Isolation and efficacy of entomopathogenic fungus (Metarhizium anisopliae) for the control of Aedes albopictus Skuse larvae: suspected dengue vector in Pakistan

Objective

To isolate the entomopathogenic fungus Metarhizium anisopliae (M. anisopliae) in the local environment, and evaluate its efficacy against the suspected dengue vector Aedes albopictus in Pakistan.

Methods

According to the standard procedure, M. anisopliae was isolated from the dead mosquitoes which were collected from the field or dead after the collection. Bioassay was performed to determine its efficacy.

Results

The results indicated that M. anisopliae had larvicidal effect with LC₅₀ value 1.09×10⁵ and LC₉₀ value 1.90×10¹³ while it took 45.41 h to kill 50% of tested population.

Conclusions

Taking long time to kill 50% population when compare with the synthetic insecticides, is the only drawback for the use of entomopathogenic fungus but these bio-pesticides are safe for the use.     

Platelet Functions in Cardiopulmonary Bypass Surgery

Background

Haemorrhage after Cardio Pulmonary Bypass (CPB) Surgery is a well recognised complication that leads to significant morbidity and mortality. The incidence varies between 5-25% depending upon the clinical situation. Several factors are implicated as causative but none have been precisely proved.

Methods

Our study was an attempt to evaluate the haemostatic defect with particular reference to platelet function abnormalities during cardio pulmonary bypass surgery, in order to reduce the morbidity and mortality associated with post CPB haemorrhage. Flow cytometric evaluation of different platelet glycoproteins like GPIb/IX, GPIIb/IIIa and GMP-140 was done.

Results

The marker expression showed deregulation during surgery which returned to base after bypass was terminated. In contrast, the cases with bleeding showed significant variation. P-Selectin (GMP 140) expression decreased progressively till 3^rd post-operative day showing lack of activation of platelets in cases of severe bleeding.

Conclusion

Longer duration of CPB initiates plasmin generation through heparin, which raises the PAI-1-tPA complex and thereby down regulating the functions of platelets. This suggests a link between duration of CPB, bleeding, platelet dysfunction and fibrinolysis. Hence serial estimations of the levels of GMP-140 and tPA can predict severe bleeding.Key Words: CardioPulmonary Bypass, Platelet dysfunction, flowcytometry, platelet glycoproteins, haemorrhage     

Antioxidant and cytotoxic activity of Acanthus ilicifolius flower

Objective

To investigate the antioxidant and cytotoxic activity of the flower of Acanthus ilicifolius (A. ilicifolius).

Methods

Antioxidant activity was determined as antiradical efficiency with diphenyl picrylhydrazil (DPPH) method and cytotoxic assay was undertaken using brine shrimp lethal toxicity test.

Results

A. ilicifolius flower contained terpenoid, phenolic compounds, and alkaloid. The methanol extract of A. ilicifolius flower showed the highest antiradical efficiency (AE=1.41×10⁻³) against DPPH radicals and the highest cytotoxicity (LC₅₀=22 µg/mL) against brine shrimp nauplii.

Conclusions

It is suggested that active compounds of A. ilicifolius flower solved in methanol play a role to inhibit free radical activity and kill Artemia salina nauplii. The substances can be considered as potential antioxidant and cytotoxic agents as well as imminent candidate for cancer therapy.     

Seasonal variation of platelets in a cohort of Italian blood donors: a preliminary report

Background

Since available data are not univocal, the aim of this study was to explore the existence of a seasonal variation in platelet count.

Methods

The study was based on the database of the Italian Association of Blood Volunteers (AVIS), section of Ferrara, Italy, 2001–2010. Hematological data (170,238 exams referring to 16,422 donors) were categorized into seasonal and monthly intervals, and conventional and chronobiological analyses were applied.

Results

Platelets and plateletcrit were significantly higher in winter-autumn, with a main peak in December-February (average +3.4% and +4.6%, respectively, P <0.001 for both).

Conclusions

Although seasonal variations have been reported for several acute cardiovascular diseases, it is extremely unlikely that such a slight increase in platelet count in winter alone may be considered as a risk factor.     

