Chloride Levels Research Articles

Safety and Digestibility of a Novel Ingredient, Brewed Lamb Protein, in Healthy Adult Dogs

Protein production through precision fermentation is an attractive option to reduce animal use in food production. This study focused on the safety and digestibility of food containing a test ingredient, brewed lamb protein (Saccharomyces cerevisiae expressing a lamb protein), at inclusion levels of 0% (control), 15%, 30%, or 40% were evaluated over 182 days in 40 dogs. No significant differences in body weight, body condition score, body composition, physical examination, food intake, or urinary parameters were observed among groups. Hematological and serum biochemical parameters were within reference ranges and were largely similar among groups. Levels of chloride, cholesterol, and homocysteine were significantly lower at some time points in dogs fed the test ingredient foods compared with the control food, but all remained within reference ranges. Whole blood taurine levels indicated no deficiency. Alanine aminotransferase levels were above the normal range at Day 177 in dogs in the control and 15% test ingredient groups. Fecal score was slightly decreased in dogs fed the 30% or 40% test ingredient foods, and fecal pH was decreased in dogs fed any of the test ingredient foods. Digestibility of most parameters was similar among foods, but apparent fat digestibility was significantly lower in foods with the test ingredient. Overall, these results indicate that the test ingredient is safe for use in dog food.

Delving into biomarkers and predictive modeling for CVD mortality: a 20-year cohort study

Accurate prediction of cardiovascular disease (CVD) mortality is essential for effective treatment decisions and risk management. Current models often lack comprehensive integration of key biomarkers, limiting their predictive power. This study aims to develop a predictive model for CVD-related mortality using a machine learning-based feature selection algorithm and assess its performance compared to existing models. We analyzed data from a cohort of 4,882 adults recruited between 1999 and 2004, followed for up to 20 years. After applying the Boruta algorithm for feature selection, key biomarkers including NT-proBNP, cardiac troponins, and homocysteine were identified as significant predictors of CVD mortality. Predictive models were built using these biomarkers alongside demographic and clinical variables. Model performance was evaluated using the concordance index (C-index), sensitivity, specificity, and accuracy, with internal validation conducted through bootstrap sampling. Additionally, decision curve analysis (DCA) was performed to assess clinical benefit. The combined model, incorporating both biomarkers and demographic variables, demonstrated superior predictive performance with a C-index of 0.9205 (95% CI: 0.9129–0.9319), outperforming models with demographic variables alone (C-index: 0.9030 (95% CI: 0.8938–0.9147)) or biomarkers alone (C-index: 0.8659 (95% CI: 0.8519–0.8826)). Cox regression analysis further identified key predictors of CVD mortality, including elevated AST/ALT, TyG, BUN, and systolic blood pressure, with protective factors such as higher chloride and iron levels. Nomogram construction and DCA confirmed that the combined model provided substantial net benefit across various time points. The integration of cardiac biomarkers, lipid profiles, and inflammatory markers significantly improves the accuracy of predictive models for CVD-related mortality. This novel approach offers enhanced prognostication, with potential for further optimization through the inclusion of additional clinical and lifestyle data.

Dose-related effects of eugenol: Exploring renal functionality and morphology in healthy Wistar rats.

Eugenol has pharmacological properties, but its impact on renal function is limitedly studied. Thus, this study evaluated the effects of eugenol at 10, 20, and 40mgkg-1, administered via gavage for 60 days, on histological, biochemical, oxidative, and proteomic parameters in rat kidneys. Adult Wistar rats treated with 10mgkg-1 of eugenol had kidneys with low total antioxidant capacity, high nitric oxide content, and high percentual of blood vessels, with no damage to renal function or morphology. The kidney proteome revealed an upregulation of proteins associated with energy metabolism, oxidative stress, and mitochondrial function. Eugenol at 20mgkg-1 did not alter kidney histology but inhibited Na+/K+ ATPase activity. This dose elicited an upregulation of proteins associated with mitochondrial function and cellular defense. Finally, 40mgkg-1 eugenol had more pronounced effects on the kidney, increasing serum sodium, potassium, and chloride levels, inhibiting Na+/K+ ATPase activity, triggering an adaptive response to oxidative stress, and showing apical brush border thinness in proximal tubules. We concluded that eugenol exerted dose-dependent effects on kidney function and morphology. These findings highlight the importance of careful consideration of eugenol's dosage in therapeutic applications.

