Sacubitril and valsartan protect from experimental myocardial infarction by ameliorating oxidative damage in Wistar rats

BACKGROUND

Sacubitril (SAC), a neprilysin inhibitor prevent degradation of neprilysin and activate cGMP signaling pathways leading to rise in blood volume concurrent to blood pressure by means of vasoactive peptides, adrenomedullin, and bradykinin.

OBJECTIVE

The aim of this study was to evaluate the anti-ischemic effects of SAC through inhibiting neprilysin in isoproterenol (ISO) induced myocardial infarction (MI) in Wistar albino rats. ISO (85 mg/kg) was injected subcutaneously at the end of 14 days pre-treatment with SAC and valsartan (VAL).

RESULT

Biochemical investigation revealed that SAC along with VAL significantly prevented the antioxidant enzymes (SOD, Catalase, GR, GPx, GST, and GSH) degradation and malondialdehyde (MDA) induced by ISO intoxication in Wistar rats. Along with this, cardiac biomarkers (LDH, CK-MB, ALT, AST, and ALP) were also significantly ameliorated by SACand VAL in ISO-treated rats. Concurrently, decreased infarction area (IA)and marked reduction in myofibril damage by SACand VAL further supported its protective benefits in MI.

CONCLUSION

Taken together, the results suggest that inhibition of enzyme neprilysin alleviated the ISO induces myocardial damage mediated by its strong antioxidant potential.

Prevalence of foot and mouth disease virus in apparently healthy buffaloes brought to Islamabad slaughterhouse in Pakistan

This study was conducted to determine the sero-prevalence of foot and mouth disease (FMD) in buffaloes (Bubalus bubalis) slaughtered at Islamabad slaughterhouse, Pakistan. Sera and oro-pharyngeal (OP) fluid were collected from 630 healthy buffaloes. These animals originated from various livestock markets from 14 districts of Punjab. The age of animals ranged from 1 to 15 years. Sera were analyzed using FMD virus (FMDV) nonstructural proteins (NSP) and indirect ELISA. The sero-prevalence of FMD was 47.1% (n=297). There was a strong association between age of animal and its risk of being positive for FMD NSP ELISA (Odds ratio 1.27; p<0.001; CI 1.22-1.32). The OP fluids were tested for the presence of FMDV by real time PCR. FMDV specific signals were detected in 33 samples (11.1%). Virus recovery attempts were made after treating them with tri-chloro-tri-flouroethane onto LFBK cell line and four FMD isolates were recovered. This study indicated high sero-prevalence of FMDV in buffaloes slaughtered at abattoir in Islamabad. Furthermore, the virus recovery from these animals is suggestive of their possible role in persistence and transmission of FMDV to other animals.

The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis

Objective

To assess the impact of surgical management of endometrioma on the outcome of assisted reproduction treatment (ART).

Design

A systematic review and meta-analysis.

Setting

Department of reproductive medicine at teaching university hospital, UK.

Patients

Subfertile women with endometrioma undergoing ART.

Interventions

Surgical removal of endometrioma or expectant management.

Main outcome measures

Clinical pregnancy rate, pregnancy rate, live birth rate, number of oocytes retrieved and number of embryos available and ovarian response to gonadotrophins.

Results

An extensive search of electronic databases for articles published from inception to September 2016 yielded 11 eligible studies for meta-analysis. Meta-analysis was conducted comparing surgery versus no treatment of endometrioma. There were no significant differences in pregnancy rate per cycle, clinical pregnancy rate and live birth rate between women who underwent surgery for endometrioma and those who did not.

Conclusion

Current evidence suggests that women with endometriosis-related infertility have similar cycle outcomes to other patients going through ART. It is pertinent for clinicians to assess the risks of surgical intervention on ovarian reserve prior to initiating therapy.