γ射线辐照对血小板CD62p表达率的影响

目的探讨γ射线辐照对单采血小板活化及输注效果的影响。方法将30袋单采血小板随机分为对照组和辐照组,分别测定保存前及保存第1、3、5天时血小板活化标志物CD62P的表达率;观察两种血小板输注后出血改善情况及血小板计数的变化情况。结果辐照组与对照组相比,保存前及保存第1、3天时CD62P的表达无显著性差异（P〉0.05）,保存至第5天时,辐照组CD62P的表达较对照组低（P〈0.05）;临床输注后,出血情况均有不同程度改善,两组患者输注血小板后其回收率无明显差异。结论γ射线辐照对单采血小板活化及输注效果均无明显影响,可以达到与输注未经辐照的等量血小板同样的疗效。     

Biofabrication of Ag nanoparticles using Moringa oleifera leaf extract and their antimicrobial activity

Objective

To formulate a simple rapid procedure for bioreduction of silver nanoparticles using aqueous leaves extract of Moringa oleifera (M. oleifera).

Methods

10 mL of leaf extract was mixed to 90 mL of 1 mM aqueous of AgNO₃ and was heated at 60 - 80 °C for 20 min. A change from brown to reddish color was observed. Characterization using UV-Vis spectrophotometry, Transmission Electron Microscopy (TEM) was performed.

Results

TEM showed the formation of silver nanoparticles with an average size of 57 nm.

Conclusions

M. oleifera demonstrates strong potential for synthesis of silver nanoparticles by rapid reduction of silver ions (Ag⁺ to Ag⁰). Biological methods are good competents for the chemical procedures, which are eco-friendly and convenient.     

A comparative study of the antioxidant,antimicrobial, cytotoxic and thrombolytic potential of the fruits and leaves of Spondias dulcis

Objective

To investigate the antioxidant, antimicrobial, cytotoxic and thrombolytic property of the fruits and leaves of Spondias dulcis (S. dulcis).

Methods

Methanolic extracts of fruits and leaves of S. dulcis were partitioned with chloroform and dichloromethane. The antioxidant potential of the crude extract and partitioned fractions were evaluated in terms of total phenolic content, total flavonoid content, DPPH radical scavenging potential, reducing potential and total antioxidant capacity by specific standard procedures. The antimicrobial activity was evaluated using disc diffusion method. The cytotoxicity was evaluated by using brine shrimp lethality bioassay and compared with vincristine sulfate. The thrombolytic activity was compared with streptokinase.

Results

The methanolic fruit extract exhibited the highest phenolic content, flavonoid content and antioxidant capacity, among the other extracts, with the highest DPPH radical scavenging activity at a concentration of 10 µg/mL (IC₅₀: 1.91 µg/mL) and maximum reducing power at a concentration of 100 µg/mL (EC₅₀: 3.58 µg/mL). Though all extract showed moderate antimicrobial activity against the bacterial strains, weak or no activity against fungus. The range of LC₅₀ value of all extracts was 1.335-14.057 µg/mL which was far lower than the cut off index for cytotoxicity. All extracts exhibited statistically significant (P<0.001) thrombolytic activity.

Conclusions

Our study suggested that S. dulcis exhibits antimicrobial activities against a wide variety of strains while it possesses significant antioxidant, cytotoxic and thrombolytic activity.     

Whole blood coagulation and platelet activation in the athlete: A comparison of marathon,triathlon and long distance cycling

Introduction

Serious thrombembolic events occur in otherwise healthy marathon athletes during competition. We tested the hypothesis that during heavy endurance sports coagulation and platelets are activated depending on the type of endurance sport with respect to its running fraction.

Materials and Methods

68 healthy athletes participating in marathon (MAR, running 42 km, n = 24), triathlon (TRI, swimming 2.5 km + cycling 90 km + running 21 km, n = 22), and long distance cycling (CYC, 151 km, n = 22) were included in the study. Blood samples were taken before and immediately after completion of competition to perform rotational thrombelastometry. We assessed coagulation time (CT), maximum clot firmness (MCF) after intrinsically activation and fibrin polymerization (FIBTEM). Furthermore, platelet aggregation was tested after activation with ADP and thrombin activating peptide 6 (TRAP) by using multiple platelet function analyzer.

