Ruby Alexander-Lindo

Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes

BackgroundYoga has been shown to be a simple and economical therapeutic modality that may be considered as a beneficial adjuvant for type 2 diabetes mellitus. This study investigated the impact of Hatha yoga and conventional physical training (PT) exercise regimens on biochemical, oxidative stress indicators and oxidant status in patients with type 2 diabetes.MethodsThis prospective randomized study consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group that were matched with a similar number of type 2 diabetic patients in the conventional PT exercise and control groups. Biochemical parameters such as fasting blood glucose (FBG), serum total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), very low-density lipoproteins (VLDL) and high-density lipoprotein (HDL) were determined at baseline and at two consecutive three monthly intervals. The oxidative stress indicators (malondialdehyde – MDA, protein oxidation – POX, phospholipase A2 – PLA2 activity) and oxidative status [superoxide dismutase (SOD) and catalase activities] were measured.ResultsThe concentrations of FBG in the Hatha yoga and conventional PT exercise groups after six months decreased by 29.48% and 27.43% respectively (P < 0.0001) and there was a significant reduction in serum TC in both groups (P < 0.0001). The concentrations of VLDL in the managed groups after six months differed significantly from baseline values (P = 0.036). Lipid peroxidation as indicated by MDA significantly decreased by 19.9% and 18.1% in the Hatha yoga and conventional PT exercise groups respectively (P < 0.0001); whilst the activity of SOD significantly increased by 24.08% and 20.18% respectively (P = 0.031). There was no significant difference in the baseline and 6 months activities of PLA2 and catalase after six months although the latter increased by 13.68% and 13.19% in the Hatha yoga and conventional PT exercise groups respectively (P = 0.144).ConclusionThe study demonstrate the efficacy of Hatha yoga exercise on fasting blood glucose, lipid profile, oxidative stress markers and antioxidant status in patients with type 2 diabetes and suggest that Hatha yoga exercise and conventional PT exercise may have therapeutic preventative and protective effects on diabetes mellitus by decreasing oxidative stress and improving antioxidant status.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12608000217303

PREVALENCE OF INJURIES AND REPORTING OF ACCIDENTS AMONG HEALTH CARE WORKERS AT THE UNIVERSITY HOSPITAL OF THE WEST INDIES

OBJECTIVES This study investigated the knowledge, awareness and practices of health care workers towards universal precautions at the University Hospital of the West Indies. The study also examined the prevalence of injuries experienced by health care workers, as well as incidence of accidents and compliance with post-exposure prophylaxis. MATERIALS AND METHODS A cross sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to two hundred health care workers including medical doctors, medical technologists, nurses and porters to assess knowledge and practices regarding universal precautions, prevalence of injuries and incidence of accidents. RESULTS Almost two-thirds (62.3%) of the respondents were aware of policies and procedures for reporting accidents while one-third (33.2%) were unsure. All nurses were aware of policies and procedures for reporting accidents, followed by medical doctors (88%) and medical technologists (61.2%). The majority (81.5%) of the respondents experienced splashes from bodily fluid. Over three-quarters of medical doctors (78%) and two-thirds of nurses (64%) reported having experienced needle stick injuries, while the incidence among medical technologists was remarkably lower (26%). The majority of the respondents (59%) experienced low accident incidence while just over one-tenth (14%) reported high incidence. Eighty four respondents reported needle stick injuries; just under two-thirds (59.5%) of this group received post-exposure treatment. CONCLUSIONS The study found that majority of health care workers were aware of policies and procedures for reporting accidents. Splashes from body fluids, needle stick injuries and cuts from other objects were quite prevalent among health care workers. There is a need for monitoring systems which would provide accurate information on the magnitude of needle stick injuries and trends over time, potential risk factors, emerging new problems, and the effectiveness of interventions at The University Hospital of the West Indies and other hospitals in Jamaica.

The microbial content of unexpired pasteurized milk from selected supermarkets in a developing country.

