Antimicrobial and toxicological evaluation of Origanum vulgare: an in vivo study

Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.

The Human Microbiome in Chronic Kidney Disease: A Double-Edged Sword

Chronic kidney disease (CKD) is an increasing global health burden. Current treatments for CKD include therapeutics to target factors that contribute to CKD progression, including renin–angiotensin–aldosterone system inhibitors, and drugs to control blood pressure and proteinuria control. Recently, associations between chronic disease processes and the human microbiota and its metabolites have been demonstrated. Dysbiosis—a change in the microbial diversity—has been observed in patients with CKD. The relationship between CKD and dysbiosis is bidirectional; gut-derived metabolites and toxins affect the progression of CKD, and the uremic milieu affects the microbiota. The accumulation of microbial metabolites and toxins is linked to the loss of kidney functions and increased mortality risk, yet renoprotective metabolites such as short-chain fatty acids and bile acids help restore kidney functions and increase the survival rate in CKD patients. Specific dietary interventions to alter the gut microbiome could improve clinical outcomes in patients with CKD. Low-protein and high-fiber diets increase the abundance of bacteria that produce short-chain fatty acids and anti-inflammatory bacteria. Fluctuations in the urinary microbiome are linked to increased susceptibility to infection and antibiotic resistance. In this review, we describe the potential role of the gut, urinary and blood microbiome in CKD pathophysiology and assess the feasibility of modulating the gut microbiota as a therapeutic tool for treating CKD.

Evaluation of the Effect of COVID-19 Pneumonia on Kidney Function

Background: Severe acute respiratory tract infection, pneumonia, kidney failure, and multi-organ failure may develop in cases that result in death due to COVID-19. It is emphasized that the awareness of healthcare professionals about kidney functions should be increased in cases of COVID-19 pneumonia. Quick and effective steps can be taken in the treatment of COVID-19 pneumonia with the controlling approach of nurses to changes in kidney functions. Method: This study was carried out retrospectively to evaluate the kidney functions of patients diagnosed with COVID-19 pneumonia who were hospitalized in the pandemic hospital. Hospital and nurse observation files of 120 patients who were introduced to COVID-19 pneumonia between 1 May and 30 November 2020 were examined. Categorical data were described as continuous data as median with interquartile range (IQR) and percentages (%). Results: In total, 30 patients (25.0%) required mechanical ventilation, Overall, 39.1% (47) developed acute kidney injury during hospitalization, out of which 10.8% reached stage 1, 15.0% reached stage 2, and 13.3% reached stage 3. Dialytic support was required for seven (17.1% of all patients). COVID-19 pneumonia patients had higher levels of aspartate aminotransferase (AST) (55.02±58.04), alanine aminotransferase (ALT) (74.07±140.94), lactate dehydrogenase (LDH) (483.48±477.51), C-reactive protein (CRP) (88.02±72.17), D-dimer (1023±1548.01), procalcitonin (3.70± 6.52). In addition, a proportion of COVID-19 pneumonia patients but no non-COVID-19 pneumonia patients had abnormally increased AST (10.0-274.0), ALT (7.0-854.0), LDH (164-3547), CRP (5.10- 310.90), D-dimer (151-6212), procalcitonin (195-433). SpO2 of COVID-19 pneumonia patients had 78-97%, patients who need dialysis treatment due to pneumonia, follow-up coagulation profile (Procalcitonin, LDH, D-dimer), liver-renal function (ALT, AST, Creatine, Urea, Albumin), assessing signs of DVT and psychological support. 89 patients (74.2%) received corticosteroid, 73 patients (60.8%) received expectorant, 61 patients (50.8%) received vitamin C or B complex, 110 patients (91.7%) received anticoagulant and 73 patients (60.8%) received antibiotics. All of the COVID-19 pneumonia patients received the antiviral drug. Conclusion: As the disease progresses, differences in laboratory results and radiological findings may indicate that some complications have developed. COVID-19 pneumonia draws attention with liver function tests such as AST / ALT, LDH, infection markers in the blood, and the high rate of coagulation factors such as PCT and D-dimer during the hospital stay. The fact that these elevated values ​​may cause necrosis in the kidneys also brings about the truth. Careful monitoring of laboratory findings such as elevation of AST / ALT, LDH, PCT, and D-dimer in patients who develop pneumonia due to COVID-19 may provide early action for kidney damage.

