Effects of Greek Honey and Propolis on Oxidative Stress and Biochemical Parameters in Regular Blood Donors

Background and objectives: Honey products contain a lot of compounds, such as vitamins, enzymes, and minerals, which make honey and its products a great antioxidant with a critical role in health status. It is well accepted that honey and propolis can improve a lot of health problems when they are consumed in certain quantities. The objective of this study is to help regular blood donors improve their health status after donation. Material and methods: Eighty regular blood donor volunteers—30 males aged 19–61 and 30 females aged 21–64—were divided into 4 groups: group A (n = 20) consumed 2 spoons of Greek honey and 1 drop of propolis per day for 1 month, group B (n = 20) consumed 2 spoons of honey per day for 1 month, group C (n = 20) consumed 1 drop of propolis per day, and group D (n = 20) did not consume any Greek honey products. Blood samples were collected from all participants just before the consumption of the products, one month after the consumption, and six months after honey product consumption had ceased. All samples were analyzed for reactive oxygen species (ROS), lipid profiles, and ferritin levels. Results: The ROS were significantly (p < 0.05) lower in groups A, B, and C after the honey product consumption and increased significantly again after six months. No significant differences in lipid profiles were observed. Only triglyceride levels were increased after six months in all groups. On the other hand, ferritin levels were not statistically significantly decreased after six months in groups A and B, while they were increased in group C. Conclusions: In the present study, statistically significant decreases in ROS status was found after a small dose of honey product consumption, indicating a diet with an extra small dose of honey products after blood donation.

Success of small-dose fractionated sodium thiosulfate in the treatment of calciphylaxis in a peritoneal dialysis patient

Background Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, fatal disorder of microvascular calcification and thrombosis that typically affects patients with end-stage renal disease (ESRD) receiving long-term dialysis. Fewer reports describe calciphylaxis in peritoneal dialysis patients than hemodialysis patients as per a literature review. To date, there are no clear guidelines for CUA diagnosis and treatment. While sodium thiosulfate (STS) has been increasingly used for treatment in recent years, there have also been reports of severe side effects. There is no uniform standard for its usage and dosage, especially for peritoneal dialysis patients. Case presentation We present a case of a 40-year-old Chinese male patient with ESRD on peritoneal dialysis who developed calciphylaxis with severe painful cutaneous ulcers on the fingers and toes that were managed successfully for 6 months with comprehensive treatment composed mainly of small-dose fractionated sodium thiosulfate. Conclusions Our experience suggests that the treatment of calciphylaxis requires timely and multi-angle intervention. Treatment with small-dose fractionated sodium thiosulfate has proven effective and tolerated in this patient.

PHARMACEUTICAL STANDARDIZATION OF PRADARANTAKA YOGA

Rasa Shastra is the pharmaceutical branch of Ayurveda. As with any other medical system, the success of Ayur- vedic treatment also depends upon the quality of medicine prescribed to the patient. An integral part of Rasa Shastra lies in the successful pharmaceutical process. Rasaoushadis are the potent Ayurvedic preparations mainly containing metals and minerals. These Oushadis possess a wide range of therapeutic efficacy and are considered superior because of their qualities like small dose, quick action, palatability and longer shelf life. Pradarantaka Yoga is an important Rasa Oushadi described in Rasa Tantra Sara Va Siddha Prayoga Sangraha (part_2)- Streeroga Prakaranam indicated in Rakta Pradara. Pradarantaka Yoga contains Gairika and Amalaki Swarasa. The pharmaceutical procedures adopted in this study are Shodhana, Bhavana, Swarasa Nirmana and preparation of Vati of Pradarantaka Yoga. The specific pharmaceutical blend of these contents can result in a more effective formulation. Till now, no research work has been carried out to standardize this formulation. Therefore, the present study has been planned to standardize the method of preparation of Pradarantaka Yoga according to the method explained in the classical literature. Keywords: Pradarantaka Yoga, Shodhana, Swarasa Nirmana, Standardization.

