properties of hydrogen peroxide and potash alum alone and in combination against clinical bacterial isolates. AbstractHydrogen peroxide (H2O2) and potash alum (ALM) are considered important for wide range of biological activities including microbial disinfection. However, comparison of H2O2 and ALM antibacterial effect alone and in combination on different clinical bacterial isolates with respect to post treatment time is still not well studied. Thus, in present study we tested susceptibility of five bacterial isolates; Enterococcus faecalis (E. faecalis), Enterococcus faecium (E. faecium), Escherichia coli (E. coli), Staphylococcus aureus (S. aureus) and Klebsiella pneumoniae (K. pneumonia) against H2O2 and ALM alone and in combination which showed concentration dependent and incubation dependent effect. The H2O2 bacterial susceptibility trend was E. coli>K. pneumoniae>S. aureus>E. faecium>E. faecalis and ALM susceptibility trend was as K. pneumoniae>S. aureus>E. faecalis>E. coli >E. faecium at highest tested concentration (35mg/ml) and 24hr of incubation period. Comparatively, antimicrobial activity was higher with H2O2 than ALM however in the order of 24hr > 48hr >72hr. Both H2O2 and ALM showed more zones of inhibition at highest tested concentration than positive control azithromycin (AZI) against E. faecalis, E. faecium and S. aureus at all incubation periods. Moreover, H2O2 and ALM in combination (1:1) showed increased zone of inhibition than ALM alone (against all bacteria), H2O2 alone (against E. faecalis and E. faecium) and, AZI (against E. faecalis, E. faecium and S. aureus) without increasing final concentration. Thus, combination treatment might be more effective disinfection and antisepsis strategy which may help us in minimizing dose dependent side effects without compromising efficacy.

The contribution of the perpetuation of atrial fibrillation is caused by electrical remodeling in which calcium, sodium and potassium channels could refer to changes in the ion channel protein expression, development of fibrosis, gene transcription and ion channel redistribution. Calcium and magnesium could influence the risk of atrial fibrillation which is the leading cause of cardiac death, heart failure and ischemic stroke. The elevated serum concentration of calcium had a higher range of in-patient’s mortality, increased total cost of hospitalization and increased length of hospital stay as compared to those without hypercalcemia in atrial fibrillation patients. Moreover, chloride channels could affect homeostasis, atrial myocardial metabolism which may participate in the development of atrial fibrillation. Up to a 50% risk of incidence of AF are higher in which left ventricular hypertrophy, sudden cardiovascular death and overall mortality relate to a low serum magnesium level. Additionally, magnesium prevents the occurrence of AF after cardiac surgery, whereas greater levels of serum phosphorus in the large population-based study and the related calcium–phosphorus products were linked with a greater incidence of AF. Numerous clinical studies had shown the high preoperative risk of AF that is linked with lower serum potassium levels. The conventional risk factor of increased risk of new onset of AF events could independently link with high dietary sodium intake which enhances the fibrosis and inflammation in the atrium but the mechanism remains unknown. Many drugs were used to maintain the electrolyte imbalance in AF patients.

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