Concomitant gentamicin-induced nephrotoxicity and bilateral ototoxicity

Early hearing threshold changes and peculiarities of audiometric assessments among patients in a drug-resistant tuberculosis treatment center

Background

Hearing threshold changes occurred relative to baseline at both one and two weeks after onset of aminoglycoside therapy.

Objectives

To assess changes in audiometric hearing thresholds between pre-treatment values and two weeks into therapy. To document observed changes, and occurrence of ototoxicity within the period.

Methods

Prospective analytical cohort study on drug-resistant tuberculosis patients. Basic demographic parameters were taken. Three-point audiometric assessments within two weeks into therapy were done. Percentage of patients with ototoxicity were calculated. Pure tone threshold changes between the three audiometric values were compared.

Results

Audiograms of 53 patients comprising 56.6% males; age range was 13 to 91 years. Both air and bone conduction hearing thresholds significantly worsened between baseline and one week into therapy (p=0.011, and 0.015 respectively), and between baseline and two weeks into therapy (p=0.003 and 0.042 respectively). Minimal insignificant reduction occurred between both air and bone conduction hearing values of week 1 and week 2 of therapy (p= 1.000 and 0.856 respectively). By audiometric criteria, 4 patients (7.5%) developed ototoxicity within two weeks of treatment.

Conclusion

Audiometric assessments within two weeks into therapy with anti-tuberculous therapy may not represent baseline audiometry. 7.5% of the patients developed ototoxicity within two weeks of therapy.

Role of Olive leaves Zinc Oxide Nanoparticles in Alleviating The Molecular and Histological Changes of Kidney in Female Goats-Induced by Gentamicin (Part III)

This study aimed to investigate the protective influence of olive leave extract zinc oxide nanoparticles (OLEZnONPs) complex against gentamicin–induced kidney dysfunctions in goats. Twenty five adult female goats were randomly divided into five equal groups and treated as follows: control group (C) administered sterile distilled water (IM) for 10 days, group G administered 25 mg/kg BW gentamicin (IM) for 7 days, group Z administered 10 ìg/kg BW of OLEZnONPs (IP) for 3 days, group GTZ administered 25 mg/kg BW gentamicin (IM) for 7 days and then 10 ìg/kg BW of OLEZnONPs (IP) for 3 days, group GWZ administered 25 mg/kg BWs gentamicin (IM) and 10 ìg/kg BW of OLEZnONPs (IP) together for first 3 days and then followed by gentamicin only for 4 days. After seven days of the experiment, the gene expression of kidney injury molcule-1(KIM-1) and neutrophil gelatinase-association lipocalin (NGAL) gene expression of kidney tissue were measured. In addition, samples of kidney were obtained for histopathological examination. Gentamicin medication induced a marked elevation in kidney tissue KIM-1 and NGAL gene expression in G and GTZ groups compared to control and other groups. Intraperitoneal treatment of goats with OLEZnONPs did not significantly affect NGAL and KIM-1 gene expression in Z, GWZ, and control groups. Histologically, in contrast to control, gentamicin induced more extensive kidney damages such as necrotized glomeruli, atrophic glomeruli, and renal tubular epithelial necrosis, while it was found that these alterations in kidney tissues wereimproved in goats given OLEZnONPs with gentamicin compared to group G. In conclusion, our results demonstrate that OLEZnONPs reduce the deleterious effects of gentamicin with significantly decreasing of KIM-1 and NGAL gene expression and remodeling the histological changes of kidney in goats.

Ototoxicity: The Radical Drum Beat and Rhythm of Cochlear Hair Cell Life and Death

The function and structure of the auditory information processing system establishes a unique sensory environment for the "perfect storm." The battle between life and death pits the cascade of an apoptotic storm, programmed cell death cascades, against simple cell death (necrosis) pathways. Live or die, the free radical biology of oxygen and hydroxylation, and the destruction of transition metal migration through the mechanical gate sensory processes of the hair cell lead to direct access to the cytoplasm, cytoplasmic reticulum, and mitochondria of the inner workings of the hair cells. These lead to subsequent interactions with nuclear DNA resulting in permanent hearing loss. The yin and yang of pharmaceutical product development is to document what kills, why it kills, and how do we mitigate it. This review highlights the processes of cell death within the cochlea.