A novel method to determine new potent angiotensin inhibitor, azilsartan, in human plasma via micelle-enhanced spectrofluorimetry using cremophor RH 40

Purpose: To develop a micelle-enhanced spectrofluorimetric method for the assay of azilsartan (AZL) in bulk form and spiked human plasma without the need for derivatization procedure. Method: The proposed method was based on studying the fluorescence behavior of AZL in Cremophor RH 40 (Cr RH 40) micellar system. The fluorescence intensity was measured at 371 nm after excitation at 264 nm. The proposed procedure was validated according to International Council on Harmonization (ICH) guidelines. Results: In aqueous solution, the fluorescence intensity of AZL was greatly enhanced by more than 3- fold in the presence of Cr RH 40. The fluorescence –concentration plot was linear over the range of 10 – 500 ng.mL-1, with a limit of detection of 3.287 ngmL-1. The proposed method was successfully applied to the determination of AZL in pure powder form and spiked human plasma. The mean recovery of AZL in spiked human plasma using the proposed method was 90.54 ± 1.17 %. Conclusion: The suggested method is highly sensitive and simple, and can easily be applied for the quantification of AZL in pure powder form as well as in biological fluids such as plasma.

X-ray fluorescence spectroscopic determination of heavy metals and trace elements in aerial parts of Origanum sipyleum L from Turkey

Purpose: To determine the heavy metal and trace element composition of the powdered aerial parts of Origanum sipyleum L. and its water extract. Methods: The heavy metal and trace elements content of the powdered plant material and 2 % aqueous extract were evaluated by x-ray fluorescence spectroscopy with silicon drift detector SDD at a resolution of 145 eV and 10,000 pulses. The process conditions were 0.1 g sample weight, process time of 300 s at a voltage of 25 kV and 50 kV, and at a current of 0.5 and 1.0 mA under helium atmosphere. Results: The major elements, K, Ca and Na, known as macronutrients, constituted 11990, 10490 and 970 ppm of the powdered drug and 8910, 2991 and 810 ppm of the water extract, respectively. Among other constituents, arsenic, lead and uranium levels were < 1, 2.1 and < 3 ppm, respectively, in the powdered material while in the aqueous extract, the levels were < 1, < 2 and 200 ppm, respectively. Conclusion: O. sipyleum is a potential source of macro- and micronutrients from which useful food additives and health supplements can be derived.

Spectrum-effect relationships between high performance liquid chromatography fingerprints and bioactivities of charred areca nut

Purpose: To investigate the spectrum-effect relationships between high performance liquid chromatography (HPLC) fingerprints and duodenum contractility of charred areca nut (CAN) on rats. Methods: An HPLC method was used to establish the fingerprint of charred areca nut (CAN). The promoting effect on contractility of intestinal smooth was carried out to evaluate the duodenum contractility of CAN in vitro. In addition, the spectrum-effect relationships between HPLC fingerprints and bioactivities of CAN were investigated using multiple linear regression analysis (backward method). Results: Fourteen common peaks were detected and peak 3 (5-Hydroxymethyl-2-furfural, 5-HMF) was selected as the reference peak to calculate the relative retention time of 13 other common peaks. In addition, the equation of spectrum-effect relationships {Y = 3.818 - 1.126X1 + 0.817X2 - 0.045X4 - 0.504X5 + 0.728X6 - 0.056X8 + 1.122X9 - 0.247X13 - 0.978X14 (p < 0.05, R2 = 1)} was established in the present study by the multiple linear regression analysis (backward method). According to the equation, the absolute value of the coefficient before X1, X2, X4, X5, X6, X8, X9, X13, X14 was the coefficient between the component and the parameter. Conclusion: The model presented in this study successfully unraveled the spectrum-effect relationship of CAN, which provides a promising strategy for screening effective constituents of areca nut.

Chromatographic-mass spectrometric analysis of ethanol extract of Maesa perlaria var formosana

Purpose: This study analyzes the chemical composition of ethanol root extracts of Maesa perlaria var formosana by gas chromatography-mass spectrometry (GC-MS). Methods: The dried root of Maesa perlaria var formosana was extracted with 95 % ethanol for composition analysis under the following optimum GC-MS conditions: 250 °C inlet temperature, 250 °C MSD detector temperature, and GC oven temperature programmed as follows: initial temperature held at 70 °C for 15 min, then increased at a rate of 2.5 °C/min and held at 170 °C for 15 min; then raised at a rate of 2 °C/min and kept at 180 °C for 20 min; then raised at 2 °C/min and kept at 250 °C for 20 min. Finally, it was raised at 3 °C/min and kept at 280 °C for 15 min. Results: A total of 59 chemical compounds were identified, representing 88.82 % of the composition of the ethanol extracts. The three major components, include 2,4-di-tert-butylphenol (16.76 %), stigmasterol (15.86 %) and campesterol (7.33 %). Conclusion: The results show that a total of 59 components were identified in the ethanol extract of Maesa perlaria var. formosana. The major component, 2,4-Di-tert-butylphenol, exhibits various biological activities.

