The protective effects of honey propolis on oxidative in kainic acid mediated excitotoxicity in rat brain

Introduction : Propolis has been proposed to be protective on neurodegenerative disorders. It has been shown to have broad biological activities, which are principally attributed to the presence of flavonoids and caffeic acid phenyl ester (CAPE). Objective : To understand the neuroprotective effects of honeybee propolis, glutamine synthetase (GS) activity, nitric oxide (NO), thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) are studies in different brain regions- cerebral cortex (CC), cerebellum (CB) and brain stem (BS) of rats supplemented with propolis and subjected to kainic acid (KA) mediated excitotoxicity. Materials and method : Twenty four Sprague Dawley male rats weighing 250-300 grams were used as subjects in this study. The animals were divided into four groups with 6 rats in each group. Group 1; control, group 2 ; kainic acid treated, group 3 ; propolis treated and group 4 ; kainic acid and propolis treated . The animals were sacrificed at the specific time and decapitated using the guillotine and brains were quickly removed and the different brain regions, namely cerebral cortex (CC), cerebellum (CB) and brain stem (BS) were separated quickly and were used to prepare the homogenates for the assay of biochemical parameters. Results were analyzed by one-way ANOVA using SPSS software version 20. Conclusion :The results of this study clearly demonstrated the restoration of GS activity and NO levels in kainic acid mediated excitotoxicity. TBARS which is the marker of oxidative stress was increased significantly in all the three brain regions tested in KA group, but the increase of TBARS concentration by KA was prevented by prior supplementation with propolis and the concentration of TAS was decreased significantly in KA group compared to propolis and KA group indicating the depletion of TAS concentration by KA was prevented by supplementation of propolis. Hence, propolis can be a possible potential candidate of protective agent against excitotoxicity and neurodegenerative disorders

Hemolyzed Specimens: Major Challenge for Identifying and Rejecting Specimens in Clinical Laboratories

Pre-analytical quality in clinical chemistry testing is as important as analytical and post-analytical quality. The most prevalent pre-analytical interference and a major source of error producing unreliable laboratory test results is hemolysis of blood samples. In vitro hemolysis may be due to the blood withdrawal technique or sample handling whereas in vivo hemolysis can originate from acquired, hereditary, or iatrogenic conditions and is not technique dependent. Interpreting in vivo or in vitro hemolysis requires clinicians to supply reliable clinical history and findings. Even then, to reject or release the result with interpretation is still under debate. Thus, hemolyzed specimens are a serious pre-analytical problem calling for well-designed and strictly implemented laboratory guidelines. The aim of this non-systematic review (addressed to healthcare professionals) was to highlight the challenges in identifying and rejecting hemolysis specimens

RESTORATION OF GLUTAMINE SYNTHETASE ACTIVITY, NITRIC OXIDE LEVELS AND AMELIORATION OF OXIDATIVE STRESS BY PROPOLIS IN KAINIC ACID MEDIATED EXCITOTOXICITY

Background: Propolis has been proposed to be protective on neurodegenerative disorders. To understand the neuroprotective effects of honeybee propolis, glutamine synthetase (GS) activity, nitric oxide (NO), thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) were studied in different brain regions- cerebral cortex (CC), cerebellum (CB) and brain stem (BS) of rats supplemented with propolis and subjected to kainic acid (KA) mediated excitotoxicity. Materials and Methods: Male Sprague-Dawley rats were divided into four groups; Control group and KA group received vehicle and saline. Propolis group and propolis + KA group were orally administered with propolis (150mg/kg body weight), five times every 12 hours. KA group and propolis + KA group were injected subcutaneously with kainic acid (15mg/kg body weight) and were sacrificed after 2 hrs and CC, CB and BS were separated homogenized and used for estimation of GS activity, NO, TBARS, and TAS concentrations by colorimetric methods. Results were analyzed by one-way ANOVA, reported as mean + SD from 6 animals, and

