Eosinophil values in exacerbation and stable chronic obstructive pulmonary disease and its relationship to maintenance therapy in stable chronic obstructive pulmonary disease patients.

Background: Chronic obstructive pulmonary disease (COPD) is characterised by persistent and progressive airflow limitations. The study aimed to determine the relationship between eosinophil values in patients with stable and exacerbated COPD, and the relationship of eosinophil values with two drug regimens used as maintenance therapy in stable COPD. Materials and methods: This cross-sectional study and the variables used in this study were eosinophil counts in stable and exacerbated COPD patients. Results: Eighty-three patients with stable and exacerbated COPD were included. Stable COPD (63.9%) was predominant, with the highest degree of symptoms in group A 18 patients (34%) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2; 35 patients (66%). The degree of COPD exacerbation was dominated by Type II COPD 15 patients (50%). Eosinophil counts in patients with stable COPD were less than 100 cells/mm3 37 patients (44.6%), while in patients with COPD exacerbation, it was greater than 100 cells/mm3 with a total of 30 patients (36.1%). Long acting muscarinic antagonist class of drugs was the most used treatment as maintenance therapy in stable COPD 34 patients (64.2%). Conclusion: The eosinophil counts in patients with COPD exacerbation were significantly higher than those in patients with stable COPD. The provision of maintenance therapy in the long acting ß-2 agonist + inhaled glucocorticosteroid group of stable COPD patients was generally provided to COPD patients with eosinophil values greater than 100 cells/mm3, and the provision of long-term maintenance therapy in stable COPD patients was generally given to COPD patients with eosinophil values less than 100 cells/mm3.

Analysis of natural resistance-associated macrophage protein-1 (NRAMP-1) level based on death, comorbidities and severity of COVID-19 patients: a cross-sectional study.

An accurate diagnosis of COVID-19 is essential for pandemic control and for establishing adequate therapeutic strategies to reduce morbidity and mortality. COVID-19 infection replicates in macrophage cells and affects the immune system. Natural resistance-associated macrophage protein-1 (NRAMP-1) carries cation ions, such as Fe2+, Zn2+ and Mn2+, and plays an essential role in the immune system to infection with micro-organisms. In addition, the function of NRAMP-1 is to limit the replication of pathogens by changing the phagosomal environment. Levels of NRAMP-1 protein are based on death, comorbidities and clinical symptoms of COVID-19 patients and it is possible for the soluble protein NRAMP-1 level to be used as an additional biomarker for forensic and medicolegal related COVID-19 cases and prosecutions from patients and families. Methods: Determination of NRAMP-1 protein levels using the enzyme link-immunosorbent assay technique in death, had comorbidities and severity of clinical symptoms of COVID-19 patients. Results: Of the 62 patients who received treatment, 10 patients died with an average NRAMP-1 level of 650 ng/ml and 52 patients who survive with an average NRAMP-1 level of 1065.26 ng/ml. The results of the study also found that 34 patients had comorbidities with an average NRAMP-1 level of 838.82 ng/ml and 28 patients without comorbidities with an average NRAMP-1 level of 1191.92 ng/ml. Based on the severity of clinical symptoms in survive patients, 10 patients with mild were found with an average NRAMP-1 level of 984.31 ng/ml, with moderate in 31 patients with an average NRAMP-1 level of 1104.71 ng/ml and severe in 11 patients with an average NRAMP-1 level of 1027.71 ng/ml. Conclusions: NRAMP-1 protein levels were significantly lower in COVID-19 patients who died and had comorbidities.

In vivo and in vitro inhibition effect of propolis on Klebsiella pneumoniae: A review.

For centuries, propolis has been used to treat various diseases in traditional medicine due to its biological and pharmacological activities. It remains popular because of its potentially beneficial role in human health due to its well-known broad multispectrum properties, including antiviral, anti-inflammatory, antibacterial, anesthetic, antioxidant, anticancer, antifungal, antiprotozoal, antihepatotoxic, antimutagenic, and antiseptic activity. Numerous studies have examined the antibacterial activity of propolis and its derivatives, which include many natural antimicrobial compounds with broad spectrum activity against different bacterial types. In vitro studies have shown propolis's antibacterial activity against Gram-positive and Gram-negative bacteria. Many studies have examined propolis's effect on inhibiting bacterial growth. Several studies examining propolis's inhibition of Gram-positive and Gram-negative bacteria have shown it to be an effective antimicrobial agent. Klebsiella pneumoniae is a Gram-negative bacterium commonly associated with respiratory infections, particularly in hospital settings. Inappropriate antibiotic use may contribute to the increasing number of bacterial strains resistant to available drugs. This review summarizes the findings of previous studies on propolis and its potential mechanisms in inhibiting K. pneumoniae growth in animals.