A case report on a rare presentation of solitary rectal ulcer syndrome

We describe a highly unusual case of solitary rectal ulcer syndrome (SRUS) that presented as a large polyp protruding from the anal canal. A 67-year-old man presented with rectal bleeding and mucus discharge. At examination under anaesthesia, a large pedunculated polypoidal lesion was found, measuring 25 × 20 mm, arising posterolaterally from the anorectal junction and protruding externally 50 mm in size. SRUS can be a misnomer as the condition can present in a number of different ways and only a minority of patients has a solitary ulcer. Other findings include multiple ulcers, hyperaemic mucosa or a broad-based polypoidal mass. In this case, a rare presentation of SRUS in the form of a large polyp was confirmed by histology. A key learning point is to remember that although less common than other causes of rectal symptoms, it should be considered as part of the differential diagnosis once sinister causes have been excluded.

Rosuvastatin ameliorates cognitive impairment in rats fed with high-salt and cholesterol diet via inhibiting acetylcholinesterase activity and amyloid beta peptide aggregation

Amyloid beta (Aβ) peptide aggregation and cholinergic neurodegeneration are involved in the development of cognitive impairment. Therefore, in this article, we examined rosuvastatin (RSV), an oral hypolipidemic drug, to determine its potential as a dual inhibitor of acetylcholinesterase (AChE) and Aβ peptide aggregation for the treatment of cognitive impairment. Molecular docking study was done to examine the affinity of RSV with Aβ_1-42 and AChE in silico. We also employed neurobehavioral activity tests, biochemical estimation, and histopathology to study the anti-Aβ_1-42 aggregation capability of RSV in vivo. Molecular docking study provided evidence that RSV has the best binding conformer at its receptor site or active site of an enzyme. The cognitive impairment in female Wistar rats was induced by high-salt and cholesterol diet (HSCD) ad libitum for 8 weeks. RSV ameliorated serum cholesterol level, AChE activity, and Aβ_1-42 peptide aggregations in HSCD induced cognitive impairment. In addition, RSV-treated rats showed greater scores in the open field (locomotor activity) test. Moreover, the histopathological studies in the hippocampus and cortex of rat brain also supported that RSV markedly reduced the cognitive impairment and preserved the normal histoarchitectural pattern of the hippocampus and cortex. Taken together, these data indicate that RSV may act as a dual inhibitor of AChE and Aβ_1-42 peptide aggregation, therefore suggesting a therapeutic strategy for cognitive impairment treatment.

Structural studies of substrate and product complexes of 5-aminolaevulinic acid dehydratase from humans,Escherichia coliand the hyperthermophilePyrobaculum calidifontis

A number of X-ray analyses of an enzyme involved in a key early stage of tetrapyrrole biosynthesis are reported. Two structures of human 5-aminolaevulinate dehydratase (ALAD), native and recombinant, have been determined at 2.8 Å resolution, showing that the enzyme adopts an octameric quaternary structure in accord with previously published analyses of the enzyme from a range of other species. However, this is in contrast to the finding that a disease-related F12L mutant of the human enzyme uniquely forms hexamers [Breiniget al.(2003),Nature Struct. Biol.10, 757–763]. Monomers of all ALADs adopt the TIM-barrel fold; the subunit conformation that assembles into the octamer includes the N-terminal tail of one monomer curled around the (α/β)8barrel of a neighbouring monomer. Both crystal forms of the human enzyme possess two monomers per asymmetric unit, termedAandB. In the native enzyme there are a number of distinct structural differences between theAandBmonomers, with the latter exhibiting greater disorder in a number of loop regions and in the active site. In contrast, the second monomer of the recombinant enzyme appears to be better defined and the active site of both monomers clearly possesses a zinc ion which is bound by three conserved cysteine residues. In native human ALAD, theAmonomer also has a ligand resembling the substrate ALA which is covalently bound by a Schiff base to one of the active-site lysines (Lys252) and is held in place by an ordered active-site loop. In contrast, these features of the active-site structure are disordered or absent in theBsubunit of the native human enzyme. The octameric structure of the zinc-dependent ALAD from the hyperthermophilePyrobaculum calidifontisis also reported at a somewhat lower resolution of 3.5 Å. Finally, the details are presented of a high-resolution structure of theEscherichia coliALAD enzyme co-crystallized with a noncovalently bound moiety of the product, porphobilinogen (PBG). This structure reveals that the pyrrole side-chain amino group is datively bound to the active-site zinc ion and that the PBG carboxylates interact with the enzymeviahydrogen bonds and salt bridges with invariant residues. A number of hydrogen-bond interactions that were previously observed in the structure of yeast ALAD with a cyclic intermediate resembling the product PBG appear to be weaker in the new structure, suggesting that these interactions are only optimal in the transition state.

