Vitaminas B neurotrópicas y neuropatía periférica: estado del arte y acuerdo de expertos / Neurotropic B vitamins and peripheral neuropathy: State of the art and agreement of experts

Propósito: La neuropatía periférica tiene un espectro clínico inespecífico y multifactorial, con frecuente subdiagnóstico y terapéutica de eficacia variable. Existe una heterogénea prescripción de vitaminas B, las cuales pueden desempeñar un rol importante en el manejo de diferentes neuropatías; sin embargo, en Colombia no existen guías clínicas al respecto. El propósito de este trabajo es orientar en el reconocimiento temprano de las neuropatías periféricas y generar recomendaciones sobre el uso adecuado de vitaminas B neurotrópicas. Descripción de la metodología: Acuerdo de expertos sobre la neuropatía periférica y el rol terapéutico de las vitaminas B con énfasis en la epidemiología en Colombia, diagnóstico y tratamiento. Contenidos: En Colombia, la prevalencia de neuropatía periférica se estima cercana al 10 %, sin embargo, no hay datos recientes. Dentro de las etiologías más frecuentes se encuentran la neuropatía diabética, infecciosa, inflamatoria, carenciales, toxica y farmacológica. Se recomiendan las siguientes herramientas de tamizaje en población de riesgo: DN4, MNSI, test de monofilamento, test de vibración y valoración de reflejos. Las vitaminas B1, B6 y B12 son seguras, accesibles y pueden ser eficaces en neuropatía periférica, incluso cuando el déficit no ha sido demostrado, pero con requerimientos particulares en su administración conjunta. Conclusiones: Las neuropatías periféricas son un reto diagnóstico y terapéutico que requiere la identificación oportuna para el tratamiento de la etiología subyacente y el control de síntomas. El uso de vitaminas B neurotrópicas es efectivo y seguro en neuropatía periférica carencial, y también parece ser eficaz en el manejo de neuropatías periféricas de diferentes etiologías.

Purpose: Peripheral neuropathy has a nonspecific and multifactorial clinical spectrum, with frequent underdiagnosis and therapeutics of variable efficacy. There is a high but heterogeneous prescription of B vitamins, which can play an important role in the management of different neuropathies; however, in Colombia there are no clinical guidelines in this regard. The purpose of this article is to guide the early recognition of peripheral neuropathy and generate recommendations on the proper use of neurotropic B vitamins. Description of the methodology: Expert agreement on peripheral neuropathy and the therapeutic role of B vitamins with emphasis on epidemiology in Colombia, diagnosis and treatment. Contents: In Colombia, there are no recent data to estimate the prevalence of peripheral neuropathy; the main etiologies are: diabetes mellitus, nutritional deficiencies, herpes zoster and neuropathies due to chemotherapy. Given risk factors in the anamnesis, the use of DN4, MNSI, monofilament test, vibration test and assessment of reflexes is recommended. Vitamins B1, B6, and B12 are safe and can be effective in peripheral neuropathy, even when the deficit has not been demonstrated, but with special requirements in their joint administration. Conclusions: peripheral neuropathies are a diagnostic and therapeutic challenge, and require timely identification, for the treatment of the underlying etiology and symptom control. The use of neurotropic B vitamins is effective and safe in deficient peripheral neuropathy, and also appears to be effective in the management of peripheral neuropathies of different etiologies.

Treatment of Seizures in the Neonate: Special Report From the ILAE Task Force on Neonatal Seizures, 2022

The International League Against Epilepsy (ILAE) task force on neonatal seizures has recently published draft guidelines and consensusbased recommendations on the treatment of neonatal seizures. This update provides a summary of the recommendations and the changes in management compared to the previous WHO ILAE guidelines, published in 2011, with emphasis on practical decision making requirements for a pediatrician.

