Invivo and invitro evaluation of antitumor effects of iron oxide and folate core shell-iron oxide nanoparticles

Nanoparticles are considered viable options in the treatment of cancer. This study was conducted to investigate the effect of magnetite nanoparticles (MNPs) and magnetite folate core shell (MFCS) on leukemic and hepatocarcinoma cell cultures as well as their effect on the animal model of acute myelocytic leukemia (AML). Through current study nanoparticles were synthesized, characterized by various techniques, and their properties were studied to confirm their nanostructure. Invivo study, nanoparticles were evaluated to inspect their cytotoxic activity against SNU-182 (human hepatocellular carcinoma), K562 (human leukemia), and THLE2 (human normal epithelial liver) cells via MTT test. Apoptotic signaling proteins Bcl-2 and Caspase-3 expression were inspected through RT-PCR method. A cytotoxic effect of MNPs and MFCS was detected in previous cell cultures. Moreover, the apoptosis was identified through significant up-regulation of caspase-3, with Bcl-2 down-regulation. Invitro study, AML was induced in rats by N-methyl-N-nitrosourea followed by oral treatment with MNPS and MFCS. Biochemical indices such as aspartate and alanine amino transferases, and lactate dehydrogenase activities, uric acid, complete blood count, and Beta -2-microglubulin were assessed in serum. Immunophenotyping for CD34 and CD38 detection was performed. Liver, kidney, and bone marrow were microscopically examined. Bcl-2 promoter methylation, and mRNA levels were examined. Although, both MNPs and MFCS depict amelioration in biochemical parameters, MFCS alleviated them toward normal control. Anticancer activity of MNPs and MFCS was approved especially for AML. Whenever, administration of MFCS was more effective than MNPs. The present work is one of few studies used MFCS as anticancer agent.

Management of chronic spontaneous urticaria: Real-world Indian perspective

Objectives: There are multiple guidelines for chronic spontaneous urticaria (CSU) by various dermatological associations, but in real-world practice in India, different approaches have been noted. In this paper, we courted to determine these different approaches in CSU management, adherence to various CSU guidelines, and the reasons for deviation from guidelines amidst dermatologists in India. Materials and Methods: A net-based questionnaire was created and validated by five panelists experienced in CSU management and then was circulated to all dermatologists in India in August 2020 for real-world management scenario. Results: We received 880 completed response out of 2235 response. Most of the dermatologists (97%) were aware of some urticaria guidelines. Although many of them follow guidelines about three forth of them reported to deviate from it sometimes. The most common reason for deviation was rely on clinical experience as opted by 53% of respondents. Dermatologists who follow guidelines also investigate routinely in terms of complete blood count, the erythrocyte sedimentation rate, and thyroid-stimulating hormone as compared to those who do not. About 70.5% of the dermatologist prescribe second-generation antihistamine (SGAH) at approved dose as the first line of treatment whereas 63.6% up dose it as second line of treatment. Surprisingly, 68% prescribe first-generation antihistamine in the evening and SGAH in the morning as combination therapy in CSU. Conclusion: From the findings of the present study, it can be strongly implied that guidelines play a vital role in delivering superior attributes of patient care although 75% of dermatologists deviated from it. Main reasons for deviance are reliability on self-clinical proficiency and consideration of economic impediments. Both these factors need to be worked upon by continuous medical education of dermatologists and more pharmaco-economic research.

