Epidemic dropsy: observations on pathophysiology and clinical features during the Delhi epidemic of 1998

Identification of Sanguinarine Metabolites in Rats Using UPLC-Q-TOF-MS/MS

Sanguinarine (SAN), as the main active component of a traditional Chinese veterinary medicine, has been widely used in the animal husbandry and breeding industry. However, the metabolites of SA are still uncertain. Therefore, this research aimed to investigate the metabolites of SA based on rats in vivo. The blood, feces, and urine of rats were collected after the oral administration of 40 mg/kg SAN. Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS) was employed to identify the metabolites of SAN. The elemental composition of sanguinarine metabolites was inferred by analyzing their exact molecular weight, and the structures of the metabolites were predicted based on their fragment ions and cleavage pathways. A total of 12 metabolites were identified, including three metabolites in the plasma, four in the urine, and nine in the feces. According to the possible metabolic pathways deduced in this study, SAN was mainly metabolized through reduction, oxidation, demethylation, hydroxylation, and glucuronidation. This present research has summarized the metabolism of SAN in rats, which is helpful for further studying the metabolic mechanism of SAN in vivo and in vitro.

Plant vs. Kidney: Evaluating Nephrotoxicity of Botanicals with the Latest Toxicological Tools

Botanicals can cause nephrotoxicity via numerous mechanisms, including disrupting renal blood flow, damaging compartments along the nephron, and obstructing urinary flow. While uncommon, there are various reports of botanical-induced nephrotoxicity in the literature, such as from aristolochia (Aristolochia spp.) and rhubarb (Rheum spp.). However, at present, it is a challenge to assess the toxic potential of botanicals because their chemical composition is variable due to factors such as growing conditions and extraction techniques. Therefore, selecting a single representative sample for an in vivo study is difficult. Given the increasing use of botanicals as dietary supplements and herbal medicine, new approach methodologies (NAMs) are needed to evaluate the potential for renal toxicity to ensure public safety. Such approaches include in vitro models that use layers of physiological complexity to emulate the in vivo microenvironment, enhance the functional viability and differentiation of cell cultures, and improve sensitivity to nephrotoxic insults. Furthermore, computational tools such as physiologically based pharmacokinetic (PBPK) modeling can add confidence to these tools by simulating absorption, distribution, metabolism, and excretion. The development and implementation of NAMs for renal toxicity testing will allow specific mechanistic data to be generated, leading to a better understanding of the nephrotoxic potential of botanicals.

Redefining food safety traceability system through blockchain: findings, challenges and open issues

In the last few decades, there has been an increase in food safety and traceability issues. To prevent accidents and misconduct, it became essential to establish Food Safety Traceability System (FSTS) to trace the food from producer to consumer. The traceability systems can help track food in supply chains from farms to retail. Numerous technologies such as Radio Frequency Identification (RFID), sensor networks, and data mining have been integrated into traditional food supply chain systems to remove unsafe food products from the chain. But, these are not adequate for the current supply chain market. The emerging technology of blockchain can overcome safety and tracking issues. This can be possible with the help of blockchain features like transparent, decentralized, distributed, and immutable. Most of the previous works missed the discussion of the systematic process and technology involved in implementing the FSTS using blockchain. In this paper, we have discussed an organized state of research of the existing FSTS using blockchain. This survey paper aims to outline a detailed analysis of blockchain technology, FSTS using blockchain, consensus algorithms, security attacks, and solutions. Several survey papers and solutions based on blockchain are included in this research paper. Also, this work discusses some of the open research issues related to FSTS.

An unusual case of pedal edema

A 40-year-old male patient reported to medical outpatient department with bilateral pedal edema of 15 days duration which was progressive, bilaterally symmetrical, pitting and with minimal pain and redness. Examination revealed pallor and bilateral pitting pedal edema with mild tenderness. Investigations revealed dimorphic anemia with reduced vitamin B12 levels. All other biochemical and radiological including radiograph of the chest, ultrasonography of abdomen, color doppler of the both lower limbs, and two dimensional echocardiography were normal. For the next one month, the patient showed significant improvement and was discharged. Fifteen days later, the patient was again readmitted with progressively worsening breathlessness with orthopnea and increasing pedal edema of two days duration. Clinically and radiologically, patient had features of congestive cardiac failure which was corroborated with markedly raised levels of NT pro brain natriuretic peptide. He also had other organ involvement with raised serum creatinine (1.9 mg/dl) and elevated transaminases of >300 IU/L. Patient was managed with high flow oxygen, ventilatory support, intravenous loop diuretics, low-dose angiotensin-converting enzyme inhibitors, and supportive care. The next day, patient's son and wife also reported with bilateral pedal edema and breathlessness. Based on this history, the diagnosis of epidemic dropsy was suspected. Mustard oil from their kitchen tested positive for nitric oxide test which was later confirmed at Public Health Laboratory. The index case showed progressive downhill course and died after 3 days. Both son and wife recovered over the next few months.

