS

The results showed that ethanol extract of Morus alba L. prevented alterations in serum creatinine (4.02 ± 0.14, p < 0.0001), blood urea nitrogen (54.18 ± 2.60, p < 0.0001), and serum uric acid levels (2.34 ± 0.12, p < 0.001). However, a decrease in creatinine clearance and urinary volume was observed in experimental groups. Histopathological examination and urinary enzymes excretion also suggested the protective role of the extract.

DISCUSSION AND CONCLUSIONS

The co-administration of M. alba with gentamicin prevented renal functioning alterations expected with the use of gentamicin alone. Therefore, it can be concluded that M. alba to protect from kidney damage, which may be because of its free radical scavenging and diuretic properties.

Otolaryngological complications of occipitocervical injury

Occipitocervical injuries are rare, accounting for 15% of all fatal spinal trauma. In patients who survive the initial incident, early detection and appropriate management is vital to avoid significant neurological disability and mortality. We present the case of a patient with neck trauma who was initially cleared of spinal injuries in the emergency department but who later developed acute hearing loss. We describe how the investigation of the hearing loss led to the detection of this devastating injury and report its successful management. Patients with persistent neck pain following trauma, particularly in the presence of degenerative spinal disease, should have cervical spine computed tomography to exclude occipitocervical injuries and other occult injuries.

Nephroprotective potentials of Citrus aurantium: a prospective pharmacological study on experimental models

Citrus aurantium is traditionally used in various kidney problems like burning of urine, urinary hesitancy and renal colic. The main objective of the present work was to evaluate the protective role of Citrus aurantium against gentamicin induced renal damage, due to its free radical scavenging properties to present experimental facts for their traditional use. 200 mg/kg/day of ethanolic extract of the plant employed in combination with the toxic doses of gentamicin for twenty-one days. The group GC-au (animals treated with co-administration of Citrus aurantium and gentamicin) protected renal damage expected with gentamicin, assessed by known functional and morphological parameters, significantly different from group G (animals treated with gentamicin). All the renal functioning parameters including; Blood urea nitrogen, Serum creatinine, Serum uric acid, Creatinine clearance, Serum electrolytes, Body weight, Urinary volume, Enzyme excretions, Urinary protein excretions and histological examination was performed for each and every group animals. The plant extract proved to have nephroprotective potentials may because of its known flavonoid contents and antioxidant properties.

Mentha piperita in nephrotoxicity--a possible intervention to ameliorate renal derangements associated with gentamicin

OBJECTIVE

Free radical generation has a strong role in the pathogenesis of renal damage associated with the use of gentamicin. Therefore, the present study was carried out to evaluate the renoprotective effect of Mentha piperita against gentamicin induced nephrotoxicity.

MATERIALS AND METHODS

A total of 24 male rabbits were divided into 4 groups receiving normal saline, gentamicin, M. piperita extract and co-therapy of extract and gentamicin respectively. Gentamicin was provided as 80 mg/kg/day intramuscularly and extract was given 200 mg/kg/day orally for a period of 21 days. Serum and urinary biochemical parameters and histological changes were studied for each group. The impact of the extract on the antibacterial action of gentamicin was also evaluated.

RESULTS

Animals treated with gentamicin showed derangements in serum and urinary biochemical parameters. These alterations were reversed by treatment with M. piperita extract. The histological changes showed in gentamicin group were also reverted by treatment with the extract. Further the plant did not influence the efficacy of gentamicin with respect to its antimicrobial properties.

CONCLUSION

Co-therapy of M. piperita with gentamicin successfully attenuated biochemical kidney functioning derangements and morphological changes associated with gentamicin.

