Environmentally benign silver bio-nanomaterials as potent antioxidant, antibacterial, and antidiabetic agents: Green synthesis using Salacia oblonga root extract.

Introduction: The use of plant extracts in the green synthesis of metallic nanoparticles is one of the simplest, most practical, economical, and ecologically friendly methods for avoiding the use of toxic chemicals. Method: Silver nanoparticles (AgNPs) were synthesized, employing a high-efficiency, non- toxic, cost-effective, green, and simple technique that included the use of Salacia oblonga root extract (SOR) as a capping agent compared to synthetic nanoparticles. The use of S. oblonga can be seen in traditional medicines for treating diabetes, obesity, rheumatism, gonorrhea, asthma, and hyperglycemia. The objectives of the current study were to green synthesize S. oblonga root extract silver nanoparticles (SOR-AgNPs), characterize them, and study their antioxidant, antibacterial, and antidiabetic activities. Result: The shape of SOR-AgNPs was spherical, at less than 99.8 nm in size, and exhibited a crystalline peak at XRD. The green synthesized SOR-AgNPs showed significant antioxidant properties like DPPH (80.64 µg/mL), reducing power capacity (81.09 ± SEM µg/mL), nitric oxide (96.58 µg/mL), and hydroxyl (58.38 µg/mL) radical scavenging activities. The MIC of SOR-AgNPs was lower in gram-positive bacteria. The SOR-AgNPs have displayed efficient inhibitory activity against α-amylase, with an EC50 of 58.38 µg/mL. Analysis of capping protein around the SOR-AgNPs showed a molecular weight of 30 kDa. Discussion: These SOR-AgNPs could be used as antibacterial and antidiabetic drugs in the future as it is cheap, non-toxic, and environmentally friendly. Bio-fabricated AgNPs had a significant impact on bacterial strains and could be used as a starting point for future antibacterial drug development.

A Search for Uniformity in Human Chorionic Gonadotropin (hCG) Reporting.

Varying reports across different laboratories or across different analysers in the same lab for the same sample is not an uncommon phenomena. Experts call this a lack of harmonization. A test that is harmonized provides the same results regardless of the manufacturer of reagents used or the laboratory where the test is performed. When laboratory tests are not harmonized, the entire continuum of patient care can be affected in a number of ways. Here, we present a case of varying reports for a single serum human chorionic gonadotropin (hCG) sample on two different immunoassay platforms for a young female presenting with an abdominopelvic mass. The lab reports for serum hCG for this particular patient showed inconsistent results with the same sample within the same lab. The phenomena behind this was lack of harmonization of test results. We introspect many of the factors responsible for lack of uniformity in hCG results amongst the major ones being with use of antibodies directed against different epitopes of hCG (analyte) and the heterogeneity of the hCG molecule itself. Harmonization is a process to ensure that different clinical testing procedures used by different laboratories give equivalent results. Harmonizing test results will enable healthcare providers to use clinical guidelines with greater confidence for diagnosing disease and managing patients.

POEMS Syndrome: Clinical and Laboratory Approach Towards Diagnosis.

Polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes (POEMS) syndrome is a rare multisystem paraneoplastic disorder. Here we describe a case of a 50 year old post-menopausal female who presented with chief complaints of difficulty in walking, getting up from squatting position and tingling sensation of bilateral lower limbs since 1 month. Additional unusual features in the patient included hepatosplenomegaly, endocrinal involvement in the form of hypothyroidism and elevated estradiol levels for her age. There were skin changes in the form of hyperpigmentation. M protein was not noted on serum electrophoresis but was visible on serum protein immunofixation (IgA lambda). She was investigated as a case of polyneuropathy and later a provisional clinical diagnosis of POEMS was made based on the presence of major and minor criteria. The patient was managed with methyl prednisolone, calcium carbonate and vit D3 and topical antibiotics for local infections.

Identification and characterization of metal-chelating bioenhancer peptide derived from fermented Citrullus lanatus seed milk.

