Acinetobacter baumannii: An overview of emerging multidrug-resistant pathogen

The emergence of infections caused by Acinetobacter baumannii, a multidrug-resistant bacterium, has been a concern worldwide. This bacterium is an important hospitalacquired pathogen that causes several diseases including ventilator-associated pneumonia, bloodstream infections, and meningitis. This study aimed to determine antibioticresistant mechanisms in the pathogenesis of A. baumannii and the alternative treatment strategies against it. The combined actions of outer membrane protein A, formation of a biofilm on biotic and abiotic surfaces, phospholipases C and D, metal homeostatic system, lipopolysaccharides, and verotoxins are relevant for virulence and pathogenesis. A. baumannii resists the broad-spectrum antibiotics by its mechanisms of resistance, such as β-lactamases, efflux pump, aminoglycoside modifying enzymes, permeability changes, and alternation of targets. In an attempt to overcome the resistance mechanisms, plant-derived compounds and a combination of the antibiotics and the plant phytocompounds have been focused. Nanoparticles synthesised with the plant extract have been studied extensively. Furthermore, we projected modern methods, including multi-omics analysis, to study insight into mechanisms of actions of antibiotics. The information suggested that the potential antibiotic mechanisms of A. baumannii could lead to an alternative treatment against A. baumannii infections.

Impact of Enhanced Lipid Peroxidation on Carotid Artery Intima Media Thickness Ratio in Patients Receiving Maintenance Hemodialysis

Objective: To determine the impact of increased lipid peroxidation on carotid intima media thickness ratio in patients receiving maintenance hemodialysis. Study Design: Comparative prospective study. Place and Duration of Study: Jinnah Post Graduate Medical Center Karachi in collaboration with University of Karachi, Pakistan, from Jan to Dec 2018. Methodology: The hemodialysis patients were selected from the dialysis center where as the controls were recruited from normal healthy population. The cases taken were receiving maintenance hemodialysis thrice a week. Doppler ultrasonography technique was employed to detect the intima media thickness (IMT) ratio of common carotid artery of study subjects as well as controls. Lipid peroxidation was detected by serum oxidized LDL (ox-LDL) levels. Results: The mean of right common carotid artery of group A samples was 0.45 ± 0.04 mm, left common carotid artery was 0.42 ± 0.01mm, and mean intima thickness was 0.43 ± 0.02 mm, the mean of right common carotid artery in group B was 0.93 ± 0.09 mm and mean of left common carotid in group B was 1.07 ± 0.14 mm and mean intima thickness of group B samples was 1.0 ± 0.09 mm. In group A mean Ox-LDL was 24.87 ± 5.23 U/ml while in group C samples mean Ox-LDL was 73.77 ± 6.77 U/ml. Conclusion: Lipid peroxidation is much enhanced in patients on maintenance hemodialysis and leads to an increased carotid artery intima media thickness ratio which is a sign of development of atherosclerosis. This study will help the nephrologists in determining the causes..................

Correlation between Serum Malondialdehyde levels and prevalence of cardiovascular disease in Haemodialysis treated patients

Objectives: To investigate the role of serum malondialdehyde as a diagnostic biomarker of free radical production and cardiovascular disease in patients treated with maintenance haemodialysis. Method: The case-control study was conducted in the Department of Biochemistry, Basic Medical Sciences Institute (BMSI) of the Jinnah Postgraduate Medical Centre (JPMC), Karachi, and the JPMC Nephrology ward from January 12, 2018, to January 15, 2019, and comprised patients receiving haemodialysis as the cases and healthy controls. Blood samples were obtained from all the subjects for checking the level of serum malondialdehyde. Doppler ultrasonography was employed to detect the intima media thickness ratio of the common carotid artery of all the subjects.  Data ws analysed using SPSS 23. Results: Of the 90 subjects, 45(50%) each were cases and controls. There were significant differences in mean values related to age, body mass index and blood pressure between the groups. A statistically significant rise was seen in serum malondialdehyde and carotid artery intima media thickness ratio in the cases compared to the controls (p<0.05). Conclusion: Serum malondialdehyde was found to be significantly raised in haemodialysis patients compared to the healthy controls. Key Words: Malondialdehyde, Haemodialysis, Cardiovascular disease, Oxidative stress, Free radicals.

Can Costus afer be used for co-treatment of COVID-19, its symptoms and comorbidities? A novel approach for combating the pandemic and implications for sub-Saharan Africa

Despite the huge loss of lives and massive disruption of the world economy by the COVID -19 pandemic caused by SARS -CoV-2, scientists are yet to come out with an effective therapeutic against this viral disease . Several vaccines have obtained 'emergency approval ', but difficulties are being faced in the even distribution of vaccines amongst high- and low- income countries . On top of it, comorbidities associated with COVID -19 like diabetes, hypertension and malaria can seriously impede the treatment of the main disease, thus increasing the fatality rate . This is more so in the context of sub -Saharan African and south Asian countries . Our objective was to demonstrate that a single plant containing different phytoconstituents may be used for treatment of COVID -19 and comorbidities . Towards initial selection of a plant, existing scientific literature was scanned for reported relevant traditional uses, phytochemicals and pharmacological activities of a number of plants and their phytoconstituents pertaining to treatment of COVID-19 symptoms and comorbidities. Molecular docking studies were then performed with phytochemicals of the selected plant and SARS-CoV-2 components - Mpro, and spike protein receptor binding domain and hACE2 interface using AutoDock V ina. We showed that crude extracts of an indigenous African plant, Costus afer having traditional antidiabetic and antimalarial uses, has phytochemicals with high binding affinities for Mpro, and /or spike protein receptor binding domain and hACE2 interface; the various phytochemicals with predicted high binding energies include aferoside C, dibutyl phthalate, nerolidol, suginal, and ± -terpinene, making them potential therapeutics for COVID -19. The results suggest that crude extracts and phytochemicals of C. afer can function as a treatment modality for COVID -19 and comorbidities like especially diabetes and malaria .