Effect of propolis supplementation on cadmium toxicity associated with renal and hepatic dysfunction in rats.

Cadmium (Cd), one of the toxic heavy metals, is of great importance for public health due to its use in many industrial areas. Propolis is a natural product with antioxidant and anti-inflammatory properties collected from plants by honey bees. The aim of this study was to investigate the protective role of propolis against the potential toxic effects of cadmium chloride in blood, liver and kidney tissues. For this purpose, rats were divided into four groups. Control group, propolis (150 mg/kg b.w.) treated group, cadmium chloride (1.76 mg/kg b.w. 1/50 LD50) treated group and cadmium chloride plus propolis (1.76 mg/kg b.w. and 150 mg/kg b.w. respectively) treated group. The substances were given to rats by gavage for 28 days. After 28 days of treatment, a statistically significant change was observed in serum biochemical parameters such as ALT, AST, BUN, LDH, urea, uric acid and creatinine, hematological parameters such as erythrocyte, hemoglobin and hematocrit, and IL-1β and IL-6 cytokine levels of cadmium chloride treated rats compared to the control group. In addition, significant changes were observed in mRNA expression levels of Casp-3, p53 and Tnf-α genes, HSP70, HSP90 and GRP78 protein levels and histopathological/immunohistochemical examinations. Improvement in biochemical and hematologic parameters, cytokines, mRNA expression, heat shock proteins and immunohistochemistry changes were observed in cadmium plus propolis treated group compared to cadmium treated group.

Assessment of the Effect of Hydro-Ethanolic Extracts of Xylopia aethiopica and Zingiber officinale on Some Haematological and Biochemical Profiles in Wistar Rats

In recent years, plant-derived natural products have gained significant attention for their diverse pharmacological benefits. This study assessed the effect of hydro-ethanolic extracts of Xylopia aethiopica (locally called Uda) and Zingiber officinale on some haematological and biochemical profiles in Wistar rats. A total of 55 albino rats weighing about 120g were assigned to five groups. The first group acted as the control, while the other four groups received a daily dose of 100mg/kg body weight of Xylopia aethiopica and Zingiber officinale extracts, along with the drug Astymin, for 28 days. Blood samples were collected through cardiac puncture from each animal to assess specific biochemical and haematological parameters. The statistical analysis used was Graph Pad Prism version 9.02. The results showed that extracts, both individually and in combination, significantly reduced renal and liver inflammation, as indicated by lower levels of creatinine, urea, chloride, potassium, and aminotransferases (AST and ALT). Both extracts reduced cardiovascular disease risk by lowering total cholesterol and triglycerides while increasing HDL-cholesterol. Xylopia aethiopica reduced triglycerides to 0.68 ± 0.01 mmol/L, while Zingiber officinale reduced them to 0.95 ± 0.01 mmol/L, both significantly lower than the control value of 1.16 ± 0.03 mmol/L. For HDL-cholesterol, Xylopia aethiopica increased it to 1.18±0.01 mmol/L, Zingiber officinale to 0.81 ± 0.01 mmol/L, and the combination to 1.23 ± 0.02 mmol/L, all significantly higher than the control level of 0.98 ± 0.01 mmol/L. The study indicates that both extracts, at a 100 mg/kg dose for up to 4 weeks, are safe for therapeutic use without causing organ toxicity.

Discovery and Development of CFTR Modulators for the Treatment of Cystic Fibrosis.

Cystic fibrosis (CF) is a genetic disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which regulates ion and fluid transport across epithelial cells. Mutations lead to complications, with life-limiting lung disease being the most severe manifestation. Traditional treatments focused on managing symptoms, but advances in understanding CF's molecular basis led to small-molecule CFTR modulators. Ivacaftor, which is a potentiator, was approved for gating mutations. Dual combinations like ivacaftor/lumacaftor and ivacaftor/tezacaftor brought together a potentiator and a class 1 corrector for F508del homozygous patients. Triple-combination CFTR modulators, including ivacaftor/tezacaftor/elexacaftor with an additional class 2 corrector, are now the standard of care for most CF patients, transforming the outlook for this disease. These drugs stabilize and potentiate the CFTR protein, improving lung function, sweat chloride levels, quality of life, and survival. This Perspective discusses CFTR structure and mutations, biological assays, medicinal chemistry research in identifying CFTR modulators, and clinical data of these agents.