Analysis of clinical phenotype and gene variation of pyridoxine-dependent epilepsy caused by ALDH7A1 gene mutation / 中华神经科杂志

Objective:To analyze the clinical phenotype and genotype characteristics of children with pyridoxine-dependent epilepsy (PDE) and provide evidence for diagnosis.Methods:Clinical data of 3 children with PDE enrolled in the Department of Neurology of Hunan Children′s Hospital from July 2016 to December 2020 were collected, and whole-exome sequencing (WES) was used for analysis. Pathogenic variants were analyzed and screened using bioinformatics tools combined with clinical phenotype. Sanger sequencing was used to analyze the source of mutations in children′s core family members.Results:Cases 1 (female) and 2 (male) were siblings, both of whom had convulsions within 24 hours after birth. WES results showed that the siblings carried compound heterozygous mutations of c.796C>T (p.R266 *) and c.1553G>C (p.R518T) in the ALDH7A1 gene, coming from the father and mother of the siblings respectively. Both of the mutations have been reported as pathogenic. Case 3, female, developed convulsions at the age of 1. WES results revealed that she carried compound heterozygous mutations of c.1094-109T>A and c.7C>T (p.R3C) in the ALDH7A1 gene, coming from her father and mother respectively. After searching HGMDPro, PubMed, 1000 Genomes, and dbSNP databases, both of the 2 mutations of c.1094-109T>A and c.7C>T (p.R3C) were not reported. The pathogenicity predictions of the 2 mutations were carried out by different biological information analysis software. The results showed that both of the mutations were harmful. All the 3 children had no epileptic seizures after treatment with increased doses of vitamin B6. Conclusions:When infants have unexplained convulsions, especially in the neonatal stage, PDE caused by ALDH7A1 gene mutation should be considered. Pyridoxine precision treatment has a good effect. The 2 de novo mutations of c.1094-109T>A and c.7C>T (p.R3C) enrich the mutation spectrum in the ALDH7A1 gene. WES has the auxiliary significance in the diagnosis of epilepsy.

Method validation of pyridoxine hydrochloride in neurorubin by high performance liquid chromatography / Монголын эм зүй, эм судлал

Introduction@#Pyridoxine hydrochloride is least expensive supplement named as a vitamin 6¹. Pyridoxal kinase is the enzyme that produces pyridoxal phosphate which known as pyridoxine hydrochloride that occurs in the human body. Diabetes, age and neurodegenerative diseases complications can be reduced by pyridoxine hydrochloride^{2 3}. Quantification of pyridoxine hydrochloride in neurorubin as an injection form was developed by high performance liquid chromatography (HPLC) method. Further, the proposed method was validated for linearity, precision (system precision, method precision, intermediate or inter-day precision), and accuracy, stability in analytical solution, system suitability and roughness. The developed method exhibited the best results in terms of the aforesaid validation parameters. The method was found to be selective, simple, economical, accurate, reproducible, rapid and reliable for routine estimation purpose of pyridoxine hydrochloride in injection.@*Goal@#The aim of this study was to develop the validation method of pyridoxine hydrochloride in injection. @*Material and Methods@#</br>I) Test Article. As a test article neurorubin injection was produced by Tsombo Farm LLC. The standard pyridoxine hydrochloride was supplied from Sigma Aldrich Co. </br>II) Reagents and Equipment. The reagents were HPLC grade acetonitrile methanol, and purified water. Balance, and micropipette used as equipment. Shimadzu HPLC (LC20AD) was used as the analytical instrument and the analysis conditions were as follows (Table 1). @*Results@#The calibration curves for pyridoxine hydrochloride were made by plotting the peak area versus the concentration for each analyte using regression analysis. Each calibration curve was obtained using six levels of concentrations in the range 12.5-100 pg/mL. The linear correlation coefficient (R²) for all calibration curves was higher than 0.995 for all analytes. The LOD and LOQ for pyridoxine hydrochloride were in 15.29 pg/mL and 46.33 pg/mL, respectively.</br> Accuracy and precision were assessed by analyzing five sets of samples, independently prepared at low, middle and high concentrations. The RSD values of both repeatability and intermediate precision were below 1.669 % and 1.678 % the accuracy remaining between 95.25 to 102.775 %. The resulting accuracy data were satisfactory for the quantitative analysis of pyridoxine hydrochloride in neurorubin injection.</br> The results of summarized in table 2, 3, 4. This article presents a simple, accurate, reproducible, and thoroughly validated HPLC-based method for qualitative and quantitative analysis of pyridoxine hydrochloride, as part of the quality assessment of products containing in injection.