2,4-Dichlorophenoxyacetic acid induced hepatic and renal toxicological perturbations in rat model: Attenuation by selenium supplementation

2,4-Dichlorophenoxyacetic acid (2,4-D) is a commercially used herbicide to manage broadleaf weeds that have various toxicological and ecological effects. In view of ever-escalating use of 2,4-D, risk assessment becomes mandatory to ensure the safety of both human health and the ecosystem. Oxidative injury has been expected as a possible mechanism implicated in 2,4-D toxicity. The present study was planned and conducted to explore the antioxidant potential of selenium (Se) supplementation to moderate the 2,4-D hepatic and renal toxicity in a rat model. The rats were randomly assigned to four equal groups and treated via oral gavage for a period of 4 weeks. Group I: received deionized water as a vehicle, group II: received 2,4-D (150 mg^-1 kg^-1 day^-1), group III: received Se supplement (1 mg^-1 kg^-1 day^-1), and group IV: received 2,4-D (150 mg^-1 kg^-1 day^-1) and Se supplement (1 mg^-1 kg^-1 day^-1) simultaneously. After 4 weeks of administration, 2,4-D induced toxicity was observed, as manifested by disrupted levels of plasma urea, creatinine, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Further, 2,4-D caused a considerable increase in tissue malondialdehyde (MDA) levels and decreased activity of antioxidant enzymes, including superoxide dismutase, catalase, and glutathione reductase. Se supplementation exhibited its antioxidant properties by significantly improving urea, creatinine, ALP, AST, and ALT, and MDA levels and antioxidant enzyme activities. In conclusion, the results suggest that 2,4-D induced hepatic and renal toxicities were attenuated by Se supplementation probably owing to its antioxidant properties.

Biosynthesis, Characterization, and Antibacterial Activity of Silver Nanoparticles Derived from Aloe barbadensis Miller Leaf Extract

Background:

There is a growing commercial demand for nano-formulations due to their prevalence applicability in various areas of bio-nanotechnology. Numerous chemical and physical methods have traditionally been used to synthesize silver nanoparticles, but they are limited due to use of toxic and harmful chemicals, thus drew researchers’ attention towards the biosynthesis of the silver nanoparticles by using medicinal plant.

Objective:

The present study enlightens the synthesis of silver nanoparticles in an echo-accommodating way by using aqueous Aloe vera leaf extract (AVLE) and evaluate its antimicrobial potential.

Materials and Methods:

The synthesis of silver nanoparticles using AVLE was determined by UV–vis spectrum and SEM. The optimization of different reaction conditions was measured, and antibacterial activity was evaluated by the disc diffusion method.

Results:

The optimum synthesis of AV-AgNPs showed at a 1mM concentration of silver nitrate, 595 ratio of AVLE to silver nitrate solution, pH 8 at ambient temperature for 24 hours. The synthesis was confirmed by UV–Vis spectroscopy maximum absorbance at 400 nm while SEM showed spherical morphology with an average particle size 20-24 nm. The antibacterial activity of AV-AgNPs was measured by disc diffusion method and exhibits significant antibacterial activity against both gram-positive and gram-negative bacteria.

Conclusion:

This method appears promising for the biosynthesis of silver nanoparticles by using Aloe vera with potent bactericidal activity, thus suggesting its role in clinical therapeutics and other fields.

Possible association of Vitamin D receptor, caudal-related homeobox 2 polymorphism with the risk of cancer

OBJECTIVE

This study was conducted to find out the possible association of Vitamin D receptor, caudal-related homeobox 2 (VDR-Cdx2) polymorphism with cancer in the given study group.

METHODS

In this study, 151 subjects (84 cases and 67 controls) were recruited from two local tertiary care hospitals of Karachi, Pakistan, suffering from various cancers including gastric cancer (GC), rectal cancer (RC), colon cancer (CC), and multiple myeloma followed by ethical approval from institutions and informed consent from all the participants. The genotyping of VDR-Cdx2 polymorphism was performed using tetra-primer amplification refractory mutation system-polymerase chain reaction method. The genotypic assortment/distribution in the control and disease groups was according to Hardy-Weinberg's equilibrium.

RESULTS

The genotype frequencies of VDR-Cdx2 polymorphism in cancer patients were observed as: AA 1.2%, AG 32%, and GG 66.8% while in control group as; AA 7.5%, AG 50.7%, and GG was 41.8%. The results unveil that the genotype VDR-Cdx2 was found significantly different in cancer and control group (P < 0.01). The AG and GG genotypes were found to be associated with the cancer (P < 0.05). Therefore, these genotypes may be considered as the risk factors for cancer. However, the frequencies of "A" and "G" alleles were not significantly different between two groups.

CONCLUSION

The observed single-nucleotide polymorphism of VDR-Cdx2 gene may be considered as a risk factor for the cancer in this study group. The AG and GG genotypes established an association with various cancers including GC, RC, CC, and multiple myeloma in Pakistani population. Further investigations examining large data are required to compare the role of VDR-Cdx2 polymorphism in cancer etiology in related population.

Hepatoprotective role of curcumin in rat liver cirrhosis

The present research work was designed to evaluate the effects of curcumin supplementation on various biochemical parameters in rats with thioacetamide (TAA) induced liver cirrhosis. For this purpose 24 male Albino Wistar rats were randomly distributed into four groups (n=6).Group I served as control, Group II and Group III received thioacetamide 200mg/kg b.w, i.p, twice a week for 12 weeks in first phase. In second phase Group II received saline and Group III received curcumin 50mg/kg b.w/day, i.p for 12 weeks, in second phase, Group IV received curcumin 50mg/kg b.w/day, i.p, for 12 weeks, in first phase and saline in second phase. Evaluation of histopathological and biochemical parameters was carried out by liver histopathology and estimation of total and direct bilirubin, liver specific enzymes, antioxidant enzymes, MDA level, plasma and intraerythrocyte sodium and potassium respectively. Histopathology of liver showed highest degree of fibrosis and nodule formation, significant alteration in biochemical parameters indicated development of severe liver cirrhosis. Curcumin treatment showed reduced amount of fibrosis and significant reduction in level of liver biomarkers, reversal of antioxidant enzymes (SOD and GSH), MDA level, catalase activity and regain of electrolyte homeostasis. These findings confirm the protective role of curcumin in liver cirrhosis.

Zika virus modulates blood-brain barrier of brain microvascular endothelial cells

Zika virus (ZIKV) is a mosquito-borne Flaviviruses. ZIKV is known to cause birth defect in pregnant women, especially microcephaly in the fetus. Hence, more study is required to understand the infection of Zika virus towards human brain microvascular endothelial cells (MECs). In this study, brain MECs were infected with ZIKV at MOI of 1 and 5 in vitro. The changes in barrier function and membrane permeability of ZIKV-infected brain MECs were determined using electric cell-substrate impedance sensing (ECIS) system followed by gene expression of ZIKV-infected brain MECs at 24 hours post infection using one-color gene expression microarray. The ECIS results demonstrated that ZIKV infection enhances vascular leakage by increasing cell membrane permeability via alteration of brain MECs barrier function. This was further supported by high expression of proinflammatory cytokine genes (lnc-IL6-2, TNFAIP1 and TNFAIP6), adhesion molecules (CERCAM and ESAM) and growth factor (FIGF). Overall, findings of this study revealed that ZIKV infection could alter the barrier function of brain MECs by altering adhesion molecules and inflammatory response.