Subacute Toxicity Study of Stem Extract of Telfairia occidentalis in Rats

Telfairia occidentalis Hook (Cucurbitaceae) is used in Ibibio ethnomedicine for the treatment of diverse diseases such as malaria, diabetes and gastrointestinal disorders. Evaluation of subacute administration of ethanol stem extract of Telfaira occidentalis for effect on hematological indices, liver and kidney functions as well as lipid profile of rats was carried out. The stem extract (200, 400, 600 mg/kg body weight) was orally administered to Wistar rats daily for 30 days and the rats were sacrificed under light diethyl ether anesthesia at the completion of the administration. Subacute administration of T. occidentalis stem extract resulted in insignificant increase in body weights of rats especially at high doses without any significant (p>0.05) effect on the weights of heart, brain, liver, kidney, spleen and testes when compared to control, but the weights of ovary was decreased significantly (p<0.01) at higher doses (400 and 600 mg/kg) relative to control. The stem extract treatment did not affect the WBC, RBC and platelets counts, hemoglobin concentration, lymphocytes, monocytes, eosinophil and basophil percentages as well as bleeding and clotting times significantly (p>0.05) relative to control. However, significant (p<0.05) increase of neutrophils percentage at low dose (200 mg/kg) and decreased PCV percentage at higher doses (400 and 600 mg/kg) when compared to control were recorded. The stem extract administration did not cause any significant (p>0.05) effect on total protein, albumin, ALP, total and conjugated bilirubin levels of rats except significantly (p<0.05-0.01) elevated ALT and AST levels at low dose (200 mg/kg) of the extract when compared to control. The stem extract did not cause any significant effect (p>0.05) on creatinine, potassium, sodium, chloride and bicarbonate levels of the treated rats except significantly (p<0.001) elevated urea level at low dose of the extract (200 mg/kg), but caused dose-dependent and insignificant (p>0.05) decreases in total cholesterol, triglyceride, HDL, LDL and VLDL levels when compared to control. The stem extract exerted mild to moderate effect on the histologies of brain, heart, spleen, livers, kidneys, testes and a severe effect on ovaries of rats. Chronic study is advocated to investigate the effect of prolonged administration of the stem extract organs and systems of rats.

Preoperative myosteatosis and perioperative serum chloride levels predict 180 day major complications after radical cystectomy

This study aimed to investigate the role of myosteatosis, sarcopenia, and perioperative serum biomarkers as independent predictors of major complications within 180 days following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). We retrospectively analyzed of 127 MIBC patients who underwent RC between 2013 and 2023 at a single institution. Preoperative body composition was assessed using CT scans at the L3 vertebral level to measure psoas muscle density (PMD), skeletal muscle density (SMD), axial muscle density (AMD), and muscle indices. Novel inflammatory and nutritional markers, including serum chloride levels within 24 h post-surgery, were also evaluated. Major complications were defined as Clavien-Dindo grade ≥ 3. Multivariate analysis was performed to identify independent predictors of postoperative complications. Among the cohort, 30.7% of patients experienced major complications within 90 days, and 36.2% within 180 days. Sepsis was the most common major complication (19 of 241 complications, 7.9%). Ten patients died during the observation period. Myosteatosis (p = 0.002) and postoperative serum chloride levels (p < 0.001) were significant independent predictors of 180-day major complications. Patients with low PMD had an adjusted odds ratio (OR) of 3.959 for developing major complications, while increased serum chloride levels were associated with a reduced risk of complications (OR = 0.985). Multivariate analysis reveals associations between myosteatosis, aging, and anemia. Myosteatosis and perioperative serum chloride levels are significant predictors of major complications after RC for MIBC. Incorporating body composition analysis and early serum chloride monitoring into perioperative care may improve risk stratification and patient outcomes following RC.

Effects of chronic exposure of specific water quality parameters in poultry drinking water on dietary amino acid digestibility and early broiler performance.