OBJECTIVE To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston, Jamaica. METHODS The quantitative study used a stratified random sampling technique in the selection of the 20 representative milk samples from six (6) supermarkets. Microbiological tests such as methylene blue reduction, standard plate count (SPC), coliform plate count (CPC), purity plate culture, gram staining and biochemical tests were performed to examine the microbes in purchased unexpired pasteurized milk. RESULTS One sample (BCr016) had a pH of 4.0, a rancid odour and curdled appearance. It decolourized within one hour during the methylene blue reduction test and was classified as class 4 milk. Seven of the samples were sterile with no microbe growth on the plate count agar and violet red bile salt agar (VRBA). The milk samples that appeared to be safe for consumption were all 10, 11, 12 and 13 days before expiration. The VRBA sample BCr016, had a colony count of 13 400 CFU/ mL. There was the presence of Escherichia coli in sample LCr021 which had a standard plate count of 1 580 SPC/mL and a coliform count of 500 CFU/mL. Enterobacter sp. was present in colonies from BCr016 and all the other milk samples. CONCLUSIONS Unacceptable levels of Enterobacter spp. and Escherichia coli were found in most of the samples. Effective measures to ensure safe milk for human consumption such as the phosphatase test and methylene blue reduction test should be routinely performed on each batch of milk processed by dairy plants.

LIPID PROFILE AND CLINICAL CHARACTERISTICS OF WOMEN WITH GESTATIONAL DIABETES MELLITUS AND PREECLAMPSIA

Lipid Profile and Clinical Characteristics of Women with Gestational Diabetes Mellitus and Preeclampsia Gestational diabetes mellitus (GDM) is associated with increased risk of pregnancy-induced hypertension and other maternal and foetal complications of pregnancy. The aims of the study were to evaluate the serum lipid profile of women with GDM, and determine the number of women with GDM who have preeclampsia (PE). A retrospective study of 84 women with GDM and 90 pregnant women with normal glucose tolerance (controls) was conducted. Women with GDM had significantly higher parity (p=0.047), total cholesterol (p=0.039) and triglycerides (p=0.033), but non-significantly lower HDL-cholesterol (p=0.086) when compared to controls. Systolic blood pressure was significantly elevated in women with GDM coupled with PE (GDM-PE; p=0.015), the mean birth weight of infants born to women with GDM-PE was significantly lower than that of women with only GDM (p=0.025). Women with GDM-PE had significantly higher triglycerides (p=0.020), had to be more multi-gravida (p=0.047) with significantly elevated VLDL-cholesterol (p=0.037) when compared with women with only GDM. 11.9% of women with GDM had PE. On the basis of these findings, it can be concluded that GDM is associated with hyperlipidaemia as evident by the significantly elevated total cholesterol and triglyceride concentrations. Women with dyslipidaemia and GDM are at risk of developing preeclampsia. It is imperative that blood lipids be evaluated in women with GDM during antenatal care as it would be helpful in the early detection and treatment of PE. Lipidski Profil I Kliničke Karakteristike Žena SA Gestacionim Dijabetes Melitusom I Preeklampsijom Gestacioni dijabetes melitus (GDM) povezan je sa povećanim rizikom od hipertenzije izazvane trudnoćom i drugih komplikacija trudnoće kod majke i fetusa. Ciljevi studije bili su da se odredi lipidski profil žena sa GDM, i utvrdi broj žena sa GDM koje imaju PE. Sprovedena je retrospektivna studija 84 žene sa GDM i 90 trudnica sa normalnom tolerancijom glukoze (kontrola). Žene sa GDM imale su značajno povišen paritet (p=0,047), ukupni holesterol (p=0,039) i trigliceride (p=0,033), ali i neznačajno niži HDL-holesterol (p=0,086) u poređenju sa kontrolom. Sistolni krvni pritisak bio je značajno povišen kod žena sa GDM u kombinaciji sa PE (GDM-PE; p=0,015), a prosečna težina novorođenčadi koju su rodile žene sa GDM-PE bila je značajno niža nego kod žena sa GDM (p=0,025). Žene sa GDM-PE imale su značajno povišene trigliceride (p=0,020), i sklonije su većem broju trudnoća (p=0,047) uz značajno povišen VLDL-holesterol (p=0,037), u poređenju sa ženama samo sa GDM. 11,9% žena sa GDM imalo je PE. Na osnovu tih nalaza može se zaključiti da je GDM povezan sa hiperlipidemijom, što se vidi iz značajno povišenih ukupnih koncentracija holesterola i triglicerida. Kod žena sa dislipidemijom i GDM postoji rizik od razvoja preeklampsije. Veoma je važno određivati lipide u krvi žena sa GDM u okviru prenatalne zaštite jer to pomaže ranom otkrivanju i lečenju PE.