Magnesium supplementation ameliorates toxic effects of 2,4-dichlorophenoxyacetic acid in rat model

2,4-Dichlorophenoxyacetic acid (2,4-D) is an extensively used herbicide in the field of agriculture, its ever-escalating use induces toxicity, health effects, and environmental impact. Oxidative stress plays a key role in pathogenesis of 2,4-D-induced liver and kidney damage. Magnesium (Mg) is a highly effective antioxidant agent in restoring oxidative damage by directly influencing the metabolic and physiological processes. Therefore, the present study aimed to evaluate Mg role in ameliorating the oxidative damages provoked by 2,4-D in rat model. Male Wistar rats (180–220 g) were distributed into four groups and treated intragastrically for 4 weeks. Group 1: control, group 2: 2,4-D (150 mg/kg body weight/day), group 3: simultaneously treated with 2,4-D (150 mg/kg body weight/day) and Mg supplement (50 mg/kg body weight/day), and group 4: Mg supplement (50 mg/kg body weight/day). Under experimental conditions, plasma hepatic and renal biomarkers, tissue oxidative status, and antioxidant enzymes activities were investigated. Results demonstrated that 2,4-D intoxication caused hepatic and renal impairments as indicated by the significantly increased ( p < 0.001) alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, urea, creatinine, and blood urea nitrogen levels. In addition, 2,4-D caused a significant enhancement ( p < 0.001) in the level of malondialdehyde as well as reduction ( p < 0.001) of the superoxide dismutase, catalase, and glutathione reductase activities in both hepatic and renal tissues. Mg treatment prevented and reversed the toxic variations induced by 2,4-D. In general, these outcomes suggest that Mg may have antioxidant potential and ameliorative effects against 2,4-D provoking hepatic and renal toxicity in rat model.

Comparison of serum levels of vitamin D and vitamin D-binding protein in normal, osteopenic and osteoporotic postmenopausal women

Objective:

To compare the serum levels of vitamin D, vitamin D binding protein (VDBP) calcium and phosphate in normal, osteopenic and osteoporotic postmenopausal women categorized on the basis of bone mineral density (BMD) scores.

Methods:

A cross sectional study carried out from May 2017 to August 2018. BMD measured by Dual energy X-ray Absorptiometry categorized women (aged 20- 70 years) into normal (n=37) (T score ≥ -1.0) osteopenic (n=25) (-2.5< T score, < -1) and osteoporotic (n= 26) (T score < -2.5) according to WHO classification. Serum concentrations of vitamin D, VDBP, calcium, phosphate analyzed by enzyme linked immunosorbent assay were compared by Analysis of Variance

Results:

In normal females higher levels of vitamin D and VDBP were observed [15.82 (8 - 69.18), 469.9 (269.57 - 875.55)] vs. osteopenic [(7.45 (4.66 - 15.1), 296.05 (232.58 - 420.23)] and osteoporotic women [(7.25 (3.97 - 17.49), 272.94 (202.23 - 351.24)]; [median interquartile range]; p value < 0.0001.

Conclusion:

Vitamin D and VDBP are linked with bone health and estimation of VDBP appears to be a valuable tool for the assessment of increased bone loss and possible risks of bone fractures especially in postmenopausal women.

Role of peroxisome proliferator-activated receptor-gamma activation on visfatin, advanced glycation end products, and renal oxidative stress in obesity-induced type 2 diabetes mellitus

The present study focused on the role of peroxisome proliferator-activated receptor-gamma (PPAR-γ) activation on renal oxidative damages, serum visfatin, and advanced glycation end products (AGEs) in high-fat diet (HFD)-induced type 2 diabetes mellitus. Following the institutional animal ethics committee guidelines, Wistar rats were categorized into five groups: group 1: fed on a normal rat diet; group 2: HFD-induced obese rats (HFD for 8 weeks); group 3: HFD-fed rats treated with rosiglitazone (RSG; 3 mg/kg orally for 7 days); group 4: T2DM rats induced by HFD and low dose of streptozotocin (i.p. 35 mg/kg); group 5: T2DM rats treated with RSG (3 mg/kg orally for 7 days). Serum levels of AGEs and visfatin, renal damage, and oxidative stress were analyzed. Results showed that HFD-induced obesity and T2DM caused an elevated blood glucose, serum AGEs, visfatin, insulin, urea, creatinine, and tissue malondialdehyde, whereas a decreased catalase and superoxide dismutase activity were observed. The PPAR-γ activation via agonist restored these changes. Our findings suggest that AGEs and visfatin possess an important role in the progression of renal oxidative stress, which can be reduced by the PPAR-γ agonist that impede deleterious effects of HFD and HFD-induced T2DM on renal damage.

Prevention of liver cirrhosis by Silymarin

This study was designed to evaluate the effects of sylimarin supplementation on different biochemical parameters in thioacetamide induced cirrhotic rats. For this purpose 24 male Albino wistar rats were divided into four groups (n=6). Group I, remained healthy control rats, Group II, received thioacetamide (at a dose of 200mg/kg b.w, i.p, for 12 weeks, twice a week) in first phase and saline in second phase, Group III, received thioacetamide (200mg/kg b.w, i.p for 12 weeks, twice a week) in first phase and silymarin (orally at a dosage of 200mg/kg b.w, twice a week, for 8 weeks) in second phase and Group IV, received silymarin (orally at a dosage of 200mg/kg b.w, twice a week, for 8 weeks) in first phase and saline in second phase. Biochemical analysis was evaluated by total and direct bilirubin (Retiman and Franhel, 1957, Sherlock, 1951), liver specific enzymes, antioxidant enzymes [SOD (Kono et al., 1978), Catalase (Sinha et al., 1979), Glutathione reductase (Calberg and Mannervik, 1985) and MDA (Okhawa et al., 1979)] and plasma and intraerythrocyte sodium and potassium (Tabssum et al., 1996). Marked increase in total and direct bilirubin and ALT activity was the indicative markers of liver cirrhosis while reduced antioxidant activity (SOD and GSH) and increased MDA and Catalase levels and disturbed electrolyte homeostasis were observed in cirrhotic group. Silymarin supplementation markedly reduced total bilirubin and ALT activity and restored the antioxidant enzymes (SOD and GSH), MDA and catalase activity and electrolyte homeostasis. These results indicate that silymarin successively attenuates the thioacetamide induced liver cirrhosis.

