Investigating the antimicrobial activity of natural honey and its effects on the pathogenic bacterial infections of surgical wounds and conjunctiva

Antimicrobial activities of 10-100% (wt/vol) concentrations of new honey, stored honey, heated honey, ultraviolet-exposed honey, and heated stored honey were tested against common human pathogens, including Escherichia coli, Entrobacter cloacae, Pseudomonas aeruginosa, Shigella dysenteriae, Klebsiella sp., Haemophilus influenzae, Proteus sp., Staphylococcus aureus, Streptococcus hemolyticus group B, and Candida albicans. Antimicrobial activity of honey was tested in acidic, neutral, or alkaline media. These were compared with similar concentrations of glucose in nutrient broth. Surgical wounds were made on the dorsum of mice and infected with S. aureus or Klebsiella sp. The wounds were treated with local application of honey four times a day or appropriate antibiotics and compared with control values. Bacterial conjunctivitis due to E. coli, Proteus sp., S. aureus, Klebsiella sp., and P. aeruginosa was induced in rats. Conjunctival application of honey four times a day or appropriate antibiotics was used for treatment and compared with control values. Growth of all the isolates was completely inhibited by 30-100% honey concentrations. The most sensitive microbes were E. coli, P. aeruginosa, and H. influenzae. Glucose showed less antimicrobial activity than honey, and many microbes showed positive culture even in 100% glucose. Heating to 80 degrees C for 1 hour decreased antimicrobial activity of both new and stored honey. Storage of honey for 5 years decreased its antimicrobial activity, while ultraviolet light exposure increased its activity against some of the microorganisms. Antimicrobial activity of honey was stronger in acidic media than in neutral or alkaline media. Single doses of honey used to prepare the 60% concentration in nutrient broth were bacteriocidal for P. aeruginosa and bacteriostatic for S. aureus and Klebsiella sp. during certain periods. Local application of raw honey on infected wounds reduced redness, swelling, time for complete resolution of lesion, and time for eradication of bacterial infection due to S. aureus or Klebsiella sp. Its potency was comparable to that of local antibiotics. Honey application into infective conjunctivitis reduced redness, swelling, pus discharge, and time for eradication of bacterial infections due to all the isolates tested.     

Immunosuppressive activity of a molecule isolated from Artemisia annua on DTH responses compared with cyclosporin A

Artemisia belongs to the family of Compositea; there are different Artemisias in Iran, of which Artemisia annua L. is grown in the north of Iran. In this study, Artemisinin was extracted and purified from the whole plants. The purification of Artemisinin was performed using column chromatography in different polarities of solvents and the results were evaluated by Thin Layer Chromatography (TLC). (1)H-NMR (NMR-500) spectroscopy was used to characterize the purified Artemisinin. The immunosuppressive activity of Artemisinin was investigated on Balb/c mice by DTH response in comparison to cyclosporin A (CsA). The data indicated that Artemisinin could suppress the delayed type hypersensitivity (DTH) against sheep blood capsule in Balb/c mice. Also its inhibitory effect on calmodulin (CaM) structure was determined by fluorescence spectroscopy. The data indicated an inhibitory effect of that on the activity of calmodulin by increasing the fluorescence emission of calmodulin. Both in vivo (DTH response) and in vitro (spectrofluorometry) studies indicated the activity of Artemisinin as an immunosuppressive agent and that the fluorescence emission of calmodulin is more than cyclosporin A.     

Natural honey lowers plasma prostaglandin concentrations in normal individuals

Twelve normal, healthy adult individuals, 9 men and 3 women, 25-48 years of age (mean, 38 years), were recruited in the study. After 12 hours of fasting, blood specimens were collected at 8:00 AM for prostaglandin E(2) (PGE(2)), PGF(2alpha), and thromboxane B(2) assays. Each individual then drank 250 ml of water containing 1.2 g/kg body weight of natural unprocessed honey, after which collection of blood was repeated at 1, 2, and 3 hours for estimation of prostaglandins. Each individual was asked to drink the same amount of honey diluted in water once a day for a maximum of 15 days. After 12 hours of fasting, morning blood specimens were collected on day 16, and plasma prostaglandin concentrations were measured. The quantitative analysis of prostaglandins was performed with use of an enzyme-linked immunosorbent (ELISA) test. Results showed that the mean plasma concentration of thromboxane B(2) was reduced by 7%, 34%, and 35%, and that of PGE(2) by 14%, 10%, and 19%, at 1, 2, and 3 hours, respectively, after honey ingestion. The level of PGF(2alpha) was decreased by 31% at 2 hours and 14% at 3 hours after honey ingestion. At day 15, plasma concentrations of thromboxane B(2), PGE(2), and PGF(2a) were decreased by 48%, 63%, and 50%, respectively. It may be concluded that honey can lower the concentrations of prostaglandins in plasma of normal individuals.     

Upregulated survivin expression in activated T lymphocytes correlates with disease activity in multiple sclerosis

Programmed cell death (apoptosis) is critical for the normal development and homeostasis of the immune system. There is emerging evidence that failure of apoptosis to eliminate potentially pathogenic, autoreactive T lymphocytes may be involved in the pathogenesis of multiple sclerosis (MS). This failure is related to multiple abnormalities of apoptosis-regulatory molecules that involve survivin, a recently described cell cycle-regulated anti-apoptosis protein. In this study, we investigated the relationship between survivin expression in peripheral T lymphocytes and clinical features of MS. We detected a significant over-expression of survivin in mitogen stimulated T lymphocytes from patients with active MS when compared with corresponding expression in patients with stable MS or those with inflammatory and non-inflammatory neurologic disorders. This over-expression of survivin in patients with active MS correlated with cellular resistance to apoptosis and with features of disease activity, such as disease duration and the number of enhanced lesions on cranial magnetic resonance imaging. There was no correlation between cellular survivin levels and the expression of other apoptosis-inhibitory proteins, such as Bcl-2 and Fas-associated death domain-like interleukin-1beta-converting enzyme inhibitory protein (FLIP). Our findings indicate that cellular over-expression of the novel anti-apoptosis protein survivin is a feature of clinically active MS.     

