Association of long-term consumption of repeatedly heated mix vegetable oils in different doses and hepatic toxicity through fat accumulation

Background: Hepatic diseases are one of the chief reasons for worldwide morbidity and mortality. The increased incidence in Asian countries is driving researchers to explore preventive ways from nature. It is more practical to go with healthy routine edibles like vegetable oils to avoid environmental and chemical hepatic injuries. With the use of thermally oxidized oils overproduction of reactive oxygen species (ROS) with overwhelmed cellular antioxidants defense system results in oxidative stress, the known cause of cardiovascular diseases (CVDs), cancers and neurodegenerative disorders. Little is investigated about the effect of daily used oxidized cooking oils on hepatic function changes with oxidative stress especially in the animal model that mimics the human situation.Methods: In this study, healthy adult male rabbits of local strain were divided into 4 groups (n = 12). First, two sets of rabbits were treated with 1 and 2 ml/kg/day of repeatedly heated mix vegetable oils (RHMVO) respectively. The third set of rabbits was given 1 ml/kg/day of single time heated mix vegetable oils (STHMVO) and the fourth set of rabbits served as controls and fed with normal rabbit diet to for 16 weeks. Serum liver function markers including total-protein, albumin, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) along with the activity of hepatic antioxidant-enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA) for lipid peroxidation were compared among different groups of rabbits. Histopathological examination was performed for all four groups.Results: Significantly (p \u3c 0.05) elevated hepatic enzymes and MDA levels, with lower total protein, serum albumin, GPx, SOD and CAT levels were found in high and low doses RHMVO treated groups, in comparison to control. In the STHMVO group, all mentioned markers were insignificantly changed. Accumulation of liver fat in low and high dose oil-treated groups was further confirmed under the microscopic examination of liver tissues, presented significant fat accumulation in liver tissues, in addition, 40-60% increased oxidative stress compared to control, in a dose-dependent manner.Conclusions: These results conclude that consumption of thermally oxidized mix vegetable oils for longer duration can impair the liver function and destroy its histological structure significantly through fat accumulation and oxidative stress both in high as well as low doses

Neurodevelopment outcome of neonates treated with intraventricular colistin for ventriculitis caused by multiple drug-resistant pathogens-A case series

Background: Multiple-drug-resistant Gram-negative bacteria (MDR-GNB)-associated neonatal ventriculitis is a life-threatening complication that needs timely diagnosis and effective treatment with broad-spectrum antimicrobials in critical-care settings. Inadequate penetration of antibiotics through the blood-brain barrier also demands an intraventricular (IVT) route of administration. This study reports mortality and neurodevelopmental sequelae of neonates till 18 months of age, who received IVT-colistin for treating MDR-GNB associated ventriculitis. Methods: In a case series of seven neonates with ventriculitis due to MDR-GNB at NICU of Aga Khan University Hospital, Pakistan, between June 2015 and 2018, we reviewed IVT-colistin therapy in critically ill neonates. Treatment outcomes were assessed based on clinical sign\u27s resolution and MDR-GNB eradication in subsequent CSF cultures. Neurodevelopmental outcomes were evaluated at 18 months after discharge. Results: The average birth weight was 1.38 kg (range: 1.02-1.5 kg), and the average gestational age was 30.7 weeks (ranged: 26-34 weeks). All neonates reported colistin-sensitive MDR-GNB in CSF, five with Acinetobacter baumannii, and polymicrobial CNS infection was found in two patients (one due to Klebsiella pneumonia and A. baumannii and one due to K. pneumonia and Escherichia coli). All neonates received IVT colistin and concomitant intravenous meropenem, and five of them also received intravenous colistin. One neonate died. At the 18-month assessment, only one neonate had cerebral palsy and hydrocephaly and 50% had seizure disorders. Conclusion: Practicing intraventricular antibiotics in the neonatal population is challenging but may be used successfully, especially to overcome the limitation of poor penetration through the blood-brain barrier

Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: A collaborative-practice model

