A pilot study on effect of intravenous iron sucrose on oxidative stress and antioxidant status of pregnant women with iron deficiency anemia

Objectives: Iron deficiency anemia (IDA) is the most common nutritional deficiency among pregnant women in India. Iron can be supplemented orally or intravenously to treat IDA. Intravenous supplementation of iron can be risky as there is more possibility for the production of free iron in circulation. The role of free iron in the generation of free radicals and thereby oxidative stress is well known. The present study tends to evaluate oxidative stress and antioxidant status of intravenous iron sucrose treated pregnant women. Materials and Methods: This prospective study was conducted in ACS Medical College and Hospital, Chennai. Twenty pregnant women with moderate IDA (Hb: 7–9.9 g/dl) were included in the present study. Blood samples were collected before and after the treatment with intravenous iron sucrose to measure antioxidants such as reduced glutathione, catalase and superoxide dismutase, and lipid peroxidation marker such as malondialdehyde. Results: In the present study, plasma malondialdehyde levels were increased significantly after the treatment with intravenous iron sucrose. No significant alterations were observed in the levels of reduced glutathione and activities of catalase and superoxide dismutase. Conclusion: In the present study, intravenous iron sucrose infusion was associated with oxidative stress as evidenced by increased lipid peroxidation in antenatal women with IDA. Hence, treatment with antioxidants during iron infusions can be considered

Odynophagia following retained bee stinger

Nearly half of Hymenoptera stings affect the head and neck region of victims, but reports on oropharyngeal bee stings are very few. We describe the case of a patient with odynophagia and suffocation in mass envenomation. He had a retained bee stinger whose removal was delayed for more than 24 hours following the sting, due to persisting angioedema. Odynophagia receded after removal of the stinger and treatment with paracetamol, steroids and metronidazole. The patient also developed rhabdomyolysis, renal failure and hepatitis that were treated with conservative therapy. Oropharyngeal stings can simulate symptoms of persisting angioedema in victims of mass envenomation.(AU)

Prevalence of bacterial pathogens causing ocular infections in South India.

Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61%) eyes had adnexal bacterial infection, 217(28.7%) had corneal infection, 6 (0.8%) had scleral involvement and the remaining 71(9.39%) eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25%) followed by S. pneumoniae (169 of 776; 21.78%) and coagulase negative staphylococci (142 of 776; 18.3%). The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%), chloramphenicol (522 of 624; 83.65%) and gatifloxacin (511 of 624; 81.89%) and gram-negative isolates were to amikacin (127 of 136; 93.38%), gatifloxacin (125 of 136; 91.91%) and ofloxacin (119 of 136; 87.5%), while aerobic actinomycetes were to amikacin (100%), gatifloxacin (14 of 16; 87.5%), chloramphenicol (14 of 16; 87.5%) and ofloxacin (13 of 16; 81.25%). Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials tested, flouroquinolones, especially gatifloxacin and ofloxacin represented a good choice for treating bacterial ocular infections.

Comparative in-vitro efficacy of fluoroquinolones against Streptococcus pneumoniae recovered from bacterial keratitis as determined by E-test.

Background and Objectives: The advent of new fluoroquinolones has drawn the attention for reliable methods on the in-vitro susceptibility testing of Streptococccus pneumoniae. This study attempts to determine the minimum inhibitory concentration (MIC) of second-generation (ciprofloxacin and ofloxacin), third-generation (levofloxacin) and the fourth-generation (moxifloxacin and gatifloxacin) fluoroquinolones against S. pneumoniae recovered from bacterial keratitis. Materials and Methods: In retrospect, the MICs of 50 strains of S. pneumoniae isolated from the corneal scrapes of patients with bacterial keratitis were determined against ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS) susceptibility patterns and the potencies of the MICs were statistically compared. Results: The median MIC of ciprofloxacin (0.25μg/ml) was found to be lower than the median MICs of ofloxacin (0.5μg/ml) (P<0.449) and levofloxacin (1.0μg/ml) (P<0.001). The median MICs of gatifloxacin (0.1μg/ml) was lower than the median MICs of ciprofloxacin (0.25μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and levofloxacin (1.0μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had showed lower median MICs than gatifloxacin (0.1μg/ml) (P<0.001) levofloxacin (1.0μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and ciprofloxacin (0.25μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had a lower MIC50 (μg/ml) than gatifloxacin (0.1μg/ml), levofloxacin (1.0μg/ml), ciprofloxacin (0.25μg/ml) and ofloxacin (0.5μg/ml). MIC90 (μg/ml) of moxifloxacin (0.06μg/ml) was found to be lower than the MIC90 (μg/ml) of gatifloxacin (0.5μg/ml), levofloxacin (1.0μg/ml), ofloxacin (0.5μg/ml) and ciprofloxacin (0.5μg/ml). Conclusion: Based on in-vitro testing, the five portrayed fluoroquinolones 100% sensitivity to S. pneumoniae. However, the fourth-generation fluoroquinolone, moxifloxacin appeared to be more effective against S. pneumoniae than gatifloxacin, levofloxacin, ofloxacin and ciprofloxacin.

