Amphotericin B (AmB) has long been used as the drug of choice for the treatment of disseminated fungal diseases and other local infections such as meningitis, peritonitis, and bladder infections due to fungi. 1) Although AmB has been a gold standard for those infectious diseases, the use of conventional AmB deoxycholate is often limited by its various side effects. Nephrotoxicity has been the major factor discouraging clinicians from using the drug. Increased blood urea nitrogen and serum creatinine levels and decreased renal blood flow occur in most patients receiving conventional AmB deoxycholate. Furthermore, AmB can lead to serious renal tubular acidosis and acute tubular necrosis which may require hemodialysis. These adverse effects of AmB appear to be related to high cumulative doses of the drug, use of diuretics, abnormal serum creatinine level at the baseline, and the use of concomitant nephrotoxic drugs.The precise mechanism by which the kidneys are affected by AmB is uncertain. Nephrotoxicity associated with AmB appears to involve several mechanisms including a direct tubular damage through its vasoconstrictive effect on renal arterioles that reduces glomerular and renal tubular blood flow and a lytic action on cholesterol-rich lysosomal membranes of renal tubular cells.A number of studies have been performed to reduce renal toxicity of AmB during recent decades, leading to the development of three lipid formulations of the drug. AmB lipid complex, AmB colloidal dispersion, and liposomal AmB. 2-4)The main limitation of their use, however, is their high cost. The current recommendation is that these drugs be used for patients whose infections do not respond to conventional AmB formulation or those who become intolerant to the drug. 5)The present study was undertaken to investigate renal toxicity when AmB was administered as nanoparticular micelles prepared with partially benzylated poly-L-aspartic acid (PBPA). Polyaspartic acid has been studied both in vivo and in vitro to protect against aminoglycoside-induced nephrotoxicity by many researchers.6-8) However, polyaspartic acid has not been examined whether it has a similar effect on AmB-induced nephrotoxicity probably because polyaspartic acid is highly water-soluble and AmB is very water-insoluble unlike aminoglycoside antibiotics. In this study, we have introduced benzyl group to polyaspartic acid chain to provide appropriate hydrophobicity for the polymer to interact with AmB and investigated whether the PBPA affects self-aggregation behavior of AmB and exerts protective effect against nephrotoxicity of the drug. MATERIALS AND METHODSMaterials AmB, resin (N-Fmoc-4-t-butyl-L-aspartic acid SASRIN resin ester), N-Fmoc-L-aspartic acid-4-benzyl ester, piperidine, and 9-fluorenyl methyl chloroformate were purchased from Sigma and used as obtained. N-Fmoc-L-aspartic acid-4-t-butyl ester was purchased from Fluka. Fungizone ® (Squibb) was kindly donated by the Pharmacy Department of Yeungnam University Medical Center. Osmium tetroxide was obtained from Polysc...
Context: Abuse of the drug, Phensedyl like any other drug might exert adverse effects on vital organs of the human body like liver, kidney and heart. Objectives:To determine the effects of Phensedyl intake on the serum biochemical parameters of the addicts in order to access for damages of vital human organs like liver, kidney and heart. Materials and Methods:Study population consisted of 127 male Phensedyl addicts within the ages of 18-55 years of defined criteria from Gaibandha district, a Northern part of Bangladesh, during July 2009 to December 2011. Fifty (50) non-drug dependent healthy men of matched age, height, and socioeconomic status were included as controls from the same community. Biochemical parameters analyzed were -Serum creatinine, SGOT, SGPT and Lipid profiles (total serum cholesterol (TC), Serum triglyceride (TG), serum high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol determined by semiautomatic biochemistry analyzer using commercially available kits Results: Abuse of Phensedyl appears not to hamper the normal renal and liver function in most of the addicts even after 8 years of Phensedyl intake irrespective of age except in case of 4 abusers. Serum total cholesterol (TC) remained almost unchanged among the addicts abusing Phensedyl for less than 8 years. But very strikingly, addicts taking Phensedyl for more than 8 years had higher trends in serum cholesterol i.e. more than 200 ml/dl. Of the addict's, 44.36% abusing Phensedyl for less than 8 years had normal triglyceride (TG) values whereas, in 45.66% addicts abusing the drug for more than 8 years had clinically very significantly elevated triglyceride levels, which was also found to be statistically very significant (p value =0.0001), indicating the risk of developing cardiac diseases. Of the total addicts 53.53% had low levels of HDL cholesterol, which is clinically and statistically found to be very significant (p value =0.002). Of the addict's 43% taking the drug for less than 8 years had normal LDL levels but significantly elevated values were recorded in 34% of the abusers who had been taking the drug for more than 8 years. Conclusion: Long time (> 8 years) Phensedyl abusers are at the high risk of developing Brain stroke, Coronary Heart Disease (CHD), Ischemic stroke or transient ischemic attack (TIA) as there is the triad of: Elevated LDL cholesterol, Low HDL cholesterol and elevated Triglyceride.
There were local, regional, state and national networking systems. These networks were available to community college LRCs. This study, then, was needed to provide data on the extent of automated library networking systems used by the participating community college LRCs.This study was designed to add to the field of knowledge the extent of automated library networking activities available in community college LRC operations. lt was the belief of the 'researcher and of the library profession that automated library networking systems have great potential benefits to libraries. lt was equally obvious that these benefits had not been fully examined at the community college level. To address the problem, specific research questions were posed and yielded data which librarians should find useful when considering automated library networking activities for their LRCS.
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