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

A report on the molecular detection and seasonal prevalence of Trypanosoma brucei in Dromedary Camels from Dera Ghazi Khan District in Southern Punjab (Pakistan)

The present study was designed for molecular detection of Trypanosoma brucei through PCR, by using kinetoplast DNA (kDNA) maxicircle primers, on seasonal basis and to demonstrate the effect of this parasite on complete blood count and selected parameters of serum biochemistry in camels from Southern Punjab (Pakistan). A total of 291 camel blood samples (61 male, 230 females) were collected from Dera Ghazi Khan District in Pakistan during March 2012 till February 2013 for Trypanosoma brucei detection by blood smear screening, micro hemato centrifugation and Polymerase chain reaction techniques. Twenty eight out of 291 blood samples (9.62%) produced a 164 bp DNA fragment specific for T. brucei. Only 6 blood samples (2.06%) were found parasite positive by microscopic examination and 13 (4.46%) were positive for microhematocrit centrifugation technique. Seasonal PCR based prevalence of trypanosomiasis was 6.9%, 13.7%, 9.7% and 8.1% during spring, summer, autumn and winter seasons respectively. T. brucei prevalence was not restricted to a particular age group or and gender of the studied animals (P > 0.05). A significant increase in WBC (P = 0.001), neutrophils (P = 0.004), ALT (P = 0.028) and decreased RBC (P < 0.000), hemoglobin (P < 0.000) and packed cell volume (P < 0.000) were detected in parasite positive as compared to the parasite negative blood samples. In conclusion, PCR is a more reliable and sensitive technique than conventional microscopic blood screening and microhematocrit centrifugation for the detection of T. brucei in camel blood. We recommend the use of PCR for the effective prophylactic detection of T. brucei in livestock in order to reduce economic losses.

Protective Effect of Guggulipid in High Fat Diet and Middle Cerebral Artery Occlusion (MCAO) Induced Ischemic Cerebral Injury in Rats

AIM

The role of guggulipid was evaluated in high fat diet and middle cerebral artery occlusion (MCAO) induced ischemic cerebral dysfunctions in rats of either sex.

MATERIALS AND METHODS

Ethyl acetate extract of guggul known as guggulipid was prepared and administered to rats. Animals were divided into 9 groups, consisting 6 rats, each receiving different treatments per orally for 8 weeks. Control group rats received normal control diet while rest of the other groups animals were fed high fat diet (HFD) for 8 weeks. Cerebral ischemia was induced for 2 h followed by reperfusion for 22 h. Locomotor activity and grip strength tests were performed immediately after 24 h of reperfusion followed by biochemical estimations and histopathology.

RESULTS

Locomotor activity and grip strength were significantly decreased in HFD and HFD fed MCAO groups and improved significantly in pretreatment groups. Cerebral infarction, thiobarbituric acid reactive substances (TBARs), nitric oxide and tumor necrosis factor alfa (TNFα) levels were increased, pretreatment of guggulipid alone and with aspirin significantly reduced these markers. Reduced glutathione (GSH), superoxide dismutase (SOD) and catalase, levels were decreased but all drug pretreated groups showed significant improvement in those markers.

CONCLUSION

Guggulipid demonstrated neuroprotection owing to its hypolipidemic, antioxidant, anti-inflammatory and anti-thrombotic activities but further research is warranted to confirm its role in cerebral ischemia.

Histamine H3 Receptor Agonist Imetit Attenuated Isoproterenol Induced Renin Angiotensin System and Sympathetic Nervous System Overactivity in Myocardial Infarction of Rats

BACKGROUND

Myocardial infarction is an alarming health issue, needs great attention. The present study investigated the role of histamine-H3 receptor (H3R) agonist imetit in relationship to sympathetic and renin angiotensin system in Wistar rats.