Association Between Neuropsychiatric Morbidity and Streptococcal Infections in Children.

We conducted a case control study to study the association between neuropsychiatric morbidity and group A streptococcal infections in children. Twenty two cases of neuropsychiatric morbidity were compared with 64 controls. Fourteen (63.6%) of the 22 cases were positive for ASO and/or ADNB while 21 of the 64 controls (32.8%) were positive for either or both antibodies (OR = 3.428; CI: 1.15 – 10.18; P=0.026). We conclude that there is a statistically significant association between neuropsychiatric morbidity and streptococcal infection in children.

Anti-nociceptive effect of synthesized di-hydroxy flavones: possible mechanism.

Renewed interest on the research on the flavonoids is gaining more importance. Earlier literature on flavonoids indicated a significant anti-nociceptive action for flavones and mono-substituted flavones. However, they exhibited a ceiling effect. The present study was undertaken by new synthesizing six disubstituted flavones (DHFs) since poly substituted ones are expected to produce more potent effect. Their anti-nociceptive effect and the role of opioid involvement were studied using acetic acid induced abdominal constriction assay. All the six DHFs administered in elicited a dose related inhibition of abdominal constrictions indicating the presence of the anti-nociceptive response. However, these substances also showed a similar ceiling effect. Like other flavonoid substances, they also utilized opioid pathways. It is suggested that these newly synthesized DHFs can be included along with other flavonoids while attempting clinical trial for analgesic use.

Modulation by insulin rather than blood glucose of the pain threshold in acute physiological and flavone induced antinociception in mice.

The present study investigated the cause effect relationship between glycemic and algesic states. The hypo- and hyperglycemic conditions were induced physiologically through exercise (3 min swim at room temperature 28 degrees - 30 degrees C) and external dextrose (2 g/kg, ip) administration respectively in mice. Besides, flavone (50 mg/kg, sc) a known antinociceptive drug was chosen to study such a cause effect relationship. The anti-nociception was assessed by acetic acid assay, blood glucose measured using glucometer (Ames) and serum insulin by radioimmunoassay. The findings revealed that irrespective of the glycemic state whether hypo-, hyper, or euglycemic induced by swim stress, dextrose or flavone per se respectively, significant antinociceptive response was recorded. Pretreatment with flavone (50 mg/kg, sc) always exhibited a tendency to reverse the hyperglycemia, if any, but enhanced the antinociceptive response either after swim stress or after dextrose. These data support the contention that changes in the glycemic state in acute condition is not responsible for antinociceptive response and thereby suggesting dissociation between these two parameters. Extended studies estimating serum insulin level after the above mentioned maneuvers showed a significant rise whenever antinociceptive response was recorded irrespective of the glycemic state. It is suggested that serum insulin level, a hormonal parameter rather than the blood glucose level, which is a metabolic parameter, appears more reliable. It appears that the changes in serum insulin level produced by various treatments may have a relationship with the antinociceptive response. However, this study has the limitation that the results can apply only for acute conditions and extrapolation to clinical conditions is debatable.

Role of ATP sensitive potassium channel on 7-hydroxy flavone induced antinociception and possible association with changes in glycaemic status.