The Application of Decitabine in Combination with G-CSF, Low-Dose Cytarabine and Aclarubicin in AML-MRC: A Single Center Case Control Study

Background: It is difficult for AML-MRC patients to achieve complete remission (CR) and these patients develop recurrence and die of either disease progression or associated complications. The CAG regimen (cytarabine, aclarubicin and G-CSF) has been widely used in treating patients with AML-MRC in Asia. Decitabine (DAC) was approved to the treatment of MDS and reported to achieve higher response rate (67%) in AML with unfavorable-risk cytogenetics. Several studies reported low dose DAC in combination with chemotherapy to treat AML. Purpose:To evaluate the clinical efficacy and safety of low-dose decitabine in combination with small-dose CAG regimen (D-CAG regimen) in the treatment of AML-MRC, compared to CAG regimen. Methods:A total of 80 patients with newly diagnosed AML-MRC from September 2015 to January 2020 in our center were included in the study. 43 cases were initially treated with G-CSF for priming, in combination with cytarabine of 10-mg/ m 2q12h for 14 days and aclarubicin of 20 mg/day for 4 days (CAG regimen) and other 37 cases were initially treated with decitabine of 20 mg/m 2 for 5 days and small-dose CAG regimen (cytarabine of 10-mg/ m 2q12h for 7 days, aclarubicin of 10 mg/day for 4 days, and G-CSF for priming (D-CAG regimen). After induction chemotherapy, the patients who achieved CR received consolidation chemotherapy or hematopoietic stem cell transplantation (HSCT). Results:Among a total of 80 patients, the median age was 55 years (18-69 years) and 32 of them were male. Baseline characteristics of patients between D-CAG group and CAG group showed no significant differences (table 1). For the overall AML-MRC patients, the MLFS rate of D-CAG group was higher than the MLFS rate of CAG group after two courses of D-CAG regimen (62.2% v. s. 48.8%, χ2 =8.727, P=0.013, bilateral). Seven patients in CAG group did not response and then received D-CAG regimen as induction therapy, and five of them achieved MLFS (5/7) and one achieved PR (1/7). Among the population with less than 9 months of AML-MRC and/or MDS history, the MLFS rate (74.1%, 20/27) of D-CAG group was statistically higher than the MLFS rate (42.9% 15/35) of CAG group (74.1% v. s. 42.9%, χ 2 =1.909, p=0.008). Compared to the CAG group, the high-risk patients classified according to SWOG criteria in D-CAG group achieved a better MLFS rate (80.0% v. s. 26.1%, χ 2 =11.392, P=0.003, bilateral). Except patients receiving HSCT, the probability of OS and LFS for patients between D-CAG group and CAG group did not show any significant difference, but among the population with less than 9 months of AML-MRC and/or MDS history, the DCAG group showed a better probability of OS than the CAG group (58.3%±18.6% v. s. 11.3%±10.3%, p=0.006). Conclusion: In conclusion, patients with AML-MRC have a poor prognosis, and might benefit from D-CAG regimen as the induction therapy. For patients with less than 9 months of AML-MRC/MDS history or with poor karyotypes, the MLFS rate for patients in D-CAG group was higher than patients in CAG group. Disclosures No relevant conflicts of interest to declare.

Finding the Optimal Regimen for Short-Term Daily Recombinant Human Erythropoietin Treatment for Blood-Saving Purpose in Patients undergoing Unilateral Primary Total Hip Arthroplasty: A Double-Blinded Randomized Placebo-Controlled Trial

