Effects of Nigerian Walnut (Juglan nigra) Lectin on Haematological Parameters and Lethal Dose (LD50) on Swiss Wistar

This study was designed to investigate the effects of Juglan nigra lectin on haematological parameters and lethal dose of rats. An authenticated Juglan nigra (UBHP401) collected from Lokoja was used to extract lectin and treated on Swiss Wistar rats (n=35) and (n=17) with weights from 75-129g for haematological parameters and LD50 respectively. The Wistar rats were divided into five equal groups labeled A, B, C, D, and E. Lectin concentrations were prepared and administered at stipulated days. Group A served as control, group B received 30%, C received 50%, D received 70% and group E received 90% of lectin intraperitoneally. Samples (Baseline-BL, First Harvests-FH and Second Harvest-SH) were collected from all the groups and analyzed for the following haematological parameters: white blood count (WBC), Red Blood count (RBC), Haemoglobin (HB), packed cell volume (PCV), platelet count, neutrophil, lymphocyte, monocytes, eosinophil and basophil. The data were analysed using two-way analysis of variance (ANOVA) in graph pad prism version 5.03. The Eosinophil count and white blood cell count were significantly increased P<0.005 and 0.05, whereas the HB, PCV and RBC showed significant different P<0.05 based on the day of exposure of the animal to the lectin, the platelet count was significantly increased on the basis of days of exposure of P<0.05, Eosinophil significantly increased too. Juglan nigra, (Nigerian walnut) Lectin is nontoxic as noted from LD50 result. Nigerian walnut lectin has a positive effect in haematopoietic activity of Swiss Wistar rats.

Effect of breastfeeding for 6 months on disease outcomes in patients with Kawasaki disease

Background Kawasaki disease (KD) is a systematic vasculitis that occurs predominantly in young children, and is the leading cause of acquired heart disease in children younger than five-years-old in developed countries. Although the etiology of KD is unknown, it is believed to be an inflammatory disease resulting from abnormal immune responses to possible environmental or infectious stimuli in genetically predisposed individuals. Breast milk contains numerous anti-inflammatory factors which may protect against allergic and autoimmune diseases. In this study we tried to examine the effect of breastfeeding for 6 months or more on disease outcomes in patients with Kawasaki disease. Methods A retrospective cohort study of 249 KD patients admitted from 1999- 2013 who were older than 6 months at time of diagnosis and had data regarding breastfeeding in the first 6 months of life. Demographic, clinical and laboratory data was collected by chart review. Continuous data was compared using Student’s t-test and categorical variables were compared using Chi-square. Stepwise multivariate regression of all demographic factors was performed. Results Breastfeeding for 6 months or more was associated with a shorter total duration of fever (5.980± 1.405 Vs. 6.910 ± 2.573 days, p = 0.001) and a lower risk of developing persistent coronary artery lesions (CALs) (7.8% Vs. 20.2%, p-value = 0.039) on univariate analysis. Multivariate regression of all factors associated with CALs including breastfeeding for 6 months found that only the presence of CALs at baseline (β-coefficient = 0.065, p < 0.001) and white blood count (β-coefficient = 0.065, p = 0.018) remained significant after regression analysis. Conclusions Breastfeeding for 6 months or more was associated with a shorter duration of fever and a lower risk of persistent CAL formation in patients with KD on univariate analysis, although this effect may be modest when other factors such as the presence of CALs at baseline and white blood cell count are also taken into consideration.

Adjunctive Clotiapine for the Management of Delusions in Two Adolescents with Anorexia Nervosa

Clotiapine is an atypical antipsychotic indicated for the management of a series of acute psychotic disorders. The current literature lacks evidence concerning the tolerability and clinical use of this drug in the management of individuals with anorexia nervosa (AN). In this study, we report two cases of adolescents with AN, treated with clotiapine. The reason for the administration of clotiapine was, for both patients, the manifestation of bizarre delusions concerning food and calories. Patient 1 presented a presyncope after the first dose of clotiapine, and treatment was rapidly discontinued. Patient 2 was treated with clotiapine for 9 months; doses were titrated from 20 mg/day to 70 mg/day, with an improvement in the reported delusions, which also enhanced compliance with psychological and nutritional interventions. EKG, QTc, white blood count, and red blood count were not relevantly influenced by the introduction of clotiapine in either patient. No extrapyramidal effect was documented. These reports stress the need for further studies assessing the tolerability and potential effect of clotiapine in treating adolescents with AN and delusional symptomatology.