Role Of Oral Pyridoxine (vitamin B6) Supplementation In The Reduction Of Hyperoxaluria And Prevention Of Recurrent Urolithiasis

Our prospective, randomised controlled study was to assess the role of oral pyridoxine (Vitamin B6) supplementation in addition to standard dietary advice, compared against only dietary advice, in the reduction of urinary oxalate levels in patients with urinary calculi along with proven hyperoxaluria. 74 subjects were randomly divided into Interventional Group (n=38) who received oral Pyridoxine 40mg/day with dietary oxalate restriction and Control Group (n=36) who received only dietary oxalate restriction. Both groups were evaluated and statistically compared at the end of 3 months. Interventional group showed statistically significant (p = 0.0001) reduction in 24 hours urinary oxalate levels. Pyridoxine, cofactor in the alanine–glyoxalate–transaminase pathway converts glyoxalate to glycine and reduces oxalate production thereby decreasing hyperoxaluria, risk factor of urolithiasis. Oral Pyridoxine supplementation (40 mg/day) with dietary oxalate restriction can be a prophylactic measure for prevention of recurrence of calcium oxalate urolithiasis.

Encuesta sobre el uso de la metadoxina en hepatopatías de pequeños animales en Colombia / Survey on the use of metadoxine in liver diseases of small animals in Colombia / Enquete sobre o uso da metadoxina em hepatopatias de pequenos animais na Colômbia

Resumen La metadoxina es un fármaco con potencial efecto antioxidante y antifibrótico suministrado en medicina humana esencialmente en el tratamiento para esteatohepatitis aguda o crónica por etanol. Numerosos ensayos clínicos e investigaciones experimentales soportan su indicación; no obstante, en medicina veterinaria no hay estudios de campo con tal propósito, pese a que reportes aislados de su indicación en hepatopatías secundarias existen en bases de datos latinoamericanas. El objetivo del presente estudio fue reportar la prescripción de metadoxina en hepatopatías de caninos y felinos en la práctica rutinaria en Colombia. Aplicando herramientas de la web en línea, se realizó una encuesta orientada a establecer algunas pautas de tratamiento con metadoxina en dicho campo. Los resultados demostraron que el 55 % de los veterinarios participantes instauraron al menos una vez la metadoxina en caninos y felinos. El 74,6 % de estos reportó una evolución favorable. Como terapia conjunta, modificaciones en la dieta, silimarina y ácido ursodeoxicólico fueron prescritos en el 80, 45,5 y 38,2 % de los casos, respectivamente. Se detectó una amplia variación respecto a la dosis, la vía, la frecuencia y la duración del protocolo terapéutico. En cuanto a la prescripción oral, la dosis fue 17,3 ± 11,4 mg/dl cada 12 h. Los resultados obtenidos confirman el uso de la metadoxina como tratamiento de hepatopatías en caninos y felinos en Colombia. De aquí se resalta la necesidad de efectuar ensayos clínicos que pongan a prueba el efecto de la metadoxina sobre la evolución clínica y paraclínica y el pronóstico de determinadas hepatopatías en caninos y felinos.

Abstract Metadoxine is a drug with a potential antioxidant and antifibrotic effect that is essentially used in human medicine in the treatment of acute or chronic alcoholic steatohepatitis. Numerous clinical trials and experimental investigations support its use; however, in veterinary medicine there are no field studies on this topic, although there exist isolated reports of its indication in secondary liver diseases in Latin American databases. The present study aimed to report on the prescription of metadoxine in canine and feline hepatopathies in routine practice in Colombia. Applying online web tools, a survey was conducted to establish some treatment guidelines for the use of metadoxine in the said field. Results showed that 55% of participating veterinarians prescribed metadoxine at least once in canines and felines. 74.6% of them reported a favorable evolution. As a joint therapy, dietary modifications, silymarin, and ursodeoxycholic acid were also prescribed in 80, 45.5, and 38.2% of the cases, respectively. A wide variation was detected regarding the dose, application route, frequency, and the duration of the therapeutic protocol. Regarding oral prescription, the dose was 17.3 ± 11.4 mg/dl every 12 hours. The results confirm the use of metadoxine as a treatment for hepatopathies in dogs and cats in Colombia. This highlights the need to carry out clinical trials that test the effect of metadoxine on the clinical and paraclinical evolution and prognosis of certain hepatopathies in dogs and cats.