The effects of S-nitrosoglutathione and S-nitroso-N-acetyl-D, L-penicillamine in a rat model of pre-eclampsia

Background: Pre-eclampsia (PE) complicates approximately 5-7% of all pregnancies. This study investigates the effects of S-nitroso-N-acetylpenicillamine (SNAP) and S-nitrosoglutathione (GSNO) on the classical features of PE. Materials and Methods: On day 14 of gestation, female Sprague-Dawley rats were separated into five groups and treated intravenously for 7 days as follows: (i) 0.3 mL 0.9% saline (control, n = 11); (ii) 50 mg/kg Body Weight (BW) N-nitro-L-arginine methyl ester (L-NAME) in 0.3 mL saline (n = 10); (iii) 50 mg/kg BW L-NAME and 8 mg/kg BW GSNO in 0.15 mL saline (n = 6); (iv) 50 mg/kg BW L-NAME in 0.15 mL saline and 8 mg/kg BW SNAP in 0.15 mL DMSO (n = 9); and (v) 0.15 mL DMSO and 0.15 mL saline (SNAP control, n = 7). Blood pressures were measured on day 14 through day 20, a 4-h urine sample was taken on day 20, and animals were sacrificed on day 21. Pups were counted and weighed individually. Results: SNAP and GSNO significantly decreased systolic, diastolic, and mean arterial pressures in PE-induced rats from day 14 through day 20 (P < 0.05). Pup weights in SNAP and GSNO groups were higher than in L-NAME group but lower than in controls (P ≤ 0.001). SNAP and GSNO partially reversed growth retardation. Conclusion: Elevated blood pressure, proteinuria, and intrauterine growth restriction associated with PE were induced in Sprague-Dawley rats using L-NAME. These were partially reversed with the use of GSNO and SNAP. The mechanism of action of these S-nitrosothiols (RSNOs) should be further explored.

Health-Beneficial Phenolic Aldehyde in Antigonon leptopus Tea

Tea prepared from the aerial parts of Antigonon leptopus is used as a remedy for cold and pain relief in many countries. In this study, A. leptopus tea, prepared from the dried aerial parts, was evaluated for lipid peroxidation (LPO) and cyclooxygenase (COX-1 and COX-2) enzyme inhibitory activities. The tea as a dried extract inhibited LPO, COX-1 and COX-2 enzymes by 78%, 38% and 89%, respectively, at 100 μg/mL. Bioassay-guided fractionation of the extract yielded a selective COX-2 enzyme inhibitory phenolic aldehyde, 2,3,4-trihydroxy benzaldehyde. Also, it showed LPO inhibitory activity by 68.3% at 6.25 μg/mL. Therefore, we have studied other hydroxy benzaldehydes and their methoxy analogs for LPO, COX-1 and COX-2 enzymes inhibitory activities and found that compound 1 gave the highest COX-2 enzyme inhibitory activity as indicated by a 50% inhibitory concentration (IC50) at 9.7 μg/mL. The analogs showed only marginal LPO activity at 6.25 μg/mL. The hydroxy analogs 6, 7 and 9 showed 55%, 61% and 43% of COX-2 inhibition at 100 μg/mL. However, hydroxy benzaldehydes 3 and 12 showed selective COX-1 inhibition while compounds 4 and 10 gave little or no COX-2 enzyme inhibition at 100 μg/mL. At the same concentration, compounds 14, 21 and 22 inhibited COX-1 by 83, 85 and 70%, respectively. Similarly, compounds 18, 19 and 23 inhibited COX-2 by 68%, 72% and 70%, at 100 μg/mL. This is the first report on the isolation of compound 1 from A. leptopus tea with selective COX-2 enzyme and LPO inhibitory activities.

The effect of nitric oxide inhibitors and s-nitrosothiols on hemodynamic parameters in an animal model

G-methyll-arginine acetate (l-NMMA) may reverse the elevated systolic, diastolic, and mean arterial pressures caused by the administration of l-NAME or l-NMMA only. Materials and methods: Blood pressure was measured using the CODA 6 machine. The hemodynamic parameters systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) were determined for each rat group. There was intravenous (IV) administration of the control (0.3 mL, saline) or dosage of 12.5 mg/kg body weight of SNAP or CapSNO via IV. Results: In CapSNO and l-NAME-treated rats, CapSNO significantly decreased SBP from 131.12 ± 4.29 mmHg to 121.42 ± 4.24 mmHg after 5 minutes (P , 0.0001), and then l-NAME (administered at t = 5 min) increased SBP to 165.29 ± 6.79 mmHg at 10 minutes (P , 0.05). In SNAP and l-NAME-treated rats, SNAP significantly decreased SBP from 135.86 ± 2.84 mmHg to 106.98 ± 1.99 mmHg (P , 0.0001) after 5 minutes, and l-NAME increased SBP to 146.18 ± 3.19 mmHg after 25.0 minutes (P , 0.05). In rats treated with SNAP and l-NAME, SNAP decreased DBP to 74.98 ± 2.49 mmHg (P , 0.0001) after 5 minutes while l-NAME increased DBP to 105.01 ± 2.60 mmHg after 25 minutes (P , 0.05). In SNAP and l-NAME treated group there was an increase in HR after the administration of SNAP (486.60 ± 30.82 at 0 minutes to 555.66 ± 32.37 beats min −1 at 5 minutes; P , 0.0001), followed

