Assessment of the anti-diabetic effect of Bauhinia variegata gold nano-extract against streptozotocin induced diabetes mellitus in rats

Diabetes mellitus (DM) is the most common type of the metabolic endocrine disorders. It is categorized as the thirdcause of death after heart and cancer diseases. Due to the undesirable side effects of the synthetic anti-diabetic drugs,the medicinal plants were selected for DM treatment. The recent studies directed to use nanotechnology in medicine toovercome restrictions of the drugs that were represented by weak bioavailability, insolubility in water, low absorptionby the intestine, and inability to reach to the appropriate site of action. The study aimed to investigate the antioxidant,antidiabetic, and hypolipidemic effect of Bauhinia variegata (B. variegata) extract before and after incorporating goldnanoparticles (Au-NPs) against DM induced by streptozotocin (STZ) in rats. The present study conducted on 36 malealbino Western rats divided into six groups {control, B. variegata extract treated group, B. variegata gold nano-extracttreated group, diabetic group [injected by STZ intrapretinoally (i.p.) at a dose of 60 mg/kg], diabetic rats treatedwith B. variegata extract, and B. variegata gold nano-extract groups}. The DM related biochemical functions (liverand kidney functions, glucose, insulin, and lipid profile) were assayed. Moreover, the enzymatic and non-enzymaticantioxidants were assayed in addition to lipid peroxidation products in liver and pancreas. Furthermore, the nativeprotein, lipoprotein patterns, and isoenzymes were electrophoretically studied. It was found that the administrationof both B. variegata extract and nano-extract to diabetic rats ameliorated the deleterious effects that occurred asa result of STZ injection and restored the biochemical functions in addition to levels of hepatic and pancreaticantioxidants to normalcy. These findings were supported by the histopathological examination. It was concluded thatB. variegata nano-extract exhibited more antidiabetic effect through restoring the normal architecture of pancreaticβ-cells in addition to the antioxidant and hypolipidemic effect than extract alone, which indicated that the efficacy ofB. variegata extract was increased after the incorporation of Au-NPs.

role of procalcitonin as a guide for the diagnosis, prognosis, and decision of antibiotic therapy for lower respiratory tract infections

Objectives: To assess the value of PCT as a rapid and sensitive marker for diagnosis, prognosis, and therapy of lower respiratory tract bacterial infections necessitating antimicrobial treatment and comparing this marker with other markers of infections including C-reactive protein [CRP] and total white-blood cell counts [WBCs]

Patients and methods: Sixty Patients were enrolled in the study, they were subjected to complete history taking, physical examination, laboratory investigations including complete blood count, blood gases, blood chemistry, bacteriological culture for sputum and blood, serology for atypicals, and PCR for respiratory viruses, serum C-reactive protein [CRP] and PCT levels were measured. The patients were divided into two groups, group 1 included 26 patients who were culture negative for bacterial infection and group 2 included 34 patients who were culture positive. Group 2 patients were given antibiotic therapy according to the culture sensitivity

Result: The results revealed that, there was no significant difference between group 1 and group 2 patients as regards age, sex, clinical manifestations, final diagnosis, white blood cell counts, blood gases, number of admitted patients, intensive care unit admission and length of hospital stay. A significant increase of PCT and CRP levels was detected in group 2 compared to group 1 at initial diagnosis. At cutoff value >0.5 ng/ml, PCT gave a sensitivity of 94.1%, specificity of 88.4%, positive predictive value [PPV] of 91.4%, negative predictive value [NPV] of 92% and diagnostic efficiency of 91.6% for diagnosis of respiratory tract bacterial infections. However, at a cutoff value >8 mg/L, CRP gave a sensitivity of 85.2%, specificity of 76.9%, PPV of 82.8%, NPV of 80% and diagnostic efficiency of 81.7%. After antibiotic therapy PCT and CRP levels dropped in group 2 patients as compared to their pre-treatment levels

Conclusion: Serum PCT level could be used as a novel marker of lower respiratory tract bacterial infections for diagnosis, prognosis and follow up of therapy. This reduces side-effects of an unnecessary antibiotic use, lowers costs, and in the long-term, leads to diminishing drug resistance

Re-emerging of colistin for treatment of nosocomial pneumonia due to gram negative multi-drug resistant pathogens in critically ill patients