Arsenic bioleaching in medical realgar ore and arsenicbearing refractory gold ore by combination of Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans

Purpose: To develop a novel biotechnological method for removing toxic arsenic from two kinds of representative arsenic-containing ores using different mixed mesophilic acidophiles. Methods: Bioleaching of the two types of arsenic-containing ores by mixed arsenic-unadapted Acidithiobacillus ferrooxidans and Acidithiobacillus thiooxidans or mixed arsenic-adapted cultures, were carried out. Arsenic bioleaching ratios in the various leachates were determined and compared. Results: The results showed that the maximum arsenic leaching ratio obtained from realgar in the presence of mixed adapted cultures was 28.6 %. However, the maximum arsenic leaching ratio from realgar in the presence of mixed unadapted strains was only 12.4 %. Besides, maximum arsenic leaching ratios from arsenic-bearing refractory gold ore by mixed adapted strains or unadapted strains were 45.0 and 22.9 %, respectively. Oxidation of these two ores by sulfuric acid was insignificant, as maximum arsenic leaching ratios of realgar and arsenic-bearing refractory gold ore in the absence of any bacterium were only 2.8 and 11.2 %, respectively. Conclusion: Arsenic leaching ratio of realgar and refractory gold ore can be enhanced significantly in the presence of arsenic-adapted mesophilic acidophiles.

Anti-biofilm and antimicrobial activity of Mentha pulegium L essential oil against multidrug-resistant Acinetobacter baumannii

Purpose: To investigate the antimicrobial and anti-biofilm activities of essential oil from Mentha pulegium L. (EOMP) on multi-drug resistant (MDR) isolates of A. baumannii , as well as its phytochemical composition, antioxidant properties and cytotoxic activity. Methods: The phytochemical composition of EOMP was analyzed by gas chromatography, while its antimicrobial activities were determined by disc diffusion and broth micro-dilution methods. Minimal biofilm inhibition concentration (MBIC) and minimal biofilm eradication concentration (MBEC) tests were used for assessment of its anti-biofilm properties. Viability in the biofilm was studied using 2,3-bis (2- methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay, while colorimetric assay was used to assess its cytotoxicity on L929 cells. Results: D-isomenthone, pulegone, isopulegone, menthol and piperitenone were the major components of the plant extract. EOMP produced > 22 mm inhibition zone for the isolates, with minimum inhibitory concentration (MIC) and MBIC of 0.6 - 2.5 and 0.6 - 1.25 μL/mL, respectively, while MBEC was ≥ 10 μL/msL. EOMP damaged biofilm structures formed by A. baumannii strains at MIC by 26 – 91 %. Conclusion: These results suggest that EOMP contains agents that may be useful in the development of new drugs against A. baumannii infections.

Prevalence of Listeria species in some foods and their rapid identification

Purpose: To investigate the occurrence of Listeria spp., (particularly L. monocytogenes ), in different foods and to compare diagnostic tools for their identification at species level. Methods: Samples of high protein foods such as raw meats and meat products and including beef products, chicken, fish and camel milk were analysed for the presence of Listeria spp. The isolates were characterised by morphological and cultural analyses, and confirmed isolates were identified by protein profiling and verified using API Listeria system. Protein profiling by SDS-PAGE was also used to identify Listeria spp. Results: Out of 40 meat samples, 14 (35 %) samples were contaminated with Listeria spp., with the highest incidence (50 %) occurring in raw beef products and raw chicken. Protein profiling by SDSPAGE was used to identify Listeria spp. The results were verified with API Listeria system. Approximately 25 % of the identified isolates were Listeria seeligeri , Listeria welshimeri , and Listeria grayi (three positive samples), while 16.66 % of the isolates were Listeria monocytogenes (two positive samples); 16.6 % of the isolates were Listeria innocua (two positive samples), while 8.3 % of the isolates were Listeria ivanovii (one positive sample). Conclusion: High protein foods contain different types of Listeria species; whole-cell protein profiles and API Listeria system can help in the identification of Listeria at the species level.