In the present investigation, a metal-chelating bioactive peptide was derived from Citrullus lanatus seed milk fermented with Lactococcus lactis. The cationic fermented milk peptide (FMP) thus obtained was purified using the HiTrap-chelating column followed by rpHPLC. The FMP possessed the ability to chelate multiple divalent cations like Cu2+ , Ca2+ , and Fe2+ with 86.81%, 61.04%, and 24.32% of chelation respectively and further it exhibited 78.03% of DPPH free radical scavenging activity. Interaction of FMP with metal ions was assessed by change in the absorption spectra and was analyzed by ultraviolet-visible and fluorescence spectroscopy. The FMP-metal complexes were found stable at simulated gastric conditions. In vitro analysis using intestinal Caco-2 cell lines revealed that there was an increase in metal bioavailability in the presence of the FMP and was least influenced by the addition of a dietary inhibitor, phytic acid. By LC-MS analysis the molecular mass of FMP was found to be 11.6 kD and it contains oxygen-rich and nitrogen-rich amino acids that favor the metal chelation. In our study, we have found that the fermented C. lanatus seed milk can serve as a potential functional food with bioenhancer peptides that increase metal bioavailability and enhance human health. PRACTICAL APPLICATIONS: Chelated metals are preferred over non-chelated ones by most nutritionists for their better absorption rate. Chelation protects the minerals from the digestive process and increases their bioavailability. Fermentation with lactic acid bacteria produces bioactive peptides with metal-chelating and antioxidant ability which provides additional health benefits beyond supplying basic nutrients. Lactococcus lactis fermented milk acts as a probiotic product with bioenhancer peptide that increases mineral bioavailability. Consumption of metals in chelated form can reduce excess intake of metal. Fermented watermelon seed milk can be a promising probiotic drink rich in bioenhancer peptides and can enhance the bioavailability of divalent cations of a high therapeutic index.

The Impact of COVID-19 Containment Actions on Extra-Analytical Phases of the Clinical Laboratory: A Case Report.

Laboratory information systems need to adapt to new demands created by the COVID-19 pandemic, which has set up new normals like containment measures and social distancing. Some of these have negatively impacted the pre- and postanalytical phases of laboratory testing. Here, we present an intriguing finding related to the generation of the accession number/specimen number on the investigation module of a hospital management information system and its impact on the dissemination of reports resulting in the wrong release of reports on a female patient amidst the background of COVID-19 containment measures. We analyze the situation that led to this false reporting and the importance of the proper customization of information software in laboratories along with a robust postanalytical framework of laboratory work culture to avert such untoward incidents. This introspection has made us realize that COVID-19 has been a scientific, medical, and social challenge. We need to redefine our priorities in the days to come because SARS-CoV-2 is here to stay.

Pseudohyperkalemia in Serum and Plasma: The Phenomena and Its Clinical Implications.

Hyperkalemia is a life threatening electrolyte derangement that must be recognized and treated quickly. Pseudohyperkalemia is defined as a difference between serum and plasma potassium concentration of more than 0.4 meq/L with serum values on the higher side when both the samples are obtained at the same time, remain at room temperature and are tested within 1 h of sample collection. Given the implication of basing medical decisions on falsely elevated potassium levels, timely identification of the entity of pseudohyperkalemia and differentiating it from true hyperkalemia becomes utmost important. Here we present a case report of a 36 year old female admitted with a provisional diagnosis of pyrexia of unknown origin with hepatosplenomegaly and anaemia under evaluation. During hospital stay her potassium levels in whole blood, serum and plasma reportedly differed significantly. An abnormal WBC count beyond assay range was reported and during subsequent investigations this lead to a peripheral smear being advised and diagnosis revealed chronic lymphoblastic leukaemia with blast crisis and 86% blast cells. In patients with leukocytosis and thrombocytosis, pseudohyperkalemia may exist in the absence of electrocardiogram changes or other clinical manifestations of true hyperkalemia thus leading to reevaluation of potassium values in serum, plasma and whole blood to arrive at the true picture.