Resumo A metadoxina é um fármaco com potencial efeito antioxidante e anti-fibrótico administrado em medicina humana essencialmente no tratamento para esteato-hepatite aguda ou crônica por etanol. Numerosos ensaios clínicos e investigações experimentais sustentam sua indicação; não obstante, em medicina veterinária não há estudos de campo com tal propósito, em que pese relatos isolados de sua indicação em hepatopatias secundárias existam em bases de dados latino-americanas. O objetivo do presente estudo foi relatar a prescrição de metadoxina em hepatopatias de caninos e felinos na prática rotineira na Colômbia. Aplicando ferramentas da web em linha, se realizou uma enquete orientada a estabelecer algumas pautas de tratamento com metadoxina neste campo. Os resultados demostraram que 55 % dos veterinários participantes utilizaram ao menos uma vez a metadoxina em caninos e felinos. O 74,6 % destes relatou uma evolução favorável. Como terapia conjunta, modificações na dieta, silimarina e ácido ursodeoxicólico foram prescritos no 80, 45,5 e 38,2 % dos casos, respectivamente. Se detectou uma ampla variação com respeito a dose, a via, a frequência e a duração do protocolo terapêutico. Quanto à prescrição oral, a dose foi 17,3 ± 11,4 mg/dl a cada 12 horas. Os resultados obtidos confirmam o uso da metadoxina como tratamento de hepatopatias em caninos e felinos na Colômbia. Daqui se ressalta a necessidade de efetuar ensaios clínicos que ponham à prova o efeito da metadoxina sobre a evolução clínica e para clínica e o prognóstico de determinadas hepatopatias em caninos e felinos.

Assessment of Vitamin B6 Intake in Relation to Tolerable Upper Intake Levels

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the intake of vitamin B6 (pyridoxine) in the Norwegian population in relation to tolerable upper intake levels (ULs). The existing maximum limit for vitamin B6 in food supplements is 4.2 mg/day. VKM has also conducted scenario calculations to illustrate the consequences of amending the maximum limitto 2, 6, 8, 10, 20 or 25 mg/day. Vitamin B6 is water soluble and comprises six compounds with vitamin B6 activity; pyridoxine (PN, an alcohol), pyridoxal (PL, an aldehyde) and pyridoxamine (PM, the amine) and their corresponding phosphates; pyridoxine 5’-phosphate (PNP), pyridoxal 5’ -phosphate (PLP) and pyridoaxamin 5’ –phosphate (PMP). These six forms of vitamin B6 are all present in food in addition to the glycosylated form, pyridoxine-5’-β-δ-glucoside (PNG), in some plants. In food supplements the most common vitamin B6 form is pyridoxine hydrochloride. Eighty to ninety percent of vitamin B6 in the body is found in muscles and estimated body stores in adults amount to about 170 mg with a half-life of 25-33 days. Vitamin B6 deficiency is mostly seen in combination with deficiency of other B vitamins. Symptoms of vitamin B6 deficiency are anaemia and neurological abnormalities (EFSA, 2016). Intakes of vitamin B6 from the diet alone have not been reported to cause adverse effects. Sensory neuropathy has been reported to be the most sensitive adverse health effect of vitamin B6 supplementation. VKM proposes to adopt the tolerable upper intake level (UL) set by the Scientific Committee for Food (SCF) in 2000 at 25 mg/day for vitamin B6, which was based on a lowest observed adverse effect level (LOAEL) of 100 mg/day found in one randomised controlled trial. VKM recognises that there are no well-designed dose-response studies of long-term use available. However, for adults, no adverse effects have been reported at doses with vitamin B6 up to 25 mg/day. Dietary calculations have been performed for mean intakes and in various percentiles (P5, P25, P50, P75 and P95) in children (2-, 4- and 9-year-olds), adolescents (13-year-olds) and in adults. To illustrate the consequences of amending the maximum limit for vitamin B6 in food supplements to 2, 6, 8, 10, 20 or 25 mg/day in the different age groups, VKM has used the scenarios with P95 from food and added the alternative amounts of supplements. VKM has compared these scenarios with the tolerable upper intake levels set by the Scientific Committee for Food in 2000 for adults, adolescents and children. In these scenarios, the 2- and 4-year-old children will exceed the tolerable upper intake level with use of 6 mg/day or higher vitamin B6 in supplements. The 9-year-old children will exceed the tolerable upper intake level with supplemental use of 10 mg/day. The 13-year-old adolescents will exceed the tolerable upper intake level with 20 mg/day of vitamin B6 in supplements. Adults will exceed the tolerable upper intake level with use of 25 mg/day of vitamin B6/pyridoxine in supplements.