Soil-Transmitted Helminths in Malaysia landscape: an aborigines study

Soil-transmitted helminths (STH) is a group of parasitic nematodes, including Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus, which can cause gastrointestinal disorders in humans. STH is prevalent among neglected communities in both developing and developed countries. This present study aims to determine the current prevalence of STH infections in Aboriginal population after mass delivering of antihelminthic drugs was proposed by WHO in 2005 and a health education learning package (HELP) was initiated in Malaysia in 2012. A total of 235 human fecal samples were collected and a pre-tested questionnaire was given to gather information about the socio-demographic of the Aborigine communities living in Kedah and Selangor, Malaysia. The samples were screened by a direct-fecal smear and confirmed by formalin-ether sedimentation methods. From human faeces, 81.7% was found to be infected with one or more STH species. T. trichiura was the most commonly detected (76.6%), followed by hookworms (26.4%) and A. lumbricoides (19.1%). Triple infections were found in 6.4% of the studied population. Univariate analysis showed that individuals with age group, male, presence of indoor toilet, family size with <7 members and bad living habits (i.e., without antihelminthic drugs) were significantly associated with STH infections. The analysis further showed that walking barefoot was the significant contributing factor to hookworm infections. The high prevalence of human STH infections is alarming. Thus, the urgency in implementing health education related behavioral practice and hygiene to reduce disease burden in these rural communities are a crucial need.

Titiwangsa Lake a source of urban parasitic contamination

Urban recreational lake acts as a source of waterborne parasites contamination, as reported in 2013 in Petaling Jaya, Selangor, Malaysia. This scenario will lead to the transmission of waterborne diseases due to exposure of water-related activities by humans. This study was conducted to reveal the occurrence of common waterborne parasites in a urban lake (i.e. Titiwangsa Lake). The lake is situated in the city of Kuala Lumpur and is known to be overcrowded with vast activities participated by both local and tourist. Results of study showed the presence of Cryptosporidium, Giardia, free-living amoeba, and helminthlike ova from the lake.

Efficacy of lycopene on modulation of renal antioxidant enzymes, ACE and ACE gene expression in hyperlipidaemic rats

INTRODUCTION

We aimed to evaluate the efficacy of lycopene on renal tissue antioxidant enzymes and angiotensin converting enzyme (ACE) gene expression and serum activity in diet-induced hyperlipidaemia.

METHODS

Thirty-two female Wistar albino rats (200-250 g weight), 5-6 months of age, were randomly selected and divided into four groups. Group I received normal diet; group II received 24 g high fat diet/100 g of daily diet; group III received 24 g high fat diet/100 g daily diet and 200 ml of lycopene extract (twice a week) for 8 weeks; and group IV received 200 ml oral lycopene extract twice a week for 8 weeks.

RESULTS

A marked increase was observed in plasma urea and creatinine levels, serum C-reactive protein, kidney weight, tissue renal malonyldialdehyde level, ACE gene expression and serum level, while a decrease catalase level among hyperlipidaemic rats was observed. Histologically, interstitial inflammation and proliferation was seen. Lycopene supplementation significantly decreased plasma urea and creatinine, serum ACE, renal tissue malonyldialdehyde level and C-reactive protein level, while it increased tissue antioxidant enzymes level and total protein. Tissue inflammation and proliferation was improved.

CONCLUSIONS

This finding suggests that supplementation of lycopene is effective for renal antioxidant enzymes, ACE gene expression and ACE serum level in hyperlipidaemic rats.

Nephroprotective effects of b-carotene on ACE gene expression, oxidative stress and antioxidant status in thioacetamide induced renal toxicity in rats

β -carotene is one of carotenoid natural pigments, which are produced by plants and are accountable for the bright colors of various fruits and vegetables. These pigments have been widely studied for their ability to prevent chronic diseases and toxicities. This study was designed to evaluate the effects of β-carotene on angiotensin converting enzyme (ACE) gene expression, oxidative stress and antioxidant status in thioacetamide induced renal toxicity. Total 24 albino wistar rats of male sex (200-250gm) were divided into 6 groups as Group-1: The control remained untreated; Group-2: Received thioacetamide (200mg/kg b.w; i.p) for 12 weeks; Group-3: Received β-carotene orally (200mg/kg b.w), for 24 weeks; and Group-4: Received thioacetamide (200mg/kg b.w; i.p) for 12 weeks + received β-carotene orally (200mg/kg b.w), for further 12 weeks. The expression of ACE gene in thioacetamide induced renal toxicity in rats as well as supplemented with β-carotene was investigated and compared their level with control groups by using the quantitative RT-PCR method. The ACE gene expression was significantly increase in TAA rats as compare to control rats specifies that TAA induced changes in ACE gene of kidney, elevated renal ACE has been correlated with increase hypertensive end organ renal damage. The quantity of ACE gene were diminish in our rats who received β-Carotene after TAA is administered, for this reason they seemed to be defended against increased ACE levels in kidney bought by TAA. In pre- and post-treatment groups, we studied the role of β-Carotene against thioacetamide in the kidney of Wistar rats. Experimental confirmation from our study illustrates that β-Carotene can certainly work as a successful radical-trapping antioxidant our results proved that TAA injury increased lipid peroxidation and diminish antioxidant GSH, SOD and CAT in renal tissue. Since β-Carotene administration recover renal lipid peroxidation and antioxidants, it give the impression that β-Carotene protects renal tissue against thioacetamide-induced oxidative damage.

Chromium scavenging ability of silver nanoparticles in human erythrocytes, real samples and their effect on the catalase enzyme

The plasmonic sensor (6APA–AgNPs) exhibited good selectivity towards Cr(vi) in real samples. It can be used as preventive xenobiotic for catalase against Cr(vi) induced toxicity.

A preliminary screening of potentially antimalarial plants against Plasmodium falciparum in vitro

Plasmodium is a blood protozoan parasite that is responsible for malaria. To date, Plasmodium falciparum has shown multi-drug resistance, particularly in Thailand, Myanmar and Malaysia. The aim of the study is to screen the plant extracts that can effectively inhibit P. falciparum 3D7, a common lab strain malaria parasite. Nine plants were collected and processed through maceration using hexane, chloroform and ethanol, resulting in 24 crude plant extracts. Of these, extracts from Artabotrys crassifolius, Pericampylus glacus and Leuconotis eugeniifolia showed promising antiplasmodial activities at IC50 of 15.32 to 39.75 µg/mL in a modified schizont maturation assay. Further studies are warranted to explore its efficacies and lead compounds of these three plant extracts for the development of antiplasmodial drugs.

