A case of ceftriaxone-induced haemolysis complicated by acute portal vein thrombosis

Ceffriaxone-induced immune haemolytic anemia is rare but severe complication of this type of antibiotics. In this article, we present a 43-year old patient who suffered from ceftriaxone-induced haemolysis complicated with acute portal vein thrombosis. After successful salvage and transfusion, we underwent thrombolysis via superior mesenteric artery route. Totally recanaliztion achieved. Repeated CT venography showed portal vein still patent with 6 months oral anti coagulation treatment.

Advances in understanding and treating liver diseases during pregnancy:A review

Liver disease in pregnancy is rare but pregnancyrelated liver diseases may cause threat to fetal and maternal survival.It includes pre-eclampsia;eclampsia;haemolysis,elevated liver enzymes,and low platelets syndrome;acute fatty liver of pregnancy;hyperemesis gravidarum;and intrahepatic cholestasis of pregnancy.Recent basic researches have shown the various etiologies involved in this disease entity.With these advances,rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival.The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention.Therefore,correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis.Therefore,here we review and summarized recent advances in understanding the etiologies,clinical courses and management of liver disease in pregnancy.This information will contribute to physicians for diagnosis of disease and optimum management of patients.

Reduction of hydrogen peroxide-induced erythrocyte damage by Carica papaya leaf extract

Objective:To investigate thein vitroantioxidant potential of Carica papaya(C. papaya) leaf extract and its effect on hydrogen peroxide-induced erythrocyte damage assessed by haemolysis and lipid peroxidation.Methods:Hydroxyl radical scavenging activities, hydrogen ion scavenging activity, metal chelating activity, and the ferrous ion reducing ability were assessed as antioxidant indices. In the other experiment, human erythrocytes were treated with hydrogen peroxide to induce erythrocyte damage. The extract(at various concentrations) was subsequently incubated with the erythrocytes and later analysed for haemolysis and lipid peroxidation as indices for erythrocyte damage.Results:Preliminary investigation of the extract showed that the leaf possessed significant antioxidant and free radical scavenging abilities usingin vitro models in a concentration dependent manner(P<0.05). The extract also reduced hydrogen peroxide induced erythrocyte haemolysis and lipid peroxidation significantly when compared with ascorbic acid(P<0.05). The IC50values were 7.33 mg/mL and 1.58 mg/mL for inhibition of haemolysis and lipid peroxidation, respectively. In all cases, ascorbic acid(the reference antioxidant) possessed higher activity than the extract.Conclusions:The findings show that C. papayaleaves possess significant bioactive potential which is attributed to the phytochemicals which act in synergy.Thus, the leaves can be exploited for pharmaceutical and nutritional purposes.

Bovine Serum Albumin-Conjugated Ferrimagnetic Iron Oxide Nanoparticles to Enhance the Biocompatibility and Magnetic Hyperthermia Performance

Magnetic hyperthermia is a fast emerging, non-invasive cancer treatment method which is used synergistically with the existing cancer therapeutics. We have attempted to address the current challenges in clinical magnetic hyperthermia-improved biocompatibility and enhanced heating characteristics, through a single combinatorial approach. Both superparamagnetic iron oxide nanoparticles(SPIONs) of size 10 nm and ferrimagnetic iron oxide nanoparticles(FIONs) of size 30 nm were synthesized by thermal decomposition method for comparison studies. Two different surface modifying agents, viz, Cetyl Trimethyl Ammonium Bromide and 3-Aminopropyltrimethoxysilane, were used to conjugate Bovine Serum Albumin(BSA) over the iron oxide nanoparticles via two different methods—surface charge adsorption and covalent amide bonding, respectively. The preliminary haemolysis and cell viability experiments show that BSA conjugation mitigates the haemolytic effect of the iron oxide nanoparticles on erythrocytes and is non-cytotoxic to the healthy Baby Hamster Kidney cells. It was observed from the results that due to better colloidal stability, the SAR value of the BSA-iron oxide nanoparticles is higher than the iron oxide nanoparticles without BSA, irrespective of the size of the iron oxide nanoparticles and method of conjugation. The BSA-FIONs seem to show improved biocompatibility, as the haemolytic index is less than 2 % and cell viability is up to 120 %, when normalized with the control. The SAR value of BSAFIONs is 2300 Wg^(-1) when compared to 1700 Wg^(-1) of FIONs without BSA conjugation. Thus, we report here that BSA conjugation over FIONs(with a high saturation magnetization of 87 emug^(-1)) provide a single combinatorial approach to improve the biocompatibility and enhance the SAR value for magnetic hyperthermia, thus addressing both the current challenges of the same.

The Effect of Surface Properties of Biomedical Materials on Their Blood Compatibility

The effect of surface properties of six types of biomedical materials on their blood compatibility was investigated in this study. The surface roughness of biomaterials was determined by confocal laser scanning microscopy （CLSM）. The contact angle was observed by contact angle measurement （CAM）. Then the surface free energy （SFE） and interfacial free energy （IFE） were calculated by the contact angle value based on the Owens- Wendt （OW） theoretical model and Young＇ s equation. Meanwhile, hemolytic assay was employed to evaluate the haemolysis. The experimental results showed that the greater roughness was, the greater contact angle would be ; the less proportion of polar component in surface free energy （SFE） was, the lower haemolysis would be.

