Alteration of cyclic nucleotides levels and oxidative stress in saliva of human subjects with periodontitis

Experimental findings suggest a protective role for cyclic nucleotides against induction of oxidative stress in saliva. Oxidative stress is a major contributor to the pathogenesis of inflammatory diseases. This study was conducted to evaluate salivary oxidative stress along with cGMP and cAMP levels in periodontitis subjects. cAMP and cGMP are second messengers that have important roles in salivary gland functions. Unstimulated whole saliva samples were obtained from periodontitis patients and age- and sex-matched healthy individuals. Saliva samples were analyzed for thiobarbituric reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power, TAP), and levels of cAMP and cGMP. Concentrations of cAMP and cGMP were reduced in the saliva of patients with moderate and severe periodontitis. Saliva of patients with severe periodontitis had higher TBARS and lower TAP than control subjects. The presence of oxidative stress and lower levels of salivary cGMP and cAMP in periodontitis are in association with disease severity.     

Drug utilization evaluation of albumin in a teaching hospital of Mashhad,Iran: an interventional pre–post design study

Background Albumin is a protein colloidal solution with limited availability and high cost. It should be used in such approved indications as paracentesis, extensive burn, spontaneous bacterial peritonitis, and nephrotic syndrome. Objectives The aim of this study was to evaluate and compare the appropriateness of albumin usage before and after an evidence-based guideline. Setting Four wards of Imam Reza Hospital, Mashhad, Iran. Method An interventional pre–post design study was performed on 2 groups of patients; in gGroup 1 as a preparation phase group in 6 months from February 2015 to July 2015 and Group 2 as an interventional group from September 2015 to February 2016. A guideline for proper indications of albumin, designed and finalized based on the physicians’ comments, was implemented in Group 2. Main outcome measure The pattern of albumin consumption. Results Fifty patients were evaluated in each group. The implementation of the guideline resulted in reduction of improper albumin use from 62 to 57.5%, which was not statistically significant; however., it reduced inappropriate dose and duration of albumin therapy (55.5–16.7%), the number of consumed albumin vial, and the average cost for each patient (317.78 ± 3.15–149.81 ± 1.91 USD) significantly, as well. Conclusion This study illustrated that in this hospital in most cases, albumin was used inappropriately and at an alarming rate. This improved after the introduction of an evidence-based guideline. Moreover, guideline implementation resulted in significant cost reduction.     

Comparison of Selenium Toxicity in Sunflower and Maize Seedlings Grown in Hydroponic Cultures

Several studies have demonstrated that selenium (Se) at low concentrations is beneficial, whereas high Se concentrations can induce toxicity. Controlling Se uptake, metabolism, translocation and accumulation in plants is important to decrease potential health risks and helping to select proper biofortification methods to improve the nutritional content of plant-based foods. The uptake and distribution of Se, changes in Se content, and effects of various concentrations of Se in two forms (sodium selenite and sodium selenate) on sunflower and maize plants were measured in nutrient solution experiments. Results revealed the Se content in shoots and roots of both sunflower and maize plants significantly increased as the Se level increased. In this study, the highest exposure concentrations (30 and 90 mg/L, respectively) caused toxicity in both sunflower and maize. While both Se forms damaged and inhibited plant growth, each behaved differently, as toxicity due to selenite was observed more than in the selenate treatments. Sunflower demonstrated a high Se accumulation capacity, with higher translocation of selenate from roots to shoots compared with selenite. Since in seleniferous soils, a high change in plants’ capability exists to uptake Se from these soils and also most of the cultivated crop plants have a bit tolerance to high Se levels, distinction of plants with different Se tolerance is important. This study has tried to discuss about it.     

Identification of undeclared active pharmaceutical ingredients in counterfeit herbal medicines used as opioid substitution therapy

Adulteration of traditional herbal drugs with undeclared active pharmaceutical ingredients is a global problem with the increase in popularity of herbal-based medications. Many unprofessional herbal stores introduce herbal medicines as traditional formulations, but there are poor regulations for traditional herbal products’ consistency and safety in Iran. The current study aimed to identify undeclared active pharmaceutical ingredients in traditional herbal medicines used as opioid substitution therapy. In this research study, systematic toxicological analysis was performed for the analysis of 80 traditional herbal medicine samples. Samples were prepared and analysed by gas chromatography/mass spectrometry (GC/MS) instrumentation. More than 96% of samples contained at least one pharmaceutical active ingredient. Diphenoxylate and tramadol were detected in 90% and 67% of samples respectively. Moreover, some other pharmaceutical ingredients such as acetaminophen, codeine, sertraline, and fluoxetine were found in the samples. Quantitative analysis of samples showed that capsules contained diphenoxylate and tramadol at concentrations of 1.4–4 mg/capsule and 67–150 mg/capsule respectively. Traditional herbal preparations are not regulated as medicines in Iran. Herbal drugs with undeclared active ingredients are potentially dangerous for consumers; therefore, serious safety concerns must be associated with their production, distribution and use.     

Blood Levels of Methemoglobin in Patients with Aluminum Phosphide Poisoning and its Correlation with Patient’s Outcome

Although methemoglobinemia following aluminum phosphide (AlP) intoxication has been reported, probable effect of blood level of methemoglobin (Met-Hb) on outcome of AlP-poisoned patients has not yet been investigated. This study aimed to evaluate blood levels of methemoglobin in patients with AP intoxication and its correlation with patient’s outcome. This prospective study was carried out at the Loghman–Hakim poison hospital from April 2009 to August 2009. All patients aged >12 years who had ingested AlP and were admitted at the hospital were enrolled in the study. Using the co-oximetry, blood Met-Hb level was measured at the time of admission and 24 h later if the patient survived. Forty-eight patients with AlP intoxication including 24 males were evaluated. Mean age of the patients was 25.5 ± 9.5 years. There was significant association between blood level of Met-Hb at the time of admission and mortality (2.4% ± 7.1% in survivors versus 15.2% ± 13.5% in non-survivors, P < 0.001). The same association was found at the 2nd day of admission (2.9% ± 8.2% in survivors versus 26.5% ± 19.9% in non-survivors, P = 0.02). The present study found an association between blood level of Met-Hb and mortality in patients with AlP intoxication. Effect of administration of vitamin C and methylene blue on outcome of patients with AlP intoxication should be investigated in future studies.     

Aggressive Care After a Massive Stroke in Young Patients: Is That What They Want?

Background  

The assumption is often made that aggressive care in the form of early decompressive hemicraniectomy is appropriate for young patients who suffer a massive stroke. However, neither their attitude toward aggressive treatment, nor their perception of acceptable quality of life after a stroke, has been adequately studied.