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Background: Zinc is an anti-inflammatory and antioxidant micronutrient found in food. Due to its well-established role in immunity, it is currently being used in some clinical trials against coronavirus disease-2019 (COVID-19). This study aimed to assess the association between the mean serum zinc level in COVID-19 Egyptian patients and its relationship with disease severity. This cross-sectional study was conducted on sixty patients with confirmed COVID-19 infection. These patients were divided into two groups according to clinical outcome, group 1 which included 30 intensive care unit (ICU) patients and group 2 which included 30 patients who were admitted to the ward. Mean serum levels of zinc were compared between the two groups. Results: There was a statistically significant difference noted among study groups regarding the serum zinc level (p < 0.039), where lower mean serum zinc levels were noted in ICU patients compared to ward patients (70.6 ± 5.7 vs 73.8 ± 6.1). Conclusion: Low serum zinc level is associated with the severe outcome of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Background: A recently reported phase III randomized trial comparing open and minimally invasive hysterectomy showed significantly higher rates of local recurrence after minimally invasive surgery (MIS) for cervical cancer. This raised concerns regarding patterns of recurrences and survival after MIS in general. This study aims to determine the effect of MIS on all-cause mortality among patients undergoing radical nephrectomy for Stage I and II renal cell carcinoma (RCC). Methods: We utilized the National Cancer Database to identify patients diagnosed with clinical stage I–II RCCs between 2010 and 2013. Patients for whom a laparoscopic or robotic radical nephrectomy was attempted were compared to patients who underwent open radical nephrectomy (ORN). Adjusted regression models with inverse probability propensity score weighting (IPW) were utilized to identify independent predictors of receiving MIS. All-cause mortality rates were compared using IPW survival functions and log-rank tests. Adjusted Cox proportional hazard models were fitted to determine independent predictors of OS. Results: 27,642 patients were identified; 11,524 (41.7%) had MIS, while 16,118 (58.3%) had ORN. Kaplan–Meier survival curves in the IPW cohort showed significant OS advantage for patients who underwent MIS (p < 0.001). Furthermore, length of hospital stays (3 vs. 4 days), 30 day readmission rates (2.4 vs. 2.87%), 30 day (0.53 vs. 0.96%) and 90 day mortality rates (1.04 vs. 1.77%) were significantly higher in the ORN group (p < 0.001). Conclusions: MIS was associated with better OS outcomes compared to ORN for stage I and II RCC. In addition, MIS had lower post-operative readmission, 30- and 90 day mortality rates. [ABSTRACT FROM AUTHOR]

The article titled "Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial" has been retracted by the Editor-in-Chief of the Archives of Gynecology & Obstetrics. The retraction is due to concerns raised about the randomization procedure and the data presented in Table 3. Post-publication peer review has confirmed these concerns, and the authors have not provided a satisfactory explanation. Some of the authors have agreed with the retraction, while others have not responded to correspondence from the Publisher. Springer Nature, the publisher, remains neutral in regards to jurisdictional claims and institutional affiliations. [Extracted from the article]

Reaction between bromo tricarbonyl manganese(I) and N,N′-bis(phenyl)-1,4-diaza-1,3-butadiene ligands, bearing different electron-donating and electron-withdrawing groups R = OCH3, Cl, and NO2 in the ortho- and para-positions on the phenyl substituent, afforded [MnBr(CO)3(N–N)] complexes. The influence of the character and position of the substituent on the dark stability and carbon monoxide releasing kinetics was systematically investigated and correlated with the data of the time-dependent density functional theory calculations. The combined UV/Vis and IR data clearly revealed that the aerated solutions of [MnBr(CO)3(N–N)] in either coordinating or noncoordinating solvents are dark stable and the fluctuations observed during the incubation period especially in the case of the nitro derivatives may be attributed to the exchange of the axial bromo ligand with the coordinating solvent molecules. The free ligands and nitro complexes were non-cytotoxic to HepG2 cells under both the dark and illumination conditions. In the dark, Mn(I) compounds, incorporating o-OCH3 and o-Cl, exhibited excellent cytotoxicity with IC50 values of 18.1 and 11.8 μM, while their para-substituted analogues were inactive in the dark and active upon the irradiation at 365 nm with IC50 values of 5.7 and 6.7 μM, respectively. [ABSTRACT FROM AUTHOR]