Heparin for patients with coronavirus disease 2019 and hypercoagulation complications: A cohort study.

Background: Thrombotic complications of coronavirus disease 2019 (COVID-19) are a worrisome aspect of the disease due to their high incidence in critically ill patients and their poor clinical outcomes. The aim of this study was to compare the effectiveness of unfractionated heparin (UFH) and low molecular weight heparin (LMWH) (fondaparinux) in hospitalized COVID-19 patients with hypercoagulable complications. Material and methods: The study design used a retrospective cohort approach incorporating pre- and post-tests via secondary data extracted from the medical records of inpatients with confirmed COVID-19. Results: Among the 98 individuals studied (52% women; 30.6% at >60 years of age), 35 patients received UFH, while the remaining 63 patients received LMWH (fondaparinux). The greatest decrease in the D-dimer value (0.01 ± 0.5 g fibrinogen equivalent units/mL) was observed in 12 (34.3%) and 15 (23.8%) patients in the UFH and LMWH (fondaparinux) groups, respectively. Most inpatients with confirmed COVID-19 were aged 50-59 years and were women. Conclusion: There was a tendency toward increased D-dimer, normal prothrombin time, normal activated partial thromboplastin clotting time, and increased fibrinogen values in each COVID-19 patient. The results demonstrated a significant relationship between the D-dimer and prothrombin time parameter in confirmed COVID-19 inpatients.

Correlations between comorbidities, chest x-ray findings, and C-Reactive protein level in patients with COVID-19.

Background: Patients with comorbidities have an increased risk for severe coronavirus disease (COVID-19) symptoms, including abnormal inflammation. Chest X-rays and C-reactive protein (CRP) level are frequently used to evaluate the severity of inflammation. The aim of this study was to investigate the correlation between comorbidities, chest X-ray findings, and CRP level in patients with COVID-19. Materials and methods: This was a cross-sectional, analytic, observational study performed using a quantitative approach. The study population included in patients with confirmed COVID-19. Secondary data from the medical records of the patients were analysed to determine the correlations between comorbidities, chest X-rays, and CRP level. Results: The data of 167 patients (87 [52.1%] females and 80 [47.9%] males) were evaluated. Regarding comorbidities, 86 (51.5%) patients had hypertension, 66 (39.5%) had diabetes mellitus, and 17 (10.2%) had dyspepsia. Chest X-rays showed that 144 (86.2%) patients had pneumonia, whereas 23 (13.8%) did not. A total of 143 (85.6%) patients showed increased CRP levels, whereas 24 (14.4%) did not show any increase. Patients who showed pneumonia on chest X-rays tended to have increased CRP levels. The results also showed that chest X-ray findings were correlated with CRP level. Diabetes mellitus and hypertension were significantly correlated with CRP level (p = 0.05), whereas dyspepsia did not show a significant relationship with CRP level (p > 0.05). Patients with hypertension had a 2.709-fold risk of having increased CRP level compared with patients without hypertension. Patients with pneumonia had a 2.953-fold increased risk for increased CRP level compared to those without pneumonia. Conclusion: Hypertension and diabetes mellitus are significantly correlated with CRP level. Chest X-ray finding is also significantly correlated with CRP level.

Doxorubicin induced immune abnormalities and inflammatory responses via HMGB1, HIF1-α and VEGF pathway in progressive of cardiovascular damage.