Results

Complete data sets were obtained in 58 athletes (MAR: n = 20, TRI: n = 19, CYC: n = 19). CT significantly decreased in all groups (MAR -9.9%, TRI -8.3%, CYC -7.4%) without differences between groups. In parallel, MCF (MAR +7.4%, TRI +6.1%, CYC +8.3%) and fibrin polymerization (MAR +14.7%, TRI +6.1%, CYC +8.3%) were significantly increased in all groups. However, platelets were only activated during MAR and TRI as indicated by increased AUC during TRAP-activation (MAR +15.8%) and increased AUC during ADP-activation in MAR (+50.3%) and TRI (+57.5%).

Discussion

While coagulation is activated during physical activity irrespective of type we observed significant platelet activation only during marathon and to a lesser extent during triathlon. We speculate that prolonged running may increase platelet activity, possibly, due to mechanical alteration. Thus, particularly prolonged running may increase the risk of thrombembolic incidents in running athletes.     

Bioactivity of seagrass against the dengue fever mosquito Aedes aegypti larvae

Objective

To identify the larvicidal activity of the seagrass extracts.

Methods

Seagrass extracts, Syringodium isoetifolium (S. isoetifolium), Cymodocea serrulata and Halophila beccarii, were dissolved in DMSO to prepare a graded series of concentration. Batches of 25 early 4th instars larvae of Aedes aegypti (Ae. aegypti) were transferred to 250 mL enamel bowl containing 199 mL of distilled water and 1 mL of plant extracts (0.01 mg – 0.1 mg). After 24 h the mortality rate was identified with the formulae [(% of test mortality – % of control mortality)/(100 – % of control mortality)] × 100. Each experiment was conducted with three replicates and a concurrent control group. A control group consisted of 1 mL of DMSO and 199 mL of distilled water only.

Results

: The root extract of S. isoetifolium showed maximum larvicidal activity with minimum concentration of extract of LC₅₀= 0.0 604 ± 0.0 040)µg/mL with lower confidence limit (LCL) – upper confidence limit (UCL) = (0.051–0.071) and LC₉₀=0.0 972µg/mL followed by leaf extract of S. isoetifolium showed LC₅₀= (0.062 ± 0.005)µg/mL. The regression equation of root and leaf extract of S. isoetifolium for 4th instar larvae were Y= 4.909 + 1.32x (R²= 0.909) and Y= 2.066 + 1.21x (R² =0.897) respectively. The results of the preliminary phytochemical constituents shows the presence of saponin, steroids, terpenoid, phenols, protein and sugars.

Conclusions

From the present study the ethanolic extracts of seagrass of S. isoetifolium possesses lead compound for development of larvicidal activity.     

Thrombus aspiration during primary percutaneous coronary intervention associated with reduced platelet activation

Objectives:

To determine the effect of thrombectomy on platelet function in patients undergoing primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI).

Methods:

This retrospective study included 413 consecutive STEMI patients who underwent PPCI between March 2012 and September 2013 at Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey that were assigned to the thrombus aspiration (TA) group or the non-TA group. Platelet count and mean platelet volume (MPV) were obtained at baseline and 24 hours (h), 48 h, and 72 h post PPCI.

Results:

Baseline MPV was similar in both groups, whereas the baseline platelet count was higher in the TA group (p=0.42 and p=0.002). The platelet count was higher in the TA group 24 h post PPCI (p=0.02), but was similar in both groups 48 h and 72 h post PPCI (p=0.18 and p=0.07). The MPV 48 h and 72 h post PPCI was higher in the non-TA group than in the TA group (8.4 ± 1.3 fL versus 8.7 ± 1.6 fL [p=0.04] and 8.5 ± 1.1 fL versus 8.9 ± 1.5 fL [p=0.04]).