Preclinical safety evaluation of Macleaya Cordata extract: A re-assessment of general toxicity and genotoxicity properties in rodents

Macleaya cordata extract (MCE) is widely used for its diverse pharmacological actions and beneficial effects on farm animals. Modern pharmacological studies have shown that it has anti-inflammatory, anti-cancer, and anti-bacterial activities, and is gradually becoming a long-term additive veterinary drug used to improve animal intestinal health and growth performance. Although some evidence points to the DNA mutagenic potential of sanguinarine (SAN), a major component of MCE, there is a lack of sufficient basic toxicological information on the oral route, posing a potential safety risk for human consumption of food of animal origin. In this study, we assessed the acute oral toxicity, repeated 90-day oral toxicity and 180-day chronic toxicity of MCE in rats and mice and re-evaluated the genotoxicity of MCE using a standard combined in vivo and ex vivo assay. In the oral acute toxicity test, the LD₅₀ for MCE in rats and mice was 1,564.55 mg/kg (95% confidence interval 1,386.97–1,764.95 mg/kg) and 1,024.33 mg/kg (95% confidence interval 964.27–1,087.30 mg/kg), respectively. The dose range tested had no significant effect on hematology, clinical chemistry, and histopathological findings in rodents in the long-term toxicity assessment. The results of the bacterial reverse mutation, sperm abnormality and micronucleus test showed negative results and lack of mutagenicity and teratogenicity; the results of the rat teratogenicity test showed no significant reproductive or embryotoxicity. The results indicate that MCE was safe in the dose range tested in this preclinical safety assessment. This study provides data to support the further development of maximum residue limits (MRLs) for MCE.

Consequences of intratumoral injection of a herbal preparation containing blood root (Sanguinaria canadensis) extract in two dogs

CASE DESCRIPTION

2 dogs were referred for surgical removal of cutaneous tumors that had previously been treated by intratumoral injection of a herbal preparation containing blood-root (Sanguinaria canadensis) extract.

CLINICAL FINDINGS

11 days following injection of bloodroot extract into a small dermal tumor, dog 1 developed a large, soft, fluctuant cutaneous mass at the site of injection. Ultrasonographic evaluation of the mass revealed a fluid-filled central cavity with increased echogenicity of the surrounding subcutaneous tissues. Dog 2 had a small dermal tumor under the left mandible that had been treated in similar fashion. However, an exuberant reaction was not observed following injection of bloodroot extract in this dog.

TREATMENT AND OUTCOME

Both dogs underwent surgical excision of the cutaneous tumors. Histologic evaluation revealed severe necrosis and inflammation in the excised tissues from dog 1. This dog experienced postsurgical wound complications and had a prolonged postsurgical recovery. Similar, although less severe, histopathologic findings were apparent in the excised tissues from dog 2; this dog recovered without complications.

CLINICAL RELEVANCE

Various products containing bloodroot are marketed on the Internet for topical and parenteral treatment of cutaneous neoplasms in domestic animals. However, the antineoplastic properties, therapeutic efficacy, and adverse effects of these products are poorly described in the veterinary literature. Clinicians should be aware of the potential for harm caused by the use of these products.

Pattern of intraocular pressure in epidemic dropsy in India

This study was conducted to report on the intraocular pressure (IOP) pattern in patients with epidemic dropsy. Two hundred and thirty proven cases of epidemic dropsy were sent for ocular examination. We measured IOP by applanation tonometry at different intervals. Patients were followed up until 24 weeks. Intraocular pressure of more than 22 mm of Hg was detected in 10.86% patients at the start of the study. However, at 12 weeks only 0.43% patients needed medication for control of IOP. None required medication for IOP control after 20 weeks. The rise of IOP in this case series of epidemic dropsy appeared to be a transient phenomenon and drugs needed to be titrated on a weekly basis.