Edible Mushroom significantly ameliorated Hepatorenal Toxicity of Butyl Paraben (BP) in Albino Rats.

Introduction: Parabens are used commonly as preservatives in a range of cosmetics applied to the under arm and breast area as well as popular preservatives because of their cost.Aim of the work: This study was done to evaluate the neprohepatic toxicity of parabens. Materials and methods: Thirty adult female rats were used and given paraben orally for six months at parabens at dose of 10 % of the LD50 equal to 4.6mg\kg.bw. Mushroom was given orally to at dose of 10 mg/kg/day for six months too. Results: Oral administration of BP induced biochemical and histopathological changes. Biochemical changes: BP toxicity manifested by changes in the liver and kidney function tests manifested by increase AST, ALT, Bilirubin, urea and createnine with decreases to plasma proteins in comparison to control group. Giving mushroom caused amelioration to the nephrohepatic toxicity by inducing recovery in liver and kidney functions in comparison to paraben treated group. For histopathological findings: BP induced vascular congestion in liver and kidney in association with necrotic changes in the hepatorenal epithelium which improved after mushroom treatment. Conclusion: BP induced hepatorenal toxicity which improved by mushroom treatment.

Hepatorenal Protective Effects of Sesame Seeds Oil, Flaxseed Oil and their Mixture against Methotrexate Toxicity in Rats

Background: Methotrexate (MTX) is an anti-metabolite drug used in the treatment of many cancers and autoimmune diseases. Methods: This study investigated the protective effect of flaxseed oil, sesame seed oil, and their mixture on the MTX-induced hepatorenal toxicity. Thirty rats divided into five groups of: normal control, MTX control, and flaxseed oil, sesame seed oil, and the mixture groups. The oils were administered to rats orally (2 ml/kg) for nine consecutive days followed by a methotrexate injection intraperitoneally (20 mg/kg) on the 9th day. Blood samples, liver and kidney tissues were collected from all rats for biochemical studies and histopathological assessments. The total phenolic content and fatty acid profiles of the oils were also determined. Results: Methotrexate induced hepatorenal toxicity as evident by the histopathological assessments of liver and kidneys, elevation of liver and kidney functions’ biomarkers, and increased plasma and liver oxidative stress associated with a rise in the tumor necrosis factor-alpha, as an inflammatory marker. Administration of flaxseed oil, sesame seed oil or the mixture prevented the MTX-toxicity at varying degrees as shown by reduced oxidative stress and inflammatory response, and improved liver and kidney functions. The mixture was the most efficient treatment associated with the histopathological improvements in the liver and kidney tissue samples, and all biochemical parameters tested. Conclusion: Flaxseed oil, sesame seeds oil and the mixture may be used therapeutically to prevent hepatorenal toxicity induced by MTX. The effect is likely due to the presence of phenolic compounds and polyunsaturated fatty acids in the oils with antioxidant and anti-inflammatory properties.

Current Trends in Nosocomial Associated UTI (NAUTI) in Urology Ward

Background: Nosocomial associated urinary tract infections are common, which not only causes morbidity and mortality but also increases cost of health related expenditure in urology patients. Such infections are more difficult to treat because of presence of risk factors e.g. stone, reduced kidney functions. Limited studies are available which focus on type of organisms involved in NAUTI and their presentation in urology departments. Objective: To determine the proportion of microorganisms involved in Nosocomial associated urinary tract infections (NAUTI) and their presentations in urology ward. Methods: This cross-sectional study was conducted in Dubai Hospital in Dubai UAE, from 2017-2018. All patients, who were admitted in urology department with negative urine cultures, were included in study. Urine cultures were sent at time of discharge and a week after discharge from hospital. Patients were followed up in outdoor at first and second week. Results: Total 475 patients were included in this study in given time period. 315(66.31%) patients were male and 160(33.68%) patients were female. On their first follow up after a week, Urine cultures, which were sent at discharge time reveals,73(15.36%) patient’s urine cultures were positive, out of them 21(28.76%) were Mixed Bacterial Growth (MBG). E.coli was most common organism 20(27.39%) in which 11(15.06%) were ESBL positive, klebsiela 9(12.32%) in which 4(5.47%) were ESBL positive. Other organisms include Psuedomonas 4(5.47%), candida 16(21.91%) and enterococcus 3(4.11%). Frequency of candida was second highest, probably because of use of antibiotics during admission. Conclusion: Prevalence of NAUTI in urology is 19.79% (94/475 patients). Enterobacterale species were main responsible organisms for NAUTI in Urology ward. E.coli was most common organism isolated and klebsiela was second most common. Key words: Nosocomial UTI, ESBL UTI, Urology ward