Poultry drinking water quality parameters influence physiological functions and bird health. This study aimed to explore the impacts of poultry drinking water pH, TDS (total dissolved solids), and elevated levels of certain minerals on the early phase of broiler performance. Four treatment groups were created based on water source and water quality types: i) municipal water source (MW); ii) well/underground water source with moderately higher levels of Ca, SO4-, and Mn (WW); iii) high-pH (>8) water (HPH); and iv) high-TDS water (>3000 ppm) (HTDS). All treatment water samples were profiled for mineral content. Treatment water was fed ad libitum throughout the experimental period. A total of 288 birds (Cobb 500 males), fed a standard diet (day(d) 0-21), were utilized for the study, creating six replicates/treatment with 12 birds/replicate cage unit. Birds were weighed on days 0, 7, 14, and 21. Water consumption, body weight gain (BWG), feed consumption, feed conversion ratio (FCR), water: feed, and amino acid digestibility were measured. Statistical analysis was performed using 1-way ANOVA with Tukey's HSD test for significance (P < 0.05). Water consumption was higher for MW and HTDS until d10, but there was no difference in overall water consumption by d21 (P > 0.05). The overall feed intake and BWG were lower for HTDS birds compared to other treatment groups (P < 0.05), however, there was no difference in FCR (P > 0.05). Meanwhile, the apparent ileal digestibility of dietary amino acids for essential and non-essential amino acids did not differ among treatment groups (P > 0.05) and ranged from 0.40 to 0.94 across all treatments. The overall results showed that high-TDS water above 3000 ppm with elevated calcium and chloride levels could negatively impact early bird performance on feed consumption and BWG.

Systemic Mechanisms of Ionic Regulation in Carcinogenesis.

Cancer is a complex disease characterized by uncontrolled cell proliferation at various levels, leading to tumor growth and spread. This review focuses on the role of ion homeostasis in cancer progression. It describes a model of ion-mediated regulation in both normal and cancerous cell proliferation. The main function of this system is to maintain the optimal number of cells in the body by regulating intra- and extracellular ion content. The review discusses the key points of ion regulation and their impact on tumor growth and spread during cancer development. It explains that normal levels of sodium, potassium, calcium, chloride, and hydrogen ions are regulated at different levels. Damage to ion transport mechanisms during carcinogenesis can lead to an increase in sodium cations and water content in cells, disrupting the balance of calcium and hydrogen ions. This, in turn, can lead to chromatin compaction reduction, gene overexpression, and instability at the epigenetic and genomic levels, resulting in increased cell proliferation and mutagenesis. Restoring normal ion balance can reduce the proliferative potential of both normal and tumor cell populations. The proposed model of systemic ionic regulation of proliferation aims to reconcile diverse data related to cell mitotic activity in various physiological conditions and explain tumor growth. Understanding the mechanisms behind pathological cell proliferation is important for developing new approaches to control ion homeostasis in the body, potentially leading to more effective cancer treatment and prevention.

Uncovering novel KCC2 regulatory motifs through a comprehensive transposon-based mutant library.

The neuron-specific K-Cl cotransporter KCC2 maintains low intracellular chloride levels, which are crucial for fast GABAergic and glycinergic neurotransmission. KCC2 also plays a pivotal role in the development of excitatory glutamatergic neurotransmission by promoting dendritic spine maturation. The cytoplasmic C-terminal domain (KCC2-CTD) plays a critical regulatory role in the molecular mechanisms controlling the cotransporter activity through dimerization, phosphorylation, and protein interaction. To identify novel CTD regulatory motifs, we used the Mu transposon-based mutagenesis system to generate a library of KCC2 mutants with 5 amino acid insertions randomly distributed within the KCC2-CTD. We determined the insertion positions in 288 mutants by restriction analysis and selected clones with a single insertion site outside known KCC2 regulatory motifs. We analyzed the subcellular distribution of KCC2-CTD mutants in cultured cortical neurons using immunocytochemistry and selected ten mutants with ectopic expression patterns for detailed characterization. A fluorescent Cl--transport assay in HEK293 cells revealed mutants with both reduced and enhanced Cl--extrusion activity, which overall correlated with their glycosylation patterns. Live-cell immunostaining analysis of plasma membrane expression of KCC2-CTD mutants in cultured cortical neurons corroborated the glycosylation data. Furthermore, the somatodendritic chloride gradient in neurons transfected with the KCC2-CTD mutants correlated with their Cl--extrusion activity in HEK293 cells. Gain- and loss-of-function mutant positions were analyzed using available KCC2 cryo-EM structures. Two groups of mutants were identified based on 3D structural analysis. The first group, located near the interface of transmembrane and cytoplasmic domains, may affect interactions with the N-terminal inhibitory peptide regulating KCC2 activity. The second group, situated on the external surface of the cytoplasmic domain, may disrupt interactions with regulatory proteins. Analyzing CTD mutations that modulate KCC2 activity enhances our understanding of its function and is essential for developing novel anti-seizure therapies.