Effect of Blood Agar from Different Animal Blood on Growth Rates and Morphology of Common Pathogenic Bacteria

Sheep and horse blood are the most commonly used blood for the isolation of microorganisms from human tissue and fluids. However, in many developing countries such as Nigeria, expired human blood from blood banks is still used despite the risk of exposure to HIV and other blood-borne infections, because it is easy to obtain. Blood agar made from blood of rams (similar to sheep), cows, chickens and goats, which are very common in Nigeria, were therefore evaluated. The isolation rates, colony size and morphology as well as haemolytic characteristics of common hospital pathogens such as Pseudomonas aeruginosa, Klebsiella pneumonae, Staphylococcus aureus, and Streptococcus spp, were tested on blood agar prepared from the different animal blood types. All reactions were observed at 24 hrs and 48 hrs respectively. Good growth was achieved by all isolates on rabbit, sheep and chicken blood agar though the best growth was achieved on ram blood agar but there was no significant variation in their morphology. There were differences in their abilities to distinguish haemolytic patterns. Beta Haemolytic Streptococci remained the same on all the blood agar, but the haemolysis of Staphylococci aureus and Pseudomonas aeruginosa varied on different media while haemolysis was least consistent on chicken and cow blood agar. Ram blood agar gave the best reactions in terms of good growth rates of organisms, good morphological characterization as well as good haemolytic reactions. Besides, it is easily available and large quantities of blood can be obtained. Despite the good qualities of ram blood agar observed in this study, however, there is a need for it to be tested further for its ability to support more fastidious organisms.

Clinical Isolates of Staphylococcus aureus Show Variation in β-Lactamase Production and Are More Susceptible to Antibiotics Conjugated with β-Lactamase Inhibitors

β-Lactam antibiotics are a cornerstone in the treatment of bacterial infections on account of its high therapeutic index and selective toxicity—they act by inhibiting the biosynthesis of peptidoglycan, a key component in bacterial cell wall. Ninety (90) clinical specimens obtained from the microbiology unit Specialist Hospital Bauchi were screened for S. aureus, positive isolates were examined for β-Lactamase expression by using two Penicillin G concentrations (5000 IU/ml and 25,000 IU/ml) in acidometric agar technique with phenol red as indicator, and the susceptibility pattern of the isolates to β-Lactam antibiotics was also determined. S. aureus prevalence of 31% (28/90) was obtained, of which 96% (27/28) of strains were β-Lactamase positive in the standard test, while 63% (17/27) were able to hydrolyze penicillin G concentration of 25,000 IU/ml (5X the concentration in the standard test), and a strain was found to be β-Lactamase negative. The resistance to five β-Lactams, ampicillin, cephalexin, amoxicillin, cloxacillin and flucloxaillin, were 100%, 96%, 89%, 74% and 56% respectively. When ampicillin and amoxicillin were conjugated to β-Lactamase inhibitors sulbactam and clavulanic acid respectively the resistance to ampicillin decreased to 21% and to amoxicillin to 15%. The antibiotic susceptibility profile revealed β-Lactamase elaboration to be the major mechanism of resistance to the β-Lactams. β-Lactam utilization as therapeutic option would thus require the search for sensitive irreversible β-Lactamase inhibitors for the β-Lactamase enzymes or agents to block the release of β-Lactamase by strains.

Haemolytic Anaemia Following High Dose Intravenous Immunoglobulin Treatment for Epidermolysis Bullosa Acquisita

Background: Epidermolysis bullosa aquisita (EBA) is a severe acquired blistering skin disease that is often resistant to prednisolone but can respond well to intravenous immunoglobulin infusion (IVIg). Main Observations: We describe the case of a 35 years old male patient with EBA who developed clinically significant haemolytic anaemia with a drop in Hb from 15.3 g/dL to a nadir of 8.4 g/dL within 5 days post IVIg infusion. The patient was blood group A and the IVIg batch was found to have a high titre of anti-A immunoglobulin. Conclusions: IVIg is an effective treatment for EBA. Haemolysis associated with IVIg has not previously been reported in the dermatology literature but review of data from other specialties shows that the problem is well recognised. Dermatologists using IVIg should be aware of this potential complication and patients should be consented appropriately and warned about this potential side effect.

Vitamin C and E supplementation and high intensity interval training induced changes in lipid profile and haematological variables of young males

High intensity interval training(HIIT)causes oxidative stress and haematological alteration.Present study was aimed to evaluate the effect of 8 weeks’supplementation of vitamin C and E on HIIT induced changes in lipid profile parameters and haematological variables.Hundred six male adolescent players were randomly assigned into five age-matched groups,i.e.,Control(no exercise+placebo),HIIT(placebo),HIIT+vitamin-C(1000mg/day),HIIT+vitamin-E 400 IU/day)and combined HIIT+vitamin C and E.Morning and evening sessions(90min)of HIIT included 4 phases(15min each)with 3 sets(4min each).Each 4min HIIT set consisted of 2min intense sprint workout(90%–95%of heart rate maximum[HRmax])followed by 1min active recovery(60%–70%HRmax)followed by 1min of complete rest(1:1 work-rest ratio).Lipid profile parameters,haematological variables,endurance capacity and vertical jump were evaluated by standard protocols.Significant decrease in body weight,fat%,total cholesterol,triglyceride,Total Cholesterol/High Density Lipoprotein-Cholesterol and significant increase in High Density Lipoprotein-Cholesterol,maximal oxygen consumption,vertical jump were observed for all four intervention groups.White blood cell count,red blood cell count,haemoglobin percentage and haematocrit values were significantly decreased while platelet count and platelet-to-leukocyte ratio(PLR)ratio were increased significantly only for HIIT group.Blood level of tocopherol and ascorbic acid was significantly increased(values were within the normal range)in all the respective vitamin supplemented groups.Supplementation of vitamin C and E secures health protection with suppressed haemolysis and improved inflammatory blood variables with enhanced explosive leg strength and lipid profile parameters without any concomitant change in endurance capacity.