Conclusion:

Thrombectomy reduced platelet activity via removal of thrombi from the coronary arteries in patients undergoing PPCI for STEMI.In acute ST-segment elevation myocardial infarction (STEMI), the main initiating factor is atherosclerotic plaque rupture or erosion, then platelets become activated and aggregated leading to acute coronary artery occlusion.1 Primary percutaneous coronary intervention (PPCI) is the standard treatment in patients with STEMI.2 In recent years, implementation of adjunctive mechanical and pharmacological therapies during PPCI, including manual thrombus aspiration (TA), has improved myocardial reperfusion and clinical outcome in STEMI patients.3-5 In daily practice, thrombectomy devices are used to remove thrombi or to prevent embolization of thrombi and plaque during PPCI.6 Platelet volume is a marker of platelet activation and is measured via mean platelet volume (MPV).7 An increase in MPV can occur in cases of acute myocardial ischemia, acute myocardial infarction, coronary atherosclerosis,8,9 and early stent thrombosis (ST).10 The Percutaneous Coronary Intervention in Acute Myocardial Infarction (TAPAS) study5 showed that TA therapy during PPCI decreases mortality and reinfarction rate.5 We speculate that the good results obtained with TA therapy are not only related to improved tissue perfusion but also may be related to reduced platelet activation. Therefore, the present study aimed to determine the effect of thrombectomy on platelet function and ST in patients undergoing PPCI for STEMI.     

African eggplant (Solanum anguivi Lam.) fruit with bioactive polyphenolic compounds exerts in vitro antioxidant properties and inhibits Ca2+-induced mitochondrial swelling

Objective

To evaluate the antioxidant and radical scavenging activities of Solanum anguivi fruit (SAG) and its possible effect on mitochondrial permeability transition pore as well as mitochondrial membrane potential (ΔΨ_m) isolated from rat liver.

Methods

Antioxidant activity of SAG was assayed by using 2,2-diphenyl-1-picrylhydrazyl (DPPH), reducing power, iron chelation and ability to inhibit lipid peroxidation in both liver and brain homogenate of rats. Also, the effect of SAG on mitochondrial membrane potential and mitochondrial swelling were determined. Identification and quantification of bioactive polyphenolics was done by HPLC-DAD.

Results

SAG exhibited potent and concentration dependent free radical-scavenging activity (IC₅₀/DPPH=275.03±7.8 µg/mL). Reductive and iron chelation abilities also increase with increase in SAG concentration. SAG also inhibited peroxidation of cerebral and hepatic lipids subjected to iron oxidative assault. SAG protected against Ca²⁺ (110 µmol/L)-induced mitochondrial swelling and maintained the ΔΨ_m. HPLC analysis revealed the presence of gallic acid [(17.54±0.04) mg/g], chlorogenic acid (21.90±0.02 mg/g), caffeic acid (16.64±0.01 mg/g), rutin [(14.71±0.03) mg/g] and quercetin [(7.39±0.05) mg/g].

Conclusions

These effects could be attributed to the bioactive polyphenolic compounds present in the extract. Our results suggest that SAG extract is a potential source of natural antioxidants that may be used not only in pharmaceutical and food industry but also in the treatment of diseases associated with oxidative stress.     

Effect of germicidal UV-C light(254 nm) on eggs and adult of house dustmites,Dermatophagoides pteronyssinus and Dermatophagoides farinae (Astigmata: Pyroglyhidae)

Objective

To examined the immediate and 24 hours post- irradiation germicidal effects of UV-C lamp on eggs and adults of house dust mites Dermatophagoides pteronyssinus (D. pteronyssinus) and Dermatophagoides farinae (D. farinae).

Methods

This study investigated the immediate and 24 hours post irradiation mortalities of adult mites exposed to UV-C at different exposure times (5 mins, 10 mins, 15 mins, 20 mins, 30 mins and 60 mins) and distances (10 cm, 25 cm, 35 cm, 45 cm and 55 cm). Fresh eggs of the 2 dust mites were also irradiated at 10, 35 and 55 cm for 0.5, 1, 2, 3, and 5 minutes, and observed daily post- irradiation for up to 7 days.