Hypophosphatemic effect of niacin extended release in ischemic kidney disease

Ischemic nephropathy is an emerging cause of end stage renal disease, associated with many co-morbidities especially cardiovascular disease risk and derangement in calcium-phosphorus homeostasis resulting in hyperphosphatemia, influencing bones, a characteristic of advancing chronic kidney disease. The management of elevated serum phosphorus has been a challenge in this patient population with compromised kidney performance, as available phosphorus lowering agents possess many undesirable hazardous secondary effects and/or are very expensive. While niacin in different formulation is known to not only correct dyslipidemia but also reduce phosphorus level, but its clinical use restricted owing to side effects. The objective of present study is to evaluate such effect of niacin extended release (NER) in ischemic nephropathy. The chronic kidney disease patients fulfilling the pre-defined criteria were randomly categorized into two groups of equal size (n=60) and prescribed either atorvastatin 20 mg/day or NER 500 mg/day with the same dose of statin for four months. A control of 50 healthy characters matched was also incorporated for local reference range. Baseline and follow up phosphorus concentration was measured and means were compared using t-test at SPSS version 17 with 0.05 chosen alpha. There was no difference in the baseline levels in both groups while significant (p<0.001) hyperphosphatemia was observed in both units as compared with healthy controls. The administration of atorvastatin alone for four weeks showed an insignificant decrease in phosphorus, whereas, NER significantly reduced phosphorus (p<0.001). The mean percent change from baseline to follow up further endorsed the finding as statin alone brought -13.8 % reduction in phosphorus and NER -47 % from baseline. NER, at its lowest prescribed dose once a day was well tolerated by most of the patients and demonstrated significant goal achievement of phosphorus reduction. It is concluded that NER even at low doses in renal compromised dyslipidemic patients may be a promising approach to prevent the harmful vascular, valvular effects caused by hyperphosphatemia in addition to its principal target of HDL-C elevation.

Association of high-density lipoprotein cholesterol with improvement of endothelial dysfunction recovery in renovascular disease

INTRODUCTION

This study was aimed to assess the ratio of total cholesterol (TC) to high-density density lipoprotein cholesterol (HDLC) and plasma nitrate levels in patients with ischemic nephropathy receiving statins and niacin extended release (NER).

MATERIALS AND METHODS

Kidney disease patients with a history of at least 5 year of diabetes mellitus or 10 year of hypertension were screened by renal artery Doppler ultrasonography. Participants were randomly assigned into two groups to receive atorvastatin, 20 mg/d, with and without NER, 500 mg/d, for 16 weeks. Serum levels of lipid profile, creatinine, and nitrate were compared before and after the study.

RESULTS

Fifty-four patients received the statin and 51 received statin-NER combination. Both statin and statin-NER groups demonstrated significant decreases in plasma levels of TC and low-density lipoprotein cholesterol. Triglyceride and very low-density lipoprotein cholesterol were significantly lowered only with statin-NER combination. The increase in HDLC level was found in both groups, but significant only with statin-NER combination therapy (P < .001). Atorvastatin combined with NER reduced TC/HDLC ratio almost double as compared with that of atorvastatin alone (102% and 36.6% reduction, respectively). A similar pattern was observed for nitrate levels (33% and 65%, respectively).

CONCLUSIONS

These findings indicated that a reduction in TC/HDLC ratio improves endothelial function in renovascular disease and use of NER in combination with atorvastatin may provide better outcomes. This could be helpful in attenuating further vascular damage and associated systemic complications.

Antibacterial potential of Calotropis procera (flower) extract against various pathogens

Increased bacterial resistance towards commonly used antibiotics has become a debated issue all over the world in a last few decades. Due to this, consumer demand towards natural anti-microbial agents is increasing day by day. Natural anti-microbial agents have gained enormous attention as an alternative therapeutic agent in pharmaceutical industry. Current study is an effort to explore and identify a bactericidal potential of various solvent extracts of Calotropis procera flower. Flowers of C. procera were extracted with hexane, butanol, ethyl acetate and aqua to evaluate the antibacterial activity by agar well diffusion method against the various human pathogens. The microorganisms used in this study includes Salmonella typhi, Escherichia coli (O157:H7), Micrococcus luteus KIBGE-IB20 (Gen Bank accession: JQ250612) and methicillin resistant Staphylococcus aureus (MRSA) KIBGE-IB23 (Gen Bank accession: KC465400). Zones of inhibition were observed against all four pathogenic strains. Fraction soluble in hexane showed broad spectrum of inhibition against all the studied pathogens. However, fractions soluble in ethyl acetate inhibited the growth of E. coli, MRSA, and M. luteus. In case of butanol and aqueous extracts only growth of M. luteus was inhibited. Results revealed that the flower extracts of C. procera have a potential to be used as an antibacterial agent against these pathogenic organisms.

Vitamin D levels in patients of acute leukemia before and after remission-induction therapy

OBJECTIVES

To determine the levels of 25-hydroxyvitamin [25(OH)D3] in patients with acute leukemia and the effect of remission-induction chemotherapy.

METHODOLOGY

This study was case control, all newly diagnosed patients of acute leukemia between the age of one to sixty years and residents of Pakistan were enrolled and evaluated. Those who were unwilling or unable to provide written informed consent were excluded. All selected patients (n=86) were grouped in to acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). AML was further categorized as A1 before remission-induction (n=17) and B1 after remission induction (n=13), ALL was further categorized as A2 before remission-induction (n=31) and B2 after remission induction (n=25). The 25-hydroxyvitamin [25(OH)D3] levels were measured in the sera of all patients (before and after remission-induction) by one step delayed chemiluminescent micro particle immunoassay (CMIA).We compared 25(OH)D3 levels in all patients before and after the remission-induction chemotherapy.

RESULTS

A total of 86 patients were analyzed, in which 60 patients were male. Mean age was 24.39 years (range, 1 to 60 years); the mean levels of 25(OH)D in group A1 (n=17) was 17.70±3.2 ng/ml, in group B1 (n=13) 14.06±2.4 ng/ml, 19.07±7.08 ng/ml in group A2 (n=31), while 10.59±3.9 ng/ml found in group B2 (n=25).