Background: Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementing TDM services, this study aimed to assess a pharmacist-directed VCM-TDM service for optimizing patient care in our institution.Materials and methods: Patients aged 1 month-18 years who received intravenous VCM were included in this quasi-experimental study. The pre-implementation phase (March-June 2018) consisted of retrospective assessment of pediatric patients, the interventional phase (July 2018 to February 2020) included educational programs and the post-implementation phase (March-June 2020) evaluated the participants based on pharmacist-directed VCM-TDM services as a collaborative-practice model including clinical and inpatient pharmacists to provide 24/7 TDM services. Outcomes of the study included the mean difference in the number of optimal (i) prescribed initial VCM doses (primary) (ii) dosage adjustments and (iii) VCM-sampling time (secondary). After ethical approval, data were collected retrospectively.Results: A hundred patients were there in each phase. The number of cases who were correctly prescribed initial VCM doses was significantly higher in the post-implementation phase, mean difference of 0.22, [95% CI (0.142-0.0.358), p \u3c 0.0001]. Patients who had correct dosage adjustments in the post-implementation phase also had higher statistical significance, mean difference of 0.29, [95% CI (0.152-0.423), p \u3c 0.05]. More correct practices of VCM-levels timing were observed in the post-implementation phase, mean difference of 0.15, [95% CI (- 0.053-0.264), p = 0.079].Conclusion: This study showed the significant role of pharmacist-directed TDM services to optimize the correct prescribing of initial VCM doses and dose adjustments

Repeatedly heated mix vegetable oils-induced atherosclerosis and effects of murraya koenigii

Background: Statins are considered as standard drugs to control cholesterol levels, but their use is also associated with renal hypertrophy, hemorrhagic stroke, hepatomegaly, and myopathy. Murraya koenigii is an herb that is used in traditional cuisine and as a medicine in South Asia. Here we assessed the antidyslipidemic and antiatherosclerotic effects of this spice in repeated heated mix vegetable oils (RHMVO)-induced atherosclerotic models.Methods: Aqueous extract of M. koenigii leaves (Mk LE) was prepared and its phytoconstituents were determined. Rabbits were divided into 5 groups (n = 10). Except for the control group, all the other four groups were treated with RHMVO for 16 weeks (dose = 2 ml/kg/day) to induce dyslipidemia and atherosclerosis. These groups were further treated for 10 weeks either with 300 and 500 mg/kg/day Mk LE, lovastatin, RHMVO, or left untreated. Body and organ weights were measured along with oxidative stress and tissue damage parameters. Lipid profile and hepatic function markers were studied. Atheroma measurement and histopathological examination were also performed in control and treated groups.Results: Mk LE significantly (p \u3c 0.05) attenuated RHMVO-induced dyslipidemia and atheroma formation. Furthermore, fat accumulation and lipid peroxidation in hepatic tissues were reduced by Mk LE in a dose-dependent manner. Our results indicated that the antidyslipidemic effects of Mk LE in 500 mg/kg/day dose were comparable to lovastatin. Additionally, oxidative stress markers were reduced much more significantly in Mk LE-500 than in the statin group (p \u3c 0.05).Conclusions: This study recommends Mk LE as a potent antioxidant and lipid-lowering natural medicine that can attenuate the RHMVO-induced atherosclerotic in optimal doses and duration. Therefore, Mk LE can be accessible, cheap, and free of adverse effects alternate to statins

Synthesis and Characterization of Novel Nanobifiller filled Epoxy Anti-Corrosive Nano-Organic coating for High Performance Automotive Applications

Nanobifiller filled epoxy, nylon 66 (PA 66) and their blend-based nanocomposites were prepared by solution casting method to produce anti-corrosive and abrasion resistant epoxy nanocoating for aerospace and automotive applications. Nanobifiller was composed of Bentonite clay modified organically with quaternary salt of threonine amino acid and nanodiamonds (ND). Various techniques were implied to investigate anticorrosive properties of polymeric nanocomposites. These techniques include salt spray analysis and electrochemical impedance spectroscopy (EIS). It was observed that epoxy nanocomposites prepared are much resistant to corrosion as compared to pristine epoxy samples with improved barrier properties

Correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at Dr. Ruth K.M. Pfau Civil Hospital Karachi.