MATERIALS AND METHODS

Subcutaneous injection of isoproterenol (85 mg/kg) on last 2 consecutive days in per se group and 7 days treatment of different groups at 24 h interval induced myocardial infarction in Wistar rats. H3R agonist imetit (10 mg/kg), H3R antagonist thioperamide (5 mg/kg), losartan (10 mg/kg) were administered orally to evaluate imetit's cardioprotective potential effect by measuring plasma cardiac antioxidant markers, angiotensin II, norepinephrine levels and histopathological analysis.

RESULTS

Isoproterenol significantly elevated the angiotensin II and norepinephrine levels in rat plasma. This study revealed that pre-treatment with imetit similar to losartan attenuated norepinephrine and angiotensin II levels whereas thioperamide showed its antagonistic effect by diminishing imetit's effects. Furthermore, its protective effect was confirmed by restoration of cardiac antioxidant markers and histopathological improvement of myocardium integrity.

CONCLUSION

This study confirm imetit's cardioprotective potential and also reveals renin angiotensin system, sympathetic system and H3R correlation in isoproterenol induced toxicity in rats. However, molecular studies must be warranted to prove the role of H3R in myocardial infarction.

The Effect of Subchronic Dosing of Ciproxifan and Clobenpropit on Dopamine and Histamine Levels in Rats

The present study was designed to investigate the effect of once daily for 7-day (subchronic treatment) dosing of histamine H₃ receptor antagonists, ciproxifan (CPX) (3 mg/kg, i.p.), and clobenpropit (CBP) (15 mg/kg, i.p), including clozapine (CLZ) (3.0 mg/kg, i.p.) and chlorpromazine (CPZ) (3.0 mg/kg, i.p.), the atypical and typical antipsychotic, respectively, on MK-801(0.2 mg/kg, i.p.)-induced locomotor activity, and dopamine and histamine levels in rats. Dopamine and histamine levels were measured in striatum and hypothalamus, respectively, of rat brain. Atypical and typical antipsychotics were used to serve as clinically relevant reference agents to compare the effects of the H3 receptor antagonists. MK-801-induced increase of horizontal activity was reduced with CPX and CBP. The attenuation of MK-801-induced locomotor hyperactivity produced by CPX and CBP was comparable to CLZ and CPZ. MK-801 raised dopamine levels in the striatum, which was reduced in rats pretreated with CPX and CBP. CPZ also lowered striatal dopamine levels, though the decrease was less robust compared to CLZ, CPX and CBP. MK-801 increased histamine content although to a lesser degree. Subchronic treatment with CPX and CBP exhibited further increase in histamine levels in the hypothalamus compared to the MK-801 treatment alone. Histamine H₃ receptor agonist, R-α methylhistamine (10 mg/kg, i.p.) counteracted the effects of CPX and CBP. In conclusion, the subchronic dosing of CPX/CBP suggests some antipsychotic-like activities as CPX/CBP counteracts the modulatory effects of MK-801 on dopamine and histamine levels and prevents MK-801-induced hyperlocomotor behaviors.

Effects of an Educational Module in Rationalizing Surgical Prophylaxis

Assessment of current antibiotic prescribing patterns is an important step towards appropriate use of antimicrobial agents. This study was planned to know the surgical prophylaxis practices and the influence of educational intervention. In this educational interventional study, only clean and clean-contaminated surgeries were included. Preinterventional study was done by collecting data regarding the use of surgical prophylaxis in the Department of Surgery. After analyzing the preinterventional data, educational intervention was done. A pretest questionnaire was given to all the surgeons to assess knowledge and practice of surgical prophylaxis in our institute. The questionnaire was designed to collect information regarding the use of prophylactic antibiotic, its duration, time of administration, and prevention of surgical site infections (SSI). In our study, third-generation cephalosporin was used in maximum cases in preinterventional analysis and prophylaxis was continued for 3-5 days. Surgeon's decision in selecting a prophylactic agent was based on information taken from departmental colleagues or drug companies. Two or more doses of antibiotic were used even when duration of surgery did not exceed more than two and half hours. Definite improvement was seen after the education where single antibiotic was used as prophylactic drug and the first dose of antibiotic was administered 30 to 60 min before incision. This shows that educational intervention makes a change in antibiotic prescribing habit. Hence, there is an urgent need for adoption of specific guidelines to ensure standardization of surgical antibiotic prophylaxis practices in hospitals.