CONCLUSION

25(OH)D3 insufficiency was evident subnormal in majority of patients with acute leukemia and 25(OH)D3 were further reduced after remission-induction as compared to untreated group, difference was statistically significant when compared with each group.

Role of selenium in protection of liver cirrhosis

Selenium is an essential trace element and has been shown to protect the rats against dietary liver necrosis. This study was designed to evaluate the effects of selenium supplementation on different biochemical parameters in thioacetamide induced cirrhotic rats. For this purpose 24 male Albino wistar rats were divided into four groups (n=6). Group I, remained healthy control rats, Group II, received thioacetamide (at a dose of 200mg/kg b.w, i.p, for 12 weeks, twice a week) in first phase and saline in second phase, Group III, received thioacetamide (200mg/kg b.w, i.p for 12 weeks, twice a week) in first phase and sodium selenite ((1mg/kg b.w, i.p. for 12 weeks, three times a week ) in second phase and Group IV, received sodium selenite (1mg/kg b.w, i.p. for 12 weeks, three times a week) in first phase and saline in second phase. Biochemical analysis was evaluated by total and direct bilirubin, liver specific enzymes, and antioxidant enzymes. Marked increase in total and direct bilirubin and ALT activity was the indicative markers of liver cirrhosis while reduced antioxidant activity (SOD and GSH) and increased MDA and Catalase levels were observed in cirrhotic group. Sodium selenite supplementation markedly reduced total bilirubin and ALT activity and restored the antioxidant enzymes (SOD and GSH) and MDA and catalase activity. These results indicate that sodium selenite successively attenuates the thioacetamide induced liver cirrhosis.

Oxidative stress and total antioxidant status in acute leukemia at diagnosis and post remission induction phase

This study evaluated the activity of superoxide dismutase (SOD1), glutathione reductase (GR) and total antioxidant status (TAS) in the hemolysate and sera of patients with acute leukemia (AL) at diagnosis, post remission induction phase and in healthy controls. However, total antioxidant status and glutathione reductase activities normalized after remission induction phase in acute myeloid leukemia (AML) only whereas levels of SOD were reduced but not achieved the normal level in acute lymphoblastic leukemia (ALL). TAS activity showed no difference in either sex among any subtype of acute leukemia but glutathione reductase level was significantly higher in female ALL patients. Activity of SOD was elevated in T-cell ALL and acute myelomonocytic leukemia however; no significant difference in the activity of GR and TAS was noted. Levels of antioxidant were reduced insignificantly in patients who achieved complete remission.

Angiotensin converting enzyme (ACE) gene expression in experimentally induced liver cirrhosis in rats

Angiotensin converting enzyme (ACE) is a key player of Renin Angiotensin System (RAS), involved in conversion of active product, angiotensin-II. Alterations in RAS have been implicated in the pathophysiology of various diseases involving heart, kidney, lung and liver. This study is designed to investigate the association of ACE gene expression in induction of liver cirrhosis in rats. Total 12 male albino Wistar rats were selected and divided in two groups. Control group received 0.9% NaCl, where as Test group received thioacidamide (TAA), dissolved in 0.9%NaCl, injected intraperitoneally at a dosage of 200mg/Kg of body weight, twice a week for 12 weeks. The rats were decapitated and blood sample was collected at the end of experimental period and used for liver functions, enzyme activity, antioxidant enzymes and lipid peroxidation estimations. Genomic DNA was isolated from excised tissue determine the ACE genotypes using specific primers. The ACE gene expression in liver tissue was assessed using the quantitative RT-PCR method. The activity of ALT, total and direct bilirubin, SOD and CAT levels were significantly high (p<0.05) and level of MDA was significantly low (p<0.05) in TAA treated rats as compared to control rats. The ACE gene expression after 12 weeks TAA treatment in cirrhotic rats was significantly increased (p<0.05) in comparison to controls. This study describes the importance of RAS in the development of hepatic fibrosis and the benefits of modulation of this system ACE gene expression. The finding of major up-regulation of ACE in the experimental rat liver provides further insight into the complexities of the RAS and its regulation in liver injury. The development of specific modulators of ACE activity and function, in future, will help determine the role of ACE and its genetic variants in the pathophysiology of liver disease.

Relationship between serum nitric oxide and sialic acid in coexisted diabetes, hypertension and nephropathy

This study was designed to study the relationship between serum nitric oxide and sialic acid in patients of diabetic nephropathy. Total 210 diabetic patients including 115 males and 95 females, suffering from diabetes and nephropathy (DN) were selected followed by informed consent and approval from institutional ethical committee. Equal number of age and sex matched normal healthy subjects were selected without any known history of hyperglycemia, hypertension and renal insufficiency as controls. Fasting blood samples from patients and controls were collected and analyzed for serum nitric oxide, sialic acid, fasting blood glucose (FBG), serum urea, creatinine, HbA1c and golmerular filtration rate (GFR). The raised levels (p<0.05) of systolic and diastolic blood pressures, BMI, FBG, HbA1c, serum urea, creatinine and sialic acid were noted in DN patients as compared to controls. Significantly lower levels of GFR and serum nitric oxide (p<0.05) were observed in DN patients as compared to controls. Strong negative correlation was found between serum sialic acid and nitric oxide levels in patients diabetic nephropathy (p<0.05). The relationship between the levels of serum nitric oxide and sialic acid may be considered as a strong biochemical indicator for micro and macro vascular complications of diabetes such as hypertension and nephropathy. These parameters should be taken into account during screening procedures regarding identifications of the diabetic patients to get them rid of progressive renal impairment to ESRD.

Role of electrolytes disturbances and Na(+)-K(+)-ATPase in cisplatin - induced renal toxicity and effects of ethanolic extract of Cichorium intybus

Cisplatin is known by its toxicity by disturbing electrolytes homeostasis. Thus we aimed to find out the role of herbal plant Cichorium intybus on Cisplatin - induced toxicity. 24 male Albino Wistar rats were randomly divided into 4 groups: Group I is termed as untreated control; Group II is Cisplatin control and received 3 mg/ kg b.w.; i.p.; Group III received C. intybus ethanolic extract at a dose of 500 mg/kg b.w. orally for 10 consecutive days and Group IV is Cisplatin + C. intybus pretreated group. C. intybus is given 30 minutes prior to Cisplatin. Cisplatin - induced electrolytes disturbances is indicated by increase Intra - erythrocyte sodium content, decreased plasma magnesium, calcium and Intra-erythrocyte Na(+)-K(+)-ATPase which implicates the renal toxicity. At a dose of 500 mg/kg b.w. of C. Intybus pretreatment showed partial counter action on the electrolytes imbalances and Na(+)-K(+)-ATPase activity.