Gram-negative [G-ve] bacilli, particularly Pseudomonas aeruginosa and Acinetobacter baumannii, are important opportunistic multidrug-resistant [MDR] pathogens in hospitalized patients, contributing to their morbidity and mortality. These organisms may still keep their sensitivity to colistin and allowed its use for these selective therapeutic indications. The aim of the present study is to evaluate and compare the effectiveness and safety of both combined intravenous [i.v.] colistin with aerosolized colistin versus i.v. colistin alone in nosocomial pneumonia due to MDR G-ve pathogens in critically ill patients. 40 Patients were hospitalized in ICU due to different etiologies. These patients experienced nosocomial pneumonia. The pathogenic organisms were G-ve MDR bacilli and only susceptible to colistin. The first group received both i.v. colistin with aerosolized colistin versus [vs] the second group who received i.v. colistin alone. Mortality was less in patients who received i.v. plus inhaled colistin. Colistin is a reasonable safe last-line therapeutic alternative for pneumonia due to MDR G-ve pathogens. Aerosolized colistin may be considered as a useful adjunctive to i.v. colistin

Pulmonary function changes in diabetic lung

Diabetes mellitus is a chronic and debilitating disease. Its complications give rise to micro and macrovascular diseases which affect eyes, kidneys, heart, blood vessels, nerves and also lungs. There may be a relationship between diabetes and reduced lung function, so this study was designed to evaluate the impairment of lung function on spirometry among diabetic patients. To study the effect of diabetes mellitus on the evolution of respiratory function parameters. Hundred subjects were enrolled in the study, 30 patients with type I, another 30 patients with type II and 40 subjects were controls. Mean age was 42.78 +/- 3.14 years, 45 were males and 55 were females. Mean HbAlC was 8.9 +/- 1.1%. 22 patients with diabetes duration from 5 to 10 years, 38 patients with a duration of more than 10 years. Spirometric tests were done for all groups by computerized Spirometry with six parameters Forced vital capacity [FVC], Forced expiratory volume in first second [FEV1], Peak expiratory flow rate [PEFR], Forced expiratory volume in first second to forced vital capacity [FEV1/FVC], Peak expiratory flow rate [FEFR 25-75] and Diffusing capacity for carbon monoxide [DLCO]. There was a predominant reduction in all the Spirometric parameters of diabetic patients toward the restrictive pattern as there was significant deterioration in DLCO in comparison with healthy controls. FVC [p < 0.01], and FEV1/FVC% [p < 0.001] were significantly lower in typel diabetic patients in comparison to those of type II. Impairment of lung functions was obvious with a longer duration of diabetes. Conclusion: Diabetes is associated with a significant impaired pulmonary function in a restrictive pattern as compared to non diabetics. The pulmonary function impairment was found to be more marked with diabetic duration especially after 10 years. Subjects with type I diabetes had lower FVC and FEV1/FVC% than predicted; it could be related to poor glycemic control

effect of chronic intermittent hypoxia in the evolution of NASH

Obstructive sleep apnea [OSA] causes chronic intermittent hypoxia [CIH] during sleep. OSA is associated with nonalcoholic steatohepatitis [NASH] in obese individuals and may contribute to progression of nonalcoholic fatty liver disease [NAFLD] from steatosis to steatohepatitis. To assess the potential role of hypoxia in the development of NASH in obstructive sleep apnea patients. Nocturnal polysomnography was performed in 60 consecutive patients for clinical suspicion of OSA. We investigated fasting blood glucose, serum insulin, TNF-alpha, ABG and liver enzymes for 30 patients with nocturnal polysomnographic recording of OSA and for 15 patients without recording OSA used as controls. Liver biopsy was offered to 15 of 30 patients with elevated liver enzymes. Patients with OSA had significantly higher levels of insulin and were more insulin-resistant according to HOMA-IR than in controls. We found that the parameters which significantly correlated with AHI were elevated liver enzyme, BMI, ultrasound grading, TNF-alpha and HOMA-IR in patients group but did not find a similar correlation in controls. Liver biopsy showed steatosis with lobular necrosis or hepatocyte ballooning in the 15 patients, associated with fibrosis in 5 patients. Hypoxic stress of obstructive sleep apnea may be implicated in the evolution of insulin resistance and steatohepatitis in obese individuals