Proliferation and apoptosis are two primary driving forces behind the pathogenesis of hepatocellular carcinoma (HCC). HCC is associated with Ki-67 and Bcl-2 overexpression, reduced Bax expression inducing disturbance of equilibrium between cellular proliferation and apoptosis, and exacerbated by reduced expression of PPAR-γ and FOXO-1. Our objective was to examine the mechanism by which the cyclic isoprenoid, β-ionone (βI), attenuated hepatocarcinogenesis and compare its possible anticancer activity with sorafenib (SF) as standard HCC treatment. HCC induction was achieved by supplying Wistar rats with 0.01% diethylnitrosamine (DENA) for 8 consecutive weeks by free access of drinking water. The effects of βI (160 mg/kg/day) administered orally were evaluated by biochemical, oxidative stress, macroscopical, and histopathological analysis. In addition, immunohistochemical assay for localization and expression of Bax and Bcl-2 and RT-PCR for expression levels of PPAR-γ, FOXO-1, and Ki-67 mRNA were performed. βI treatment significantly reduced the incidence, total number, and multiplicity of visible hepatocyte nodules, attenuated LPO, near-normal restoration of all cancer biomarkers, and antioxidant activities, indicating the chemotherapeutic impact of βI. Histopathological analysis of the liver confirmed that further. βI also induced pro-apoptotic protein Bax expression and reduced anti-apoptotic expression of Bcl-2 protein. Moreover, βI induced mRNA expression of tumor suppressor genes (PPAR-γ and FOXO-1) and decreased proliferative marker Ki-67 mRNA expression. For the first time, the present study provides evidence that βI exerts a major anticancer effect on DENA-induced HCC, at least in part, through inhibition of cell proliferation, oxidative stress, and apoptogenic signal induction mediated by downregulation of Bcl-2 and upregulation of Bax, PPAR-γ, and FOXO-1 expressions. [ABSTRACT FROM AUTHOR]

Purpose: The commonest surgical procedure for women is cesarean delivery. Postpartum hemorrhage and intra-operative blood during cesarean delivery is a major concern to all obstetricians. This study was conducted to assess the efficacy of the adjuvant use of misoprostol and oxytocin in decreasing intra-operative blood loss in cesarean delivery.Methods: This was a double-blinded randomized clinical trial including 636 term pregnant woman scheduled for cesarean section at Ain Shams University Maternity Hospital, Cairo, Egypt, between February 2013 and February 2014. Participants received either 400-μg misoprostol rectally or sublingually or placebo before cesarean section together with 5-IU oxytocin IV. The main outcome measure was intra-operative blood loss. Difference between the three groups was analyzed using one-way ANOVA test (for numeric variables) and Chi-square test (for categorical variables). P < 0.05 was considered statistically significant.Results: Intra-operative blood loss was higher in patients who did not receive misoprostol (Placebo Group) (295-1075 ml, 641.7 ± 135.7) than those who received it, regardless the route of administration, rectal (135-830 ml, 457.5 ± 140.7; P < 0.001), and sublingual (135-680 ml, 357.8 ± 129.7; P < 0.001). In addition, sublingual route was associated with significantly lower estimated intra-operative blood loss compared to rectal administration (P < 0.001).Conclusions: Misoprostol with oxytocin is an effective drug-combination for decreasing intra-operative blood loss during cesarian section with clinical superiority to sublingual over rectal route. [ABSTRACT FROM AUTHOR]

Presentation of bladder exstrophy epispadias complex (BEEC) during adulthood is rare. A major surgical challenge encountered in adults with BEEC is the closure of the anterior abdominal wall defect. In this case series we report our experience with the abdominal closure without osteotomy. Five adult male patients with BEEC were managed at our center. None of the patients had any prior attempts of surgical correction. A right renal tumor was incidentally discovered in one patient and a right partial nephrectomy was performed. All patients underwent urinary diversion and abdominal wall closure at the same operative setting except one. Cystectomy was performed in two patients while the vesical plate muscular coat was utilized for providing support to the anterior abdominal wall in the other three patients. One patient underwent an ileal conduit, while the other patients underwent continent cutaneous diversion. None of our patients underwent osteotomy. Follow-up ranged from 6 to 52 months (mean = 31). Patients who underwent continent cutaneous diversion were continent by day and night. One patient had wound infection and partial disruption and secondary sutures were performed. One patient developed stomal stenosis and was managed by stomal dilatation. All patients showed marked satisfaction with their body image following surgery. Management of BEEC in adults is challenging. Utilization of the vesical plate muscular coat for supporting the anterior abdominal wall is a reliable method for abdominal reconstruction. Urinary diversion and abdominal wall closure in one surgical procedure without osteotomy is feasible. [ABSTRACT FROM AUTHOR]