Glycemic control, dyslipidemia and endothelial dysfunction in coexisted diabetes, hypertension and nephropathy

Diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic and retinal complications. Diabetes clustered with hypertension and nephropathy has become the leading cause of end-stage renal disease globally. This study describes diabetes, hypertension and nephropathy with reference to glycemic control, dyslipidemia and endothelial dysfunction indicating the foremost basis of morbidity and mortality world wide and rapidly progressing in Pakistan. Study subjects selected and divided in four groups (60 each) followed by institutional ethical approval and informed consent. Group 1: non-diabetic, normotensive control subjects; Group 2: diabetic, normotensive patients; Group 3: diabetic, hypertensive patients and Group 4: diabetic, hypertensive patients with nephropathy. Their fasting blood samples analyzed for the estimations of blood glucose, HbA1c, serum triglyceride, cholesterol, LDL-cholesterol, HDL-cholesterol, urea, creatinine, nitric oxide and sialic acid levels. Results showed that all the groups showed significant rise in fasting blood glucose. Similarly HbA1c levels were also significantly high in all the patients as compared to controls. Group 2 showed significantly high serum cholesterol and LDL levels and low HDL levels. Group 3 and 4 showed significantly high serum triglyceride, cholesterol and LDL levels where as low HDL levels as compared to controls. Group 3 showed significantly high serum creatinine. Group 4 showed a significantly high serum urea and creatinine as compared to controls. Persistent albuminuria was characteristic in Group 4 patients. Significantly low production of serum nitric oxide with high concentration of serum sialic acid was observed in Group 3 and 4 as compared to controls. Results indicate a clear relationship of declining renal function with poor glycemic control, abnormal lipid metabolism, endothelial dysfunction and initiation of acute phase response in tissues affected from the microvascular complications of diabetes like hypertension and nephropathy. It must be taken into account while screening diabetic patients to get them rid of progressive renal impairment leading to end stage renal disease.

Sodium selenite attenuated cisplatin-induced toxicity in rats: role of electrolytes homeostasis

Sodium selenite (1 mg/kg body weight, ip) for 10 consecutive days treatment showed marked increase in intra-erythrocytes K+ and plasma Na+ level while slight increase in Na+ K+ ATPase level. No mortality was observed at this dose of sodium selenite. However, sodium selenite pretreatment partially restored the Na+ K+ ATPase and intra-erythorcytes and plasma sodium level, while completely restored the intra-erythrocytes K+ and plasma Mg2+ level. No change was observed in plasma Ca2+ level. Thus sodium selenite successively attenuated the Cisplatin-induced electrolytes alterations and toxicity by exerting the stress response of sodium.

Electrolytes and NA(+)-K(+)-ATPase: potential risk factors for the development of diabetic nephropathy

Diabetic nephropathy is the leading cause of death that affects more than 40% of diabetic patients. Its metabolic derangements are frequently accompanied with electrolyte imbalances. This study was aimed to evaluate the electrolyte homeostasis during the progression of diabetic nephropathy in various stages of developing nephropathy. Patients admitted in diabetic wards of various hospitals of Karachi were selected and divided into 4 groups with 50 individuals each. Group I (healthy normotensive, non-diabetics with normal renal functions as control). Group II (diabetic patients with normal blood pressure and renal functions). Group III (diabetic hypertensive patients without renal disease). Group IV (diabetic nephropathy patients with nephropathy). Their fasting blood samples were drawn and analyzed for the estimations of intra erythrocyte and serum electrolytes and NA(+)-K(+)-ATPase activity. Group II patients showed a significant increase in intra erythrocyte sodium, serum potassium and calcium levels where as intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium and magnesium were significantly decreased as compared to control. Group III showed a significant rise in intra erythrocyte sodium levels but intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium, calcium and magnesium were significantly lowered as compared to control. Group IV revealed a significant increase in intra erythrocyte sodium and significant decrease in intra erythrocyte potassium, NA(+)-K(+)-ATPase, serum sodium, calcium and magnesium levels as compared to control. The results suggest the progressive trends in electrolyte abnormalities in diabetes mellitus leading to end stage renal disease along with the abnormality of their chief transport mechanism. It points towards the potentiality of electrolytes disturbances as indicators for the progression of diabetic nephropathy and also beneficial in prognosis and treatment of the disease.

Electrolytes and sodium transport mechanism in diabetes mellitus

The metabolic derangements and disturbances and their consequences in diabetes mellitus are well known more or less in details too. However, knowledge on the diabetic disorders in membrane functions and transport mechanisms is limited which is an essential factor in progression of the disease. Serum electrolytes were measured by flame photometer (Corning 410) and spectrophotometer (Spectro SC) in 60 diabetic patients with stable glycemic control (aged 38 +/- 2.5 years) and in 60 age-matched normal subjects with no known history of hyperglycemia as control. Erythrocytes were isolated from samples, washed and used for the estimation of sodium and potassium concentrations using flame photometer. Erythrocyte membranes were prepared for the estimation of Na+-K+-ATPase activity in terms of inorganic phosphate released/mg protein/hour. Na+-K+-ATPase activity, Intra-erythrocyte potassium and serum magnesium levels were significantly low in diabetic patients than in the controls. Serum and intra-erythrocyte sodium and serum potassium levels were increased significantly in patients as compared to control subjects. A significant effect of sex and interaction was observed on serum sodium, potassium and magnesium. A significant effect of sex, disease and interaction on red cell sodium, potassium and Na+-K+-ATPase activity was observed in male and female subjects. Na+-K+-ATPase dysfunction and changes in intra-erythrocyte and serum sodium, potassium and magnesium induced by diabetes may be implicated in the pathogenesis of neuropathy, nephropathy and vascular diseases in humans. It is suggested that male diabetic patients are at high risk of diabetic complications than females.

Ionic and allied variations in normotensive and hypertensive diabetic patients

OBJECTIVE

To investigate the disturbances of serum and red cell electrolytes in association with membrane Na(+)-K(+)- ATPase activity as well as the status of serum Urea, Creatinine and osmolality in normotensive diabetic and hypertensive diabetic patients.