Cathepsin S as an early biomarker for cardiovascular disease in chronic kidney disease patients

Introduction: A high incidence of cardiovascular disease (CVD) events and premature mortality is observed in patients with chronic kidney disease (CKD). Thus, new biomarkers that may help predict the development of CVD in early stages of CKD are being investigated along with other traditional risk factors. Objective: To investigate cathepsin S as an early biomarker for CVD in patients with CKD. Methods: A total of 64 patients with CKD were included and classified into 2 groups: CKD patients with established CVD and CKD patients with non-established CVD. All patients were submitted to routine investigations including complete blood count, random blood sugar, glycated hemoglobin (HbA1c), serum electrolytes, urea, creatinine, total protein, total albumin, calcium total, phosphorous, uric acid, vitamin D, parathormone, lipid profile, liver function test, measurement of serum cathepsin S (Cat S), and 2D Echo of the heart. Results: The level of serum Cat S was increased in CKD patients with CVD (p <0.05) as well as in later stages of CKD (p <0.05). CVD was also more common in patients in early stage CKD. In early stages CKD, Cat S and CVD were positively correlated. Conclusion: These findings suggest that serum Cat S might be useful as an early biomarker for CVD in CKD patients.

Assessment of the Haematological Alterations in Cervical Cancer Patients Attending Sabratha

Background: Cervix cancer is one of the most common cancers in women worldwide, and is the third most common malignant disease in women. It is one of the main health problems in Libyan women. Blood act as a pathological reflector of the status of exposed patient to infections and other conditions. Laboratory tests on the blood are vital tools that help detect any deviation from normal in the human body As the disease progresses, changes appear in haematological parameters which have been of relevant consideration in context of cancer patients. Objectives: The present study aimed to evaluate the alterations in haematological parameters among cervical cancer patients in Sabratha National Cancer Institute. Subjects and Methods: The present study was conducted on 150 cervical cancer patients, attending the National Cancer Institute of Sabratha from the 11th February, 2006 to the 3rd February, 2020. This study was approved by the Research and Ethical Committee of Sabratha University and Sabratha National Cancer Institute. Age was extracted from patient files. Also, 60 healthy individuals without any chronic disease were recruited for the control group. Blood samples were collected by vein puncture, 3 ml of venous blood withdrawn from each participant in the study by using disposable syringes under aseptic technique; they then transferred to a sterile EDTA tube, for complete blood count. The statistical significance of differences between groups was evaluated with the Mann Whitney U test. Results: The results showed that the mean age of the cervix cancer patients was 53.37±11.6 years.RBCs count, hemoglobin concentration, Hct value, MCH, MCHC, and lymphocytes % were significantly (P<0.01) decreased compared with the healthy individuals. On the other hand, leukocytes and platelets count, mixed %, neutrophils %, PLTs/Lymph, and Neutrophils/Lymphocytes ratios were significantly increased as compared with the healthy individuals. Conclusion: It can be concluded that a significant increase in leukocytes and platelets count, mixed %, neutrophils %, and the studied inflammation related haematological parameters and a significant decreased in lymphocytes %, RBCs count and most its indices. Further haematological studies are needed to confirm these results. Also, there is need to routinely monitor the haematological parameters and among cervical cancer patients.

Correlation between Red Blood Cell Distribution width, Neutrophil to Lymphocyte Ratio and Neutrophil to Platelet Ratio with 3-month Prognosis of Patients with Intracerebral Hemorrhage: A Retrospective Study

Background: Red cell distribution width (RDW) is a parameter that indicates the heterogeneity of red blood cell size and could be as a prognostic factor in some diseases. Also, intracerebral hemorrhage (ICH) is considered a vascular event with a high mortality rate. Here, we aimed to examine the role of RDW, neutrophil to lymphocyte (NLR) and neutrophil to platelet ratios (NPR) in predicting the prognosis of patients with ICH.Methods: This is a retrospective cohort study which conducted on 140 patients with ICH admitted to the neurology ward and intensive care unit (ICU) in Imam Reza Hospital, Tabriz, Iran. Demographic data, National Institutes of Health Stroke Scale (NIHSS), and complete blood count (CBC) test parameters evaluated within 24 hours after hospitalization. These variables collected and re-evaluated three months later. Results: The mean age of the study population was 61.14 (±16) years and 51% were male. RDW had a significant positive correlation with hemoglobin concentration (r=0.3; p<0.001) and significant negative correlation with MCHC (r=-0.57; p<0.001) and neutrophil count (r=-0.235; p=0.006). Also, the mean NLR (p=0.05), neutrophil and platelet count (p=0.05), NIHSS (p=0.05), and RDW (p=0.01) had a significant difference between the deceased patients and those who partially recovered after 3 months. Moreover, the results of logistic regression showed variables including RDW (p=0.006) and NIHSS (p<0.001) levels were correlated significantly with mortality. Conclusion: RDW could be an appropriate prognostic factor and predictor in determining 3-months survival in ICH. Nevertheless, further large-scale prospective cohorts might be needed to evaluate the associations.