Effect of Ninety-day Repeated Adiministration of Leaf Extract of Solanum anomalum on Rats

The leaves and fruits of Solanum anomalum Thonn. ex Schumach are used locally for the treatment of pains, fever and malaria among others. Effect of 90-day repeated administration of S. anomalum leaf extract on rats was investigated. Oral administration of the leaf extract (70, 140 and 210 mg/kg) to rats (male and female) was carried out daily for 90 days and the rats were sacrificed after being anaesthesized with light diethyl ether at the completion of the administration. Oral treatment of rats subchronically with S. anomalum leaf extract had no significant (p&gt;0.05) effect on rats’ body weights, hemoglobin concentration, WBC, RBC, platelets counts, percentages of PCV and eosinophils relative to control. However, percentages of neutrophils, monocytes and basophils were elevated significantly (p &lt;0.05-0.01) at the highest dose (210 mg/kg), while lymphocytes percentage was reduced. The leaf extract had no significant (p&gt;0.05) effect on bleeding and clotting times relative to control. The leaf extract non dose-dependently caused significant (p&lt;0.05) lowering of ALT, AST and ALP levels. However, total and direct bilirubin levels were elevated significantly (p&lt;0.01-0.001) only at raised leaf extract’ doses (140 and 210 mg/kg). The leaf extract exerted no significant (p&gt;0.05) changes on uric acid, bicarbonate, chloride, potassium and sodium levels, but lowered urea, creatinine, total cholesterol, triglyceride, HDL, VLDL and LDL levels of rats significantly (p&lt;0.05) relative to control. There was no observable distortion of heart, testis and spleen histologies. Distortion in the histology of livers, kidneys, ovaries and brains of rats were observed at raised extract doses (140 and 210 mg/kg). High doses of the leaf extract should be avoided to prevent serious toxic effects.

Association of serum chloride levels with all-cause mortality among patients in surgical intensive care units: a retrospective analysis of the MIMIC-IV database

This study explores the association between serum chloride concentrations and all-cause mortality among patients in the Surgical Intensive Care Unit (SICU). Employing a retrospective cohort design, the study utilized data extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, specifically focusing on individuals admitted to the surgical/trauma ICUs. This dataset encompassed demographic profiles, laboratory findings, historical medical data, vital statistics, and variables pertinent to prognosis. Participants were divided into four groups based on their serum chloride concentrations. The primary outcomes assessed were mortality rates at 30, 90, and 180 days post-admission to the ICU. Analytical methods included Kaplan–Meier survival curves, Cox proportional hazards regression models, and Restricted Cubic Spline (RCS) analyses to delineate the relationship between serum chloride concentrations and patient outcomes. The study cohort comprised 10,996 patients, with observed mortality rates of 12.78% at 30 days, 17.14% at 90 days, and 20.32% at 180 days. Kaplan–Meier analyses revealed significant disparities in survival rates across the quartiles of serum chloride during the follow-up intervals (p < 0.001). The results from the multivariable Cox regression suggested a substantial inverse association between high serum chloride levels and decreased mortality at 30 days (hazard ratio [HR]: 0.96; 95%confidence interval [CI]: 0.95–0.97; P < 0.001), 90 days (HR: 0.97; 95% CI: 0.96–0.98; P < 0.001), and 180 days (HR: 0.97; 95% CI: 0.96–0.98; P < 0.001). Particularly, patients in the highest quartile of serum chloride faced significantly lower mortality risks compared to those in the lowest quartile (30 days HR = 0.65, 90 days HR = 0.71, 180 days HR = 0.69, P < 0.001). RCS analysis depicted an L-shaped curve demonstrating the dynamics between serum chloride concentrations and the risk of all-cause mortality across the 30-day, 90-day, and 180-day periods.Starting at a concentration of 104 mmol/L, a decrease in serum chloride levels was associated with an increased risk of mortality.These findings elucidate a marked nonlinear association between serum chloride levels and all-cause mortality in SICU patients, enhancing our comprehension of serum chloride’s impact on clinical outcomes in this setting.