AST, ALT, Bilirubin and AST/ALT Ratio role; Covid- 19 Patients

Background Impaired liver function upon admission has been linked to the severity of COVID-19 infection, yet the data is debated [1]. Therefore, this retrospective study aimed to evaluate the liver function among COVID-19 patients during hospitalization and its association with the disease severity. Methodology The patient aged 18 to 80 with positive COVID-19 at Hospital Raja Perempuan Zainab II (HRPZ II), Kota Bharu, Kelantan, with available AST, ALT, Bilirubin, and AST/ALT ratio data on admission, were retrospectively evaluated from March 2021 to March 2022. Disease severity was categorized based on Annex 2e guidelines by Malaysia's Ministry of Health, which further classified them into mild to moderate disease (Stage 1-3) and severe to critical illness (Stage 4-5). The AST, ALT, Bilirubin, and AST/ALT ratio levels on Day 1 admission were archived from the electronic medical record system and compared between the two groups. The statistical analysis was using SPSS version 27. This study was approved by (JEPeM-USM) protocol code USM/JEPeM/21100691 and Ministry of Health Malaysia NMRR-21-762-58458 (IIR). Results and Discussion The study included a total of 168 COVID-19 patients with a mean (SD) age of 46.67(16.10) for mild to moderate and 56.66(12.41) for severe to critical. There is a significant age group for both groups (p-value=0.002). During hospitalization, 16(14.41%) patients progressed to death from severe to critically ill patients. Upon admission, the median (IQR) of AST and ALT were significantly higher in the severe to critical group compared to in the mild to moderate group, [AST; 39.0(49.0) and 24.0(14.0), ALT 38.0(43.0) and 21.0(18.0)], p<0.05. However, no significant difference between both groups for bilirubin level and AST/ALT ratio. Non-survivors had a higher AST and ALT level compared to survivors, with a median (IQR) of [AST 98.0(88.0) and 32.0 (26.0), ALT of 67.5(90.0) and 28.0(31.0), (p<0.05). Similarly, no significant difference between non-survivors and survivors for bilirubin and AST/ALT ratio. Our study support that, abnormal liver function at admission has been shown to be associated with the disease severity and mortality of COVID-19 infection. However, there is also a need to observe the COVID-19 survivors' hepatobiliary sequelae and dynamic liver function changes following hospital discharge. Conclusion Abnormal AST and ALT level at admission has been shown to be associated with the disease severity and mortality of COVID-19 infection. Further study needed to evaluate liver damage in COVID-19 post-discharge

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases (n = 64, hyperthyroid; n = 53 euthyroid; n = 18, hypothyroid) and healthy controls (n = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm2). The results showed that the mean serum vitamin D Levels of all groups was low (&lt;50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD

Global Prevalence of Macroprolactinemia among Patients with Hyperprolactinemia: A Systematic Review and Meta-Analysis

Hyperprolactinemia (hPRL) often poses a diagnostic dilemma due to the presence of macroprolactin. Understanding the prevalence of macroprolactinemia (mPRL) has an important implication in managing patients with hPRL. The primary aim of this study was to determine the prevalence of mPRL globally and to explore selected factors influencing the prevalence estimate. Studies with original data related to the prevalence of mPRL among patients with hPRL from inception to March 2020 were identified, and a random effects meta-analysis was performed. Of the 3770 records identified, 67 eligible studies from 27 countries were included. The overall global prevalence estimate was 18.9% (95% CI: 15.8%, 22.1%) with a substantial statistical heterogeneity (I2 = 95.7%). The highest random effects pooled prevalence was observed in the African region (30.3%), followed by Region of the Americas (29.1%), European (17.5%), Eastern Mediterranean (13.9%), South-East Asian (12.7%), and Western Pacific Region (12.6%). Lower prevalence was observed in studies involving both sexes as compared to studies involving only female participants (17.1% vs. 25.4%) and in more recent studies (16.4%, 20.4%, and 26.5% in studies conducted after 2009, between 2000 and 2009, and before 2000, respectively). The prevalence estimate does not vary according to the age group of study participants, sample size, and types of polyethylene glycol (PEG) used for detection of macroprolactin (PEG 6000 or PEG 8000). With macroprolactin causing nearly one-fifth of hPRL cases, screening for mPRL should be made a routine before an investigation of other causes of hPRL