Clinical Studies on conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor in second-line treatment of non-small cell lung cancer

Purpose: To study the effect of conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in the second-line treatment of non-small cell lung cancer (NSCLC). Methods: A total of 316 patients attending Shanghai Pulmonary Hospital affiliated to Tongji University, were divided into two groups: 106 patients were treated with conformal radiotherapy combined with EGFR-TKI (gefitinib, 250 mg/day; or erlotinib, 150 mg/day), while 210 patients were treated with EGFRTKI alone. Some factors, including adverse reactions (AR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and one-year and two-year survival rate, were evaluated. Results: No obvious difference was observed in AR between the two groups (p > 0.05). In the combination therapy group, complete response (CR) was 5 cases, partial response (PR) 43 cases, and stable disease (SD) 47 cases, progressive disease (PD) was 11 cases, response rate (RR) was 45.3 %, and DCR 89.6 %. Median PFS in the combination therapy group and targeted therapy group was 6.5 and 5.0 months, respectively. On the other hand, median OS in the combination therapy group and targeted group was 14.1 and 12.6 months, respectively. One-year survival rate of the combination therapy group and EGFR-TKI group was 60.3 and 50.0 %, respectively, while the two-year survival rate was 26.3 and 19.0 %, respectively. Conclusion: Conformal radiotherapy combined with EGFR-TKI can be used as an effective second-line treatment for NSCLC.

Patterns of prescribing and utilization of asthma medications in a tertiary hospital in Dubai, United Arab Emirates

Purpose: To assess the prescribing patterns of asthma medications in a hospital in Dubai, United Arab Emirates (UAE) with regard to the demographic pattern of the population. Methods: One hundred fifty four patients, 83 male and 71 female, were randomly selected from the outpatient respiratory diseases clinic of a tertiary hospital in Dubai, UAE over a 3-month period. Patients were asked to complete a structured questionnaire and data were analyzed using STATA 12 software. Results: Most of the patients were within the age range of 0 – 10 years. About 86 % of the patients were overweight. Half of the patients were non-smokers while 51 % of them had a family history of asthma. About 54 % of the patients received multiple drug therapy of which two-drug combinations were widely prescribed (31 %). The most utilized drug classes were short acting β-agonists (42 %), xanthine drugs (16 %), leukotriene modifiers (14 %) and oral and intravenous corticosteroids (13 %). Statistical significant differences among the age groups (F = 2.33, p = 0.0275) were found. Conclusion: Primary prevention to reduce the level of exposure to common risk factors for asthma would be a vital step to control the disease. More resources should be channeled into educating physicians and patients on rational drug utilization to improve the quality of patients’ care.

Prevalence of diabetic retinopathy in type II diabetic patients in a health facility in Karachi, Pakistan

Purpose: To study the prevalence of diabetic retinopathy in known diabetic patients attending the diabetes outpatient department (OPD) of Sind Government Hospital (SGH), New Karachi Township (NKT), Pakistan. Methods: A cross-sectional observational study was carried out at the diabetic OPD of SGH, NKT over the period of 17 months from March 2013 to August 2014. The selected patients were interviewed based on a questionnaire; laboratory investigations were performed and examination of the eye was conducted by a specialist ophthalmologist. One hundred and fifty four (154) subjects out of 305 patients contacted fully completed the study. Stratification of the data on gender basis was done, after which one-way ANOVA, χ2 test of correlation, binary logistic regression and relative risk analyses were carried out using SPSS-20. Results: It was found that 66 % men of normal weight (χ2 = 4.667, p < 0.05) and 60.7 % overweight women (χ2 = 5.143, p < 0.05) were more likely to present with diabetic retinopathy (DR). Prevalence of DR in this target population was 42.86 % (N = 66). Background DR (56 %) and maculopathy (23 %) were more prevalent than advanced conditions of the disease. There was no gender-based preponderance for the presentation of DR (χ2 = 0.663; p > 0.05), nor was this seen in different ethnic groups. Conclusion: DR is prevalent in the target population and, therefore, emphasis should be on the education of the local population of New Karachi Township on how to attain euglycemic state with regular medication, diet and exercise to avoid development and progress of DR.