Investigation of Chloride Salt Erosion on Asphalt Binders and Mixtures: Performance Evaluation and Correlation Analysis.

Asphalt pavement, widely utilized in transportation infrastructure due to its favourable properties, faces significant degradation from chloride salt erosion in coastal areas and winter deicing regions. In this study, two commonly used asphalt binders, 70# base asphalt and SBS (Styrene-Butadiene-Styrene)-modified asphalt, were utilized to study the chloride salt erosion effect on asphalt pavement by immersing materials in laboratory-prepared chloride salt solutions. The conventional properties and adhesion of asphalt were assessed using penetration, softening point, ductility, and pull-off tests, while Fourier transform infrared spectroscopy (FTIR) elucidated the erosion mechanism. The Marshall stability test, freeze-thaw splitting test, and Cantabro test were applied to study the effects of chloride exposure on the strength, water stability, and structural integrity of the asphalt mixture. Finally, the grey correlation analysis was employed to assess the impact of chloride salt erosion on the performance of asphalt binders and mixtures. The findings highlight that chloride salt erosion reduces penetration and ductility in both types of asphalt binders, raises the softening point, and weakens asphalt-aggregate adhesion, confirmed as a primarily physical effect by FTIR analysis. Asphalt mixtures showed decreased strength and water stability, intensifying these impacts at higher chloride concentrations and longer erosion duration. SBS-modified asphalt binders and mixtures exhibited greater resistance to chloride salt erosion, particularly in adhesion, as demonstrated by the Cantabro and pull-out tests. Grey relational analysis revealed that erosion duration is the most influential factor, with TSR and softening point emerging as the most responsive indicators of chloride-induced changes. These findings offer critical insights for practice, providing evidence-based guidance for designing and constructing asphalt pavements in environments with high chloride levels.

Phthalate plasticizer affects blood electrolytes, hormones, and reproductive parameters of black Bengal goats

Objective: The present study looked at how electrolytes, hormones, and postpartum reproductive physiology were affected in black Bengal goats (BBGs) when they were fed a phthalate mixture (PHA). Materials and Methods: Twenty clinically healthy BBGs, 1–2 months pregnant, aged 6–8 months with a body weight of 10–12 kg, were chosen and randomly allocated to two experimental groups (n = 10 each). The BBGs of the treatment group (n = 10) were administered a standard ration containing a mixture of Diethyl Phthalate, Dibutyl Phthalate, Di-isobutyl Phthalate, and Dipropyl Phthalate. The non-treated control group (n = 10) received the goat ration without any phthalates up to parturition. Blood samples were taken from experimental pregnant goats just before parturition to analyze serum hormone and electrolyte levels. Results: The levels of sodium, chloride, and calcium were reduced (p &lt; 0.05) in PHA-exposed goats than in the non-exposed control group. No significant difference was observed in potassium and phosphorus levels between the two groups. PHA-exposed goats showed significantly decreased levels of estrogen, progesterone, luteinizing hormone, and thyroxin compared to control goats (p &lt; 0.05). Postpartum reproductive traits, such as gestation length, postpartum heat period, abortion rate, and retained placenta, were significantly (p &lt; 0.05) prolonged in BBG that had been exposed to PHA. Conclusion: PHA plasticizer exposure during pregnancy affects the electrolytes, hormones, and postpartum reproductive physiology of BBGs.

Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis.