The effect of nitric oxide inhibitors and Snitroso-Nacetylpenicillamine on glucose concentration in an animal model

Background: Nitric oxide (NO) is becoming an increasingly important signaling molecule implicated in a growing number of physiological and pathophysiological processes. Research on the effect of NO donors on glucose metabolism in peripheral tissues have grown rapidly in the last decade. This study examined the effects of NGmethyl-L-arginine acetate (L-NMMA) and NGmethyl-L-arginine ester (L-NAME) on fasting and postprandial blood glucose concentrations. The study also investigated if L-NMMA and L-NAME decrease the hyperglycemic effect caused by the NO donor S-nitrosoN-acetylpenicillamine (SNAP) in normoglycemic rats. Results: L-NAME and L-NMMA significantly lowered the postprandial blood glucose concentrations. Mean postprandial blood glucose concentrations in rats treated with L-NAME were 5.04 ± 0.07 mmol/L at 120 min, 4.62 ± 0.19 mmol/L at 150 min and 4.36 ± 0.17 mmol/L at 180 min time points compared with 5.46 ± 0.14 (P = 0.029), 5.20 ± 0.17 mmol/L (P = 0.036), and 4.89 ± 0.14 mmol/L (P = 0.015) at the same time points respectively for saline control. Mean blood glucose concentrations in rats treated with L-NMMA were 4.35 ± 0.23 mmol/L (P = 0.0018) at 120 min, 4.60 ± 0.14 mmol/L (P = 0.090) at 150 min and 3.88 ± 0.16 mmol/L (P 0.001) at 180 min. There were significant differences in mean postprandial blood glucose concentrations in rats treated with SNAP, compared with those treated with L-NAME and SNAP at 90 min (P = 0.012), 180 min (P = 0.013) and 210 min (P < 0.0001). In addition, there were significant differences in mean postprandial blood glucose concentrations in rats treated with SNAP compared with those treated with L-NMMA and SNAP at 90 min (P = 0.0011), 180 min (P = 0.015) and 210 min (P = 0.0077). Conclusion: The nitric oxide synthase [NOS] inhibitors were effective in reducing postprandial blood glucose concentration in rats treated with SNAP. This suggests that although SNAP is an effective antihypertensive agent it decreases glucose tolerance which can be improved by the use of NOS inhibitors such as L-NMMA or L-NAME. These drugs could be beneficial in controlling blood glucose tolerance in rats administered with SNAP, and possibly in humans.

The Use of Soluble Transferrin Receptor in the Detection of rHuEPO Abuse in Sports

Erythropoietin (EPO) increases the number of circulating erythrocytes and muscle oxygenation. The recombinant forms of EPO have indiscriminately been used by athletes, mainly in endurance sports to increase their erythrocytes concentration, thus generating a better delivery of oxygen to the muscle tissue. The administration of recombinant human erythropoietin (rHuEPO) except for therapeutic use was prohibited by the International Olympic Committee (IOC) and its unauthorized use considered as doping. In the last few years, a number of studies using parameters indicative of accelerated erythropoiesis have investigated a number of indirect methods for the detection of rHuEPO abuse. No single indirect marker has been found that can satisfactorily demonstrated rHuEPO misuse. Soluble transferrin receptor (sTfR) is a new marker of iron status and erythropoietic activity. It has been included in multivariable blood testing models for the detection of performance enhancing EPO abuse in sports. Indirect markers of altered erythropoiesis give reliable evidence of current or discontinued rHuEPO usage. This review describes the physical, biological and pharmacokinetic properties of endogenous EPO and its recombinant form. It also discusses the available strategies for the detection of rHuEPO abuse in sports, involving the use of sTfR concentration directly or in mathematical multivariate models.