Diagnosis and Management of Classica Homocystinuria in Brazil: A Summary of 72 Late-Diagnosed Patients

Abstract This study described a broad clinical characterization of classical homocystinuria (HCU) in Brazil. This was a cross-sectional, observational study including clinical and biochemical data from 72 patients (60 families) from Brazil (South, n = 13; Southeast, n = 37; Northeast, n = 8; North, n = 1; and Midwest, n = 1). Parental consanguinity was reported in 42% of families. Ocular manifestations were the earliest detected symptom (53% of cases), the main reason for diagnostic suspicion (63% of cases), and the most prevalent manifestation at diagnosis (67% of cases). Pyridoxine responsiveness was observed in 14% of patients. Only 22% of nonresponsive patients on treatment had total homocysteine levels <100 mmol/L. Most commonly used treatment strategies were pyridoxine (93% of patients), folic acid (90%), betaine (74%), vitamin B12 (27%), and low-methionine diet + metabolic formula (17%). Most patients diagnosed with HCU in Brazil are late diagnosed, express a severe phenotype, and poor metabolic control. Milder forms of HCU are likely underrepresented due to underdiagnosis.

Vitamin B6 related epilepsy / 中华实用儿科临床杂志

Vitamin B6 related epilepsy is a group of epileptic diseases,seizures in which could not be con-trolled by antiepileptic drugs,but could be controlled or obviously improved by vitamin B6 .It comprises of pyridoxine dependent epilepsy and pyridoxine responsive epilepsy predominantly,and the latter includes vitamin B6 responsive in-fantile spasms,pyridox(am)ine -5′-phosphate oxidase (PNPO)deficiency,hyperphosphatasia mental retardation syndrome (Mabry syndrome)and so on.The clinical presentations of the diseases above are nonspecific,manifesting as refractory seizures onset in neonatal or infantile period,which need to be distinguished from other diseases such as new-born hypoxic ischemic encephalopathy,Ohtahara syndrome and non -ketotic hyperglycinemia.Pyridoxine dependent epilepsy,PNPO deficiency and Mabry syndrome have relative specific biomarkers and known disease -causing genes, which are helpful for diagnosis.It is suggested that pyridoxine or pyridoxal phosphate should be tried first for all patients started seizures early (including all infantile spasms patients),avoiding missing these diseases.And once diagnosed,vi-tamin B6 should be maintained long -term or all the life according to the detailed disease.

Inhibitory effect of pyridoxine hydrochloride combined with chemotherapeutics on mice hepatoma cell line H22 / 肿瘤研究与临床

Objective To observe the inhibitory effect of pyridoxine hydrochloride (PN) combined with common chemotherapeutics on mice hepatoma cells H22 in vitro. Methods MTT assay was used to determine the effects of PN in combination with 10 different antineoplastic agents on H22 cells, and immuno-histochemistry was used to observe the distribution of PN in H22 cells and morphologic changes of the cells before and after PN treatment. Results After 24 hours incubation with 5 mmol/L PN, the treated cells expanded apparently with nucleus chipping. PN entered the tumor cell and was mainly condensed in cytoplasma and H22 cells were sensitive to PN. When administered concomitantly with chemotherapic agents, most of the combinations showed antagonistic effects while a few of the combinations were additive. For instance, doxorubicin (ADM) used in combination with PN inhibited cell proliferation with an IR value (IR=0.63) much lower than ADM alone (IR=0.71, P0.9), and the IR value (IR=0.60) in combined group was higher than that (IR=0.40) in ICTX group (P<0.05). Conclusion PN treatment could increase the intracellular PLP level and result in growth inhibition and cell death, and combined administration of PN and ICTX might be a potential method to improve efficacy and to reduce toxic effects while a co-administration of PN and ADM should be avoided.

Sensory Polyneuropathy Associated with Pyridoxine Overdose

Pyridoxine deficiency and excess have both been implicated as causes of peripheral neuropathy. A 74-year-old man presented with paresthesia in both legs that first appeared 2 months previously. A nerve conduction study revealed axonal sensory polyneuropathy. He had consumed 100 milligrams of pyridoxine every day for 1 year, in the form of vitamin tablets. His blood levels of vitamin B6 were markedly elevated to above 250 nmol/L. This case indicates that the consumption of high-dose pyridoxine can cause sensory polyneuropathy.