Interferences of HbA1c analysis in Hospital Universiti Sains Malaysia – 3 years study

Haemoglobin A1c (HbA1c) is used to monitor glycaemic control and predict diabetic complications. Measurement of HbA1c can be interfered by haemoglobin (Hb) variant and other Hb derivatives include carbamylated Hb and elevated labile A1c. This study is to determine the percentages and type of interferences during HbA1c analysis and the percentages of nonreportable HbA1c results. This is a cross-sectional study using retrospective data of HbA1c. The HbA1c is measured on Biorad D10 using the ion-exchange high-performance liquid chromatography method. The data were analyzed using descriptive statistics. A total of 26,560 patients were included. The result showed the presence of interferences of 2269 (8.56%). The most common causes of the interferences were the Hb variant (8.48%) followed by carbamylated Hb and labile A1c (0.03% each). The non-reportable HbA1c results were 0.46% with the Hb variant contributed most of the causes. By knowing the presence of interferences particularly the Hb variant, the HbA1c results hopefully are interpreted with caution and correct management can be given to the patients

Serum urea/albumin ratio; Covid-19 patients

Background The blood urea to albumin ratio is an inflammatory biomarker that has been linked to clinical outcomes in a variety of diseases . In this regard, the urea/albumin ratio can be a useful biomarker that allows the clinician to identify those at higher risk of critical illness quickly. This study aims to determine the association between the urea/albumin ratio and severity among COVID-19 patients. Methodology This was a retrospective study on hospitalised adult COVID-19 patients aged 18 to 80 at Hospital Raja Perempuan Zainab II (HRPZ II) between February 2021 and February 2022. A total of 170 COVID-19 patients were enrolled in this study. The serum urea, albumin, and creatinine level on admission were recorded. The patients were classified into five clinical stages based on Annex 2e guidelines by Malaysia's Ministry of Health. The patients were grouped by disease severity into mild to moderate disease (Stage 1-3) and severe to critical illness (Stage 4-5). The statistical analysis was using SPSS version 27. This study was approved by (JEPeM-USM) protocol code USM/JEPeM/21100691 and Ministry of Health Malaysia NMRR-21-762-58458 (IIR). Results and Discussion Of the patients who were included in the study, 56 (32.9%) were mild to moderate category, and 114 (67.1%) were in the severe to the critical group. 69(40.6%) were male, and 101(59.4%) were female. The mean age was significantly higher in the severe to the critical group, 59.26 ± 13.6 years, compared to the mild to moderate group, 52.09 ± 22.2 years, p=0.010. The severe to critical group had a significantly higher median value of urea, creatinine, and urea/albumin ratio compared to the mild to moderate group. (urea: 7.0(7.20) and 3.6(3.2), p<0.001; creatinine 89.50(59.75) and 54.3(39.75), p<0.001; urea/albumin ratio 0.21(0.24) and 0.08(0.07), p<0.001). The mean albumin value in the severe to the critical group was significantly lower than in the mild to moderate group (34.95 ± 5.57 and 37.8 ± 5.58, respectively; p = 0.002). These findings suggest that markers of renal function could reliably identify the risk of COVID-19 in individuals. Conclusion Based on our study findings, a high urea/albumin ratio on admission was associated with severe COVID-19 infection. This biomarker could aid in risk stratification models for predicting serious and fatal outcomes of COVID-19 disease. Further studies are needed to define the optimal cut-off point for this marker and reach a consensus on its prognostic value