Fluid resuscitation is the first-line treatment for patients with diabetic ketoacidosis (DKA). However, the optimal choice of resuscitative fluid remains controversial. This study aims to evaluate the impact of balanced electrolyte solution (BES) compared to 0.9% sodium chloride (NS) on various physiological and clinical outcomes in adult DKA patients. An extensive search of electronic databases, including Embase, PubMed, Cochrane Library, Web of Science, and Google Scholar, was conducted to select studies that directly compared BES and NS in adult DKA patients. This systematic review and meta-analysis included nine studies, comprising both randomized controlled trials and retrospective studies. Combined estimates were expressed as mean differences (MDs) with 95% confidence intervals (CIs). The primary outcomes were time to resolution of DKA and length of hospital stay. The secondary outcomes were post-resuscitation chloride and bicarbonate levels and adverse events. No significant difference was observed between BES and NS in the time to DKA resolution (MD: -1.63; 95% CI: -7.66-4.41; p = 0.60) or length of hospital stay (MD: -0.07; 95% CI: -0.44-0.31; p = 0.73). However, BES resulted in significantly higher post-resuscitation bicarbonate levels (MD: 1.63; 95% CI: 0.86-2.39; p < 0.001) and lower post-resuscitation chloride levels (MD: -2.37; 95% CI: -3.56 to -1.19; p < 0.001). The use of BES is associated with improved post-resuscitation electrolyte balance and preventing hyperchloremic metabolic acidosis in DKA patients. While BES may offer some biochemical advantages, both BES and NS are safe for treating DKA. Gupta P, Nasa P, Shahabdeen SM. Effectiveness of Balanced Electrolyte Solution vs Normal Saline in the Resuscitation of Adult Patients with Diabetic Ketoacidosis: An Updated Systematic Review and Meta-analysis. Indian J Crit Care Med 2025;29(1):65-74.

Indication and functional outcome of orthotopic neo-bladder reconstruction following radical cystectomy for bladder cancers in a specialist hospital in north-west Cameroon

BackgroundRadical cystectomy (RC) and urinary diversion are treatment modalities for muscle invasive bladder cancer (MIBC). However, in Cameroon, there is little information on orthotopic neo-bladder (ONB) reconstruction in the literature.ObjectiveWe aimed to share our indications for ONB reconstruction, evaluate the functional outcomes, and enumerate the surgical complications. By sharing our experience with ONB reconstruction, we hope to broaden the understanding of this procedure and aid in anticipating its various outcomes.MethodsA retrospective assessment of medical records was conducted for all patients who underwent ONB reconstruction after RC for bladder cancer from January 2020 to April 2023 at Nkwen Baptist Hospital. Data collected included socio-demographic details, clinical and pathological data, indications for surgery, voiding, and metabolic outcomes at 6 and 12 months postoperatively. Data analysis was performed using IBM-SPSS version 26.0.ResultsEighteen patients (66.7% male) with a mean age of 60.50 (± 6.90) years were included. Indications for ONB were 56% for pT2b, 23% for pT2a, and 23% for multifocal T1 disease without ureteral, urethral, or bladder neck extension. At 12 months, 77.8% had acceptable diurnal continence, and 72.2% had acceptable nocturnal continence. Peak urinary flow rates and post-void residual volumes were acceptable in 77.8% and 83.3% of patients, respectively. Additionally, 88.9% had normal sodium levels, 94.4% had normal potassium levels, and 94.4% had normal chloride levels at 12 months post-ONB creation.ConclusionsONB reconstruction provides satisfactory continence and minimal rates of electrolyte derangement, contributing valuable insights into the functional outcomes of this procedure.

Successful Therapy over 12 Months of People with Cystic Fibrosis with Rare Non-phe508del Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Mutations with Elexacaftor/Tezacaftor/Ivacaftor (ETI).

Background: Elexacaftor/Tezacaftor/Ivacaftor (ETI) is a CFTR modulator therapy approved for people with cystic fibrosis (pwCF) who have at least one phe508del mutation. However, its approval in the European Union (EU) for pwCF with non-phe508del mutations is lacking, because data on treatment response in this subgroup are scarce. Methods: This retrospective observational study evaluated six pwCF (ages 6 to 66) with responsive CFTR mutations (M1101K, R347P, 2789+5G>A, G551D) undergoing off-label ETI therapy. Evaluations were conducted at 0, 3, 6, 9, and 12 months, assessing lung function (FEV1), sweat chloride levels, body mass index (BMI), quality of life, medication satisfaction, ear, nose and throat (ENT) symptoms, and physical activity. A control group of four pwCF with classic symptoms and no ETI treatment was included. Results: FEV1 improved significantly after 3 and 6 months (p < 0.05) and stabilized by 12 months. Sweat chloride levels decreased significantly, with four pwCF achieving levels <60 mmol/L. Improvements in the upper and lower airway symptoms, medication satisfaction, and increased BMI were noted. Conclusions: ETI demonstrates high efficacy in this small group of pwCF with rare CFTR mutations, offering a treatment option that warrants further monitoring and evaluation.