Protective potential of Tamarindus indica against gentamicin-induced nephrotoxicity

Abstract Context: Gentamicin is an antibiotic that is effective against Gram-negative microorganisms. However, its clinical applications are often limited due to nephrotoxic effects. Objective: This study investigated the protective effects of aqueous-ethanol extract of Tamarindus indica L. (Leguminosae) fruits against gentamicin-induced renal toxicity. Materials and methods: A daily dose of 200 mg/kg of 70% aqueous-ethanol extract derived from T. indica was employed in male rabbits as a co-therapy with gentamicin (80 mg/kg) for a period of three weeks. Serum and urinary renal function parameters and histological assessments were carried out and compared with one way analysis of variance (Graphpad prism version 5.00, Graphpad Software, San Diego, CA). Results: The results showed that gentamicin-treated animals had significantly elevated blood urea nitrogen (54.1 ± 2.6 mg/dl), serum creatinine (4.0 ± 0.1 mg/dl), serum uric acid (2.3 ± 0.1 mg/dl) and urinary protein excretion (3.8 ± 0.3 mg/dl) with a fall in body weight (10 ± 1%), creatinine clearance (0.7 ± 0.09 ml/min), serum potassium (3.4 ± 0.1 mEq/l), serum calcium (7.6 ± 0.2 mg/dl), urinary volume (126 ± 9 ml/24 h) and urinary lactate dehydrogenase secretion (103.1 ± 4.2 U/l). However, animals treated by co-therapy with gentamicin and T. indica had significantly improved renal structure and function. Discussion and conclusion: Co-therapy of 200 mg/kg/d of T. indica for a period of three weeks successfully prevented functional and morphological derangements caused by gentamicin as assessed by different renal function parameters and histological examinations.

Interaction of nanomaterials with cells and their medical applications

Many studies have been conducted on the development of nanomaterials for medical applications. The interaction of nanomaterials with human cells is the most important criterion for biomedical application and has been studied in detail. Three common approaches have been suggested for nanomaterial mechanisms for cellular interaction and internalization: direct diffusion or disruption to the plasma membrane, endocytosis, and entry through ion channels and transporter proteins. Several important factors affect the interaction and cellular uptake of nanomaterials: size, shape, rigidity, surface properties, cell type, and endocytotic pathways. In this review, we summarize the mechanisms of cell-nanomaterial interactions, and the various factors that influence these interactions. The importance of proper cell-nanomaterial interaction for medical research applications is also highlighted. The results summarized in this review may add new dimensions to our understanding of cell-nanomaterial interactions and their applications in therapeutic and diagnostic techniques for biomedical, academic, and industrial research.

The outcome of paediatric LCP hip plate use in children with and without neuromuscular disease

BACKGROUND

The relatively new paediatric LCP hip plate (Synthes GmBH Eimattstrasse 3 CH-4436 Oberdorff) is used in children, both with and without neuromuscular disease, for fixation of proximal femoral osteotomy for a variety of indications.

MATERIALS AND METHODS

We retrospectively reviewed the notes and radiographs of all those children who have had paediatric LCP device for the fixation of proximal femoral osteotomy and proximal femur fractures in our institution (Royal Manchester Children's Hospital), between October 2007 and July 2010, for their clinical progress, mobilization status, radiological healing and any complications.

RESULTS

Forty-three paediatric LCP hip plates were used in 40 patients (27 males and 13 females) for the fixation of 40 proximal femoral osteotomies and three proximal femur fractures. This included 13 children with underlying neuromuscular pathology and 27 children without neuromuscular disease. All osteotomies and fractures radiologically healed within 6 months [majority (n = 40) within 3 months]. There was no statistically significant difference (p = 0.45) in the neck shaft angle between the immediately post-operative and final X-rays after completion of bone healing. There were no implant-related complications both in patients with and without neuromuscular disease. No metalwork loosening was observed and no plate revisions were required. Three post-operative fractures occurred in patients with neuromuscular pathology treated with post-operative plaster immobilisation.

CONCLUSION

The paediatric LCP hip plate provides a stable and reliable fixation of the proximal femoral osteotomy performed for a variety of paediatric orthopaedic conditions.