Results

Highest immediate mortality of 100% occurred with direct irradiation at 10 cm distance from UV-C lamp and for 60 mins, for both species of mites. The post 24 hours mean mortality rates were (58.4±17.4)% for D. pteronyssinus and (27.7±9.7)% for D. farinae when irradiated for 1 hour at 55 cm distance under UV-C lamp. When mites were irradiated in the presence of culture media, the highest mortality rates were lower compared to the direct irradiation; at 10 cm distance and 60 mins exposure, the mean mortality was (74.0±6.8)% for D. pteronyssinus and (70.3±6.7)% for D. farinae. Egg hatchability for both species of mites was also notably reduced by greater than 50% following irradiation.

Conclusions

Ultraviolet C irradiation is lethal to an array of organisms by damaging their nucleic acids (DNA and RNA). This study demonstrates the increasing mite mortalities with increasing exposure times and decreasing distances.     

Study of Single Donor Platelet (SDP) Preparation by Baxter CS 3000 plus and Haemonetics MCS plus

Background

In plateletpheresis blood is withdrawn from a donor in anticoagulant solution and separated into components. Platelets are retained and the remaining components are returned to the individual.

Methods

The present study was aimed to compare the platelet yield and collection efficiency of Baxter CS 3000 plus and Haemonetics MCS plus cell separators and to study adverse donor reactions. Donors were selected as per the set criteria for single donor platelet (SDP) preparation. Donors'' samples for pre donation and post donation platelet count were collected in EDTA and for product counts in the sample pouch attached with apheresis kits. The results were obtained by haematology analyzer. Platelet yield and collection efficiency were calculated.

Result

Results were tabulated for both the cell separators and analyzed. Platelet yield was marginally better with Baxter CS 3000 plus but collection efficiency was better with the Haemonetics MCS plus. Residual white cells were more in single donor platelet concentrate preparation by MCS plus. Adverse donor reactions were similar with both cell separators, in form of mild citrate toxicity and mild to moderate pain at phlebotomy site.

Conclusion

Findings of the present study along with other factors such as less priming time for kit, portability of cell separator, better patient comfort owing to single arm venous access and lesser cost suggest that Haemonetics MCS plus is a better choice as compared to Baxter CS 3000 plus cell separator.Key Words: Plateletpheresis, Single donor platelet (SDP)     

Joint detection of ERCC1, TUBB3, and TYMS guidance selection of docetaxel, 5-fluorouracil and cisplatin (DDP) individual chemotherapy in advanced gastric cancer patients

Background

To investigate the guidance selection of docetaxel (D), cisplatin (DDP) (C), and 5-fluorouracil (5-FU) (F) as individual chemotherapy agents via joint detection of ERCC1, TUBB3, and TYMS genes in patients with advanced gastric cancer (AGC).

Method

Clinical data of 120 patients with AGC who enrolled in our hospital between May 2009 and May 2012 were analyzed. These patients were randomly assigned to experimental and control groups. The mRNA expression of ERCC1, TUBB3, and TYMS was measured by DNA chip technology in the experimental group. Different chemotherapies were administered according to the mRNA expression levels of the three genes, while DCF chemotherapy was directly applied to the control group. Correlation between the three genes’ mRNA levels, efficiency rate, the median time to progression (MTP), median survival time (MST) and adverse reactions was evaluated.

Results

As a result, there was a significant correlation between ERCC1 and TUBB3 mRNA expression (P = 0.005), but no obvious correlation between TUBB3 and TYMS or ERCC1 and TYMS. There was also no significant difference in the efficiency rate of chemotherapy (50% versus 55%; P = 0.357) and the MTP (10 months versus 7 months; P = 0.091) between the two groups. However, there was obvious significance in MST (13.7 months versus 11.6 months; P = 0.004). Additionally, the experimental group provided us with a more effective way for controlling adverse reactions to chemotherapy.