Reference Range of Complete Blood Count in Healthy Term Newborns 1 Week after Birth

BACKGROUND: Determination of the complete blood count (CBC) and reticulocyte reference range helps diagnose a disease related to changes in erythrocyte indices, white blood count, platelets, and reticulocytes, especially in newborns. AIM: The aim study is to establish a reference range for CBC and reticulocyte in healthy term newborns 1 week after birth. MATERIAL AND METHODS: The study method is prospective analyses of CBC and reticulocyte in term newborns within 1 week after birth. Inclusion criteria are term newborn (gestational age 37–42 weeks) with good tone, breathing, or crying immediately, do not have resuscitation, and the birth weight is ≥2500 g. RESULTS: Two hundred and seventy-seven term newborns met the inclusion criteria. There were 145 (52.35%) male infants and 132 (47.65%) female infants. The reference range of newborns for hemoglobin (Hb) at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 standard deviation (SD) was 11.70–19.60 g/dL, 11.90–19.57 g/dL, 12.20–19.20 g/dL, and 11.35–19.63 g/dL, respectively. In addition, reference range of male newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2SD was 12.20–20.14 g/dL, 12.28–19.91 g/dL, 12.63–19.38 g/dL, and 11.47–20.15 g/dL, respectively. The reference range of female newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 SD was 11.37–19.20 g/dL, 11.50–19.20 g/dL, 11.80–19.20 g/dL, and 11.37–18.93 g/dL, respectively. CONCLUSION: The reference range of CBC and reticulocyte for healthy term newborns, male newborns, and female newborns in this study can be used as a benchmark.

Thyroid Hormones, Peripheral White Blood Count, and Dose of Basal Insulin Are Associated with Changes in Nerve Conduction Studies in Adolescents with Type 1 Diabetes

Type 1 diabetes (T1D) in the child population is the third most common chronic disease. Diabetic peripheral neuropathy (DPN) is a very disabling and silently developing complication. This prospective, observational study enrolled 182 (93 girls) patients with T1D, aged 16.5–18 years. The aim of the study was to assess the correlation between factors of diabetes metabolic control, blood count, thyroid hormones, thyroid-stimulating hormone (TSH), level of cortisol, vitamin D3, metabolic factors, demographic data, and nerve conduction study (NCS) parameters. We revealed that in multivariate regression models for almost all NCS parameters, beside height and diabetes duration, significant factors were basal insulin dose per kilogram of weight (BID/kg), body mass index (BMI), and thyroid hormones. For conduction velocities of the motor nerves, mean HbA1c exists in models. In all models for all NCS parameters there exists at least one parameter of peripheral white blood cell counts (predominantly monocytes). There is a significant influence of thyroid hormones, peripheral blood white cells count, and BID per weight on parameters of NCS. It is essential to take care of the proper insulin dose per weight of patients and the adequate proportion of basal to prandial insulin.

NT-Probnp As Personalized Medicine Tool and New Biomarker Predicting Response to Chemotherapy and Survival in AML