Background: Doxorubicin (DOX) is a commonly used treatment for cancer and the mechanism of DOX-induced cardiomyocyte damage in cardiovascular disease is not fully understood. High-mobility group box 1 (HMGB1), strong induce proinflammatory cytokines via damage associated molecular pattern (DAMP) which its interaction with the receptor of advanced glycation end products (RAGE), that affect cytokine release, and angiogenesis via the role of HMBG1, HIF-1α and VEGF as an important regulator in these cardiac failure processes. Hypoxia-inducible factor-1α (HIF-1α) is plays an important role in the cellular response to systemic oxygen levels of cells and VEGF is an angiogenic factor and can stimulate cellular responses on the surface of endothelial cells will be described. Objective: The aim of this article is to comprehensively review the role of HMGB1, HIF-1α, and VEGF in DOX-induced Cardiovascular Disease and its molecular mechanisms. Methods: The data in this study were collect by search the keyword combinations of medical subject headings (MeSH) of "HMGB1", "HIF-1 α", "VEGF", "DOX" and "Cardiovascular disease" and relevant reference lists were manually searched in PubMed, EMBASE and Scopus database. All relevant articles in data base above were included and narratively discussed in this review article. Results: Several articles were revealed that molecular mechanisms of the DOX in cardiomyocyte damage and related to HMGB1, HIF-1α and VEGF and may potential treatment and prevention to cardiovascular disease in DOX intervention. Conclusion: HMGB1, HIF-1α and VEGF has a pivotal regulator in DOX-induce cardiomyocyte damage and predominantly acts through different pathways. The role of HMGB1 in DOX-induced myocardial damage suggests that HMGB1 is a mediator of DOX-induced damage. In addition, DOX can inhibit HIF-1α activity where DOX can decrease HIF-1α expression and HIF-1α is also responsible for upregulation of several angiogenic factors, including VEGF. VEGF plays an important role in angiogenesis and anti-angiogenesis both in vitro and in vivo and reduces the side effects of DOX markedly. In addition, the administration of anti-angiogenesis will show an inhibitory effect on angiogenesis mediated by the VEGF signaling pathway and triggered by DOX in cells.

The strong correlation between ADAM33 expression and airway inflammation in chronic obstructive pulmonary disease and candidate for biomarker and treatment of COPD.

Airway inflammation in patients with chronic obstructive pulmonary disease (COPD) is an amplified response of the normal immune system that occurs as a result of chronic irritation by toxic substances, such as cigarette smoke. This leads to the characteristic pathological changes in the inflammatory cells of COPD patients. ADAM33 has been reported to be involved in the pathogenesis of COPD in East Asia by affecting airway inflammation and other immune responses. The aim of this study was to determine the potential role of ADAM33 (mRNA and soluble levels) as a biomarker of inflammation in COPD patients. This is a case control study using consecutive sampling. The COPD case and control (non-COPD) groups comprised 37 and 29 patients, respectively. We used univariate analysis to assess differences in the parameters between the groups and bivariate analysis to non-parametrically compare these parameters between the two groups. We observed significantly higher mRNA levels of ADAM33 in the COPD patients (10.39 ± 1.76) as compared to that in the non-COPD individuals (6.93 ± 0.39; P < 0.001). The levels of soluble ADAM33 were also significantly higher in the COPD patients (2.188 ± 1.142 ng/ml) compared to the non-COPD individuals (0.487 ± 0.105 ng/ml; P < 0.001). The mRNA and soluble ADAM33 levels were significantly higher in COPD patients compared to those in the parameter-matched non-COPD individuals. Thus, ADAM33 is a potential biomarker and treatment for inflammation in COPD patients.

Intestinal tuberculosis: Case series of three patients.

BACKGROUND: Intestinal tuberculosis (ITB) is a fraction of extrapulmonary TB, and its diagnosis often pose a significant challenge due to nonspecific presentation. Several methods have been utilized to diagnosed ITB, including findings of specific inflammatory process on histopathological examination. We hereby report three cases of ITB that manifested as caecal and adnexal mass. CASE REPORT: First case, a 22-year-old male, presenting with abdominal pain, underwent exploratory laparotomy, biopsy, right hemicolectomy, and anastomosis end-to-side to the transverse ileocolical region due to partial ileus obstruction from caecal tumor. The second and third cases, a 27-year-old and 39-year-old females, both presenting with abdominal pain and distension, underwent exploratory laparotomy, adhesiolysis and biopsy. Histopathological examination in all three cases showed chronic granulomatous inflammation caused by TB. All three patients were diagnosed as ITB and received 6 months of anti-tuberculosis drug (ATD). DISCUSSION: Intestinal TB most commonly affected region is the ileocaecal, accounts for 64% of the incidence of gastrointestinal TB. The main reasons for the predilection of ileocaecal region are due to relatively longer faecal static, the abundant of lymphoid tissue, a neutral pH environment and absorptive transport mechanisms that allow swallowed mycobacterium to be absorbed. Intestinal TB may pose similar symptoms as those found in pulmonary TB, yet patients most commonly presenting with abdominal pain. Bacteriological signs and histopathological findings are gold standard for ITB diagnosis. Therapy for ITB includes pharmacological ATD and surgical therapy.