Introduction: Cirrhotic patients suddenly or insidiously develop hepatic en-cephalopathy. Approximately three-fourth of the patients usually die within 3 years of onset of their first episode of hepatic encephalopathy. Hypo-natremia, a multifactorial phenomenon in cirrhotic patients may lead to cer-ebral edema and astrocytes swelling.Objective: To determine the correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at tertiary care hospital, Karachi.Methodology: This prospective cross-sectional study conducted at Depart-ment of Medicine, Civil Hospital, Karachi between October 31, 2019 till April 4,2020. Data collected from 138 patients after taking written consent; pre-sented as was as mean, standard deviation, frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable taking p-value of ≤0.05 as significant.Results: Among 138 patients 92 (66.7%) were male and 46 (33.3%) were female. Mean age, duration of symptoms, height, weight and serum sodium in our study was 51.14±4.49 years, 12±7.21 hours, 161±6.78 cm, 85.2±8.54 kg and 132.7±6.32 mEq/L. Out of 136 patients, 28 (20.3%), 35 (25.4%), 54 (39.1%) and 21 (15.2%) patients belonged to sodium quartile 1, 2, 3 and 4; while 21 (15.2%), 41 (29.7%), 28 (20.3%) and 48 (34.8%) belonged to hepatic encephalopathy severity grade 1, 2, 3 and 4. Hepatic encephalopathy severi-ty showed correlation with rising sodium levels.Conclusion: Hyponatremia was found with increased frequency in patients with cirrhosis of liver having a correlation with frequency and severity of hepatic encephalopathy.Key words: Encephalopathy, Liver Cirrhosis, Hyponatremia

Meropenem-induced pancytopenia in a preterm neonate: A case report

Background: A post-marketing surveillance study has reported an association between meropenem use and the incidence of hematologic abnormalities, including leukopenia, thrombocytopenia, hemolysis, and neutropenia, but the precise incidence in neonates is unknown. Here, we report meropenem-induced pancytopenia in a preterm neonate.Case presentation: A preterm newborn Pakistani received intravenous meropenem 40 mg/kg every 8 hours to treat Klebsiella pneumoniae in blood cultures and suspected meningitis. The baby developed severe thrombocytopenia, with a platelet count of 22 × 103 cells/mm3, low hemoglobin level of 9.7 g/dl, and low absolute neutrophil count (ANC) of 816 cells/mm3 on days 3, 14, and 17 of meropenem therapy, respectively. Based on the blood culture and institutional guidelines, meropenem treatment was continued with monitoring and supportive care for a total of 19 days. After discontinuation of meropenem, the baby was monitored continuously for hematological changes, and low counts persisted for 3 days. ANC improved to \u3e 1500 cells/mm3 on the fourth day, and the platelet count reached \u3e 150 × 103 cells/mm3 for the first time on the seventh day of meropenem discontinuation. All subsequent complete blood count (CBC) reports showed improving trends. The baby was discharged on the 48th day of life (DOL), with follow-up monitoring of CBC. The baby was kept on iron supplements, and hemoglobin level of 11.2 g/dl was observed on the 59th DOL.Conclusion: Neonatal pancytopenia may lead to serious health complications; therefore, clinicians and pharmacists need to vigilantly monitor CBC in this vulnerable population, even when administering meropenem in septic doses for the recommended duration

Transition metal oxide nanopowder and ionic liquid: an efficient system for the synthesis of diorganyl selenides, selenocysteine and derivatives

We have developed an efficient method for the synthesis of diorganyl selenides and β-seleno amines using Zn, catalytic amounts of ZnO nanopowder, as a catalyst and ionic liquid as a recyclable solvent. This ZnO/ionic liquid system shows high efficiency in catalyzing these transformations with the formation of the desired products in high yields

Ameliorative effects of Vitamin E and Urtica dioica against thiamethoxam-induced teratogenicity in embryonated chicken eggs

Background: The purpose of this study was to explore the defensive effects of Vitamin E (Vit. E) and Urtica dioica (UD) in the mitigation of developmental anomalies induced by thiamethoxam (TMX) in chicken embryos.Methods: For this purpose, a total of 140 fertile eggs were equally divided into seven experimental groups (A-G); Groups A and B were kept as negative and sham control, respectively. Group C was exposed to TMX while groups D and E were supplemented with Vit. E and U. dioica, respectively along with TMX. Group F received Vit. E and group G U. dioica, only. The eggs were examined on days 10th and 20th of incubation for the assessment of developmental flaws and musculoskeletal anomalies.Results: The mortality rate was highest (40%) in group C (TMX) followed by groups D and E (20 and 15%), respectively. Developing embryos were exposed to TMX for retarded growth weight and crown-rump length (CRL) were significantly decreased as compared to the control group. The highest survival rate was recorded in negative control group A. The teratogenic defects recorded in this study include growth retardation, decreased crown-rump length, shortened beak, exencephaly, feather scantiness, and limb deformities. Morphometric analysis revealed improved growth by all parameters in Vit. E and U. dioica supplemented groups.Conclusion: It was concluded that developmental defects are due to induced TMX, can be counteracted with Vit. E and U. dioica and have no phytochemicals negative effects