Identification of genome regions controlling cotyledon, pod wall/seed coat and pod wall resistance to pea weevil through QTL mapping

Pea weevil, Bruchus pisorum, is one of the limiting factors for field pea (Pisum sativum) cultivation in the world with pesticide application the only available method for its control. Resistance to pea weevil has been found in an accession of Pisum fulvum but transfer of this resistance to cultivated pea (P. sativum) is limited due to a lack of easy-to-use techniques for screening interspecific breeding populations. To address this problem, an interspecific population was created from a cross between cultivated field pea and P. fulvum (resistance source). Quantitative trait locus (QTL) mapping was performed to discover the regions associated with resistance to cotyledon, pod wall/seed coat and pod wall resistance. Three major QTLs, located on linkage groups LG2, LG4 and LG5 were found for cotyledon resistance explaining approximately 80 % of the phenotypic variation. Two major QTLs were found for pod wall/seed coat resistance on LG2 and LG5 explaining approximately 70 % of the phenotypic variation. Co-linearity of QTLs for cotyledon and pod wall/seed coat resistance suggested that the mechanism of resistance for these two traits might act through the same pathways. Only one QTL was found for pod wall resistance on LG7 explaining approximately 9 % of the phenotypic variation. This is the first report on the development of QTL markers to probe Pisum germplasm for pea weevil resistance genes. These flanking markers will be useful in accelerating the process of screening when breeding for pea weevil resistance.

Controversies in the management of congenital pseudarthrosis of the tibia and fibula

Congenital pseudarthrosis of the tibia (CPT) is a rare but well recognised condition. Obtaining union of the pseudarthrosis in these children is often difficult and may require several surgical procedures. The treatment has changed significantly since the review by Hardinge in 1972, but controversies continue as to the best form of surgical treatment. This paper reviews these controversies.

Cite this article: Bone Joint J 2013;95-B:1027–34.

Citrullus colocynthis failed to combat against renal derangements, in spite of its strong antioxidant properties

Gentamicin is a potent antibiotic, effective against Gram negative bacteria. The most common adverse effect of gentamicin is nephrotoxicity. Present study was aimed to explore the protective potentials of Citrullus colocynthis against gentamicin induced nephrotoxicity due to its strong antioxidant properties. Toxic doses of gentamicin (80 mg/kg/day, i.m.) were administered alone and as co-therapy with the extract of C. colocynthis (25 mg/kg/day, p.o.). Physiological, biochemical and histological examinations were performed to compare the experimental and toxic groups (n = 6) with control group animals. Co-therapy of C. colocynthis with gentamicin protected changes in the body weight, blood urea nitrogen, creatinine clearance, proteins and lactate dehydrogenase excretions. However, a significant rise in serum creatinine and serum uric acid with fall in serum calcium and serum potassium was observed, which were significantly different from control group animals. Necrotic and ruptured tubules were also found abundantly. This study revealed that co-theapy of C. colocynthis with gentamicin for twenty one days, failed to protect renal injury associated by gentamicin in spite of its strong antioxidant properties.

Do South African general practitioners believe that ‘Exercise is Medicine’?

Background. Physical activity (PA) has been described as medicine, owing to the clear evidence for its role in the prevention and management of various diseases.Objectives. To determine the knowledge, perceptions and attitudes of South African general practitioners (GPs) towards the promotionof PA.Methods. A total of 255 private-sector GPs from various provinces in SA participated in our cross-sectional study, by completing a selfreportquestionnaire surveying their knowledge, perceptions and attitudes towards the promotion of PA.Results. The findings indicated that South African GPs in general do promote PA to their patients for treatment and health promotion. Themajority of GPs in our study strongly believed that promoting PA is an important part of primary healthcare. The GPs frequently promotedexercise in the treatment of obesity, type 2 diabetes and hyperlipidaemia.Conclusion. South African GPs appear to be recommending PA to their patients at a primary-care level. Clear practice guidelines are needed to promote PA in a way that will have a population-level impact. To aid this, GPs are encouraged to provide written information to promote PA in a way that will have an effect.