Influence of concentration on the radiolytic decomposition of thiamine, riboflavin, and pyridoxine in aqueous solution / Influencia de la concentración en la descomposición radiolítica de tiamina, riboflavina y piridoxina en solución acuosa / Influência da concentração na decomposição radiolítica de tiamina, riboflavina e piridoxina em solução aquosa

Vitamin loss during irradiation has been claimed as a critical area in food irradiation technology, especially that of thiamine (B1), which has been considered as the most sensitive to radiation. Although it has been suggested that no vitamin deficiency could result from consuming irradiated food, a long debate on the loss of vitamins and other nutrients during food irradiation has been maintained by the lack of experimental studies monitoring decomposition rates at different concentrations and doses. Since thiamine, riboflavin, and pyridoxine are labile vitamins, this study has focused on their radiolytic decomposition in dilute aqueous solutions in the presence of air. The decomposition process was followed by HPLC and UV-spectroscopy. The results obtained in aqueous solutions showed a dependence of the decomposition as a nonlinear function of the dose. Of these three compounds, the decomposition was higher for thiamine than for riboflavin and even less in pyridoxine.

La pérdida de vitaminas durante procesos de irradiación ha sido considerada como un área crítica en la tecnología de irradiación de alimentos, especialmente la tiamina (B1), que ha sido considerada como la más sensible a la radiación ionizante. La deficiencia de vitaminas en humanos no es producida por el consumo de alimentos irradiados, sin embargo, existen debates sobre la pérdida de vitaminas y otros nutrientes provocada por la irradiación de alimentos, esta discusión sigue latente debido a que hay pocos estudios experimentales de la descomposición de vitaminas a diferentes dosis y concentraciones. Esta investigación se centró en el estudio de la descomposición radiolítica de tiamina, riboflavina y piridoxina en soluciones acuosas y en presencia de aire. El proceso de descomposición fue seguido por cromatografía líquida con detección UV. Los resultados obtenidos en soluciones acuosas mostraron una dependencia no lineal entre la descomposición en función de la dosis. De estos tres compuestos, la descomposición fue mayor en tiamina que en riboflavina y menor en la piridoxina.

A perda de vitaminas durante processos de irradiação tem sido considerada uma área crítica na tecnologia de irradiação de alimentos, especialmente no caso da tiamina (B1), que tem sido considerada como a mais sensível à radiação ionizante. Embora a deficiência de vitaminas em seres humanos não seja produzida pelo consumo de alimentos irradiados, longos debates sobre as perdas de vitaminas e outros nutrientes causadas pela irradiação de alimentos tem sido mantidos devido aos estudos experimentais limitados monitorando a proporção da decomposição em diferentes concentrações de vitaminas e doses de radiação aplicadas. Considerando que a tiamina, riboflavina e piridoxina são vitaminas instáveis, o presente estudo focalizou a decomposição radiolítica dessas vitaminas em soluções aquosas diluídas e na presença de ar. O processo de decomposição foi analizado por cromatografia líquida com detecção UV. Os resultados obtidos em soluções aquosas mostraram uma dependência da decomposição como função não linear da dose. Destes três compostos, a descomposição foi mais alta para tiamina que na riboflavina e menor para piridoxina.

Isoniazid Induced Psychosis (Self Harm Behaviour) with Neuropathy & Vitamin B6 Deficiency.

Isoniazid induced psychosis (IIP) is well reported with varied clinical presentations. Many hypotheses are available to explain the mechanism of (IIP) but lack conclusive evidence in its favour. The current case establishes neuropathy with vitamin B6 deficiency as a possible cause for IIP warranting early clinician's attention as the condition may be potentially serious & life threatening.