Clinical effects of sirolimus treatment in patients with increased serum creatinine levels after renal transplant

Purpose: To observe the clinical effects of sirolimus (SRL) immunosuppressive therapy in patients with progressively increasing levels of serum creatinine (Scr) after renal transplant. Methods: In total, 180 patients whose Scr levels had been rising after renal transplant were given an oral calcineurin inhibitor (CNI): either cyclosporine A (CsA) or tacrolimus (FK506). All patients were treated at People’s Hospital of Zhengzhou, China, between January 2011 and December 2013, and were given SRL-based conversion treatment. Scr level and glomerular filtration rate (GFR) were observed before and 1, 3, and 6 months after treatment initiation. In addition, liver function, blood glucose, blood lipid levels, rejection reaction incidence, and mortality were recorded to evaluate the effects of SRL. Results: Scr levels were 116.60 ± 30.60 μmol/L and 119.00 ± 24.60 μmol/L, and GFR was 70.00 ± 19.70 mL/min and 75.90 ± 15.60 mL/min, at 3 and 6 months after treatment, respectively. The 3- and 6- month Scr and GFR values were statistically different (p < 0.05) compared to pre-treatment levels (Scr: 144.10 ± 61.70 μmol/L vs and GFR: 59.10 ± 16.20 mL/min. Acute rejection (AR) occurred in 20 patients (13.30 %) within 6 months of treatment initiation, but rejection was reversed with conventional methylprednisolone therapy. Twenty-one patients (11.70 %) developed lung infections, but all were cured. There were no significant differences in liver function before and after treatment. Conclusion: SRL-based immunosuppressive therapy is effective in treating patients with increased Scr levels after renal transplant.

Role of Erythropoietin in Renal Anemia Therapy

Renal anemia is a common complication of chronic renal failure caused by erythropoietin deficiency; targeting erythropoietin is a common approach to renal anemia treatment. This paper describes the role of erythropoietin and others drugs in renal anemia treatment, as well as the cause of erythropoietin resistance.

Natural plant polyphenols for alleviating oxidative damage in man: Current status and future perspectives

The balance between oxidation and reduction is important for maintaining a healthy biological system. Oxidative stress results from an imbalance between excessive formation of reactive oxygen species (ROS) and/or reactive nitrogen species (RNS) and limited endogenous defense systems, and this imbalance can adversely alter lipids, proteins and DNA, causing a number of human diseases. Thus, exogenous antioxidants that can neutralize the effect of free radicals are needed to diminish the cumulative effects of oxidative damage over human life span. Current research reveals that phenolic compounds in plants possess high antioxidant activity and free radical scavenging capacity and can prevent the body from oxidative damage over human life span. This review focuses on the present understanding of free radicals and antioxidants and their importance in human health and disease. Information about the chemical features of free radicals as well as their deleterious effects on cell structures is reviewed. The chemical structure and anti-oxidative mechanisms of essential polyphenols and their potential health benefits are presented. In addition, the limitation of natural antioxidants and a perspective on likely future trends in this field are also discussed.

Radioprotective effect and other biological benefits associated with flavonoids

Ionizing radiation has the potential to cause extensive damage to living organisms. It can directly act on DNA, proteins and lipids, resulting in ionizing excitation and chemical bond cleavage, which can lead to molecular and cellular damage. Ionizing radiation can hydrolyze water molecules in the body, resulting in increased numbers of free radicals with strong oxidation ability. This process indirectly leads to tissue degeneration and necrosis, which can possibly result in cancer. In this paper, the intervention mechanism of flavonoids on ionizing radiation was analyzed. It has been revealed that the intervention mechanism associated with flavonoids may offer protective properties for DNA, prevent scavenging free radicals, and protect against auto-immune damage. In addition, this invention mechanism can protect the hematopoietic system and reduce inflammation.

Suppression of HIV-1 viral load after multiple changes in high active antiretroviral therapy: A case report

High active antiretroviral therapy (HAART) can reduce plasma viremia to levels below the limit of detection, leading to adequate immune recovery and clinical stability in most HIV-1-infected patients. However, the virus persists in reservoirs, and free virions can be found in the plasma. We report here the case of an HIV-infected patient diagnosed in 1999, who exhibited good adherence to medication and HAART efficacy after multiple protocol changes. In this study, we describe the clinical features, chronological changes in HIV viral load and CD4+ T-cell count, and treatment outcomes of multiple combinations of antiretrovirals (ARV).The patient presented cycles of viral load during treatment ranging from undetectable, low, and intermediate HIV-1 RNA levels, to levels above the limits of quantification. A therapeutic regimen intensified with raltegravir (RAL) promoted constant depletion of HIV viral load and an increase in CD4+ T-cells. The report shows that enhanced HAART efficacy using RAL can reduce HIV viral load.