BLASTOCYSTIS HOMINIS: EVIDENCE FOR HUMAN PATHOGENICITY AND EFFECTIVENESS OF METRONIDAZOLE THERAPY

1. Clinical symptoms and oral treatment with metronidazole were studied in 103 patients with pure infections by Blastocystis hominis. 2. The results showed that excessive flatulence is the chief gastrointestinal symptom associated occasionally with diarrhoea and abdominal cramps. All the patients showed good responses with treatment of metronidazole and 74 patients whose stools were reexamined 1-2 months after the treatment demonstrated no signs of infections. 3. It is concluded that B. hominis is a pathogenic intestinal parasite and the infection could be eradicated successfully by oral metronidazole.     

Opioid use,treatment and harm reduction services: the first report from the Persian Gulf region

Objective: The objective was to review all the available published studies and reports with particular emphasis on the prevalence of opioid use and the availability of opioid treatment and harm reduction services for adults in nine countries of the Persian Gulf region. The countries are the members of the Middle and North Africa Harm Reduction Association (MENAHRA).

Methods: Data were collected by searching Pub Med, Med line and EMBASE, by reviewing the reports of the United Nations Office on Drugs and Crime (UNODC), World Health Organization (WHO), Ministries of Health (MoH) in each country, regional databases, conference presentations and annual AIDS progress reports over the last one decade.

Results: We found that with an exception of Iran, there is a paucity of research on opioid use in the region. With an exception of Iran, opioid substitution therapy (OST) is not developed but in some countries, needle and syringe programs (NSPs) are slowly emerging. Voluntary counselling and testing (VCT), HIV testing and antiretroviral therapy (ART) have been widely addressed. Non-governmental organizations (NGOs) are generally inactive. Islamic prohibitions against opioid use and stigma have prevented developing opioid treatment and harm reduction in the region.

Conclusion: An exchange of knowledge and experience on opioid use prevention, treatment and harm reduction is required between Iran and the region. Collaborations among religious leaders, mass-media, clinicians and policy makers are rigorously suggested to remove Islamic prohibitions and stigma and make opioid treatment a social norm.     

Beta-blockade in adriamycin-induced cardiomyopathy

Beta-blockade consistently improves myocardial systolic function in patients with both nonischemic and ischemic cardiomyopathy. The effects of beta-blockade on Adriamycin-induced cardiomyopathy (ACM), however, are unknown. We retrospectively evaluated the effects of beta-blockade on patients with ACM by using a case-controlled design. The control group consisted of 16 consecutively chosen age- and sex-matched patients with idiopathic dilated cardiomyopathy (IDC) who were treated with beta-blockers. Patients with ACM had a baseline mean left ventricular ejection fraction (LVEF) of 28%, which improved to 41% (P = .041) after treatment with beta-blockers. The control group had a baseline mean LVEF of 26%, which improved to 32% (P = .015) after treatment. The mean duration of beta-blocker therapy in the Adriamycin and control groups was 8 and 9 months, respectively. The degree of improvement between the 2 groups was not significantly different. Beta-blockers have a beneficial effect on cardiac function in patients with ACM, which is at least comparable with other forms of heart failure with systolic dysfunction.     

Dietary Assessment of Individuals with Chronic Kidney Disease

Examining the quality and quantity of food intake by appropriate methods is critical in the management of patients with chronic kidney disease (CKD). The four commonly used dietary assessment methods in CKD patients include short‐term dietary recalls, several days of food records with or without dietary interviews, urea kinetic based estimates such as protein nitrogen appearance calculation, and food histories including food screeners and food frequency questionnaires (FFQ). There are a number of strengths and limitations of these dietary assessment methods. Accordingly, none of the four methods is suitable in and of itself to give sufficiently accurate dietary information for all purposes. Food frequency questionnaires, which is the preferred method for epidemiological studies, should be used for dietary comparisons of patients within a given population rather than individual assessment. Food histories including FFQ and dietary recalls may underestimate important nutrients, especially in CKD patients. Given the large and increasing number of dialysis patients and work responsibilities of renal dietitians, routine analysis of dietary records and recalls is becoming less feasible. Ongoing and future studies will ascertain additional strengths and limitations of dietary assessment methods in CKD populations including the assessment of food intake during an actual hemodialysis treatment.     

Dietary Protein Intake in Patients with Advanced Chronic Kidney Disease and on Dialysis

Many patients with chronic kidney disease (CKD), particularly those with stage 5 CKD, have protein wasting. The degree to which increased morbidity and mortality seen in these patients is due to protein depletion rather than to the often accompanying comorbidity is not clear. High protein diets lead to the accumulation of metabolites of protein that are potentially toxic. The MDRD Study, which investigated the effects of three levels of dietary protein and phosphorus intakes and two blood pressure goals on the progression of CKD, has several limitations. Several meta‐analyses have examined the effects of low protein diets (LPD) on the progression of CKD. It is possible that the lower SUN levels or lesser degree of uremic symptoms may have contributed to the positive findings of LPD in the meta‐analyses of Fouque and Pedrini et al., when compared with the study of Kasiske et al. A number of published reports indicate that LPD provide adequate protein for almost all clinically stable CKD patients and do not adversely affect body composition. In general, there are no large differences in the protein intake recommended by different expert groups for a given stage of CKD.