Acute myeloid leukemia (AML) is a hematologic neoplasm resulting from abnormal proliferation and accumulation of clonal myeloid precursor cells. The course and prognosis of AML vary depending on the type of AML, karyotype, and molecular abnormalities. In addition, patient-related factors and comorbidities are of prognostic relevance. Cardiac comorbidities are of particular importance as they influence treatment tolerability, early death (ED) and survival in patients receiving chemotherapy. Brain natriuretic peptide (NT-proBNP) is a well-established marker of cardiac function and often used to predict treatment tolerability and outcome. However, so far, little is known about the impact of NT-proBNP levels on the clinical course in patients with AML. We analyzed 312 AML patients (median age: 61 years; range 17-89 years; &lt;60 years: n=141, ≥60 years: n=171; f:m-ratio: 1:1.15; observation period: February 1998 - September 2020) treated with a daunorubicin (day 1-3) and ARA-C (day 1-7)-based induction therapy and consolidation with up to 4 cycles of intermediate-dose (2x1g/m² for 3 day) or high-dose (2x3g/m² for 3 days) ARA-C. In 199 patients (63.8%), elevated NT-proBNP levels were detected, and in 113 (36.2%), NT-proBNP levels were within normal range (0-125 pg/mL). In 20 patients (6.4%) NT-proBNP exceeded 2000 pg/mL. NT-proBNP levels differed significantly between patients aged &lt;60 years (median: 146.7 pg/mL; range: 0.5-15930 pg/mL) and patients ≥60 years (median: 226 pg/mL; range 1-19883 mg/dL; p=0.003). A weak correlation was observed between NT-proBNP levels and other clinical or laboratory parameters like age (R=0.183; p=0.001), lactate dehydrogenase (LDH; R=0.242; p&lt;0.001) and serum creatinine levels (R=0.256; p&lt;0.001). Applying the Charlson comorbidity index (CCI), patients without comorbidities (n=60) had the lowest median NT-proBNP levels followed by those with moderate (n=79), intermediate (n=95), and high-risk comorbidities (n=56) (139.3 pg/mL, 156.0 pg/mL, 199.5 pg/mL, and 307.7 pg/mL, respectively; p=0.028). The Eastern Cooperative Oncology Group (ECOG) performance status was available in 176 patients. Those with ECOG 1 had a significantly higher median NT-proBNP (225.1 pg/mL, range: 0.5-5369 pg/mL) compared to patients with ECOG 0 (133.6 pg/mL, range: 1-15930 pg/mL) (p=0.008). Following induction therapy, 219 patients (70.2%) achieved complete remission (CR), 63 (20.2%) had no remission (NR), and 30 (9.6%) died within 60 days after chemotherapy (ED). Median NT-proBNP levels differed significantly among CR, NR and ED patients, with 153.3, 225.9, and 735.5 pg/mL, respectively (p&lt;0.0001) (Figure 1). The difference in NT-proBNP levels among CR, NR and ED patients was significant in patients aged &lt;60 years and in those aged ≥60 years (p=0.004 and p=0.001, respectively). In multivariate analysis including NT-proBNP together with age, sex, the ELN-2009 classification, white blood count (WBC) and CCI, NT-proBNP remained an independent prognostic factor for treatment response (CR, NR, or ED; p&lt;0.001). In this analysis, age and the ELN-2009 classification were also independent prognostic markers (p=0.014 and p&lt;0.001 respectively). The median overall survival (OS) was 1.38 years (IQR 0.96-1.84) in the total cohort of patients. Significant differences in OS were observed when comparing patients with normal (&gt;125 pg/mL), moderately elevated (125-2000 pg/mL), and highly elevated NT-proBNP levels (p=0.0002). The median OS in these groups was 3.08 (IQR 0.8-16.5), 1.14 (IQR 0.5-4.8), and 0.34 (IQR 0.04-3.7) years, respectively (Figure 2). In multivariate analysis including NT-proBNP, age, ELN-2009 classification, WBC, sex, and CCI, NT-proBNP remained an independent predictive variable for OS (p=0.006). Significant differences were also observed when analyzing OS in patients &lt;60 years (p=0.012) but were not seen in those aged ≥60 years (p=0.203). Similar results were obtained for continuous complete remission (CCR) (median CCR of all patients: 1.6 years), where NT-proBNP was of prognostic significance in the cohort aged &lt;60 years (p=0.011) but not in patients aged ≥60 years. Together, NT-proBNP is a new emerging biomarker and independent prognostic factor indicating the risk of induction failure, ED and reduced survival in patients with AML. The predictive power of NT-proBNP is particularly strong in AML patients aged &lt;60 years. Figure 1 Figure 1. Disclosures Gleixner: Novartis: Honoraria; BMS: Honoraria; Incyte: Honoraria; Pfizer: Honoraria; Abbvie: Honoraria. Knoebl: Ablynx/Sanofi: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Shire/Takeda: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Jaeger: Norvartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS/Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees. Hoermann: Novartis: Honoraria. Valent: Novartis: Honoraria; Pfizer: Honoraria, Research Funding; Celgene/BMS: Honoraria, Research Funding; Incyte: Honoraria, Research Funding; OAP Orphan Pharmaceuticals: Honoraria. Sperr: AbbVie, BMS-Celgene, Daiichi Sankyo, Deciphera, Incyte, Jazz, Novartis, Pfizer, StemLine, Thermo Fisher: Honoraria, Research Funding.