PHYTOCHEMICALS ANALYSIS AND TOXICITY STUDIES OF ETHANOL LEAVES EXTRACT OF AZADIRACHTA INDICA, ANACARDIUM OCCIDENTALE, AND MORINGA OLEIFERA IN RATS

Medicinal plants have importance medicinal properties and pharmacological activities. Medicinal value and pharmacological activities of plants are attributed to their bioactive constituents. The efficacy of medicinal plants could not only be considered but also their safety for consumption. The phytochemicals analyses were performed using standard methods. Toxicity tests were conducted using Lorke’s method. The ethanol leaves extract of Azadirachta indica, Anacardium occidentale, and Moringa oleifera contain several phytochemicals. The LD50 value of ethanol leaves extract of Azadirachta indica, Anacardium occidentale, and Moringa oleifera was 3807.89 mg/kg, 4505.55 mg/kg, and above 5000 mg/kg, respectively. The ethanol leaves extract of Anacardium occidentale and Azadirachta indica demonstrated an increase in the levels of ALT, AST, total bilirubin, and globulin, while the Moringa oleifera exhibited a decrease in the levels of ALT, AST, and total bilirubin coupled with increase in total protein and albumin levels. The administration of ethanol leaves extract of Anacardium occidentale and Azadirachta indica increased the levels of urea, creatinine, sodium, potassium, calcium, chlorides, and HCO3- while decreased by the administration of the ethanol leaves extract of Moringa oleifera in rats. The ethanol leaves extract of Azadirachta indica and Anacardium occidentale demonstrated significant decrease in RBC count and PCV while Moringa oleifera exhibited significant increase in RBC count and PCV. Hemoglobin content was significantly decrease by the ethanol leaves extract of Azadirachta indica. The presence of these bioactive metabolites implies that the plants have medicinal properties. The ethanol leaves extract of Moringa oleifera at 5000 mg/kg dose is relatively non-toxic and safe for gavage administration while ethanol leaves extract of Azadirachta indica and Anacardium occidentale are slightly toxic for oral administration.

High-salt–fat diet: a risk factor for elevated blood pressure associated with dyslipidemia, perturbation in cardio-renal anti-oxidant and pro-inflammatory status in Wistar rats

Abstract Background Fatty and salty diets are reported risk factors in the etiology of hypertension, renal and cardiac failure. Oxidative stress and inflammation are biochemical processes in the onset of most diseases. This study sought to evaluate the role of high-salt–fat diet (HS-HFD) on blood pressure (BP), cardio-renal function, redox and inflammatory status. Twelve male Wistar rats were divided into two groups and fed with normal chow and HS-HFD, respectively. Results After 12 weeks, HS-HFD-fed rats showed considerable weight reduction, elevated systolic and diastolic BP. Serum cholesterol and low-density lipoprotein (LDL) were increased, and high-density lipoprotein (HDL) and triacylglycerol levels were significantly (p &lt; 0.05) reduced in the HS-HFD-fed animals. Angiotensin 1-converting enzyme was elevated in the HS-HFD rats, with no difference in nitric oxide between the two groups. Urea, lactate dehydrogenase, creatinine, bicarbonate and chloride levels were elevated in the HS-HFD-fed group, while potassium, sodium and magnesium were reduced. Creatine kinase activity was reduced in the heart of HS-HFD rats, with no difference in serum troponin. The kidney of HS-HFD rats showed increased superoxide dismutase (SOD), glutathione peroxidase, glutathione and glutathione-S-transferase (GST) with reduced catalase and malondialdehyde (MDA). Heart SOD, catalase and MDA levels were similar in the two groups, with GPx, GST and GSH elevated in the control. Kidney tumor necrosis factor-α (TNF-α) increased in HS-HFD group, with no difference in the heart of the rats in the two groups. TGF-β decreased in the kidney and heart of the HS-HFD-fed rats. Conclusions HS-HFD elicited hypertension associated with perturbation in redox and pro-inflammatory status in the kidney and heart of the rats.