Significance of Addressal of Clinical Investigations of Kidney Functions in Recovery/Mortality of Certain COVID-19 Patients

Clinical management of COVID-19 patients through a robust protocol is key to the good recovery and reduced mortality of patients. Efficient kidney functions during treatment period can contribute for improvised recovery and reduced mortality of patients. Analysis of the kidney function among Recovered and Dead cases of COVID-19 was made to reveal the degree of association of kidney functions with the two categories of patients. 83.4% of recovered patients did not show hyper values of blood urea whereas 72.5% of dead patients showed hyper-urea level in blood. 88.8% of survivors showed non-hyper creatinine level of blood whereas only 40% of dead cases showed hyper creatine level. Strong degree of association of blood urea with recovery/mortality was observed. Sodium levels were seen to be low while potassium and chloride ions were seen to be high in COVID-19 individuals. Our preliminary study suggests that kidney functions especially the value of blood urea and creatinine need to be addressed during COVID-19 patients to ensure the best recovery and reduced mortality. After more number of case studies, the present observation could sensitize consideration for inclusion of addressal and treatment of kidney functions into treatment protocol against COVID-19. It was also interesting to observe that levels of sodium and potassium ions among Survivors and Dead cases have impacted function of the essential ion channels in patient’s physiology.

Hepatic and Renal Safety of Remdesivir in COVID-19 Patients Observational prospective study

Background: SARS-CoV-2 has been demonstrated to be inhibited by Remdesivir, a broad-spectrum antiviral medication. Remdesivir has been tried for a compassionate use in severe COVID-19 in the absence of any viable treatment for SARS-CoV-2 infection (COVID-19). Methods: In 50 patients with SARSCoV-2 infection who were given Remdesivir as part of their institutional treatment plan, we conducted an observational prospective analysis. Remdesivir 100 mg was given daily for7 days during the therapy period. The results of liver and kidney function tests were compared before and after Remdesivir administration. Results: With the administration of Re%) exhibited an improvement in their oxygen needs. Patients reported only a few minor side effects. Serious side effects, on the other hand, were rare. Conclusion: Remdesivir seems to have an excellent safety profile, while its efficacy in the treatment of COVID-19 is currently inconclusive. Remdesivir use in patients was shown to be safe, with no serious side effects or significant changes in normal test results for liver and kidney functions. Keywords: Adverse events, Covid-19, liver function, remdesivir, renal function

Role of Endothelial Glucocorticoid Receptor in the Pathogenesis of Kidney Diseases

Glucocorticoids, as multifunctional hormones, are widely used in the treatment of various diseases including nephrological disorders. They are known to affect immunological cells, effectively treating many autoimmune and inflammatory processes. Furthermore, there is a growing body of evidence demonstrating the potent role of glucocorticoids in non-immune cells such as podocytes. Moreover, novel data show additional pathways and processes affected by glucocorticoids, such as the Wnt pathway or autophagy. The endothelium is currently considered as a key organ in the regulation of numerous kidney functions such as glomerular filtration, vascular tone and the regulation of inflammation and coagulation. In this review, we analyse the literature concerning the effects of endothelial glucocorticoid receptor signalling on kidney function in health and disease, with special focus on hypertension, diabetic kidney disease, glomerulopathies and chronic kidney disease. Recent studies demonstrate the potential role of endothelial GR in the prevention of fibrosis of kidney tissue and cell metabolism through Wnt pathways, which could have a protective effect against disease progression. Another important aspect covered in this review is blood pressure regulation though GR and eNOS. We also briefly cover potential therapies that might affect the endothelial glucocorticoid receptor and its possible clinical implications, with special interest in selective or local GR stimulation and potential mitigation of GC treatment side effects.