Conclusion

Combination regimen of D, C, and F in AGC patients according to their ERCC1, TUBB3, and TYMS mRNA expression level may reduce adverse reactions and improve MST.     

Impact of creatinine production on the agreement between glomerular filtration rate estimates using cystatin C-derived,and 4- and 6-variable Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations

Background.

It has recently been reported that patient selection has a strong impact on the agreement between glomerular filtration rate (GFR) estimates from serum cystatin C and creatinine. The aim of our study was to evaluate the effect of creatinine production rate (CPR) on this subject.

Material and methods.

GFR was estimated from serum cystatin C and from creatinine using the 4- and 6-variable Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in 50 healthy subjects, 43 patients with renal failure, 794 kidney and 104 liver transplant recipients, 61 patients with heart failure, 59 patients with biliary obstruction, and 113 critically ill patients.

Results.

In the 295 patients with impaired CPR (< 900 mg/24 h/1.73 m²), discordances of more than 40% between GFR_MDRD4 and GFR_cystatinC were observed in 38% of cases, between GFR_MDRD6 and GFR_cystatinC in 22%, and between GFR_CKD-EPI and GFR_cystatinC in 27% (in all cases due to GFR overestimation from creatinine). In the 929 patients with maintained CPR (> 900 mg/24 h/1.73 m²), greater discordances than 40% between GFR_MDRD4 and GFR_cystatinC were observed in 8% of cases, between GFR_MDRD6 and GFR_cystatinC in 9%, and between GFR_CKD-EPI and GFR_cystatinC in 7% (in the major part of cases due to GFR overestimation from cystatin C).

Conclusion.

The main source of differences of more than 40% between GFR estimates from serum creatinine and cystatin C is a GFR overestimation in patients with low CPR and GFR underestimation in patients with high CPR by the creatinine-derived equations.     

Leucodepletion and Blood Products

Background

Leucoreduction of blood products is increasingly being employed to produce blood products with residual WBCs < 5 × 10⁶ per unit (99.9 percent or a log 3 leucoreduction). Clinical data suggests that non-haemolytic febrile transfusion reactions can be prevented by leucodepletion. The procedure also prevents alloimmunisation to HLA antigens in patients who will repeatedly require transfusion of blood/blood products.

Method

Of the methods available to reduce the number of WBC in blood products washing of red cells, freezing and deglycerolisation are effective and yield a product with only a 24 hour shelf life. Other methods such as leucodepletion filters are relatively inexpensive, simple and the final product has a normal shelf life. Modern generation of leucoreduction filters and apheresis machines can provide greater than 4 log reduction of WBC.

Results

After the introduction of leucodepletion of blood for Thalassemics at our center in 2003, the incidence of non haemolytic febrile transfusion reactions (NHFTR) fell from 4% in 2002 to 1% in 2003.

Conclusion

In patients undergoing long-term blood transfusion therapy e.g. Thalassemics, alloimmunisation against the HLA antigens on donor white cells is prevented by leucodepletion and prevents NHFTRs.Key Words: Leucoreduction, leucodepletion, alloimmunisation     

Pharmacological potential of Populus nigra extract as antioxidant,anti-inflammatory,cardiovascular and hepatoprotective agent

Objective

To evaluate antioxidant, anti-inflammatory, hepatoprotective and vasorelaxant activities of Populus nigra flower buds ethanolic extract.

Methods

Antioxidant and anti-inflammatory activities of the extract were assessed using respectively the ABTS test and the animal model of carrageenan-induced paw edema. Protection from hepatic toxicity caused by aluminum was examined by histopathologic analysis of liver sections. Vasorelaxant effect was estimated in endothelium-intact and -rubbed rings of porcine coronary arteries precontracted with high concentration of U46619.

Results

The results showed a moderate antioxidant activity (40%), but potent anti-inflammatory activity (49.9%) on carrageenan-induced mice paw edema, and also as revealed by histopathologic examination, complete protection against AlCl₃-induced hepatic toxicity. Relaxant effects of the same extract on vascular preparation from porcine aorta precontracted with high concentration of U46619 were considerable at 10⁻¹ g/L, and comparable (P>0.05) between endothelium-intact (67.74%, IC₅₀=0.04 mg/mL) and -rubbed (72.72%, IC₅₀=0.075 mg/mL) aortic rings.