Electrochemical Behavior and Determination of Pyridoxine Hydrochloride at Graphene-Carbon Nanotubes/Poly(nicotinic acid) Modified Electrode / 分析化学

Graphene ( GN) and multiwalled carbon nanotubes ( MWCNT) composites were coated on glassy carbon electrode ( GCE ) and then poly ( nicotinic acid ) ( PNA ) was electrodeposited on the modified electrode. The electrochemical behavior of pyridoxine hydrochloride ( VB6 ) was investigated at the modified electrode by cyclic voltammetry ( CV ) and differential pulse voltammetry ( DPV ) . Results showed the oxidation current of VB6 at the GN-MWCNT/PNA/GCE was obviously larger than that at GCE, PNA/GCE and GN/MWCNT/GCE. The oxidation process of VB6 was an irreversible diffusion-controlled process involving one electron and two protons. The liner range between the peak current intensity of DPV and the concentration of VB6 was 0 . 05-200 μmol/L with a detection limit of 0 . 02 μmol/L ( S/N=3 ) . The modified electrode showed a good reproducibility with a relative standard deviation of 3 . 1% ( n=8 ) . The proposed method was applied to the analysis of vitamin B6 in vitamin B6 tablets and compound vitamin B tablets with recoveries between 96 . 1%-104 . 5%.

A Case of Seizure and Metabolic Acidosis Due to Renal Adjustment Dosage of Isoniazid in an Elderly Woman / 고신대학교의과대학학술지

Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.

Effect of Potassium Magnesium Citrate and Vitamin B-6 Prophylaxis for Recurrent and Multiple Calcium Oxalate and Phosphate Urolithiasis

PURPOSE: To study the effects of long-term treatment with potassium magnesium citrate and vitamin B-6 prophylaxis (Urikind-KM6; 1,100-mg potassium citrate, 375-mg magnesium citrate, and 20-mg pyridoxine hydrochloride/5 mL) every 8 hours over 3 years. MATERIALS AND METHODS: A total of 247 patients with recurrent idiopathic hypocitraturia with or without hyperuricosuria and randomized controls were studied prospectively for 3 years. The total patients were divided into three groups. Control group 1 consisted of 61 patients (24.7%) who had moderate to severe hypocitraturia with or without hyperuricosuria and were recurrent stone formers but discontinued prophylaxis because of drug intolerance within 1 month of therapy. Control group 2 constituted 53 patients (21.5%) who were first-time stone formers and who had mild hypocitraturia with or without hyperuricosuria and were not put on prophylactic therapy and were followed for 3.16+/-0.08 years. Control group 3 constituted 133 patients (54.8%) who were recurrent stone formers who had moderate to severe hypocitraturia with or without hyperuricosuria and were put on prophylaxis therapy and were followed for 3.16+/-0.08 years. All patients were followed up at 6-month intervals. RESULTS: Potassium magnesium citrate prophylaxis produced a sustained increase in 24-hour urinary citrate excretion from initially low values (221.79+/-13.39 mg/dL) to within normal to high limits (604.04+/-5.00 mg/dL) at the 6-month follow-up. Urinary pH rose significantly from 5.62+/-0.2 to 6.87+/-0.01 and was maintained at 6.87+/-0.01. The stone recurrence rate declined from 3.23+/-1.04 per patient per year to 0.35+/-0.47 per patient per year. CONCLUSIONS: Potassium magnesium citrate prophylaxis was effective in reducing the recurrence of calcium oxalate and phosphate urolithiasis.

Medicamentos antieméticos no tratamento da náusea e vômitos associados à gestação / Antiemetic medications in the treatment of nausea and vomiting associated with pregnancy

Náusea e vômitos (NV) são os sintomas mais comuns durante a gravidez, geralmente iniciando-se entre a 6ª e a 8ª semana, atingindo a intensidade máxima em torno da 9ª semana e resolvendo-se até a 12ª semana. Embora sua etiologia seja, provavelmente, multifatorial, seu curso clínico se correlaciona com as concentrações plasmáticas da gonadotrofina coriônica humana. Por comprometerem a qualidade de vida, NV devem ser abordados com modificações dietéticas que incluem dieta fracionada e redução do consumo de alimentos gordurosos, entre outras. O uso de piridoxina pode melhorar a náusea de intensidade leve, embora não diminua significantemente os episódios de vômitos. Os anti-histamínicos são os medicamentos mais utilizados como terapia medicamentosa de primeira linha e têm sua segurança comprovada; dentre eles, o dimenidrinato determina início de ação mais rápido e menor sedação que a meclizina. Entre os antagonistas dopaminérgicos, a prometazina e a metoclopramida podem ser utilizadas, mas apresentam como desvantagem o potencial de eventos adversos maternos. O antagonista dos receptores 5-HT3, ondansetrona, pode ser considerado quando outros medicamentos não foram efetivos no tratamento de NV de intensidade grave. Do mesmo modo, os corticosteroides devem ter seu uso reservado para casos não responsivos a outros medicamentos e preferencialmente após a 10ª semana de gestação...

