Bacterial membrane barrier provides a cytoplasmic environment for organelles of bacteria. The membrane is composed of lipid compounds containing phosphatide protein and a minimal amount of sugars, and is responsible for intercellular transfers of chemicals. Several antimicrobials have been found that affect bacterial cytoplasmic membranes. These compounds generally disrupt the organization of the membrane or perforate it. By destroying the membrane, the drugs can permeate and replace the effective macromolecules necessary for cell life. Furthermore, they can disrupt electrical gradients of the cells through impairment of the membrane integrity. In recent years, considering the spread of microbial resistance and the side effects of antibiotics, natural antimicrobial compounds have been studied by researchers extensively.These molecules are the best alternative for controlling bacterial infections and reducing drug resistance due to the lack of severe side effects, low cost of production, and biocompatibility. Better understanding of the natural compounds' mechanisms against bacteria provides improved strategies for antimicrobial therapies. In this review, natural products with antibacterial activities focusing on membrane damaging mechanisms were described. However, further high-quality research studies are needed to confirm the clinical efficacy of these natural products.
Background Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of l-carnitine adjunctive therapy on monitoring variables in critical illness. Method A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g l-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. Result Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (<0.001), creatinine (Cr) (0.005), and international normalized ratio (INR) (0.049) decreased meaningfully in the intervention vs. control group. Conclusion l-Carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, lactate, Ca, Alb, and total protein. Trial registration Iranian Registry of Clinical Trials IRCT 20151108024938N2. This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) (available at https://en.irct.ir/trial/30748, May 2018).
Background: Critically ill patients admitted to the intensive care unit (ICU) are often hyper-metabolic and hyper-catabolic and at risk of malnutrition. This study aimed to evaluate the amount of energy and protein intake and its correlation with the required amount in critically ill patients.Method: Seventy patients with critical conditions who were admitted to ICU were eligible (age ≥18 years and over a 3-day stay in ICU). Basic characteristics, medical history, and laboratory test results were extracted from the patients' medical records. Anthropometric indices and APACHE II questionnaire were assessed by an expert nurse. The calorie and protein requirement of patients were considered 25 kcal/kg/day and 1.2 g/kg/day, respectively.Result: Mean age in the target population was 57.69 ± 20.81 years, and 48.6% were men. The mean actual energy intake was signi cantly lower than the requirement (531.27 ±365.40 vs. 1583.77 ± 329.36 Kcal/day, P 0.001). The mean actual protein intake was signi cantly lower than the requirement (14.94 ±18.33 vs. 74.11 ± 17.89 gr/day respectively, P 0.001). Patients had a growing trend in providing energy and protein over time. There is a signi cant reverse correlation between the age of patients and total lymphocyte count (r= -0.38, P=0.003). Also, there is a signi cant reverse correlation between the Glasgow coma scale and the duration of mechanical ventilation (r=-0.49, P 0.001). The lowest average calorie and protein intake are in patients with poisoning. Conclusion:The amount of calorie and protein intake in critically ill patients is signi cantly less than the recommended amount, therefore, it is necessary to perform routine nutritional assessments.
Background Critically ill patients must be monitored constantly in intensive care units (ICU). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of L-carnitine adjunctive therapy on monitoring variables in critical illness. Method A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 gr L-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. Result Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P value: 0.001), total protein (P value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (< 0.001), creatinine (Cr) (0.005), and international normalized ratio (INR) (0.049) decreased meaningfully in the intervention vs. control group. Conclusion L-carnitine supplementation in critically ill patients can improve several parameters including INR, Cr, ALT, Lactate, Ca, Alb, and total protein. Trial Registration: This trial was approved by the Research Ethics Committee of Mashhad University of Medical Sciences (registration code: IR.MUMS.fm.REC.1396.671) and was registered in the Iranian Registry of Clinical Trials (registration code: IRCT 20151108024938N2) (Available in https://en.irct.ir/trial/30748).
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