Purpose: To find the best short-term daily rhEPO-based treatment protocols for blood-saving purpose in THA.Method: The patients were randomized to 1 of 3 interventions: Patients in group A received 10,000 IU (150IU/kg) of subcutaneous rhEPO (1 ml) daily from 5 days preoperatively to 3 days postoperatively (9 doses in total); Patients in group B received 1 ml of subcutaneous normal saline daily from 5 days preoperatively to 4 days preoperatively and then 10,000 IU (150IU/kg) of subcutaneous rhEPO daily till 3 days postoperatively (6 doses in total). Patients in group C received 1 ml of subcutaneous normal saline daily from 5 days preoperatively to one day preoperatively and then 10,000 IU (150IU/kg) of subcutaneous rhEPO daily from the day of surgery to 3 days postoperatively (4 doses in total). Results: 180 patients were included. On postoperative day one, patients in the group A showed significantly higher Hb level (108.4±11.4 g/L) than group B and C (107.8±8.4 and 103.9±8.8 g/L, respectively) (p<0.001), the Hb level in group B was also markedly higher than in group C (p=0.045). On postoperative day 3, no significant difference was found between group B and C in Hb level (98.7±10.5 and 94.9±8.7 g/L, respectively) (p=0.094), but the Hb level in group A (103.6±11.0 g/L) was still markedly higher than in group B and C. In terms of blood loss, no markedly difference was found in intraoperative blood loss among group A, B and C (78.3±22.4, 84.6±29.1, and 80.3±23.9 ml, respectively) (p=0.381), but on postoperative day one, the mean blood loss was significantly more in groups B and C (371.2±124.6, and 522.4±189.4 ml, respectively) than in group A (284.8±112.9 ml) (p<0.001), and group B had significantly less blood loss than group C (p<0.001). With respect to the total blood loss, group B and C had markedly more total blood loss (642.6±232.9, and 881.6±314.9 ml, respectively) than group A (514.5±204.6 ml) and group B had significantly less blood loss than group C (p<0.001) (Table 2). Only 2 patients in each group received allogeneic blood transfusion and each patient received 2 units of red blood cells, so, the transfusion requirements among the three groups were comparable.Conclusions: Daily small-dose of subcutaneous rhEPO administered from 5 days before THA could significantly decrease perioperative blood loss and improve postoperative Hb levels, without increasing risks of complications, when compared with the application of rhEPO from 3 days before THA or from the day of surgery. Therefore, we recommend the more practical and highly effective therapeutic regimen of small-dose of subcutaneous rhEPO daily from 5 days preoperatively to 3 days postoperatively for patients scheduled for THA.

Nanorobots is an Emerging Technology Which is Helpful in the Diagnosis and Treatment of Various Diseases

This review is provided detailed overview of the types, properties and application of nanorobot in the diagnosis, prevention and treatment of various diseases. Now a day’s health care industry focusing on the development of nanotechnology for the diagnosis and treatment of various diseases. Development of nanorobots is an interesting and hopeful area of nanotechnology which is produce on nanoscale. Many drugs exhibit is the problem of less bioavailability of drug and require the administration of higher amount for treatment of various diseases. To overcome such problem, nanorobot are the novel solution that deliver the drug to the target thus small dose is sufficient to achieve the desired therapeutic effect. Nanorobots are tiny device which is measure on the nanometer scale. Nanorobots also known as nanite, nanobots, or nanomites. Nanorobots are used in the diagnosing, treatment and prevention of the diseases, relieving pain and improving the human health.

Anesthetic management of super-elderly patients with remimazolam: a report of two cases

Background Remimazolam is a newly developed benzodiazepine with more rapid onset and offset of sedation effects than midazolam. We report elderly patients in whom a small dose of remimazolam was successfully used for general anesthesia. Case presentation Two elderly women (patients 1 and 2, aged 95 and 103 years, respectively) underwent hip fracture surgery under general anesthesia guided by bispectral index (BIS). Anesthesia was induced with 1.2 and 1.0 mg/kg/h and maintained with 0.2 and 0.1 mg/kg/h remimazolam, combined with fentanyl and remifentanil in patients 1 and 2, respectively. Their hemodynamics were stable with a small dose of vasopressor, and they awoke soon after the discontinuation of remimazolam without flumazenil reversal. Their postoperative courses were uneventful without any complications. Conversely, the remimazolam dose required to achieve adequate sedation were much lower than expected. Conclusion Remimazolam could be useful in general anesthesia, particularly for super-elderly patients. However, the appropriate dose for induction and maintenance of anesthesia should be carefully considered based on BIS or vital signs.