Opioid type of analgesics open ATP sensitive potassium channel at the cellular level to produce antinociceptive response. These channels have also been shown to modulate insulin secretion by the pancreas. 7-hydroxy flavone, an antinociceptive agent shown to act through opioid pathways was investigated for its effect on glycaemic state and associated algesic state. The involvement of ATP sensitive potassium channel in the action was examined by using glybenclamide. The result reveal that 7-HF per se did not elicit any significant change in the glycaemic state simultaneously eliciting antinociceptive response as tested by acetic acid induced abdominal constriction assay procedure. Glibenclamide treatment attenuated the antinociceptive effect of 7-HF and while maintained its hypoglycaemic response. The present finding suggest that 7-HF induces antinociception like morphine, utilise ATP sensitive potassium channel at the cellular level and do not suggest a cause-effect relationship between the changes in the glycaemic and algesic state. Possibly, insulin which is controlled by ATP sensitive potassium channel at the cellular level might also modulate antinociception exhibiting a cause-effect relationship between them.

Antinociceptive pattern of flavone and its mechanism as tested by formalin assay.

Flavone, dextrose and long swim stress exhibited antinociception. Degree of antinociception was greater with long swim stress as compared to flavone or dextrose. Combination of these treatments resulted in potentiation of antinociception. Naloxone (opioid antagonist; 5 mg/kg i.p.) antagonised flavone or long stress induced antinociception showing opioid medicated mechanism, however, failed to reverse the potentiated antinociceptive component recorded in long stressed animals which received flavone and dextrose. Antinociceptive activity of flavone, dextrose and long swim stress which was documented by acetic acid assay has been confirmed in the present study. Role for opioid system in this action has been demonstrated. Therefore, formalin test can also be considered as an useful assay procedure for testing flavonoids. However, like acetic acid assay this assay procedure also has the limitation that it is unable to detect minor changes in the degree of antinociception produced by physiological interventions such as long swim and dextrose.

Comparative studies on immunoreactivity of truncated recombinant proteins of foot and mouth disease virus (FMDV) produced in E.coli and insect cells.

For effective FMD control programme, India needs large quantities of cheaper diagnostics in addition to vaccine. Diagnostic reagents produced through conventional methods may not be able to meet such requirements. Alternatively, rDNA technology using suitable heterologous systems that permit production of recombinant antigens to the most native form may be exploited. Studies conducted in our laboratory have led us to select carboxy terminal part of VP1 for expression and evaluation. The protein, which was purified from E.coli under denaturing conditions, was renatured and its reactivity was compared with the protein expressed in insect cells through recombinant baculovirus. The expressed protein in the insect cell whole lysate reacted more efficiently with antibodies raised against whole virus than the purified and renatured protein produced in E.coli. But for its lower reactivity, protein produced from E.coli was found to be suitable in type detection. In addition, the size of the protein is small (16 kD) and production and purification of it from E.coli may be cost effective. Hence, it may be exploited for FMDV typing.

Influence of gossypin on the development of acute tolerance to morphine induced antinociception.

Gossypin, a flavonoid is known to induce opioid mediated anti nociceptive response in experimental models. Unlike morphine, tolerance to and dependence on gossypin does not develop and it is known to attenuate the withdrawal signs induced in morphine dependent animals. In this study, the influence of gossypin on the development of acute tolerance to morphine was investigated using acetic acid induced writhing assay procedure in mice. Gossypin pre-treatment significantly attenuated the acute tolerance development to morphine induce antinociceptive response. All these evidences suggest that the therapeutic potential of gossypin as a substitute to morphine.

Insecticide impregnated cotton fabrics of different hydrophobicity against Aedes aegypti (Diptera:Culicidae).

Residual efficacy of synthetic pyrethroids, viz, permethrin, deltamethrin, lambdacyhalothrin and an insect repellent DEPA in cotton fabrics of different hydrophobicity was tested against Aedes aegypti. Amino silicone was used for enhancing the hydrophobicity of the fabrics. The results showed that there was an increasing trend in repellency/feeding deterrency with the increase in hydrophobicity up to 17.5 weeks at an optimum level of 30g/l. The adulticidal effect lasted for 1 to 4 weeks and this lower residual activity was attributed to the repellency of the treated fabrics. The results indicated that the residual efficacy of cotton fabrics could be enhanced by treating with an hydrophobic agent that increases the availability of the insecticide on the surface.