Conclusions

The extract exerted significant anti-inflammatory, hepatoprotective and vasorelaxant activities, the latter being endothelium-independent believed to be mediated mainly by the ability of components present in the extract to exert antioxidant properties, probably related to an inhibition of Ca²⁺ influx.     

The impact of the heparin-induced thrombocytopenia (HIT) computerized alert on provider behaviors and patient outcomes

Objective

The aim of this study was to measure the effect of an electronic heparin-induced thrombocytopenia (HIT) alert on provider ordering behaviors and on patient outcomes.

Materials and Methods

A pop-up alert was created for providers when an individual''s platelet values had decreased by 50% or to <100 000/mm³ in the setting of recent heparin exposure. The authors retrospectively compared inpatients admitted between January 24, 2008 and August 24, 2008 to a control group admitted 1 year prior to the HIT alert. The primary outcome was a change in HIT antibody testing. Secondary outcomes included an assessment of incidence of HIT antibody positivity, percentage of patients started on a direct thrombin inhibitor (DTI), length of stay and overall mortality.

Results

There were 1006 and 1081 patients in the control and intervention groups, respectively. There was a 33% relative increase in HIT antibody test orders (p=0.01), and 33% more of these tests were ordered the first day after the criteria were met when a pop-up alert was given (p=0.03). Heparin was discontinued in 25% more patients in the alerted group (p=0.01), and more direct thrombin inhibitors were ordered for them (p=0.03). The number who tested HIT antibody-positive did not differ, however, between the two groups (p=0.99). The length of stay and mortality were similar in both groups.

Conclusions

The HIT alert significantly impacted provider behaviors. However, the alert did not result in more cases of HIT being detected or an improvement in overall mortality. Our findings do not support implementation of a computerized HIT alert.     

Does Carica papaya leaf-extract increase the platelet count? An experimental study in a murine model

Objective

To investigate the potential role of fresh Carica papaya (C. papaya) leaf extract on haematological and biochemical parameters and toxicological changes in a murine model.

Methods

In total 36 mice were used for the trial. Fresh C. papaya leaf extract [0.2 mL (2 g)/mouse] was given only to the test group (18 mice). General behavior, clinical signs and feeding patterns were recorded. Blood and tissue samples were collected at intervals. Haematological parameters including platelet, red blood cell (RBC), white blood cell (WBC), packed cell volume (PCV), serum biochemistry including serum creatinine, serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic-pyruvic transaminase (SGPT) were determined. Organs for possible histopathological changes were examined.

Results

Neither group exhibited alteration of behavior or reduction in food and water intake. Similarly, no significant changes in SGOT, SGPT and serum creatinine levels were detected in the test group. Histopathological organ changes were not observed in either group of mice except in three liver samples of the test group which had a mild focal necrosis. The platelet count (11.33±0.35)×10⁵/µL (P=0.000 04) and the RBC count (7.97±0.61)×10⁶/µL (P=0.000 03) were significantly increased in the test group compared to that of the controls. However, WBC count and PCV (%) values were not changed significantly in the test group. The platelet count in the test group started to increase significantly from Day 3 (3.4±0.18×10⁵/µL), reaching almost a fourfold higher at Day 21 (11.3×10⁵/µL), while it was 3.8×10⁵/µL and 5.5×10⁵/µL at Day 3 and Day 21 respectively in the control. Likewise, the RBC count in the test group increased from 6×10⁶/µL to 9×10⁶/ µL at Day 21 while it remained near constant in the control group (6×10⁶/µL).

Conclusions

Fresh C. papaya leaf extract significantly increased the platelet and RBC counts in the test group as compared to controls. Therefore, it is very important to identify those chemicals of C. papaya leaves as it can be recommended to be used as a medication to boost thrombopoiesis and erythropoiesis in humans and in animals in which these cell lineages have been compromised.