Hematological Parameters and Iron Status in Adult Men and Women Using Altitude Adjusted and Unadjusted Hemoglobin Values for Anemia Diagnosis in Cusco, Peru (3400 MASL)

(1) Background: Current diagnosis of anemia in high altitude populations uses an adjustment of observed hemoglobin (Hb) values. Such an approach has been challenged by findings in different populations in Tibet, Ethiopia and the Andes as inappropriate, as it might incorrectly classify an individual with complete iron stores as anemic. We aimed to assess the suitability of this approach in adult men and women from Cusco, Peru (3400 m); (2) Methods: Complete blood count and iron status biomarkers were measured in 345 subjects (189 females and 156 males), iron status biomarkers were quantified with enzyme-linked immunoassays; (3) Results: Anemia prevalence was overestimated when the altitude-adjustment factor was applied. Hematological parameters were better correlated to iron status biomarkers in the non-adjusted anemia category. When stratified by sex, only women showed a significant association between Hb and other hematological parameters with iron storage and availability (Hepcidin and TFR-F); (4) Conclusion: The prevalence of anemia is overestimated with current guidelines. The rate of anemia using non-adjusted Hb values is more closely related to the rates of anemia or iron deficiency when used hematological parameters, markers of iron status, and measurements of hepcidin and erythropoietin. Sex differences related to iron status were observed, suggesting that men are at a higher risk of iron overload than women at high altitudes. It could be highlighted that a personalized approach is important when assessing a subject, taking in to account hematological parameters as well as origin (Southern Andean or other).

Effectiveness of antimicrobial therapy for community-acquired pneumonia in real clinical practice

Background. Community-acquired pneumonia (CAP) remains one of the most common infectious diseases, occupying an important place in the structure of mortality worldwide.Aim. To evaluate the effectiveness of antimicrobial therapy for community-acquired pneumonia in hospitalized patients in real clinical practice.Materials and methods. A retrospective, observational study was conducted, which included 236 patients hospitalized for community-acquired pneumonia at the Regional Clinical Hospital in Ryazan in 2019. Based on these case histories, an analysis of the effectiveness of the initial empiric antimicrobial therapy was performed.Results. The initial empiric antimicrobial therapy in 73% of cases included administration of ceftriaxone, in 45% of cases – levofloxacin, in 14% of cases – azithromycin. It was found that initial antimicrobial therapy was effective in 58% of patients who did not require replacement for the antibiotic. A need for a change in the treatment regimen was significantly associated with an increase in the length of hospitalization (p < 0.001), heart rate upon admission (p = 0.032), myelocyte count in the complete blood count (p < 0.001), and urea and blood creatinine levels (p = 0.004 and p = 0.044, respectively). The selected antimicrobial therapy regimen was significantly associated with the expected treatment effectiveness (p = 0.039). The choice of levofloxacin in monotherapy or in combination with ceftriaxone was accompanied by a decrease in the relative risk of replacing the antimicrobial, compared with other treatment regimens (odds ratio (OR) = 0.86 (95% confidence interval (CI): 0.55–1.34) and OR = 0.57 (95% CI: 0.37–0.87), respectively).Conclusion. Empiric antimicrobial therapy for community-acquired pneumonia in real clinical practice complies with current recommendations, however, at the same time, its ineffectiveness persists. Respiratory fluoroquinolones are most effective in treating pneumonia in hospitalized patients.