METHODS

Thirty normotensive and thirty hypertensive patients (age and sex matched) were selected along with thirty control subjects. Erythrocytes were isolated from freshly drawn blood samples, washed and used for the estimation of sodium and potassium concentrations using flame photometer (Corning 410). Erythrocyte membranes were prepared for the estimation of Na(+)-K(+)-ATPase activity in terms of inorganic phosphate released/mg protein/hour. Serum glucose, creatinine and urea were determined by well-documented ortho toulidine, Jaffe's and diacetyl monoxime methods respectively. Osmomat 030 was used to estimate the plasma osmolality.

RESULTS

The intra-erythrocyte sodium, serum glucose, urea, creatinine and osmolality were increased significantly in hypertensive diabetic patients as compared to normotensive diabetic patients whereas Na(+)-K(+)-ATPase activity, serum sodium, potassium, magnesium and calcium were decreased significantly in hypertensive diabetic patients as compared to normotensive diabetic patients.

CONCLUSION

Results confirmed that there is a significant difference between normotensive and hypertensive diabetic patients with respect to their electrolyte metabolism and associated pathways. These results will notably help the physicians to treat diabetic patientswith associated morbidity like hypertension.

Antihypertensive and metabolic effects of verapamil: role of Na-K-ATPase and electrolytes homeostasis in male and female rats

Calcium channel antagonists have been shown to be effective in the management of coronary vascular diseases. Although initially restricted to the treatment of angiopectoris could prevent cardiovascular complication in patients with diabetes. In view of a possible role of electrolytes in the therapeutic effects of verapamil, the present study concern effects of verapamil on serum, red cell, tissue electrolytes and Na-K-ATPase activity in both male and female rats. Verapamil (30 mg/kg body weight) was administered intraperitoneally to the test group. Control group received same volume of deionize water. A slight decreased Na-K-ATPase activity was observed in both sexes. Verapamil treatment decreases serum sodium and magnesium levels in both male and female rats. However serum potassium was slightly increased in both sexes. Verapamil treatment in red cells decreases sodium and increases potassium content in both sexes. Verapamil administration decreases sodium and calcium content in heart, liver and kidney tissues in both sexes, whereas an increased content of potassium and magnesium was observed in these tissues except liver in which the magnesium content was slightly decreased in both male and female rats. The results showed that the changes in electrolyte levels are more pronounced in female than in male rats. The results reported in the present study suggests that the drug has been shown to inhibit aldosterone biosynthesis to a variable degree. Although the antihypertensive effect of verapamil is considered to be mainly due to its vasodilation or by inhibition of vasoconstriction. It is suggested that verapamil lower blood pressure by correcting a pathophysiological derangements of electrolytes present in hypertension. The cellular mechanism involved is the altered serum, intracellular, tissue electrolytes and ATPase activity.

Electrolyte content of serum, erythrocyte, kidney and heart tissue in salt induced hypertensive rats

The effect of salt load on the systolic blood pressure (SBP) and electrolyte levels of serum, erythrocyte, kidney and heart tissue was studied in rats. NaCl treatment increased sodium (5.69 +/- 0.4 mmol/L p < 0.001, 149.8 +/- 4.0 mEq/L, p < 0.001) and decreased potassium (112.6 +/- 2.4 mmol/L p < 0.001, 5.0 +/- 0.2 mEq/L, p < 0.001) in red cell and serum respectively. A decreased level of serum magnesium (1.4 +/- 0.3 mEq/L, p < 0.005) was observed. Sodium content was increased in both heart (39.93 +/- 2.9 mumol/g, p = n.s) and kidney tissues (44.39 +/- 0.5 mumol/g, p < 0.001). A pronounced increase in intracellular calcium (2.54 +/- 0.2 mumol/g, p < 0.001) and a decrease of magnesium content (6.05 +/- 0.8 mumol/g, p < 0.001) was observed in kidney tissue after treatment. The results suggested that marked changes in electrolyte levels of erythrocytes, serum, heart and kidney tissues in NaCl loaded rats may play a definite role in the development of salt induced hypertension.

Stress and hypertension: role of serum, red cell and tissue electrolytes

The role of stress in the precipitation of hypertension is often described in clinical studies, although the underlying mechanism remains unknown. The present study concerns the role of electrolytes in stress induced hypertension in rats. Acute immobilization stress of one hour elevated systolic blood pressure (SBP) in rats. Restraint induced blood pressure elevation was associated with increased sodium concentration in the red cells, heart and kidney, and decreased potassium in the red cells. Magnesium concentration increased and calcium concentration decreased in the serum. Increases of calcium and decreases of magnesium were also observed in the heart and kidney tissues. The results may help toward an understanding of the relationship between hypertension and electrolyte homeostasis. A possible role of Na(+)-K(+)-ATPase activity leading to observed changes of electrolytes or vice versa is discussed.

Effect of NSAIDS on serum electrolytes and osmolality

Rabbits and rats were injected two Nonsteroidal anti-inflammatory drugs (aspirin 300 mg/kg or indomethacin 3 mg/kg) intraperitoneally. One hour after injection blood was analyzed for serum electrolytes and osmolality. Administration of both aspirin and indomethacin in rabbits and rats caused increase in serum sodium, potassium, calcium, chloride, magnesium, phosphorus and osmolality. Results suggest the marked similarity in the action of aspirin and indomethacin on electrolytes and osmolality. It is concluded that the ingestion of aspirin and indomethacin can have a major effect on serum electrolytes and osmolality that may influence the interpretation of clinical data in patients taking these drugs.

Effect of ethanol on serum electrolytes and osmolality

Rats and rabbits were injected ethanol 2 g/kg intraperitoneally. One hour after injection blood was analyzed for serum electrolytes and osmolality. Administration of ethanol caused decrease in serum sodium (p less than 0.0005), potassium (p less than 0.0005), calcium (p less than 0.0005), chloride (p less than 0.005), magnesium (p less than 0.0005) in rabbits. Further studies of intraperitoneal administration of ethanol in rats showed decrease in concentration of sodium (p less than 0.025), potassium (p less than 0.025), calcium (p less than 0.01) chloride (p less than 0.005) magnesium (p less than 0.005), phosphorus (p less than 0.025) and glucose (p less than 0.005). Administration of ethanol caused an increase in serum osmolality in both rabbits and rats (p less than 0.005, p less than 0.05). It is concluded that ethanol ingestion is probably the commonest cause of the hyperosmolar state. Although the osmotic and sedative effects of ethanol are pharmacologically unrelated, the presence of ethanol should be considered in comatose patients in whom the measured plasma osmolality appreciably exceeds that predicted on the basis of plasma glucose, urea and electrolytes concentration.