Acute Myocardial Infarction (AMI) Treated with Snake Antivenom

Cardiac complications following snakebites are uncommon but fatal. Here, we discuss a case of a snakebite that led to acute myocardial infarction (AMI). Forty-five-year-old male presented to the emergency room with snakebite on the right middle finger. He was given symptomatic treatment and admitted for observation. His vital signs and initial investigations were normal except for the white blood count that was high. During observation, he developed vomiting and bradycardia. He was diagnosed with a right bundle branch block on ECG. The patient developed chest pain after a few hours and was diagnosed with AMI on ECG. The toxicology team started antivenom therapy. His troponin kept rising initially but later started coming down without percutaneous intervention (PCI). He was treated successfully with antivenom therapy and discharged.

Effectiveness of lactic acid bacteria to increase the body resistance of common carp, Cyprinus carpio Linnaeus, 1758 against Aeromonas hydrophila

This study aims to find out the right lactic acid bacteria (LAB) isolates to improve the common carp body's immune system against the attack of the Aeromonas hydrophila bacterium. Lactic Acid Bacteria (LAB) isolates were obtained from the organs of the common carp intestine. The study used a Completely Randomized Design consisting of four treatments and three replications. The treatment used was immersion of test fish for 24 hours in several isolates of LAB with a density of 108 cfu ml-1, namely A: without LAB isolate (control), B: isolate CcB7, C: isolate CcB8, D: isolate CcB15. Immersion is done three times with a frequency of seven days. Parameters observed included clinical symptoms, survival rate, red and white blood cell counts. The results showed the immersion of LAB isolate CcB15, namely Lactobacillus gasseri was most effective for increasing the body's resistance to Common Carp, which was demonstrated by mild clinical symptoms and faster recovery, high fish survival rate (83.33%), and number of cells the highest white blood count of 147,47x103 cell mm-3 (an increase in white blood cells by 38%).

Effectiveness of Intensive Perioperative Nutrition Therapy Among Adults Undergoing Gastrointestinal And Oncological Surgery In Public Hospital: Study Protocol For A Pragmatic Randomised Control Trial.

Background: Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgical and associated with longer hospital stays, increased post-operative complications, poorer quality of life and lower survival rate. Current practice emphasises the roles of early perioperative nutrition therapy as early intervention in order to combat the post-operative complications of patients and the implementation is now widely adopted. The aim of the study is to determine the effects of intensive perioperative nutrition therapy to overcome the post-operative complications in adult patients undergoing gastrointestinal and oncological surgery. Methods: This is a pragmatic randomised control trial study where elective admitted patients will be randomised into Intervention (SS) or Control (NN) Group. All data will be collected during a face to face interview, anthropometric measurement, blood sampling (albumin, white blood count, haemoglobin and c-reactive protein), handgrip strength and post-operative complications. Group SS will be receiving a tailored lifestyle and intensively supplemented with oral nutrition support as compared with Group NN that receive standard medical care. The primary outcomes are length of stay in hospital, bowel function and solid food toleration. Additional outcome measures are changes in biochemical profile, nutritional and functional status. The effects of intervention between groups towards outcome parameters will be analyse by using the SPSS General Linear Model (GLM) for repeated measure procedure.Discussion: The intervention implemented in this study will serve as a baseline data in providing an appropriate nutritional management in patients undergoing gastrointestinal and oncological surgery. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (PRS), NCT04347772. Registered 20 November 2019, https://www.clinicaltrials.gov

Antihypertensive and Cardio-Protective Potentials of Ethanolic Leaf Extract of Mucuna Pruriens in Male Albino Rats

Hypertension is a risk factor for a variety of morbidities, especially stroke, myocardial infarction, and the development of congestive heart failure, as well as death. Several treatment options are used for treatment of hypertension; however, a lot of short comings have been associated with them. In order to proffer a possibly better and cheaper means of preventing hypertension, this study aims at investigating the antihypertensive and cardio-protective effects of the ethanolic leaf extract of Mucuna pruriens. Thirty-six male albino rats were used for the study. Oral administration of 8% salt diet was used to induce hypertension which significantly increased blood pressure and oxidative stress in the hypertensive animals compared to the control group. The phytochemical screening of the extract was carried out, the weight of the experimental animals was monitored, hematological indices was assessed, and systolic and diastolic rates were evaluated at different concentrations of the extract. The screening indicated the presence of tannin, saponins, flavonoids, terpenoids, and phenols while reducing sugars, cardiac glycosides, glycoside, alkaloids and steroids were absent. The weight of the liver of rats given standard drug, 150 mg/ml of the extract, 250 mg/ml of the extract and untreated groups were significant lower (p<0.05) when compared with the control group while the group administered with 100 mg/ml was higher. The white blood count