Treatment efficacy of ginger v/s pyridoxin in the first trimester nausea & vomitings of pregnancy-a comparative study.

Nausea and vomiting are the main symptoms in 1st trimester of pregnancy. Ginger is safe and highly effective in the treatment of pregnancy induced nausea and vomitings. The present study aimed to evaluate the effectiveness of Ginger and Pyridoxine in the treatment of pregnancy induced nausea and vomitings (First trimester).100 pregnant women attending the out patient department of Obstetrics and Gynecology of Narayana medical college hospital, Nellore with complaints of nausea and vomitings in 1st trimester of pregnancy are recruited into the study after obtaining informed consent. These 100 were divided into two groups. 50 were given Ginger administration and another 50 were given Pyridoxine for a period of 35 days. During the period of treatment the symptom relief in both the groups are assessed periodically by visual analog scales .The results have shown that nausea and vomiting scores reduction was found to be much better in Ginger group compared to Pyridoxine group. Ginger administration is proved to be a better treatment in treating 1st trimester pregnancy induced nausea and vomitings.

Clinical analysis of pyridoxine-dependent epilepsy in a child and ALDH7A1 mutation / 中华实用儿科临床杂志

Objective To analyze clinical diagnosis and treatment,aldehyde dehydrogenase 7 family member A1 (ALDH7A1) gene mutations in 1 Chinese child with pyridoxine dependent epilepsy(PDE).Methods The clinical manifestations and course of treatment were observed in a PDE patient with early epilepsy onset.Video-electroencephalogram(VEEG) and magnetic resonance imaging (MRI) were performed.The mutations of ALDH7A1 gene were examined.Results At the age of 2 months,recurrent epileptic seizures occurred and the child was resistant to antiepileptic drugs.Patient hospitalized several times due to frequent seizures and pyridoxine was used intravenously for several days.For each hospital stay,the frequent seizures were controlled completely under the treatment of pyridoxine and antiepileptic drugs.Seizures recurred at intervals of 13,14 and 38 days due to the treatment with antiepileptic drugs only without pyridoxine.Continuing oral pyridoxine without anticonvulsants led to seizure free for 5 months.No epileptiform discharges were found during several interictal VEEG monitoring and MRI showed normal.ALDH7A1 gene mutation analysis revealed two heterozygote mutations:c.410G ＞ A (p.G137E) in exon 5 that was transmitted from the father,and IVS11 + 1G ＞ A in intron 11 transmitted from the mother.Conclusions Early onset seizures have better response to pyridoxine and recurred after pyridoxine withdrawal in the patient,which suggested that he is a PDE patient.The interictal normal EEG could not rule out the possibility of PDE.This is the first report on ALDH7A1 mutations in PDE patient in China.Both the c.410G ＞ A(p.G137E) and IVS11 + 1G ＞ A mutations have not been reported previously.

Gyrate Atrophy of the Choroid and Retina Diagnosed by Ornithine-delta-aminotransferase Gene Analysis: A Case Report

A pair of 19-year-old female identical twins was referred to our hospital with progressive visual loss. They exhibited bilateral chorioretinal atrophy involving the midperiphery on fundoscopy and fluorescein angiography. Bilateral visual field constriction was noted on dynamic Goldmann perimetry, and a markedly impaired response was observed on both photopic and scotopic electroretinograms. Cystoid macular edema was identified in both eyes on optical coherence tomography. Plasma levels of ornithine were elevated. Based on these observations, the patients were diagnosed with gyrate atrophy of the choroid and retina. The clinical diagnosis was confirmed by mutation analysis of the ornithine-delta-aminotransferase (OAT) gene. Patients were treated with a pyridoxine supplement (300 mg/day) and an arginine-restricted diet to lower plasma levels of ornithine, which were successfully reduced without progression of chorioretinal atrophy for 15 months. Our report describes the first case of gyrate atrophy in the Korean population diagnosed by OAT gene analysis and treated with vitamin B6 dietary supplementation.